ESPEN 2017 - Abstract Book

36 ISSUE 4
VOL. 36 SUPPLEMENT 1 AUGUST 20172017

SEPTEMBER ISSN 0261-5614
0261-5614
14
Clinical Nutrition Vol. 36/4 (2017) 915–1186

S1–S308
2
Abstracts of the 39th ESPEN Congress,
The Hague, Netherlands, 9–12 September 2017
ELSEVIER
Cover.indd All Pages 11-Aug-17 5:05:51 PM

Clinical
Nutrition
An international journal devoted to
clinical nutrition and metabolism
Official Journal of ESPEN — The European Society for Clinical Nutrition and Metabolism
Editor
N.E.P. Deutz, MD, PhD
Center for Translational Research in Aging & Longevity,
Department of Health & Kinesiology,
Texas A&M University,
College Station, Texas 77843-4253, U.S.A.
E-mail: espenjournals@espen.org
Managing Editor
J.A. Mays S.C. Roeske
Center for Translational Research in Aging & Longevity, Center for Translational Research in Aging & Longevity,
Department of Health & Kinesiology, Department of Health & Kinesiology,
Texas A&M University, Texas A&M University,
College Station, Texas 77843-4253, U.S.A. College Station, Texas 77843-4253, U.S.A.
E-mail: espenjournals@espen.org E-mail: espenjournals@espen.org
Associate Editors
M.D. Ballesteros-Pomar, MD,PhD (Spain) K. Norman, MSc, PhD (Germany)
J. Bauer, MD, PhD (Germany) C. Pichard, MD, PhD (Switzerland)
M. Beattie (UK) C. Prado, PhD (Canada)
M.M. Berger, MD, PhD (Switzerland) P. Ravasco, RD, MD, Msc, PhD (Portugal)
F. Carli, MD (Italy) M. Rondanelli, MD, PhD (Italy)
E. Cereda, MD, PhD (Italy)
O. Rooyackers, PhD (Sweden)
A. Forbes, BSc, MD, FRCP, FHEA (UK)
P. Singer, MD (Israel)
P. Greenhaff, (UK)
Y. Hamada, MD, PhD (Japan) M.R. Soeters, MD, PhD (The Netherlands)
K. Joosten, MD, PhD (The Netherlands) M. Usami, MD, PhD (Japan)
S. Klek, MD, PhD (Poland) E. Volpi, MD, PhD (USA)
A. Laviano, MD (Italy) D.L. Waitzberg, MD (Brazil)
D. Lobo, MS, DM, FRCS, FACS (UK) P. Wischmeyer, MD (USA)
Amsterdam • Boston • London • New York • Oxford • Paris • Philadelphia • San Diego • St. Louis
Past Editor–in–Chief
M.A. Gassull (Spain)
Past Associate Editors

G. Biolo (Italy) L. Gramlich (Canada) B. Morio (France) B.M. Winklhofer-Roob
E. Cabré (Spain) R. Griffiths (UK) H. Ohyanagi (Japan) (Austria)
T. Cederholm (Sweden) B. Koletzko (Germany) M.A.E. van Bokhorst – de T. Ziegler (USA)
A. Davies (Australia) H. Lochs (Germany) van der Schueren
X. Forceville (France) Y. Luiking (USA) (The Netherlands)
Editorial Advisory Board/ESPEN Faculty

J. Arends (Germany) E. Fiaccadori (Italy) O. Ljungqvist (Sweden) R. Shamir (Israel)
M. Bahar (Turkey) G. Filippatos (Greece) D. Lobo (UK) A. Shenkin (UK)
M.D. Ballesteros-Pomar E. Fontaine (France) H. Lochs (Austria) D. Silk (UK)
(Spain) A. Forbes (UK) C. Löser (Germany) P. Singer (Israel)
R. Barazzoni (Italy) X. Forceville (France) Y. Luiking (USA) R.J.E. Skipworth (UK)
J.Bauer (Germany) C. Fusch (Canada) K. Lundholm (Sweden) L. Sobotka (Czech Republic)
J. Baxter (UK) M.A. Gassull (Spain) J. MacFie (UK) M.R. Soeters (The Netherlands)
M.M. Berger (Switzerland) L. Genton (Switzerland) E.M.H. Mathus-Vliegen
P. Soeters (Belgium)
Y.N. Berner (Israel) O. Genzel-Boroviczeny (The Netherlands)
Z. Stanga (Switzerland)
H.K. Biesalski (Germany) (Germany) R. Meier (Switzerland)
J.-C. Melchior (France) M. Staun (Denmark)
J. Bines (Australia) A. Gil (Spain)
G. Biolo (Italy) J.M. Gómez Sáez (Spain) K. Melzer (Switzerland) R. Stratton (UK)
S.C. Bischoff (Germany) F. Gottrand (France) M. Merli (Italy) H. Szajewska (Poland)
B. Bistrian (USA) O.J. Goulet (France) B. Messing (France) P. Szitányi (Czech Republic)
G. Bodoky (Hungary) L. Gramlich (Canada) W.A. Mihatsch (Germany) K.A. Tappenden (USA)
Y. Boirie (France) E. Granot (Israel) A. Miján (Spain) L. Tappy (Switzerland)
I. Bosaeus (Sweden) R. Griffiths (UK) J.M. Moreno (Spain) V. Teplan (Czech Republic)
F. Bozzetti (Italy) R.F. Grimble (UK) B. Morio-Liondore P. Tesinsky (Czech Republic)
M. Braga (Italy) I. Grintescu (Romania) (France) D. Teta (Switzerland)
I. Bretón (Spain) G. Guarnieri (Italy) S. Mühlebach J.-P.M. Thissen (Belgium)
A. Buchman (USA) D.C. Guttridge (USA) (Switzerland) A.G. Thomas (UK)
R. Burgos Peláez (Spain) Y. Hamada (Japan) M.M.J. Müller (Germany) A. Thorell (Sweden)
E. Cabre (Spain) G. Hardy (New Zealand) M. Muscaritoli (Italy)
M. Usami (Japan)
P. Calder (UK) X. Hébuterne (France) G. Nitenberg (France)
M. Uyar (Turkey)
M.E. Camilo (Portugal) B.L. Heitmann (Denmark) K. Norman (Germany)
B. Campillo (France) I.B. Nyulasi (Australia) N. Vaisman (Israel)
O. Hernell (Sweden)
A.C.L. Campos (Brazil) M. Holst (Denmark) J.G. Ockenga (Germany) L. Valentini (Germany)
N. Cano (France) P. Howard (UK) H. Ohyanagi (Japan) M.A.E. van Bokhorst – de
Y.A. Carpentier (Belgium) G. Iapichino (Italy) R. Olav (Sweden) van der Schueren
J.J. Carrero (Sweden) Ø. Irtun (Norway) M. Pertkiewicz (Poland) (The Netherlands)
T. Cederholm (Sweden) K.N. Jeejeebhoy (Canada) C. Pichard (Switzerland) G. van den Berghe
E. Cereda (Italy) G.L. Jensen (USA) L. Pironi (Italy) (Belgium)
I. Chermesh (Israel) P.B. Jeppesen (Denmark) M. Pirlich (Germany) A. van Gossum (Belgium)
I. Correia (Brazil) C.G. Jonkers-Schuitema C. Pison (France) P.A.M. van Leeuwen
A.G. Cosslett (UK) (The Netherlands) M. Plauth (Germany) (The Netherlands)
M. Cravo (Portugal) K. Joosten (Netherlands) C. Prado (Canada) C.W. Van Way (USA)
C. Cuerda (Spain) F.E. Kalfarentzos (Greece) J.-C.E.A.M. Preiser M.F.J. Vandewoude
L. Cynober (France) S. Kilicturgay (Turkey) (Belgium) (Belgium)
E. Dárdai (Hungary) S. Klek (Poland) J. Puntis (UK) E. Volpi (USA)
A. Davies (Australia) S.S.K. Kolaček (Croatia) P. Ravasco (Portugal) M. von Meyenfeldt
J.-P. de Bandt (France) B. Koletzko (Germany) O. Riggio (Italy) (The Netherlands)
I. de Blaauw R. Komsa-Penkova O. Rooyackers (Sweden) J. Wahren (Sweden)
(The Netherlands) (Bulgaria) F. Rossi-Fanelli (Italy)
D.L. Waitzberg (Brazil)
P. Dechelotte (France) J. Kondrup (Denmark) G.S. Rozen (Israel)
C.H.C. Dejong S.M. Schneider (France) A. Weimann (Germany)
Z. Krznaric (Croatia)
(The Netherlands) J. Ksiazyk (Poland) A.(AMWJ). Schols J. Wernerman (Sweden)
N.E.P. Deutz (USA) A. Lapillonne (France) (The Netherlands) B.M. Winklhofer-Roob
S.J. Dudrick (USA) A. Laviano (Italy) J.M.G.A. Schols (Austria)
M. Elia (UK) M. Leon-Sanz (Spain) (The Netherlands) P. Wischmeyer (USA)
J. Faintuch (Brazil) E. Lerebours (France) T. Schütz (Germany) Z. Zadak (Czech Republic)
K.C.H. Fearon (UK) B. Lindholm (Sweden) J.L. Shaffer (UK) M. Ziva (Slovenia)
ESPEN
Abstracts of the
39th
37th ESPEN Congress
The Lisbon,
Hague, Netherlands,
Portugal, 5 89–12 September
September 2017
2015
Authors are responsible for content and language quality of abstracts

Clinical Nutrition Aims and Scope Being the journal of ESPEN with members from various interests, either
Clinical Nutrition, the official journal of ESPEN, The European Society focused on basic research or clinical disciplines, the journal reflects the
for Clinical Nutrition and Metabolism, is an international journal providing scientific nature of this multidisciplinary background and encourages the
scientific information on nutritional and metabolic care and the relationship coordination of investigation and research from these disciplines. The
between nutrition and disease both in the setting of basic science and
journal publishes high quality papers like guidelines, consensus statements,
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Nutrition and nutritional care have gained wide clinical and scientific and nutritional implications. It also publishes scientific works related to the
interest during the past decades. The increasing knowledge of metabolic development of new techniques and their application in the field of clinical
disturbances and nutritional assessment in chronic and acute diseases has nutrition.
stimulated rapid advances in design, development and clinical application
of nutritional support. The aims of ESPEN are to encourage the rapid Clinical Nutrition is abstracted/indexed in Current Contents, Science
diffusion of knowledge and its application in the field of clinical nutrition Citation Indexed Expanded, Index Medicus, PubMed/Medline, EMBASE.
and metabolism. Also covered in the abstract and citation database SCOPUS®.
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Clinical
Volume 36
Number 4 1
Supplement
August 2017
September 2017
Pages S1–S328
915–1186
Nutrition
For details of where
this journal is
abstracted and
indexed, please go to
http://www.elsevier.
com/locate/clnu
An international journal devoted to clinical nutrition and metabolism
and click on the link
“Abstracting/Indexing” Official Journal of ESPEN—The European Society for Clinical Nutrition and Metabolism
on the right hand
navigation bar.
CONTENTS
Abstracts Page(s)
Programme
EDITORIAL Overview vii
Clinical nutrition education in medical schools: Results of an ESPEN survey
Oral communications
C. Cuerda, S.M. Schneider, A. Van Gossum 915
Oral Communication I: Macro and Micronutrient Metabolism OR01-OR09 S1-S4
Oral Communication II: Nutrition and Chronic Disease OR10-OR18 S4-S7
Oral Communication III: Nutritional Assessment, Epidemiology
REVIEWS
and Formulations OR19-OR27 S8-S11
Towards
ESPEN Besta multidisciplinary approach
Abstracts 2017 & ESPEN to Awards
Travel understand and manage obesity and related
OR28-OR32 S11-S13
diseases
Oral Communication
S.C. IV:, Nutrition
Bischoff, Y. Boirie in the, Surgical
T. Cederholm Patient
M. Chourdakis OR33-OR41
, C. Cuerda, N.M. S14-S17
Delzenne, N.E. Deutz ,
Oral Communication V: Paediatrics OR42-OR50
D. Fouque, L. Genton, C. Gil, B. Koletzko, M. Leon-Sanz, R. Shamir, J. Singer, P. Singer S17-S20
,
N. Stroebele-Benschop
Oral Communication VI:, A. Thorell
Liver, , A. Weimann,Tract
Gastrointestinal R. Barazzoni 917
and Cancer OR51-OR59 S21-S24
Oral Communication
Effectiveness VII:
and effi cacyCritical Care
of nutritional therapy: A systematic review OR60-OR68 S24-S27
following Cochrane
methodology
Poster
M. tours
Muscaritoli, Z. Krznarić, P. Singer, R. Barazzoni, T. Cederholm, A. Golay, A.Van Gossum, N. Kennedy,
G. Kreymann
Poster , A.
Tour 1: Laviano, T. Pavić, L. Puljak, D. Sambunjak, A. UtrobičićPT01.1-PT01.6
Geriatrics , S.M. Schneider 939S29-S31
Poster Tour 2: Liver and GI PT02.1-PT02.6 S31-S33
Hospital malnutrition in Latin America: A systematic review
Poster Tour
M.I.T.D. 3: Nutrition
Correia and Chronic
, M.I. Perman Disease 1 958
, D.L. Waitzberg PT03.1-PT03.6 S34-S36
Poster Tour 4: Obesity and Metabolic Syndrome PT04.1-PT04.6 S36-S38
Recent advances in complementary and replacement therapy with nutraceuticals in
Poster Tour 5: Nutritional Assessment PT05.1-PT05.6 S39-S40
combating gastrointestinal illnesses
Poster Tour 6: Paediatrics
N. Yang, K. Sampathkumar, S.C.J. Loo 968 PT06.1-PT06.6 S41-S43
Poster Tour 7: Nutrition and Chronic Disease 2 PT07.1-PT07.6 S43-S45
Poster Tour 8: Nutrition and Cancer PT08.1-PT08.6 S46-S48
RANDOMIZED CONTROLtechniques
Poster Tour 9: Nutritional TRIALS PT09.1-PT09.5 S48-S50
Poster Tour 10: Micronutrients PT10.1-PT10.6 S50-S52
High-dose vitamin D3 reduces circulating hepcidin concentrations: A pilot, randomized,
double-blind, placebo-controlled trial in healthy adults
Poster
E.M. Smith, J.A. Alvarez, M.D. Kearns, L. Hao, J.H. Sloan, R.J. Konrad, T.R. Ziegler, S.M. Zughaier,
V. Tangpricha and
Carbohydrate 980lipid metabolism SUN-P001-SUN-P009 S53-S55
Critical Care 1 SUN-P010-SUN-P035 S56-S65
Geriatrics 1 SUN-P036-SUN-P059 S66-S75
Contents continued
Contents continued over
over page
page
Available online at www.sciencedirect.com
ScienceDirect
http://www.elsevier.com/locate/clnu
Liver and gastrointestinal tract 1 SUN-P060-SUN-P075 S75-S81
Nutrition and cancer 1 SUN-P076-SUN-P114 S81-S96
Nutrition and chronic diseases 1 SUN-P115-SUN-P152 S96-S110
Nutritional assessment 1 SUN-P153-SUN-P217 S111-S134
Nutritional epidemiology 1 SUN-P218-SUN-P234 S135-S141
Obesity and the metabolic syndrome 1 SUN-P235-SUN-P254 S141-S147
Paediatrics 1 SUN-P255-SUN-P263 S148-S151
Perioperative care 1 SUN-P264-SUN-P275 S151-S155
Protein and amino acid metabolism 1 SUN-P276-SUN-P284 S155-S159
Qualitative design studies SUN-P286-SUN-P293 S159-S162
Vitamins, antioxidants and minerals 1 SUN-P294-SUN-P303 S162-S166
Late Breaking Abstract 1 SUN-LB304-SUN-LB338 S166-S179
Critical Care 2 MON-P001-MON-P026 S179-S189
Geriatrics 2 MON-P027-MON-P050 S189-S198
Hormones, mediators and immunity MON-P051-MON-P061 S198-S202
Liver and gastrointestinal tract 2 MON-P062-MON-P077 S202-S208
Nutrition and cancer 2 MON-P078-MON-P116 S208-S222
Nutrition and chronic diseases 2 MON-P118-MON-P154 S222-S236
Nutritional assessment 2 MON-P155-MON-P219 S236-S259
Nutritional epidemiology 2 MON-P220-MON-P233 S259-S264
Nutritional techniques and formulations MON-P234-MON-P245 S264-S268
Obesity and the metabolic syndrome 2 MON-P246-MON-P264 S268-S276
Paediatrics 2 MON-P265-MON-P273 S276-S279
Perioperative care 2 MON-P274-MON-P285 S279-S283
Protein and amino acid metabolism 2 MON-P286-MON-P293 S284-S286
Vitamins, antioxidants and minerals 2 MON-P294-MON-P302 S287-S290
Late Breaking Abstract 2 MON-LB303-MON-LB343 S290-S307
Author index S309

Clinical Nutrition
Nutrition (2017) 34(S1), vii–x
(2015) 36(S1), vii–viii
Contents lists available at ScienceDirect
Clinical Nutrition
journal homepage: http://www.elsevier.com/locate/clnu
Programme Overview
37th
Time Friday 4 September 2015 Room

09:00 13:00 LLL Sessions (See LLL information section)
TIME 14:00 Lunch
13:00 FRIDAY
break8 SEPTEMBER 2017 ROOM
14:00 18:00 LLLLLL
09:00–13:00 Sessions
Session (See LLL information
Session section)
1: Nutritional Support in GI Diseases Yangtze 1
09:00–13:00 LLL Session Session 2: ICU Nutrition and Problem Solving Yangtze 2
Time
09:00–13:00Saturday 5 September 2015
LLL Session Session 3: Nutrition in the Perioperative Period Room
Europe 1&2
09:00–13:00 LLL Session
07:30 11:30 Special Interest Groups Meetings Session(SIGs
4: Nutrition
listed ininprogramme
Obesity day by day) Oceania
13:00–14:00
09:00 13:00 LLLLLL LUNCH
Sessions BREAK
(See LLL information section)
14:00–18:00
12:00 LLL Session
13:30 Satellite Symposium AbbottSession
Nutrition5: Nutritional Support in Cancer
Health Institute Yangtze
Audi II 1
14:00–18:00 LLL Session
12:00 13:00 Satellite Symposium Shire Session 6: Nutrition in Metabolic Syndrome Audi VI 2
Yangtze
14:00–18:00 LLL
13:30 14:00 Break Session Session 7: Nutrition and Prevention of Diseases Asia
14:00–18:00
14:00 LLL Session
15:00 Opening Session Session 8: Nutrition in Neurological Diseases Europe
Audi I 1&2
14:00–18:00
15:00 LLL Session
16:30 Nutrition Session 9: Nutrition in Older Adults
for obese adult in-patients Oceania
Audi II
TIME SATURDAY 9 SEPTEMBER
15:00 16:30 How to make home parenteral 2017
nutrition safer? ROOM
Audi VIII
15:00 16:30 Fatty
09:00–13:00 LLLliver disease is it allSession
Session about 10:
food?Nutrition and Sports Audi I
Yangtze 1
15:00 16:30 Towards
09:00–13:00 personalized nutrition
LLL Session Session 11: Approach to Oral and Enteral Nutrition Audi VII 2
Yangtze
09:00–13:00
15:00 16:30 OralLLL Session
Communications Session
1: Critical 12: Home Parenteral Nutrition in Adult Patients
Care Asia VI
Audi
09:00–13:00
16:30 LLL Break
17:00 Coffee Session Session 13: Approach to Parenteral Nutrition Europe 1&2
Exhibition Area
09:00–13:00
17:00 LLL Session
18:30 Malnutrition Session
in hospital patients 14: insights
with Nutritional
fromsupport in pediatric patients II
nD results Oceania
Audi II
10:00–11:30
17:00 Symposium
18:30 Nutrition PROMISS /
and age related cognitive MaNuEL Symposium
decline Amazon
Audi I
12:30–13:30
17:00 18:30 NewSymposium
perspectives on glutenAbbott Nutrition Health Institute Symposium
toxicity KingVII
Audi Willem Alexander
13:30–14:00
17:00 BREAKand atherosclerosis
18:30 Nutrition Audi VIII
14:00–15:30
17:00 18:30 OralEducational
CommunicationsSession2: Clinical
Geriatrics Guideline
Nutrition consensus meeting
and Metabolism 1 OnyxVI
Audi
14:00–15:30
18:30 Scientific
20:30 Welcome Session
Reception Improving outcomes for cancer patients: dedicated to Kenneth King Willem
Entrance Alexander
Foyer LCC
CH Fearon
14:00–15:30Sunday
Time LLL Live Session 2015LLL live course 1- Let’s talk about nutrition (NESG)
6 September Yangtze 1&2
Room
14:00–15:30 Educational Session Novel approaches to optimize dietary intake in older adults Mississippi
07:30 08:30 Special
14:00–15:30 Interest
Scientific Groups (SIGs
Session Thelisted in programme
link between day by day)
environment and energy metabolism Amazon
08:00 10:00
15:30–16:00LLL Live Course
COFFEE BREAK Nutrition and Sports Audi VIII
EXHIBITION AREA
08:30 10:00 Keep
16:00–17:30 fit for life
Scientific Nutritional
Session and functional
Debate: Saturatedenhancement
fat – harmful of
or older adults
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Kindly find the Abstract
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programme of Poster
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Programme Overview ix
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Clinical Nutrition (2017) 36(S1), S1–S28
Clinical Nutrition
j o u r n a l h o m e p a g e : h t t p : / / w w w. e l s e v i e r . c o m / l o c at e / c l n u
Oral communications
appears to be associated with reduced mitochondrial energy
Oral Communication I: Macro and
metabolism.
Micronutrient Metabolism
Disclosure of Interest: None declared.
OR01
N-3 POLYUNSATURATED (N-3 PUFA) FATTY ACID ENRICHMENT OR02
PREVENTS INTRAVENOUS LIPID-INDUCED ACUTE AD LIBITUM FEEDING OF A LOW CARBOHYDRATE-HIGH FAT
STIMULATION OF MITOCHONDRIAL REACTIVE OXYGEN DIET REDUCES PLASMA AND INTESTINAL PRO-INFLAMMATORY
SPECIES GENERATION AND LOWERS ATP PRODUCTION IN RAT CYTOKINE LEVELS AFTER GUT ISCHEMIA REPERFUSION
SKELETAL MUSCLE IN MICE
G. Gortan Cappellari1 *, A. Semolic1, P. Vinci1, R. Munaò1, T. Watanabe1,2 *, K. Fukatsu1, S. Murakoshi1, T. Moriya2,
M. Zanetti1, G. Ruozi2, M. Giacca2, R. Barazzoni1. 1Medical, K. Higashizono1, A. Watkins1, H. Ueno2, J. Yamamoto2,
Surgical and Health Sciences, University of Trieste, 2Molecular H. Yasuhara1. 1Surgical Center, The University of Tokyo
Medicine Laboratory, International Centre for Genetic Hospital, Bunkyoku, 2Surgery, National Defense Medical
Engineering and Biotechnology (ICGEB), Trieste, Italy College, Tokorozawa city, Japan
Rationale: Acute increments in lipid availability may be Rationale: Low carbohydrate-high fat diets (LCHFDs) report-
associated with enhanced skeletal muscle mitochondrial edly reduce the risk of metabolic syndrome. However, whether
reactive oxygen species (ROS) generation, with potential LCHFDs are also beneficial in terms of the host response to
negative metabolic consequences. The potential differential surgical insults is controversial. We previously demonstrated
impact of different fatty acids on skeletal muscle ROS ad libitum feeding of LCHFD, as compared with normal diet, to
generation and energy metabolism remains however to be improve survival at early time points after gut ischemia
determined. reperfusion (gut I/R) in mice. Overproduction of pro-inflam-
Methods: 150-minute iv saline (300 µl/h; C), n-3 PUFA- matory cytokines is known to be an important mechanism
enriched (Omegaven© 300 µl/h 20% emulsion; PUFA) or underlying poor survival after gut I/R. Herein, we evaluated
monounsaturated- and n-6 PUFA-enriched soybean-based pro- and anti-inflammatory cytokine levels in plasma and
fatty acid emulsions (Intralipid© 300 µl/h 20% emulsion; intestinal tissues of mice which had been fed LCHFD or normal
Mixed) were infused in 12-week-old Wistar rats (n = 6–8 per diet and then undergone gut I/R.
group). Skeletal muscle ATP production and ROS generation Methods: Male ICR mice were randomized to normal feeding
from mitochondria and non-mitochondrial sources were mea- (NF) (n = 10:fat18%) or the LCHFD (n = 10:fat60%). The mice
sured by fluorimetry or chemoluminescence. were fed the respective diets ad libitum for 3 weeks and then
Results: Gastrocnemius muscle ATP production was unchanged underwent 60-min gut I/R. At 3 or 6 hours after reperfusion,
but global and mitochondrial ROS generation was higher blood and small intestinal tissues were harvested. Pro(TNF-α,
(P < 0.05) in Mixed compared to C. In contrast, PUFA was not MCP-1, IL-6)- and anti(IL-10)-inflammatory cytokine levels in
associated with higher global and mitochondrial ROS gener- plasma and intestinal tissue homogenates were determined by
ation (P < 0.05 vs SFA, P = NS vs C), while it lowered ATP flow cytometry.
production (P < 0.05 vs Mixed). Superimposable differential Results: The results are expressed as means ± SD( pg/ml).
effects of PUFA and Mixed on mitochondrial ROS production
were confirmed in vitro in C2C12 myotubes. In vivo non-
Time after TNF-α MCP-1 IL-6 IL-10
mitochondrial ROS production through xanthine (XO) or NADPH reperfusion
oxidase (N-Ox) was unaffected by either treatment.
Plasma NF 3 h(n = 5) 95.2 ± 8.6 112.6 ± 16.7 112.6 ± 16.7 14.3 ± 3.0
Conclusion: Soybean-based mixed fatty acid infusion acutely 6 h(n = 5) 105.4 ± 31.4 9,104.5 ± 4,620.5 9,104.5 ± 4,620.5 27.4 ± 4.5
enhances mitochondrial ROS generation in rat skeletal muscle. LCHFD 3 h(n = 5) 12.2 ± 2.9* 177.2 ± 99.3 177.2 ± 99.3 19.8 ± 6.1
6 h(n = 5) 28.8 ± 4.8† 5,891.2 ± 1,377.5 5,891.2 ± 1,377.5 20.1 ± 4.1
n-3 PUFA enrichment prevents lipid-induced enhancement of Intestine NF 3 h(n = 5) 37.3 ± 1.7 15.7 ± 1.2 15.7 ± 1.2 16.0 ± 1.6
ROS generation while lowering mitochondrial ATP production. 6 h(n = 5) 42.6 ± 4.0 902.5 ± 255.1 902.5 ± 255.1 13.9 ± 2.9
LCHFD 3 h(n = 5) 33.0 ± 4.1 15.3 ± 1.0 15.3 ± 1.0 17.3 ± 2.7
These results suggest a potential beneficial effect of enhanced 6 h(n = 5) 36.1 ± 1.1† 240.9 ± 30.9† 240.9 ± 30.9† 19.5 ± 5.2
n-3 PUFA lipid availability on skeletal muscle redox state, which
*p < 0.05 vs NF at 3 h †p < 0.05 vs NF at 6 h (ANOVA).
S2 Oral communications
Conclusion: Reduction of pro-inflammatory but not anti- Rationale: Postprandial hyperlipemia is a key factor in the
inflammatory cytokine levels in plasma and intestinal tissues onset of cardiovascular diseases. Chronic treatment with inulin
might be among the mechanisms underlying the survival type prebiotic targeting the gut microbiota, has shown to
benefit after gut I/R in the LCHFD group. decrease lipogenesis and fasting serum lipid levels in mice and
Disclosure of Interest: None declared. in humans. In this study, we have assessed the effect of native
inulin supplementation on postprandial triglyceridemia after
an oral fat load in obese and lean mice
OR03
Methods: Mice were divided into 4 groups and were fed 6 weeks
NO ASSOCIATION BETWEEN IMPAIRED GLYCEMIC CONTROL
with a control (CT) or a western diet (WD), supplemented or not
AND ADVERSE OUTCOME IN HIP FRACTURE PATIENTS
with inulin (Inu). After 6 weeks, mice were given an oral fat
J. Thörling1 *, O. Ljungqvist2, O. Sköldenberg3, F. Hammarqvist1. load (olive oil, 10 µl/g BW) with or without a previous injection
1
Department of Clinical Science, Intervention and Technology of tyloxapol (a known inhibitor of lipoprotein lipase).
(CLINTEC), Karolinska Institutet, Stockholm, 2Surgery, Faculty Triglyceridemic response was evaluated on a 4-hour period.
of Medicine and Health, Örebro, 3Department of Clinical The expression of genes involved in the capture and secretion
Sciences at Danderyd Hospital, Stockholm, Sweden of lipids in the jejunum, liver, muscle and adipose tissue was
analyzed.
Rationale: Several observational studies have shown an Results: Inulin treatment significantly lessened post-load
association between hyperglycemia and increased complica- hypertriglyceridemia induced by WD, namely by decreasing
tions in surgical non-ICU patients. The aim of the study was to jejunal fatty acid uptake (i.e. CD36 expression). APOC3
clarify whether preoperative glycemic control, estimated by expression was downregulated in WD + Inu versus WD suggesting
HbA1c, or perioperative stress hyperglycemia (SH) are asso- also a potential effect on lipoprotein lipase activity. Indeed,
ciated with adverse events in hip fracture patients. tyloxapol injection blunted the effect of inulin on post-load
Methods: HbA1c and glucose were prospectively measured in triglyceridemia. Post-load non-esterified fatty acids were
159 patients with hip fracture. All patients were divided into slightly decrease by the treatment.
two groups: Group 1 (n = 115) with normal glycemic control and Conclusion: Our data show for the first time that in addition to
Group 2 (n = 44) with either SH or HbA1c ≥42 mmol/mol, their well-known effect on gut microbiota, Inulin-type fructans
indicating impaired glycemic control. Rates of complications may also modulate nutrients (lipid) absorption in the upper
within 30 days of surgery and 1-year mortality were compared part of the gut, and the systemic catabolism of triglyceride-rich
between the groups. SH was defined as at least two plasma lipoproteins. Both phenomenon could contribute to a nutrition-
glucose (mmol/L) analyzed on admission in hospital ≥11.1, pre- based improvement of health, if proven in humans. Further
lunch ≥12.2 or fasting ≥7.0. Glucose was analyzed on admission investigation are currently in progress to evaluate the effect of
and three days after the hip fracture surgery. Complications inulin on lipoprotein lipase activity and on the metabolism of
were classified according to Clavien-Dindo1 and stratified as lipids within the enterocytes.
grade 0 ‘no complication’, 1-3a ‘easy to moderate complica-
tion’ and 3b-5 ‘Severe to fatal complication’. The difference in Disclosure of Interest: None declared.
the incidence of complications was analyzed by chi square-test.
Difference in survival was determined using the log-rank test. OR05
Results: The patients (114 women, 45 men) had a mean age of POST-PRANDIAL PROTEIN HANDLING FOLLOWING INGESTION
80 (±10), mean BMI of 24 (±4). Of the 159 patients, 18 had OF DIFFERENT AMOUNTS OF PROTEIN DURING POST-
diabetes and 4 more had likely occult diabetes (HbA1c ≥48). EXERCISE RECOVERY IN OLDER MALES
Distribution of complications: Group 1 had 50% grade 0, 43% gr A. M. Holwerda1,2 *, K. J. Paulussen2, M. Overkamp2,
1-3a and 7% gr 3b-5. Group 2 had 45% gr 0, 48% gr 1-3a and 7% gr I. F. Kramer2, J. P. Goessens2, W. K. Wodzig3, L. B. Verdijk1,2,
3b-5. There were no statistically significant differences in 30- L. J. van Loon1,2. 1Top Institute Food and Nutrition (TIFN),
day complications ( p = 0.83) or 1-year mortality ( p = 0.34) Wageningen, 2NUTRIM School of Nutrition and Translational
between the groups. Research in Metabolism, Maastricht University, 3Central
Conclusion: HbA1c or SH are not associated with increased Diagnostic Laboratory, Maastricht University Medical Centre+,
complications or mortality after hip fracture surgery, a finding Maastricht, Netherlands
that may be explained by older age and multiple comorbidities
in this group of patients. Rationale: The age-related decline in skeletal muscle mass is,
at least partly, attributed to anabolic resistance to food intake.
Reference
Resistance-type exercise sensitizes skeletal muscle to the
1. PubMedID 15273542 anabolic properties of amino acids.
Disclosure of Interest: None declared. Methods: We aimed to define the amount of ingested protein
needed to maximize post-exercise myofibrillar protein synthe-
OR04 sis rates in older individuals. In a parallel design, 48 healthy
RELEVANCE OF INULIN TYPE PREBIOTICS IN THE older males (66 ± 1 y) were randomly assigned to ingest 0, 15,
IMPROVEMENT OF POSTPRANDIAL HYPERLIPEMIA: A 30 or 45 g protein after performing resistance-type exercise.
MECHANISTIC APPROACH Post-prandial protein digestion and absorption kinetics, whole-
body protein metabolism, and myofibrillar protein synthesis
S. Hiel1 *, B. Pachikian1, J. Rodriguez1, A. Neyrinck1,
rates were assessed using continuous infusions of L-[ring-2H5]-
J.-P. Thissen2, N. Delzenne1. 1LDRI, Metabolism and Nutrition
phenylalanine, L-[1-13C]-leucine and L-[ring-2H2]-tyrosine
Research Group, 2Pole of Endocrinology, Diabetology and
Nutrition, Université Catholique de Louvain, Brussels, Belgium
Oral Communication I: Macro and Micronutrient Metabolism S3
combined with the ingestion of intrinsically L-[1-13C]-phenyl- (P < 0.001; 3 > 2,4 and 1 > 4) in the metabolic and renal
alanine and L-[1-13C]-leucine labeled milk protein. impairment groups. Reduced to oxidized human mercaptalbu-
Results: A total of 76 ± 2% (11.4 ± 0.3 g), 63 ± 3% (18.9 ± 0.9 g) min ratios differed significantly (P < 0.001; 2,3,4 > 1 and 4 > 3)
and 60 ± 3% (26.8 ± 1.2 g) of the protein-derived amino acids in the presence of significant differences (P < 0.001) in
were released in the circulation during 6 h after ingesting antioxidant status (ascorbate, 1 < 2,4 and 2 > 3 and 4 > 3; α-
15, 30 or 45 g protein, respectively (P < 0.01). Whole-body tocopherol, 1,3 > 4).
net protein balance increased in a dose-dependent manner Conclusion: These results demonstrate significant differences
after ingesting 0, 15, 30 and 45 g protein (0.02 ± 0.00, 0.11 ± of promising new ‘biomarkers of health’ in subjects with
0.00, 0.16 ± 0.01, 0.22 ± 0.01 μmol phe·kg−1 min−1, respect- impaired health and the human ‘super healthy’ model that
ively; P < 0.001). Myofibrillar protein synthesis rates, assessed could be useful for health claim support.
using L-[1-13C]-leucine, were higher after ingesting 45 g (0.0725 Disclosure of Interest: None declared.
± 0.0031% h−1) when compared to 0 g (0.0574 ± 0.0037% h−1,
P < 0.05). The incorporation of dietary protein-derived
amino acids (L-[1-13C]-phenylalanine) into de novo myofibrillar OR07
protein was greater after ingesting 45 g (0.0397 ± 0.0026 MPE) HYPOXIA INCREASE CITRULLINE PRODUCTION BY HUMAN
when compared to the ingestion of 15 g (0.0171 ± 0.0017 MPE; ENTEROCYTES: AN IN VITRO STUDY
P < 0.001) and 30 g (0.0296 ± 0.0030 MPE; P < 0.05) protein. M. Couchet1 *, S. Pestour2, C. Breuillard1, F. Lamarche1,
Conclusion: Ingestion of 45 g protein is required to increase C. Corne3, E. Fontaine1, C. Moinard1. 1Laboratory of
post-exercise myofibrillar protein synthesis rates in older Fundamental and Applied Bioenergetics INSERM-U1055, UGA,
individuals. Grenoble Cedex 9, 2Gastroenterology Unit, 3Biochemistry,
Pharmacology and Toxicology Unit, Grenoble-Alpes University
Hospital, Grenoble, France
OR06 Rationale: Citrulline (CIT) production by the enterocytes is
PLASMA ACYLCARNITINES AND AMINO ACIDS, FATTY ACIDS, usually fallen down among intensive care patients and
LEPTIN/ADIPONECTIN AND HUMAN MERCAPTALBUMIN IN combined with hypoxia and inflammation [1].
STUDY SUBJECTS WITH MILDLY IMPAIRED RENAL, VASCULAR The aim of this study was to determine, in vitro, if hypoxia and
AND METABOLIC HEALTH COMPARED TO ‘SUPER HEALTHY’ inflammation had an impact on CIT production through the
SUBJECTS ornithine carbamoyl transferase enzyme (OCT) pathway. Those
B. M. Winklhofer-Roob1 *, G. Faustmann1,2, effects were evaluated by using a model of human duodenal
H. Hafner-Giessauf2, P. Kieslinger3, J. Grabher2, M. C. Sattler1, explant incubation [2].
G. Fauler3, K. Öttl4, B. Tiran3, J. M. Roob2. 1Human Nutrition & Methods: Duodenal biopsies were removed from selected
Metabolism Research and Training Center, Institute of patients and incubated in a cell culture medium during 6 h of
Molecular Biosciences, Karl Franzens University of Graz, time within 4 conditions: control, inflammation (IL-1β, 1 μg/l ±
2
Clinical Division of Nephrology, Department of Internal TNFα, 20 μg/l ± IFNγ, 10 μg/l), hypoxia (3% O2) and hypoxia
Medicine, 3Clinical Institute of Medical and Chemical coupled to inflammation. Levels of CIT released in the culture
Laboratory Diagnostics, 4Institute of Physiological Chemistry, medium, OCT activity and OCT protein expression were
Medical University oif Graz, Graz, Austria measured. OCT activity was weighed up in relation to the
amount of cell death. The statistical analyses were performed
Rationale: The aim of this study was to identify and validate with a repeated measures ANOVA test followed by a fisher post-
new biomarkers in an integrated approach in the BIOCLAIMS hoc test.
cohort consisting of 1,310 study participants, 607 M, 704 F, aged Results: The percentages of cell death at the end of the
18–85 years. incubation period were the same in each condition.
Methods: Four contrasting groups were studied: Group 1, CIT production and OCT activity in the 4 groups, after 6 h of
impaired renal health (glomerular filtration rate eGFR 30– incubation (mean ± SEM):
60 ml/min/1.73 m2); Group 2, impaired vascular health
(intima-media thickness, IMT, left and right >75th percentile;
Group 3, impaired metabolic health (HOMA index >2.5 and Condition CIT (μmol/mg/6 h) OCT activity (%)
HbA1c 38.8–44 mmol/mol); Group 4, ‘super healthy’ subjects Control 0.062 ± 0.022 100.000 ± 0.000
(clinical chemistry variables within normal range ±10%, IMT Inflammation 0.082 ± 0.021 110.321 ± 9.314
not >75th percentile at both sides, not taking medications). Hypoxia 0.155 ± 0.033* 117.452 ± 7.633
Hypoxia- 0.214 ± 0.043** 119.612 ± 10.495
Care was taken to avoid overlaps between the groups; matching Inflammation
for age was not possible (age of group 1 > 2, 4 and 3 > 4).
Results: Plasma metabolomics biomarkers (28 acylcarnitines, *p = 0.05 vs control. **p = 0.004 vs control.
17 amino acids and 21 plasma fatty acids) showed significant
(P < 0.001) differences between groups for serine, threonine,
CIT production was increased after 6 h of incubation in Hypoxia
histidine (4 > 1) and glycine + lysine, glutamine and carnitine
and Hypoxia coupled to Inflammation conditions without
(1 > 4); all plasma acylcarnitines differed significantly
modification of the enzyme activity or the protein amount.
(P < 0.001; 1 > 2,3,4) except C22-6 and C6DC + C7OH (4 > 1).
Conclusion: CIT production by the enterocytes seems
Fatty acid profiles also differed significantly, such as C22:4n-6
increased in hypoxia +/− inflammation conditions without
(P < 0.001; 1 > 2,3,4), C22:5n-3 (P = 0.006; 1 > 3,4), C22:6n3
modifications of the OCTactivity or the OCT protein expression.
(P = 0.002; 1 < 2,4). Leptin:adiponectin ratios were higher
So the underling mechanisms need to be further determined.
References of 2 types of curcumin, the natural curcumin and a hydro-

1. Piton C. et al. Intensive Care Med. 2010. genated version (white), known for their wide range of
2. Coëffier M. et al. Cytokine 2001. physiological effects especially the management of oxidative
Disclosure of Interest: None declared. stress and inflammation, as new nutritional solution for
sarcopenia in old rats.
Methods: Forty four 20 months-old rats received a complete
OR08 diet supplemented with either natural curcumin (CUR, n = 11)
THE PROTECTIVE EFFECT OF VITAMIN D3 ON INTESTINAL or hydrogenated curcumin (WCUR, n = 11) for 3 months. A
FAILURE-ASSOCIATED LIVER DISEASE IN A RAT MODEL OF control group (CON, n = 22) received cellulose instead of
SHORT BOWEL SYNDROME curcumin. Exact Wilcoxon test associated with Hodges-
Y. Li1, S. Fan2, Y. Huang3*. 1Department of Surgery, Shanghai Lehmann to estimate the difference between groups has
Ninth People′s Hospital, Shanghai Jiaotong University School of been performed for statistical analysis.
Medicine, Shanghai, 2Department of Surgery, Gulou Hospital, Results: Evolution of gait speed from baseline to 3 months
Nanjing University School of Medicine, Nanjing, 3General measured with the cat walk were greater in the CUR (P < 0.05)
Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiaotong than in the CON group and was associated with an increase in
University School of Medicine, Shanghai, China lean mass gain measured by nuclear magnetic resonance
(P = 0.056). Such benefit was not observed in WCUR group.
Rationale: 1,25(OH)2D3 could induce the activation of farne- Body weight gain was significantly higher in the CUR and WCUR
soid X receptor (FXR), which is the most important bile acid groups compared to CON. Alpha2-macroglobulin, a blood
sensor. The purpose of this study was to explore the effect of marker of inflammation, was lower and plasma total antioxi-
vitamin D3 on intestinal failure-associated liver disease in a rat dant capacity, a marker of oxidative stress, was improved in
model of short bowel syndrome. CUR than in CON (P < 0.05) but not in WCUR. The 3 months
Methods: Twelve adult male rats with a central catheter placed supplementation with polyphenols had no effect on food
in the right jugular vein were assigned into two groups: control intake, fat gain, muscles weight and gastrocnemius muscle
group (n = 6) and experimental group (n = 6). All rats underwent protein synthesis.
75% intestinal resection and accepted total parenteral nutri- Conclusion: Muscle functionality, lean mass and body weight
tion (TPN) for 14 days. The experimental group received gain were enhanced after supplementation of natural curcumin
intraperitoneal injection of vitamin D3 at a dose of 4 μg/kg in old rats. This was associated with a decrease of low grade
body weight once a day for 14 days. Serum alanine transamin- inflammation and an improvement of total oxidant capacity.
ase (ALT), aspartate transaminase (AST), direct bilirubin
Disclosure of Interest: C. Boutry Other: Working for Nestlé, O. Rizzo
(DBIL), and total bilirubin (TBIL) were observed. After blood
Other: Working for Nestlé, E. Cazaubon Other: Working for Nestlé, J.-P.
collection the bile flow was determined and the liver tissue
Godin Other: Working for Nestlé, M.-N. Horcajada Other: Working for
specimens was obtained for pathological examination. Nestlé, F. Membrez Other: Working for Nestlé, D. Breuillé Other:
Results: The serum values of liver function were increased as Working for Nestlé.
time went on. The serum ALT (55.23 ± 6.41 U/L vs. 64.01 ±
7.23 U/L, P < 0.05), AST (177.22 ± 26.42 U/L vs. 209.00 ± 31.24
U/L, P < 0.05), TBIL (3.23 ± 0.21 μmol/L vs. 3.65 ± 0.23 μmol/L,
P < 0.05), DBIL (0.99 ± 0.03 μmol/L vs. 1.15 ± 0.06 μmol/L,
Oral Communication II: Nutrition and
P < 0.05) of experimental group were significantly lower than Chronic Disease
those of control group at day 14 postoperatively. In addition,
OR10
the bile flow of experimental group (8.23 ± 1.26 μml/min)
BASELINE CHARACTERISTICS AND CLINICAL RESPONSE TO
wassignificantly higher than that of control group (5.85 ± 1.41
TEDUGLUTIDE IN PATIENTS WITH SHORT BOWEL SYNDROME
μml/min) (P < 0.05). The pathological score of experimental
BASED ON RESIDUAL BOWEL ANATOMY
group (1.23 ± 0.26) were significantly lower than those of
control group (1.85 ± 0.41) (P < 0.05). P. B. Jeppesen1 *, S. M. Gabe2, D. L. Seidner3, H.-M. Lee4,
Conclusion: Vitamin D3 could lead to amelioration in serum ALT, C. Olivier5. 1Rigshospitalet, Copenhagen, Denmark, 2St Mark′s
AST, TBIL and DBIL in short bowel syndrome patients depending Hospital, Northwick Park, United Kingdom, 3Vanderbilt
on parenteral nutrition. In addition, vitamin D3 could reduce University Medical Center, Nashville, 4Shire Human Genetic
liver damage of intestinal failure associated liver disease. Therapies, Inc., Lexington, United States, 5Shire International
GmbH, Zug, Switzerland
Rationale: Intestinal failure associated with short bowel
OR09 syndrome (SBS–IF) arises from different etiologies resulting in
SUPPLEMENTATION WITH CURCUMIN IMPROVED AGE- a heterogeneous population. This is a post hoc analysis of SBS–IF
RELATED LOSS OF MUSCLE FUNCTION IN OLD RATS patients ( pts) based on residual bowel anatomy.
C. Boutry1 *, O. Rizzo2, E. Cazaubon1, J.-P. Godin1, Methods: STEPS (NCT00798967; EudraCT2008-006193-15) was
M.-N. Horcajada1, F. Membrez1, D. Breuillé1. 1Nestlé Research a 24-wk, placebo (PBO)–controlled study of teduglutide (TED)
Center, 2Nestlé Institute of Health Science, Lausanne, 0.05 mg/kg/day in pts with SBS−IF. Three groups were
Switzerland evaluated: Grp1 (no colon/stoma present/no colon-in-continu-
ity), Grp2 (≥50% colon/no stoma/colon-in-continuity), and
Rationale: Sarcopenia is defined as a syndrome characterized Grp3 (other bowel anatomies). Clinical response was defined as
by an age-related loss of skeletal muscle mass and function-
ality. The objective of this study was to determine the effects
Oral Communication II: Nutrition and Chronic Disease S5
≥20% reduction from baseline in weekly parenteral support weeks. Data were compared in univariate analysis to identify
(PS) volume at Wks20–24. Data presented as mean (SD). predictive factors for very early response and withdrawal from
Results: Baseline pt details are shown in Table. TED-induced PS PS at 12 weeks.
volume reduction (change in L/wk) took longer to be realized in Results: 42 SBS patients (21 F/21M, mean age 53.2 (23–84) yrs),
Grp2 (Wk12: −0.9 [1.2], Wk24: −2.5 [2.1]) vs Grp1 (Wk12: −5.5 with a PS duration of 11 (0.5–31) yrs, a PS weekly volume of
[3.8], Wk24: −6.4 [4.5]) or Grp3 (Wk12: −2.7 [1.2], Wk24: −5.1 10,860 (2,000–38,500) ml were treated with TED for at least 3
[3.7]). Response rates were higher with TED vs PBO in all grps, months. At week 12, 25/42 (59.5%) were VER, 13/42 had no
but the difference was significant only in Grp1 (76% vs 19%, change in PS, 4/42 had a PS reduction < than 20%. At week 12,
P = 0.001; Grp2: 56% vs 40%, P = 0.36; Grp3: 57% vs 29%, 9/42 were weaned off PS. VER had a significantly higher oral
P = 0.33). Adverse events were reported by 94% (Grp1), 72% intake at baseline (2,709 vs 2,108 kcal, p = 0.012) regardless of
(Grp2), and 86% (Grp3) of TED pts. age, gender and BMI. Factors associated with PS discontinu-
ation were the presence of high baseline food intake (2,938 vs
Grp1 Grp2 Grp3 2,237 kcal/d, p = 0.013) and low initial PS volume (1,646 vs
2,533 ml/d, p = 0.001). No patient or SBS characteristic
TED, PBO, TED, PBO, TED, PBO,
predicted the therapeutic response and withdrawal of PS.
n = 17 n = 16 n = 18 n = 20 n=7 n=7
Conclusion: This first ‘real life’ study evaluating in a large
Cause of SBS−IF, % cohort the very early efficacy of TED in adult SBS patients
Crohn′s disease 53 44 0 0 14 14
Vascular
confirms, as early as 3 months, a significant reduction of PS.
complications 12 13 50 65 29 14 Hyperphagia appears as a major predictive factor of very early
Other 35 44 50 35 57 71 response. Evaluation and dietary optimization should be the
Colon-in-
continuity, % 0 0 100 100 100 100
focus of attention prior to any initiation of TED treatment. An
Stoma present, % 100 100 0 0 57 14 assessment of this ongoing cohort at 6 months will confirm the
Ileocecal valve benefit of treatment over a longer period of time.
present, % 0 0 17 40 0 14
Mean (SD) estimated 137.7 113.7 52.2 39.2 59.3 49.3 Disclosure of Interest: None declared.
remaining small (70.9)* (79.8)* (27.4) (30.4)† (44.4) ‡
(30.0)‡
bowel length, cm
Mean (SD) PS 14.5 18.8 10.6 10.5 12.4 9.1
OR12
volume, L/wk (9.6) (7.9) (5.8) (5.3) (7.1) (3.9) NEUROPROTECTIVE EFFECT OF EGCG LOADED
NANOPARTICLES ON ALUMINIUM CHLORIDE INDUCED
*
n = 15. ALZHEIMER DISEASE IN WISTAR RATS
†
n = 19.
‡
n = 6. N. A. Singh1 *, C. Ravi2, Z. A. Khan3, A. K. A. Mandal2.
1
Integrative Biology, 2Biotechnology, VIT University, Vellore,
3
Conclusion: SBS−IF pts in Grp1 had the highest baseline PS Centre for Interdisciplinary Biomedical Research, Adesh
volume needs and responded most and fastest to TED with PS University, Bathinda, India
volume reductions compared with pts in Grp2 or Grp3.
Rationale: Alzheimer’s disease is a neurodegenerative path-
Disclosure of Interest: P. Jeppesen Consultant for: Shire, Speaker ology characterized by the presence of senile plaques and
Bureau of: Shire, S. Gabe Consultant for: Shire, D. Seidner Consultant neurofibrillary tangles. Aluminium has been reported to play an
for: Shire, H.-M. Lee Other: Employee for Shire, C. Olivier Other:
important role in the aetiology and pathogenesis of this
Employee for Shire.
disease. Hence, the present study aimed to evaluate the
neuroprotective role of epigallocatechin-gallate (EGCG)
loaded nanoparticles (nanoEGCG) against aluminium chloride
OR11
(AlCl3) induced neurobehavioral and pathological changes in
FIRST STUDY IN ‘REAL LIFE’ ON THE EFFECT OF
Alzheimeric rats.
TEDUGLUTIDE AT 3 MONTHS IN A COHORT OF ADULT PATIENTS
Methods: 100 mg/kg body weight AlCl3 was administered orally
WITH SHORT BOWEL SYNDROME (SBS)
for 60 days, which was followed by 10 mg/kg body weight free
F. Joly1 *, D. Quilliot2, P. Beau3, F. Poullenot4, EGCG and nanoEGCG treatment for 30 days. Morris water maze,
L. Armengol-Debeir5, C. Chambrier6, J. Lallemand7, V. Boehm8, open field and novel object recognition tests were employed
A. Nuzzo8, O. Corcos8, S. Schneider9. 1Gastroenterology and for neurobehavioral assessment of the rats. This was followed
Nutrition Support, Beaujon, Clichy, 2CHU Nancy, Nancy, 3CHU by histopathological assessment of the cortex and the
Poitiers, Poitiers, 4CHU Bordeaux, Bordeaux, 5CHU Rouen, hippocampus of the rat brain. Further validation was done
Rouen, 6Hospices civiles, Lyon, 7Clinique Vert Coteau, with biochemical and western blot assays.
Marseille, 8Beaujon, Clichy, 9CHU Nice, Nice, France Results: Aluminium exposure reduced the exploratory and
locomotor activities in open field test and significantly reduced
Rationale: Phase III clinical studies have shown that treatment
the memory and learning curve of rats in morris water maze and
with teduglutide (TED) was associated with at least 20%
novel object recognition tests. These neurobehavioral impair-
reduction in PS at 6 months in SBS patients. The aim of the
ments were significantly attenuated in nanoEGCG treated rats.
study was to evaluate in a ‘real life’ SBS cohort, the predictive
Histopathological assessment of the cortex and the hippocam-
factors of very early response in SBS patients treated with TED.
pus of aluminium-exposed rat brains showed the presence of
Methods: This is a national retrospective multicentre study. All
both senile plaques and neurofibrillary tangles. In nanoEGCG
consecutive SBS patients treated by TED with a follow-up of at
treated rats this pathology was absent. Significant increase in
least 3 months were analysed. The very early responders (VER)
biochemical and protein expression levels of AChE, APP, PDK1
were: TED patients achieving ≥20% PS volume reduction at 12
and GSK3 was noted in aluminium-exposed rats, while these OR14

levels were greatly reduced in nanoEGCG treated rats. OBSTRUCTIVE SLEEP APNEA AND MALNUTRITION: A
Conclusion: In conclusion, this study strengthens the hypoth- PRELIMINARY STUDY
esis that EGCG nanoparticles can reverse memory loss, senile C. Breuillard1 *, S. Moulin2, S. Bouyon2, M. Couchet1,
plaque and neurofibrillary tangles formation. G. Maillard1, C. Moinard1, E. Belaidi2. 1Laboratory of
Disclosure of Interest: None declared. Fundamental and Applied Bioenergetics - INSERM U1055,
2
HP2 Laboratory, INSERM U1042, Grenoble Alpes University,
OR13 Grenoble, France
LONG-TERM EFFICACY OF A NUTRITIONAL INTERVENTION
STRATEGY TO OPTIMIZE AND MAINTAIN EFFICACY OF Rationale: Obstructive sleep apnea (OSA) is well known to be
PULMONARY REHABILITATION IN COPD: THE NUTRAIN TRIAL associated to metabolic disturbances, including glucose and
lipid metabolism (1,2). But, surprisingly, no data are available
M. van Beers1 *, C. van de Bool1, A. van Helvoort2,3, concerning possible malnutrition associated to OSA whereas it
S. Kremers4, F. Franssen5, E. Wouters1, A. Schols1. 1Department often goes along with an anorexia which is an important factor
of Respiratory Medicine, 2School of Nutrition and Translational leading to malnutrition.
Research in Metabolism, Maastricht University Medical Center Methods: 24 Wistar male rats were divided into 3 groups and
(MUMC+), Maastricht, 3Nutricia Research, Nutricia Advanced submitted to different O2 pressure for 14 days: intermittent
Medical Nutrition, Utrecht, 4Department of Health Promotion, hypoxia (IH - 21–5% FiO2, 60-s cycle, 8 h/day a validated model
Maastricht University Medical Center (MUMC+), Maastricht, of OSA), normoxia (N), and normoxia pair fed to IH group (PF).
5
Department of Research and Education, CIRO, Center of Food intake and body weight of the animals were measured
Expertise for Chronic Organ Failure, Horn, Netherlands throughout the study. At the end of the study, muscles (EDL,
Tibialis, Soleus), intestine mucosa ( jejunum and ileon), liver,
Rationale: The 4-month placebo-controlled part of the
rate, heart and thymus were weighed. Data are presented as
NUTRAIN trial showed that targeted nutritional supplementa-
(mean ± SEM).
tion (NS) during outpatient pulmonary rehabilitation in COPD
Results: Cumulated food intake was well lower in IH group
patients with moderate airflow obstruction and low muscle
compared to N group (IH: 390 ± 16 g vs N: 536 ± 20; p < 0.05),
mass did not enhance muscle regain and improvements in
and it was accompanied by a lower body weight (IH: 362 ± 7 g vs
physical performance, but improved nutritional status and
N: 407 ± 6; p < 0.05). But, interestingly, body weight of PF group
prevented a decline in daily step count. The current study
was different to IH group, and not different to N group (PF:
investigates if the changes obtained during nutritional
400 ± 6 g vs IH: 362 ± 7; p < 0.05; PF: 400 ± 6 g vs N: 407 ± 6;
rehabilitation consolidated during the 8-month maintenance
p > 0.05). Furthermore, thymus weight was lower in IH group
phase.
compared to N and PF groups (IH: 0.56 ± 0.04 g, N: 0.73 ± 0.03,
Methods: 81 patients were randomized to 4 months outpatient
PF: 0.77 ± 0.03; p < 0.05), while the other organs were not
rehabilitation ± NS (3 portions enriched with leucine, vitamin D
affected.
and polyunsaturated fatty acids) or ± PLACEBO. In an 8-month
Conclusion: This preliminary study shows that IH specifically
maintenance program thereafter, both groups received feed-
induces body weight loss, and thymic involution suggesting a
back on their physical activity level using accelerometry. The
possible nutritional alteration that remains to be character-
NS group additionally received nutritional counseling sessions
ized. For that, further studies will investigate AA content,
based on motivational interviewing and maintenance NS (1
protein content and protein anabolism.
portion).
Results: Significant between-group differences were found References
at 12 months for leucine (Δ 16.5 µmol/l, p = 0.04), vitamin D 1. Iiyori N. et al. Am J Respir Crit Care Med, 2007.
(Δ 14.0 nmol/l, p < 0.001), EPA (Δ 8.8 mgL, p < 0.001) and 2. Pauly M. et al. Scientific Report, 2017.
DHA (Δ 12.0 mgL, p < 0.001) plasma levels, and body weight Disclosure of Interest: None declared.
(Δ 1.5 kg, p = 0.04). The latter was a net result of an increase
in NS (Δ 0.64 kg) and a decrease in PLACEBO (Δ −0.90 kg).
OR15
Enhanced physical functioning after 4 months maintained
OMEGA 3 FATTY ACIDS ATTENUATE ENDOTHELIAL
after 12 months in both groups, but step count was
DYSFUNCTION BY RESTORING NITRIC OXIDE AVAILABILITY IN
significantly higher in NS (Δ 1,030 steps per day, p = 0.03).
CHRONIC KIDNEY DISEASE
Intrinsic and extrinsic motivation towards a healthy lifestyle
were high in both groups and did not change; only negative G. Gortan Cappellari1 *, A. Semolic1, R. Barazzoni1, M. Zanetti1.
1
motivation towards eating decreased in NS ( p = 0.04). Medical Sciences, University of Trieste, Trieste, Italy
Conclusion: The short-term effects of nutritional supplemen-
Rationale: Omega 3 polyunsaturated fatty acids (n-3 PUFA)
tation on body weight, targeted plasma nutrient levels and
exert antioxidant and anti-inflammatory effects and may
daily step count were retained during the 8-month mainten-
positively impact cardiovascular disease in chronic kidney
ance phase.
disease (CKD). We tested the hypothesis that n-3 PUFA dietary
Disclosure of Interest: None declared. enrichment may improve endothelial dysfunction in a rodent
model of CKD.
Methods: CKD was induced by 5/6 nephrectomy in 12-week-old
male Wistar rats, that were then maintained on a regular
(Fat = 5.5% total, mainly from soybean oil; CKD: n = 8) or n-3
PUFA diet (Fat = 5.5% total; 27% total fat EPA + DHA, replacing
Oral Communication II: Nutrition and Chronic Disease S7
soybean oil; CKD-PUFA: n = 8). An additional group underwent association emerged between HGST/arm lean mass and IMAT
sham-surgery and was fed regular diet (SHAM; n = 10). At 40 or IMCL.
days, aortas were harvested. Analyses included assessment of Conclusion: Insulin resistance, and not myosteatosis per se,
endothelium-dependent (EDD) and -independent (EID) vaso- may play a role in the decline of muscle strength, leading to the
dilation in organ chambers, endothelial nitric oxide synthase phenotype of dynapenic obesity. Dynapenia may precede the
(eNOS) and NADPH oxidase NOX4 and p22phox subunit protein decline of lean body mass in metabolically unhealthy obese
expression by Western blot women.
Results: Compared to SHAM rats, CKD rats exhibited impaired Disclosure of Interest: None declared.
( p < 0.05) EDD and reduced ( p < 0.05) eNOS expression while
EID, NOX4 and p22phox protein expression were unchanged.
OR17
Incubation in the presence of the antioxidant Tiron failed to
CITRULLINE AND LPS-INDUCED OXIDATIVE STRESS DURING
improve endothelial dysfunction in CKD. In aortas from CKD-
NONALCOHOLIC FATTY LIVER DISEASE
PUFA endothelial dysfunction was partly ( p < 0.05) reverted
compared with CKD, while blockade of eNOS by L-NAME W. Ouelaa1, P. Jegatheesan1, J. M’bouyou-Boungou1,
worsened ( p < 0.05) EDD. In addition, treatment with n-3 C. Vicente1, S. Nakib1,2, E. Nubret1, J.-P. De Bandt1,2 *.
1
PUFA restored eNOS expression in CKD rats and decreased NOX 4 EA4466, Université Paris Descartes, 2Clinical Chemistry dpt,
protein expression. Hôpital Cochin, APHP, Paris, France
Conclusion: Thus, oral administration of n-3 PUFA reduces
Rationale: Hepatic lipid accumulation during nonalcoholic fatty
endothelial dysfunction in a chronic experimental model of
liver disease (NAFLD) is believed to sensitize the liver to the
CKD by restoring eNOS protein expression and activity and by
adverse effects of endotoxin via increased oxidative stress and
lowering vascular oxidative stress, suggesting a role of dietary
inflammation thus contributing to the progression of the
n-3 PUFA to treat CKD-associated vascular disease.
disease. We evaluated whether the protective effect of citrul-
Disclosure of Interest: None declared. line against fructose-induced NAFLD may be related to its ability
to prevent oxidative stress. This was tested using perfused livers
OR16 isolated from NAFLD rats subjected to endotoxemia.
THE ONSET OF DYNAPENIA MAY PRECEDE SARCOPENIA DUE Methods: Thirty SD male rats were given either a standard diet
TO METABOLIC DERANGEMENTS IN ADULT WOMEN WITH or a 60%>fructose diet alone or supplemented with citrulline
OBESITY (1 g/kg/d) for 4 weeks. Thereafter, fasted animals received an
E. Poggiogalle1 *, C. Lubrano1, L. Gnessi1, S. Mariani1, A. Lenzi1, IP injection of LPS (2.5 mg/kg) and, one hour later, the livers
L. M. Donini1. 1Department of Experimental Medicine- Medical were isolated and perfused under standard conditions for the
Pathophysiology, Food Science and Endocrinology Section, study of hepatic function, metabolism and oxidative and
Sapienza University, Rome, Italy inflammatory status. Statistical analysis: ANOVA and Fischer
PLSD.
Rationale: The aim of the present study was to investigate the Results: The 60% fructose diet induced a moderate steatosis
phenotype of sarcopenic obesity- lean body mass, muscle associated with insulin resistance and dyslipidemia signifi-
strength and muscle quality (namely, myosteatosis) in women cantly attenuated by the administration of citrulline. In the
with and without the Metabolic Syndrome (MetS). isolated livers from fructose-fed rats, endotoxemia led to a
Methods: Study participants were enrolled at the Sapienza increase in hepatic cytolysis (ALT + 80%, p < 0.05) and TLR4
University, Rome, Italy. Body composition was assessed by DXA. expression ( p = 0.08); this was prevented by citrulline.
The Handgrip strength test (HGST) was performed. HGST was Oxidative stress (4-hydroxynonenal) and antioxidant defenses
normalized to arm lean mass; intramuscular adipose tissue (vitamins A and E, glutathione) were similar between the 3
(IMAT) and intramyocellular lipid content (IMCL) were mea- groups. Hepatic amino acid exchanges and metabolism (urea,
sured by magnetic resonance spectroscopy, as indicators of glucose, ammonia) did not differ significantly between groups.
myosteatosis. Different indices of sarcopenia were calculated, Conclusion: In this model of moderate steatosis, fructose leads
based on appendicular lean mass (ALM, kg) divided by height to increased sensitivity to inflammation but not to LPS-induced
squared, or weight, or BMI. The NCEP-ATPIII criteria were used oxidative stress. The protective effect of citrulline on
to diagnose the MetS. HOMA-IR was calculated. The physical endotoxin appears to be independent of its antioxidant
activity level (PAL) was assessed through the IPAQ properties.
questionnaire. Disclosure of Interest: W. Ouelaa: None declared, P. Jegatheesan:
Results: 54 women (age: 48 ± 14 years, BMI: 37.9 ± 5.4 kg/m2) None declared, J. M’Bouyou-Boungou: None declared, C. Vicente: None
were included. 54% had the MetS (metabolically unhealthy). declared, S. Nakib: None declared, E. Nubret: None declared, J.-P. De
HGST/arm lean mass was lower in metabolically unhealthy Bandt Shareholder of: Citrage.
women than women without the MetS (6.3 ± 1.8 vs. 7.8 ± 1.6,
p = 0.03). No differences emerged in terms of absolute ALM (kg) OR18
or other indices of sarcopenia (ALM/h2, ALM/weight, or ALM/ RANDOMISED TRIAL SHOWS LOW VOLUME ENERGY DENSE
BMI) between metabolically healthy vs. unhealthy women ORAL NUTRITIONAL SUPPLEMENTS IMPROVE TOTAL
( p > 0.05) after adjustment for age, body fat, hs-CRP and PAL. NUTRITIONAL INTAKE WITH LITTLE SUPPRESSION OF FOOD
HGST/arm lean mass was negatively associated to HOMA-IR INTAKE IN MALNOURISHED FREE LIVING OLDER PEOPLE
( p = 0.02), after adjustment for age, body fat, hs-CRP levels,
T. Smith1 *, A. L. Cawood2, N. Guildford3, R. J. Stratton2.
and PAL. IMATand IMCL were not different in obese women with 1
Department of Gastroenterology, University Hospital
the MetS compared to women without the MetS ( p > 0.05). No
Southampton NHS Foundation Trust, 2Faculty of Medicine,
University of Southampton, 3Department of Nutrition and Agricultural Social Mutual (MSA) of Haute Vienne, 9Legrand
Dietetics, University Hospital Southampton NHS Foundation Society Autonomous Medical Department, 10Specialized
Trust, Southampton, United Kingdom Center of Obesity of Limousin, University Hospital of Limoges,
Limoges, France
Rationale: Large randomised trials assessing the effect of low
volume energy dense oral nutritional supplements (ONS) and Rationale: Obesity is a worldwide public health problem. In
simple dietary advice (DA) on food and total nutrient intake in France, prevalence of obesity is of 15.0%. The food behavior of
older free living people are lacking. French workers evolves with society and tachyphagia can
Methods: 308 free living older people (>50 y) recruited through promote weight gain. The aim of our work was to study the
GPs (mean ± SD; age 71.5 ± 10.7 y, BMI 19.4 ± 2.5 kg/m2, modalities of the lunch break and the link with obesity in
Charleston Comorbidity Index (CCI) 1.02 ± 0.93, 67% female) French workers
at risk of malnutrition (‘MUST’) were randomised to receive DA Methods: This prospective study was conducted from January
(as a diet sheet) (n154) or readymade low volume ONS (Fortisip to May 2016 in 5 departments of Occupational Medicine of the
Compact range, Nutricia; 2.4 kcal/ml) plus DA (n154) for 12 French region of Haute-Vienne. With an anonymous self-
weeks. At baseline, 4, 8 and 12 weeks, energy and protein questionnaire, declarative data concerning general informa-
intake was measured (24 h recalls, analysed by WISP) and the tion including weight and height with calculation of the body
extent to which ONS intake was additive to the diet calculated mass index (BMI) and the modalities of the lunch break
(1). Intention to treat analysis was undertaken controllng for including the time of meal were collected. Statistical analysis
baseline, age, gender, ‘MUST’ category and CCI. included Student t test, Chi2 and logistic regression.
Results: Dietary intake of energy and protein did not differ Results: Four hundred and fifteen workers with a mean age of
between groups at baseline. Over the 12 weeks, total energy 41.1 ± 12.6 years were included. The mean BMI was 23.8 ± 4.6
and protein intakes were significantly greater in the ONS + DA kg/m2 and the prevalence of obesity was of 15.9%. Tachyphagia
group than the DA group alone (2,300 ± 43 kcal, 89 ± 1.7 g vs. (meal time <15 min) was found in 20.3%. In multivariate
1,899 ± 45 kcal, 74.0 ± 1.9 g; mean ± SE; p < 0.001), due to no analysis, eating alone and eating fast food were positively
significant difference between groups in food intake associated with tachyphagia (OR = 4.59 [95% CI: 2.44–9.08],
(1,820 kcal/d, 68 g protein/d vs.1,848 kcal/d, 71 g protein/d) p < 0.0001 and OR = 2.03 [95% CI: 1.10–3.70], p = 0.023,
and a mean daily ONS intake of 480 kcal and 21 g protein in the respectively) but also with obesity (OR = 2.14 [95% CI: 1.21–
ONS + DA group. Overall, 94% of the energy and 83% of the 3.79]; p = 0.008 and OR = 2.40 [95% CI: 1.25–4.52], p = 0.009,
protein of the ingested ONS was additive to food intake. respectively). But we did not found a significant association
Conclusion: This large randomised trial shows that low volume between tachyphagia and obesity.
energy dense ONS are effective at increasing total energy and Conclusion: Our study provides important information on
protein intakes with little suppression of food intake in free the modalities of lunch in French workers. Indeed, tachyphagia
living older people. Further evaluation is needed of the effect was found in 20%. It is essential to investigate the eating habits
of ONS and DA on micronutrient intakes and relevant clinical of workers during their meal break, especially in patients with
outcomes. excess of weight. The General Practitioner and the
Reference
Occupational Medicine departments are therefore key players
in the screening of nutritional disorders of workers.
1. Stratton & Elia 1999. Clin Nutr 18, 29–84.
Disclosure of Interest: T. Smith: None declared, A. Cawood Other:
Nutricia Ltd, N. Guildford: None declared, R. Stratton Other: Nutricia Ltd.
OR20
FACTORS THAT AFFECT SURVIVAL IN TYPE 3 INTESTINAL
FAILURE; A SINGLE CENTRE EXPERIENCE OF 978 PATIENTS
Oral Communication III: Nutritional OVER 37 YEARS
Assessment, Epidemiology and S. Oke1 *, D. A. Lloyd2, J. M. Nightingale1, S. M. Gabe1. 1Lennard
Formulations Jones Intestinal Failure Unit, St Mark’s Hospital, Harrow,
2
Hampshire Hospitals NHS Foundation Trust, Winchester,
OR19 United Kingdom
PREVALENCE OF TACHYPHAGIA AT LUNCH AND ASSOCIATED
FACTORS IN 415 FRENCH WORKERS Rationale: Standard management of type 3 intestinal failure
C. Millotte1, P. Fayemendy2,3,4, M. Druet-Cabanac2,3,5, (IF) is long-term parenteral support (PS). While it is clear that
M. Perrier6, M. Gravelat7, M. Dupont Cuisinier8, C. Le Flahec9, PS is lifesaving treatment for IF, it carries significant morbidity
J. C. Desport2,3,4,10 *, P. Jésus2,3,4,10. 1Department of General and mortality. We report the largest single-centre series
Medicine, University Hospital of Limoges, 2UMR_S 1094, assessing the long-term survival of adult patients on all forms
Tropical Neuroepidemiology, Institute of Neuroepidemiology of home PS ( parenteral nutrition and parenteral fluids) for
and Tropical Neurology, CNRS FR 3503 GEIST, University of type 3 IF.
Limoges, 3INSERM, U1094, Tropical Neuroepidemiology, School Methods: Clinical records of 978 adult patients receiving home
of Medicine, 4Nutrition Unit, 5Department of Occupational parenteral support for IF at our tertiary referral centre were
Medicine, University Hospital of Limoges, 6Interprofessional analysed from January 1979 until October 2016. Demographic
Association for Occupational Health 87 (AIST87), 7Inter- data including survival was recorded. Differences between
Company Medical Service of the Health Insurance of the Haute- groups were analysed by chi-squared tests. Kaplan-Meier and
Vienne, 8Department of Occupational Health of the
Oral Communication III: Nutritional Assessment, Epidemiology and Formulations S9
Cox’s regression models were used to assess factors affecting residents with dentures problems (PR 1.6, 95% CI 1.2–2.1).
survival. Within somatic wards, 9.0% were malnourished, where 13.2% of
Results: Overall rates of survival for all patients on PS without residents in psychogeriatric wards were malnourished.
active malignancy as a cause of IF, were 90%, 66%, 55%, 45%, 33% Increased risk for malnutrition was found among psychogeriat-
and 25% at 1, 5,10, 15, 20 and 30 years respectively. There is a ric residents that had problems with eating due to dentures
significant difference in survival dependent on underlying IF problems (PR 1.6, 95% CI 1.1–2.3).
aetiology. The worst 1-year survival of 62% was seen for Conclusion: Poor oral health, mostly problems with eating due
malignancy and the best with pseudo-obstruction (excluding to dentures problems, was associated with an increased risk for
scleroderma) at 93%. Multivariate analysis demonstrated a malnutrition in older residents in Dutch nursing homes.
significant relationship between survival and the following Disclosure of Interest: None declared.
factors; age at start of PS; HR 1.03 ( p < 0.001), form of PS; HR
0.48 ( p = 0.04), presence or absence of colon in continuity; HR
OR22
0.42–0.70 ( p = 0.03), and the aetiologies underlying IF HR 0.74–
COMPATIBILITY STUDY WITH A NATURAL FOOD-BASED TUBE
8.19 ( p < 0.001).
FOOD
Conclusion: Our data have shown a better prognosis was
associated with an earlier age of onset of type 3 IF and the S. B. Schmidt1 *, A. S. Vasold2, R. Winter3, J. D. Rollnik1.
1
presence of colonic continuity, while a worse prognosis was Institut für neurorehabilitative Forschung (InFo), Hessisch
associated with underlying aetiologies such as malignancy and Oldendorf, 2Medizinische Einrichtung des Bezirkes Oberpfalz
radiation enteritis. To our knowledge, this is the largest single- KU, Klinik für Neurologische Rehabilitation, Bezirksklinikum
centre case series looking at survival in type-3 IF to date and Regensburg, Regensburg, 3SRH Kurpfalzkrankenhaus
adds to our current understanding of the long-term outcomes in Heidelberg gGmbH, Heidelberg, Germany
type 3 IF.
Rationale: Diarrhea is frequently observed in patients receiv-
Disclosure of Interest: None declared. ing enteral tube feeding (ETF). Anecdotal observations suggest
that the composition of food administered via tube may be
OR21 among the factors determining the development of diarrhea.
ASSOCIATION BETWEEN MALNUTRITION AND ORAL HEALTH IN The current study investigates the effect of natural food-based
DUTCH NURSING HOME RESIDENTS: RESULTS OF THE LPZ- tube feed (NFTF) versus standard used tube feed on the
STUDY incidence of low consistence stools or diarrhea.
L. C. de Groot1 *, V. Huppertz1, G.-J. van der Putten2,3, Methods: Neurological patients (n = 117) obtained NFTF (HIPP;
R. J. Halfens4, J. M. Schols4. 1Human Nutrition and Health, intervention group n = 59) or standard tube feed (Fresenius;
Wageningen University, Wageningen, 2Dept Oral Function and control group n = 58). For a maximum of 30 days following data
Prosthetic Dentistry, Radboud University Medical Centre, was recorded daily: nutrition protocol (amount of nutrition,
Nijmegen, 3Amaris Zorggroep, Hilversum, 4Department of feed rate, daily amount of liquid); changes in medication;
Health Services Research, Maastricht University, Maastricht, result of stool microbiology (when conducted); number of
Netherlands defecations and the consistence of stools classified according
to the Bristol Stool Chart.
Rationale: Malnutrition as well as bad oral health are of great Results: A two sided ANCOVA with the factors group, age,
concern to global health, especially among frail older centrum and duration of antibiotic treatment revealed that the
population. Beyond sole prevalence estimations of malnutri- patients of the intervention group showed significant lower
tion, dentures problems, chewing problems and xerostomia, number of low consistence stools as compared to the control
this study aimed to assess the associations between malnutri- group after 15 days as well as after 30 days of ETF. In addition,
tion and oral health problems in somatic and psychogeriatric the number of days with low consistence stools (3.8 vs. 9.6;
wards from Dutch nursing homes. p < 0.001) as well as the number of days with ≥3 low consistence
Methods: Data were collected in the cross-sectional National stools (0.6 vs. 1.7; p < 0.05) was significant lower in the
Prevalence Measurement of Quality of Care study (LPZ-study) in intervention group.
the study rounds of 2013, 2014 and 2015 in the Netherlands. Conclusion: NFTF showed reduced incidence of low consist-
3,220 residents, aged 65 or older and living in somatic or ence stools during ETF in neurological patients compared to
psychogeriatric wards in Dutch nursing homes were included. standard tube feed produced from powdered raw materials.
Malnutrition was based on the valid ESPEN definition; age- Disclosure of Interest: S. Schmidt Paid Instructor at: Working position
adjusted BMI combined with weight loss (%). Oral health was (50%) of the first author was funded by HIPP GmbH & Co KG during study
assessed by means of a standardized questionnaire. To examine investigation. Furthermore, HIPP incur any expenses for the congress
associations between malnutrition and oral health factors, participation., A. Vasold: None declared, R. Winter: None declared,
prevalence ratios (PR) were generated from Cox regression. J. Rollnik: None declared.
Results: Mean age of the study population was 84.3 (±7.4)
years, with 70.2% female and 65.2% living in psychogeriatric
wards. Among the total population, 11.7% were malnourished
28.6% suffered from xerostomia, 25.6% from chewing problems
and 10.1% experienced problems with eating due to dentures
problems. Increased risks for malnutrition was found for
OR23 bedside following proactive advise from a nutritional assistant,

OCCURRENCE & SALVAGE OF INFECTED CENTRAL VENOUS improves dietary intake and patient satisfaction, compared to
CATHETERS IN HOME PARENTERAL NUTRITION: EXPERIENCE the traditional 3-meals a day service (TMS).
FROM A NATIONAL UK CENTRE Methods: We performed a prospective cohort study at medical
A. Bond1, A. Teubner 1 *, M. Taylor1, A. Abraham1, M. Dibb2, (Gastroenterology) and surgical (Gynaecology, Urology,
P. Chadwick3, S. Lal1. 1Intestinal Failure Unit, Salford Royal Orthopedics) wards, between July 2015 and December 2016.
Foundation Trust, Salford, 2Gastroenterology, Royal Liverpool Patients were offered TMS (n = 326) or FfC meal service
and Broadgreen University Hospital Trust, Liverpool, (n = 311). Protein and energy intake was measured at days 1
3
Microbiology, Salford Royal Foundation Trust, Salford, and 4 of full oral intake. Patient satisfaction comprised rating of
United Kingdom the experienced quality of the meals and the meal service
(scale 0–10) and a questionnaire developed by Naithani et al.
Rationale: Prevention and salvage of catheter related blood was used. Differences in metric variables were evaluated using
stream infections (CRBSI) is vital in patients on home unpaired t-tests.
parenteral nutrition (HPN)[1]. It is unclear if patients are best Results: Patient demographics between groups were similar,
trained for catheter care at home or in hospital or whether with the exception of a higher proportion of oncology patients
CRBSIs are lower in CVC self caring patients. in the FfC group ( p = 0.028). FfC improved daily protein intake
Methods: We conducted a retrospective study of CRBSI and CVC relative to requirements at day 1 (mean ± SD: 79 ± 33 vs.
salvage in patients on HPN at a UK centre between 2012 & 2016. 59 ± 28; p < 0.05) and day 4 (73 ± 38 vs. 59 ± 29; p < 0.05). Mean
Pre 2012, patients were primarily trained in hospital; there- daily energy intake relative to requirements improved at day 1
after, patients underwent home training. A standardised 14-day (88 ± 34 vs. 70 ± 30; p < 0.05) and day 4 (84 ± 40 vs. 73 ± 31;
protocol involving antibiotic/urokinase locks and systemic p = 0.05). Satisfaction was maintained, both in terms of food
antibiotics was used for CVC salvage in most cases [1]; in quality (7.7 ± 1.5 vs. 7.4 ± 1.4; p = 0.09) and service (7.8 ± 1.3
2013, this was reduced to 10-days for Coagulase-negative vs. 7.7 ± 1.1; p = 0.29). The FfC group was more satisfied with
Staphylococci (CNS) CRBSIs. the appearance ( p < 0.05) and smell of the meals ( p < 0.05).
Results: 134 CRBSIs were recorded in 92 patients from a cohort Conclusion: Implementation of this novel meal service
of 559 HPN patients (1,163 HPN years). The overall CRBSI rate substantially improved protein and energy intake while main-
was 0.316/1,000 catheter days (cds). CNS were the commonest taining, and on some points, improving patient’s satisfaction.
isolates 41/134 (30.5%), polymicrobial 14/134 (10.4%) and Disclosure of Interest: D. Dijxhoorn Grant/Research Support from:
Klebsiella 16/134 (11.9%). Salvage was not attempted in 34 FoodforCare Foundation, G. Wanten: None declared, M. van den Berg:
cases MRSA infection 1/34, fungal 19/34, clinical instability None declared.
14/34. 68/100 CVC attempted salvages were successful. 36/41
CNS infections had attempted salvage (80.5% successful OR25
salvage); there was no difference in salvage rates between VALIDITY OF PREDICTIVE EQUATIONS FOR RESTING ENERGY
CNS CRBSIs salvaged for 10-days (27/36) vs 14-days (7/9) EXPENDITURE FOR OVERWEIGHT OLDER ADULTS WITH AND
( p = 0.5). CRBSI rate, per 1,000 cds, in those cared for by WITHOUT DIABETES
trained nurses was the lowest 0.270 (self 0.342, family carer
A. M. Verreijen1 *, V. Garrido1,2, M. F. Engberink1,
0.320)( p = 0.03). The median time from discharge to first CRBSI
R. G. Memelink1, M. Visser3,4, P. J. Weijs1,3. 1Faculty of Sports
was 406 days (range 77–1,717)
and Nutrition, Amsterdam University of Applied Sciences,
Conclusion: We report a sustained very low CRBSI rate in a large
Amsterdam, Netherlands, 2University CEU-San Pablo, Madrid,
cohort of HPN patients as previously described [1]; we now
Spain, 3Department of Nutrition and Dietetics, Internal
further report that this is not influenced by training patients at
Medicine, VU University Medical Center, 4Department of
home but is lower when trained nurses manage the CVC at
Health Sciences, Faculty of Earth and Life Sciences, Vrije
home. CNS CRBSIs can be successfully salvaged with a reduced
Universiteit Amsterdam, Amsterdam Public Health research
duration of antibiotic therapy.
institute, Amsterdam, Netherlands
Reference
1. Dibb et al. JPEN 2016;40:699–704. Rationale: Predictive equations for resting energy expenditure
(REE) are used in the treatment of overweight and obesity, but
the validity of these equations in overweight older adults is
unknown. This study evaluates which predictive REE equation is
OR24 the best alternative to indirect calorimetry in overweight older
A NOVEL IN-HOSPITAL MEAL SERVICE IMPROVES PROTEIN AND adults with and without diabetes.
ENERGY INTAKE, A PROSPECTIVE STUDY Methods: In total 273 adults aged ≥55 years with a BMI of
D. N. Dijxhoorn1 *, G. J. A. Wanten1, M. G. A. van den Berg2. ≥25 kg/m2 were included. REE (by indirect calorimetry), body
1
Gastroenterology, 2Dietetics, Radboudumc, Nijmegen, weight, body height, age, gender, and fat-free and fat mass
Netherlands (from air-displacement plethysmography) were measured. The
measured REE was used as a reference and compared with 28
Rationale: Improvement of hospital meal services is a strategy existing REE equations. The accuracy of the equations was
to optimize protein and energy intake and prevent or treat evaluated by the percentage accurate predictions (within 10%
malnutrition during hospitalization. This study aimed to of REE measured), the root mean squared error (RMSE), and the
investigate whether FoodforCare (FfC), a new concept com- mean percentage difference (bias) between predicted and
prising 6- protein-rich meals per day, provided directly at the
ESPEN Best Abstracts 2017 & ESPEN Travel Awards S11
measured REE. Subgroup analyses were performed for type 2 OR27

diabetics (T2D) and non-T2D. LET’s DIAGNOSE SARCOPENIA WITH A DEEP BREATH
Results: Mean age was 64 ± (SD 6) years, 42% had T2D (n = 116), O. Deniz1 *, S. Kaya1, N. B. Demir2, M. C. Pence2,
and mean BMI was 32.8 ± (SD 4.5) with range 25–54 kg/m2. The H. Dogan Varan1, M. C. Kizilarslanoglu1, S. Ozhan Oktar2,
adjusted Harris & Benedict (1984) provided the highest B. Goker1. 1Department of Geriatrics, 2Department of
percentage accurate predictions in all adults (70%) and in T2D Radiology, Gazi University, Ankara, Turkey
(74%), and second best in non-T2D (67%). RMSE was 184, 175
and 191 kcal/day, and bias −1.2%, −1.5% and −1.0% for all Rationale: Previous preclinical studies have shown that
adults, T2D and non-T2D, respectively. sarcopenic mice may have thinner diaphragmatic muscle than
Conclusion: For Dutch overweight older adults with and non-sarcopenic ones, however, to the best of our knowledge,
without diabetes the adjusted Harris–Benedict (1984) predict- there are no clinical studies on diaphragm thickness in
ive equation for REE seems to be the best alternative to indirect sarcopenic patients. The aim of this study is to investigate
calorimetry. whether the sarcopenic patients have thinner diaphragmatic
Disclosure of Interest: None declared. muscles compared to non-sarcopenic controls.
Methods: Thirty sarcopenic and 30 non-sarcopenic elderly
OR26 patients aged over 65 were included in the study. The patients
NATIONAL OBLIGATORY SCREENING LEAD TO DECREASED known to have any type of pulmonary disorder, such as asthma
MALNUTRITION RATES IN PAEDIATRIC INPATIENTS or chronic obstructive pulmonary disease were excluded from
the study. Diagnosis of sarcopenia was made according to the
A. van den Berg1 *, A. Brinksma2, J. Olieman3, K. Joosten4, criteria of the European Working Group on Sarcopenia in Older
J. Hulst5, on behalf of the Dutch Malnutrion Steering Group. People. Ultra-sonographic evaluations of the patients were
1
Paediatrics, Juliana Children’s Hospital, The Hague, 2Health carried out by experienced radiologists. Diaphragm thickness
Sciences, University Medical Center, Groningen, 3Dietetics, was measured at 3 positions: at the end of deep inspiration,
4
Paediatric Intensive Care, 5Paediatric Gastroenterology, neutral and at the end of expiration. Peak expiratory flow (PEF)
Erasmus MC/Sophia Children’s Hospital, Rotterdam, rates of the patients was also evaluated by a peak flow meter.
Netherlands Results: The mean age of the patients was 76.7 ± 6.4 years and
56.7% were female. Gender rate was similar between sarco-
Rationale: Disease related malnutrition in children is asso-
penic and non-sarcopenic groups ( p = 0.602). Diaphragmatic
ciated with adverse outcome. From 2008, Dutch hospitals have
thicknesses in three different positions (deep inspiration
been required to screen for and treat acute malnutrition in
[2.35 mm (min-max: 1.30–4.10) vs. 2.50 mm (min-max: 1.90–
paediatric patients on admission as part of a national quality
4.90)], neutral [1.80 mm (min-max: 1.00–2.80) vs. 2.00 mm
indicator. The indicator stipulate that all hospitals report the
(min–max: 1.30–3.90)] and end of expiration [1.15 mm (min–
number of children screened on admission and the energy and
max: 0.70–2.50) vs. 1.55 mm (min–max: 0.50–3.40)] were found
protein intake on day 4 in malnourished children. The aim of
to be thinner in sarcopenic patients compared to non-
this study was to assess if the malnutrition quality indicator
sarcopenic group ( p = 0.023, p = 0.017, p = 0.003, respect-
altered (1) the number of children screened for malnutrition on
ively). Moreover, PEF results were also lower in sarcopenic
admission and (2) the treatment of malnutrition.
patients compared to non-sarcopenic group (245 L/min [min–
Methods: Centrally reported data of all Dutch hospitals with a
max: 150–500] vs. 310 L/min [min–max: 220–610], p = 0.001).
paediatric inpatient ward regarding screening for malnutrition
Conclusion: Results of the study suggest that sarcopenia may
(weight, height), and its treatment (energy and protein intake
be associated with lower diaphragmatic thickness and asso-
on day 4) from 2008 to 2015 were analysed. Acute malnutrition
ciated lower PEF rates.
was defined as weight for age <−2 SD in patients <1 year and as
weight for height <−2 SD in patients aged 1–18 years. For Disclosure of Interest: None declared.
children >1 year nutritional intake on day 4 was compared to set
minimum energy requirements using Schofield formula + 30%
and protein intake of 1.2–1.5 g/kg/day. ESPEN Best Abstracts 2017 & ESPEN
Results: Data of 667.291 admissions taken together since 2008 Travel Awards
show that screening for malnutrition on admission rose from
22% to 75% and from 34 to 90 institutions. Prevalence of acute OR28
malnutrition dropped from 9.4% to 6.5%. From 2008, the % of PERFORMANCE OF CT-BASED DIAGNOSIS OF SARCOPENIA
children with an adequate energy and protein intake on day 4 (SCT) AND BIOELECTRIC IMPEDANCE DERIVED LOW PHASE
remained more or less the same (adequate protein and energy ANGLE (PA) IN THE DETECTION OF AN INCREASED RISK OF
intake in respectively 67% and 65% of the malnourished NUTRITION RELATED MORTALITY
children). M. Wäsch1, M. Plauth1 *. 1Dessau Community Hospital, Dessau-
Conclusion: Since 2008, the national quality indicator on acute Roßlau, Germany
malnutrition has lead to significantly increased screening
numbers, whereas prevalence of malnutrion in paediatric Rationale: The aim of this study was to examine in a
patients has dropped. Although the percentage of children prospective study whether hospitalized patients with SCT
with adequate energy and protein intake on day 4 of admission show an increased mortality risk as assessed by Pandora score
remained practically the same, the number of registering (PS) in a head to head comparison with PA.
hospital almost tripled. Methods: A total of 7.736 patients were hospitalized in Dessau
Disclosure of Interest: None declared. community hospital (Nov 11, 2016–Feb 05, 2017). In 227/7.736
patients a CT scan was obtained and muscle index (SCT cutoff: Conclusion: The inhibited intestinal FADS1 gene expression
female≤ or >38.5 cm2/m2; male ≤ or >52.4 cm2/m2) was deter- after RYGB suggests a decrease in ability to synthesize bioactive
mined at L3 level using Slice-O-Matic. In 180/227 patients omega-3. Our data suggest that supplementation of omega-3
malnutrition screening (NRS-2002 ≥3 or <3), determination of may be required for obese patients undergoing RYGB.
PA (<5th or ≥ 5th percentile) and calculation of 30-day mortality References
risk (PS ≥ 5% or <5%) were done within 6 days after the CT scan.
1. Rhee NA, et al. Effect of Roux-en-Y gastric bypass on the
Results: Muscle index (41.8 ± 8.0 vs 47.6 ± 8.2 cm2/m2; p <
distribution and hormone expression of small-intestinal enteroen-
0.001) and PA (3.4 ± 1.1 vs 5.0 ± 1.2; p < 0.001) were lower in docrine cells in obese patients with type 2 diabetes. Diab. 2015; 58
70/180 patients with a mortality risk of ≥5%. SCT had a (10):2254–8.
sensitivity of 68.8%, a specificity of 50.0%, a positive predictive
value of 50.5% and a negative predictive value of 74.1% in the
detection of increased mortality risk. PA <5th percentile had a
sensitivity of 87.1%, a specificity of 50.0%, a positive predictive OR30
value of 52.6% and a negative predictive value of 85.9% in the A HIGHER PROTEIN INTAKE IS NOT ASSOCIATED WITH 5-YEAR
detection of increased mortality risk. ROC characteristics CHANGE IN MID-THIGH MUSCLE CROSS-SECTIONAL AREA BY
showed an AUC of 0.780 for PA <5th percentile and 0.694 for COMPUTED TOMOGRAPHY IN OLDER ADULTS: THE HEALTH,
SCT alone and 0.805 for the combination of PA <5th percentile AGING, AND BODY COMPOSITION (HEALTH ABC) STUDY
with NRS ≥ 3 and 0.742 for the combination of SCTwith NRS ≥ 3. A. M. Verreijen1 *, M. F. Engberink1, D. K. Houston2,
The combination of PA <5th percentile with SCT showed a I. A. Brouwer3, P. M. Cawthon4, A. B. Newman5, F. A. Tylavsky6,
prediction accuracy of >95%. T. B. Harris7, P. J. Weijs1,8, M. Visser3,8. 1Faculty of Sports and
Conclusion: Determination of phase angle <5th percentile is a Nutrition, Amsterdam University of Applied Sciences,
convenient non-invasive bedside method with an acceptable Amsterdam, Netherlands, 2Sticht Center on Aging, Wake Forest
sensitivity and negative predictive value to detect patients at University School of Medicine, Winston-Salem, NC, United
risk of nutrition related mortality. States, 3Department of Health Sciences, Faculty of Earth and
Disclosure of Interest: None declared. Life Sciences, Vrije Universiteit Amsterdam, Amsterdam
Public Health research institute, Amsterdam, Netherlands,
4
California Pacific Medical Center Research Institute,
OR29
San Francisco, CA, 5University of Pittsburgh, Pittsburgh, PA,
REDUCED INTESTINAL FADS1 GENE EXPRESSION AND PLASMA 6
Health Science Center, Preventive Medicine, University of
OMEGA-3 FATTY ACIDS AFTER ROUX-EN-Y GASTRIC BYPASS
Tennessee, Memphis, TN, 7National Institute on Aging,
P. C. G. El-Gohary1 *, P. Calder2, P. C. Sala1, D. L. Waitzberg1. Bethesda, MD, United States, 8Department of Nutrition and
1
Gastroenterology, University of São Paulo, São Paulo, Brazil, Dietetics, Internal Medicine, VU University Medical Center,
2
Nutritional Immunology, University of Southampton, Amsterdam, Netherlands
Southampton, United Kingdom
Rationale: A higher protein intake is suggested to preserve
Rationale: Roux-en-Y gastric bypass (RYGB) is an effective muscle mass during aging, and may therefore reduce the risk
method to treat severe obesity, enabling weight loss and for sarcopenia. We explored whether the amount, type
reversing type 2 diabetes mellitus (T2DM). Anatomical changes (animal/vegetable) and essential amino acid (EAA) compos-
induced by RYGB may alter the expression of gastrointestinal ition of protein intake were associated with 5-year change in
genes involved in the resolution of metabolic disorders. Aside mid-thigh muscle cross-sectional area (CSA) in older adults.
from limiting food intake, the anatomical changes may reduce Methods: Protein intake was assessed at year 2 by a Block food-
absorption of omega-3 which may lead to deficiency in the frequency questionnaire in 2,597 participants of the Health ABC
postoperative patient (1). Aim: To investigate the gastrointes- study, aged 70–79 y. At year 1 and year 6 mid-thigh muscle CSA
tinal expression of genes involved in lipid metabolism, plasma (cm2) was measured by computed tomography. Multiple linear
total lipids, and omega-3 in obese women with T2DM pre and regression analysis was used to examine the association between
post RYGB. energy adjusted protein residuals (total, animal and vegetable
Methods: Gastrointestinal biopsies were collected through protein) and muscle CSA at year 6, adjusted for muscle CSA at
double-balloon endoscopy in 20 obese women (age, 46.9 ± 6.2 year 1 and potential confounders including prevalent health
yr; BMI, 46.5 ± 5.3 kg/m2) before, 3 and 12 months after RYGB. conditions, physical activity and 5-year change in fat mass. EAA
Gastrointestinal gene microarray analysis was performed on all intake was expressed as percentage of total protein intake.
biopsy samples and validated by RT-qPCR and protein expres- Results: Mean protein intake was 0.90 (SD 0.36) g/kg/d and
sion by mass spectrometry. Plasma samples were collected to mean 5-year change in muscle CSA was −9.8 (17.0) cm2
assess fatty acids by gas chromatography. (n = 1,561). No association was observed between energy
Results: FADS1 gene expression, a component of the metabolic adjusted total (β = −0.00 cm2; SE = 0.03; P = 0.98), animal
pathway that catalyzes biosynthesis of PUFAs, was significantly (β = −0.00 cm2; SE = 0.03; P = 0.92), and plant (β = +0.07 cm2;
reduced in duodenum (−0.479 fold change, p < 0.05), jejunum SE = 0.07; P = 0.291) protein intake and muscle CSA at year 6,
(−0.116 fold change, p < 0.05) and ileum (−0.358 fold change, adjusted for baseline mid-thigh muscle area and potential
p < 0.05) in obese women who underwent T2DM resolution confounders. No associations were observed for the EAAs.
following RYGB. Plasma total lipids and omega-3 α-linolenic Conclusion: A higher total, animal or vegetable protein intake
(ALA), eicosapentaenoic (EPA) were reduced 3 months and 1 was not associated with 5 year change in mid-thigh cross-
year after RYGB ( p < 0.001) compared with the pre-operative sectional area in older adults. This conclusion contradicts
period.
ESPEN Best Abstracts 2017 & ESPEN Travel Awards S13
some, but not all previous research, therefore optimal protein Bologna, Bologna, Italy, 5Gastroenterology, Aalborg University
intake for older adults is currently not known. Hospital, Aalborg, Denmark, 6Gastroenterology, University
Disclosure of Interest: None declared. College London Hospital, London, United Kingdom
Rationale: Both taurolidine 2% and saline 0.9% solution are

OR31 used as catheter lock solutions (CLS) to prevent catheter-
SHORT AND LONG TERM EFFECT OF ENDOSCOPIC DUODENAL related bloodstream infections (CRBSI) in patients on home
SLEEVE FOR THE TREATMENT OF DIABETES AND OBESITY parenteral nutrition (HPN). The optimal agent however,
T. Engel1 *, G. Segal-Lieberman2, R. Eliakim1, M. Lahav1, remains unclear. We hypothesized that taurolidine 2% locking,
A. Lang1. 1Gastroenterolgy, 2Endocrinology, Chaim Sheba when compared with saline 0.9% locking, decreases the risk for
Medical Center, Sackler School of Medicine, Tel-Aviv University, CRBSI in HPN patients.
Ramat Gan, Israel Methods: This multicenter, parallel-group, double blinded trial
randomly assigned HPN patients to use either the CLS
Rationale: To evaluate the short and long term effect of taurolidine 2% or saline 0.9% for one year. Primary outcome
EndoBarrier, an endoscopically-delivered sleeve anchored in was the number of CRBSI/1,000 catheter days.
the duodenum, for the treatment of diabetes and obesity in Results: Of 105 randomized patients, 102 were enrolled as
patients with uncontrolled diabetes. modified intention-to-treat population. With taurolidine, 5
Methods: Open-label, two phase trial, 1 year with the CRBSI occurred during 15,318 catheter days. In the saline arm
implanted sleeve and one year of follow up without it. 18 CRBSI occurred over 12,493 catheter days. CRBSI/1,000
Patients with BMI over 30 and HbA1C ≥ 8 were included. catheter days were 0.33 and 1.44 in the taurolidine and saline
Clinical assessment and blood test were performed monthly. groups, respectively (relative risk, 0.23; 95%CI, 0.07 to 0.63;
We report the final results after 104 weeks follow up P = 0.002). The cumulative proportion of CRBSI-free patients
Results: 45 patients underwent sleeve implantation. Early after one year was 88% in the taurolidine group and 49% in the
sleeve retrieval was performed in 12 patients, out of them 8 saline group (P = 0.002). The number of catheter removals due
were before 6 month follow up. Reasons for early retrieval to CRBSI was two (4%) in the taurolidine group and eight (16%)
were: abdominal pain (n = 7), occlusion or migration (n = 3), in the saline arm (P = 0.049). The cumulative proportion of
bleeding (n = 1), Liver abscess (n = 1). Thirty-tree patients patients without a catheter removal due to CRBSI was higher in
completed 1 year of follow up with the implanted sleeve and 22 the taurolidine group (P = 0.025). Exit-site infection and
completed the year after sleeve explant follow up. At 56 catheter occlusion rates were similar in both groups. Except
weeks, the average BMI decreased from 37.7(±4.6) at baseline for occurrence of CRBSI (P = 0.002), there was no difference in
to 32.8 (Sd ± 5.07) the average EWL was 32.6% (±2.9), the (serious) adverse events between groups. Drug-related adverse
average weight loss was 13.04 Kg (±1.1). The average HbA1C events were rare and generally mild to moderate.
decreased from 9.4(±1.2) at baseline to 6.8 gr/dl (±1.04). Conclusion: Taurolidine 2% decreased the risk for CRBSI by
Average Insulin units requirement dropped by 54% to 34.1 units more than four times in HPN patients compared to saline 0.9%.
(±6.2) and average FPG decreased by 33.7% to 128.1 mg/dl Given its favorable safety profile and lack of evidence for
(±35.05) indicated improvement in glucose control. At 104 altering microbial susceptibility, taurolidine locking therefore
weeks (n = 22), the average BMI, EWL and weight loss was 35.6 seems a key strategy to prevent CRBSI.
(±4.6), 14.27%(±3.8%), 6.3 kg (±1.6) respectively. Average
Disclosure of Interest: Y. Wouters Grant/Research Support from:
HbA1C was 8.4 gr/dl (±1.4) and average insulin units was 47 U
Financial support for study from Geistlich Pharma AG, M. Theilla Grant/
(±4.8) a 24.2% decrease compare to baseline. Average FPG was Research Support from: Financial support for study from Geistlich
157.8 (±12.6), a 17.1% decrease compare to baseline. Pharma AG, P. Singer Grant/Research Support from: Financial support
Conclusion: Endobarrier is an effective short term treatment for study from Geistlich Pharma AG, S. Tribler Grant/Research Support
for weight loss and glucose control in obese patient with from: Financial support for study from Geistlich Pharma AG, P. Jeppesen
uncontrolled diabetes. The effect is still apparent 1 year post Grant/Research Support from: Financial support for study from
retrieval but wanes with time. Geistlich Pharma AG, L. Pironi Grant/ Research Support from: Baxter,
B. Braun, NPS/Nycomed and Shire. Financial support for study from
Geistlich Pharma AG, Consultant for: Baxter, B. Braun, NPS/Nycomed
and Shire, L. Vinter-Jensen Grant/Research Support from: Financial
OR32 support for study from Geistlich Pharma AG, H. Rasmussen Grant/
TAUROLIDINE LOCKING PREVENTS CATHETER-RELATED Research Support from: Financial support for study from Geistlich
BLOODSTREAM INFECTIONS IN PATIENTS ON HOME Pharma AG, F. Rahman Grant/Research Support from: Financial support
PARENTERAL NUTRITION – A RANDOMIZED CONTROLLED for study from Geistlich Pharma AG, G. Wanten Grant/Research Support
TRIAL from: Baxter, B. Braun, and Fresenius. Financial support for study from
Geistlich Pharma AG, Consultant for: Baxter, B. Braun, and Fresenius.
Y. Wouters1 *, M. Theilla2, P. Singer2, S. Tribler3, P. Jeppesen3,
L. Pironi4, L. Vinter-Jensen5, H. Rasmussen5, F. Rahman6,
G. Wanten1. 1Gastroenterology and Hepatology, Radboudumc,
Nijmegen, Netherlands, 2General Intensive Care, Beilinson
Hospital, Petah Tikva, Israel, 3Medical Gastroenterology,
Copenhagen University Hospital Rigshospitalet, Copenhagen,
Denmark, 4Medical and Surgical Science, University of
Oral Communication IV: Nutrition in the involvement of cholecystokinin receptors on the protective
effects of high-fat EN on intestinal mucosal barrier function
Surgical Patient after peritoneal air exposure.
OR33 Methods: Male adult rats underwent peritoneal air exposure for
RANDOMIZED CONTROLLED TRIAL OF AN ENHANCED 3 hours. High-fat EN was administrated via gavage before and
RECOVERY AFTER SURGERY PROTOCOL IN PATIENTS after surgery, and antagonists to cholecystokinin receptors
UNDERGOING PANCREATICODUODENECTOMY were administrated intraperitoneally before surgery but after
preoperative high-fat EN administration. Twenty four hours
K. Takagi1 *, R. Yoshida1, T. Yagi1, Y. Umeda1, D. Nobuoka1,
after surgery, blood and intestinal samples were collected to
T. Kuise1, T. Fujiwara1. 1Department of Gastroenterological
assess intestinal inflammation status by analyzing intestinal
Surgery, Okayama University Graduate School of Medicine,
levels of tumor necrosis factor-α, interleukin (IL)-1β, and IL-6,
Okayama, Japan
and to assess intestinal mucosal barrier changes in serum D-
Rationale: Evidence of the advantages of Enhanced Recovery lactate levels, intestinal permeability, and intestinal
After Surgery (ERAS) in pancreaticoduodenectomy (PD) is histopathology.
limited. The aim of this study was to examine the efficiency Results: High-fat EN significantly reduced peritoneal air
of ERAS protocols in patients following PD. exposure induced intestinal inflammatory response, and pre-
Methods: Between June 2014 and October 2016, patients servered intestinal mucosal barrier function when compared to
undergoing PD were randomly assigned to receive ERAS the control group (P < 0.05). However, administration of
protocols (ERAS group, n = 40) or standard care (control antagonists to cholecystokinin receptors significantly pre-
group, n = 40). The primary endpoint was the postoperative vented high-fat EN’s anti-inflammatory activity and further
length of hospital stay. Secondary endpoints were post- offseted its protective effects on the intestinal mucosal barrier
operative complications, postoperative quality-of-life (QoR- function (P < 0.05).
40J), readmission, and medical cost. Analysis was performed by Conclusion: High-fat EN could protect against intestinal
intention-to-treat principles. mucosal barrier damage induced by peritoneal air exposure,
Results: Among 80 patients who were randomized, 74 (92.5%) and the underlying mechanism may be associated with the
completed the study. The mean hospital stay was significantly activation of cholecystokinin receptors mediated vagal anti-
shorter in the ERAS group than in the control group (20.1 ± 5.4 inflammatory pathway.
vs. 26.9 ± 13.5 days, P < 0.001). The ERAS group had a Disclosure of Interest: None declared.
significantly lower overall morbidity (P = 0.038) and readmis-
sion (P = 0.038). Quality-of-life was also significantly better in OR35
the ERAS group (P = 0.022). The total medical cost was IMPACT OF EARLY ENTERAL NUTRITION WITH AN
decreased in the ERAS group, but not significantly (P = 0.085). IMMUNOMODULATING DIET ENRICHED WITH HYDROLYZED
Conclusion: This randomized controlled trial showed that WHEY PEPTIDE ON OUTCOMES AFTER LIVER
optimization of ERAS protocols in patients undergoing PD was as TRANSPLANTATION
safe as standard care, and ERAS accelerated perioperative N. Kamo1 *, T. Kaido1, Y. Hamaguchi1, A. Kobayashi1, H. Shirai1,
recovery, thereby reducing hospital stay. Mortality, morbidity, S. Yagi1, H. Okajima1, Y. Tamai2, S. Uemoto1. 1Division of
and medical costs were not increased. General implementation Hepato-Biliary-Pancreatic and Transplant Surgery,
of ERAS protocols during PD should be considered. 2
Department of Metabolism and Clinical Nutrition, Kyoto
Disclosure of Interest: None declared. University, Kyoto, Japan
OR34 Rationale: Infection is the leading cause of death after liver

HIGH-FAT ENTERAL NUTRITION ACTIVATES CHOLECYSTOKININ transplantation (LT). Therefore, prevention of infection is
RECEPTORS TO PRESERVE INTESTINAL MUCOSAL BARRIER crucial to improve outcomes after LT. In the present study, we
FUNCTION AFTER PERITONEAL AIR EXPOSURE examined the impact of early enteral nutrition with an
immunomodulating diet (IMD) enriched with hydrolyzed whey
S. Tan1 *, G. Wu1, Q. Xi1, Q. Zhuang1, Q. Meng1, Y. Jiang1,
peptide (HWP) on outcomes in patients undergoing living donor
Y. Han1, C. Yu2, Z. Yu3, N. Li4. 1Department of Surgery,
LT (LDLT) especially focusing on postoperative infection and
Zhongshan Hospital, Fudan University, 2Department of
sarcopenia.
Nephrology & Rheumatology, Shanghai Tenth People’s
Methods: Two hundred and seventy-nine patients who under-
Hospital, Tongji University School of Medicine, 3Department of
went LDLTat our institute between January 2008 and April 2015
General Surgery, Shanghai Tenth People’s Hospital, Tongji
were enrolled. The IMD enriched with HWP and conventional
University School of Medicine, Shanghai, 4Research Institute of
elemental diet were administered enterally to 164 (HWP group)
General Surgery, Jinling Hospital, Medical School of Nanjing
and 115 (control group) patients respectively within the first
University, Nanjing, China
24 h after surgery. Incidence of rejection and bacteremia were
Rationale: Previous studies have shown that high-fat enteral compared between the two groups in all patients and according
nutrition (EN) could reduce intestinal mucosal barrier damage to sarcopenia (low muscle mass). Moreover, risk factors for
after peritoneal air exposure. However, the mechanism is still posttransplant bacteremia were examined.
unknown. It is suggested that high-fat EN administration could Results: The incidence of rejection did not differ between the
activate cholecystokinin receptors mediated vagal anti-inflam- 2 groups. The incidence of bacteremia was significantly lower
matory pathway and further protect against intestinal com- in HWP group (24.4%) than in the control group (41.7%)
promise in critical illness. This study was to investigate the (P = 0.002) in all patients, and higher in the sarcopenia group
Oral Communication IV: Nutrition in the Surgical Patient S15
than in the non-sarcopenia group. Absence of enteral nutrition OR37

with HWP, MELD score (≥25), ABO incompatibility, massive NURSE-INITIATED POSTOPERATIVE ENTERAL NUTRITIONAL
bleeding (≥10,000), and steroid administration were independ- INTERVENTION FOR PATIENTS UNDERGOING
ent risk factors for bacteremia. GASTROINTESTINAL OPERATIONS: A PROSPECTIVE
Conclusion: Postoperative early enteral nutrition with an IMD CONTROLLED STUDY
enriched with HWP was useful to prevent posttransplant J. W. Ho1 *, T. P. Cheng1, D. Y. Fong2, A. H. Wu3, M. W. K. Lee1,
bacteremia. C. Au-Yeung1, W. S. Kan3, C. K. Chan1, S. S. Kwok3, C. F. Lam1,
Disclosure of Interest: None declared. S. Y. Lau3, S. O. Lee1, W. S. Lau3, W. S. Leung1, L. K. Leung3,
C. K. Tam1, O. Y. Tsui3, K. Y. Wong3. 1Department of Surgery,
OR36 QUEEN MARY HOSPITAL, 2School of Nursing, The University of
INFLUENCE OF SHORT-TERM FASTING AND CARBOHYDRATE Hong Kong, 3Department of Surgery, United Christian Hospital,
ADMINISTRATION ON GUT IMMUNITY AND MUCOSAL Hong Kong, Hong Kong
MORPHOLOGY IN MICE
Rationale: Malnutrition adversely affects outcomes of GI
K. Higashizono1 *, K. Fukatsu2, A. Watkins2, M. Noguchi2, operations. Integration of enteral nutrition (EN) supplementa-
T. Watanabe2, S. Murakoshi2, H. Yasuhara2, Y. Seto1. tion into postoperative nursing care may optimize nutritional
1
Department of Gastrointestinal Surgery, Graduate School of intakes and surgical outcomes. This study assessed the
Medicine, The University of Tokyo, 2Surgical Center, The feasibility and safety of this proposed nursing intervention.
University of Tokyo Hospital, Tokyo-to, Japan Methods: Chinese adult patients undergoing GI operations
were recruited during two 9-month periods (observation and
Rationale: Carbohydrate (CHO) administration prior to surgery intervention periods) before and after education program for
is recommended in the ERAS® guideline. However, its effects on nurses in surgical wards of two acute hospitals in Hong Kong.
gut immunity remains unclear. We examined the effects of Preoperative malnutrition risk was assessed by C-MUST. During
short-term fasting and CHO administration on gut associated the intervention period, patients were given EN supplement to
lymphoid tissue (GALT) lymphocyte numbers and phenotypes, take ad libitum by nurses once oral intake were allowed.
mucosal immunoglobulin A (IgA) levels, and intestinal morph- Postoperative estimated nutritional requirement and actual
ology in mice. intakes were assessed daily.
Methods: ICR mice (n = 60) were divided into 5 groups: control Results: 578 patients (321 controls, 257 cases; 63% male; mean
(C), 12 h fasting without CHO (F), and 12 h fasting with CHO age 67.8+/−12.7 years) underwent GI resections (79% elective
administration at 2 h, 4 h, or 8 h before sacrifice(2 h, 4 h or 8 h). procedures) were recruited. According to C-MUST, 31.7% were
Then, lymphocytes were isolated from Peyer’s patches (PPLs), at high-to-moderate risk of malnutrition. The median daily
the intraepithelial spaces (IELs), and the lamina propria (LPLs) volume and total duration of EN supplement intakes by cases
of the small intestine. GALT lymphocyte numbers and pheno- were 116.7 ml (IQR 203.7 ml) and 2 days (IQR 4 days),
types (αβTCR+, γδTCR+, CD4+, CD8+, B220+) were evaluated. respectively. When compared with control group, intervention
IgA levels in respiratory and small intestinal washings were group had significantly lesser extent and shorter duration of
determined with ELISA. Morphology, proliferation and apoptosis postoperative caloric and protein deficiency before and after
of the intestinal epithelium were also evaluated. control of potential confounders (all p values ≤0.001). Nurses
Results: Data are shown below were compliant in prescribing EN supplement to eligible
patients (compliance rate >85%). No patient had aspiration
C F 2h 4h 8h pneumonia; 11 patients (4.2%) developed diarrhea after EN
6
PPLs(×10 /body) 11.8 ± 0.9 10.1 ± 0.5 10.6 ± 0.8 10.6 ± 0.9 9.7 ± 0.9 supplement and 1 patient died from unrelated causes.
IELs (×106/body) 12.0 ± 1.9 5.4 ± 0.9* 10.4 ± 1.8 6.4 ± 1.6* 7.3 ± 1.6* Conclusion: Nurse-initiated postoperative EN supplementation
LPLs (×106/body) 6.9 ± 1.3 3.3 ± 0.6* 5.8 ± 1.4 6.4 ± 1.0 4.2 ± 0.9* is feasible and safe for patients after GI resection. The reduced
Jejunal villous 499.1 ± 429.7 ± 463.4 ± 430.9 ± 424.3 ±
height (μm) 13.2 16.3* 17.0 22.8* 18.4* extent and duration of postoperative nutritional deficiency
Ileal villous 256.5 ± 9.5 230.7 ± 7.8 232.1 ±11.9 223.2 ± 6.3 241.5 ± 6.5 have the potential to improve surgical outcomes.
height (μm)
Jejunal crypt 112.4 ± 4.8 96 ± 7.7* 108.6 ± 4.7 98.6 ± 5.5* 94.2 ± 4.5*
depth (μm)
Ileal crypt depth 99.5 ± 4.0 87.2 ± 4.3* 86.7 ± 3.9* 83.3 ± 3.1* 83.3 ± 3.7* OR38
(µm)
Jejunal cell 14.1 ± 0.8 9.0 ± 0.4* 13.0 ± 0.3 9.6 ± 0.5* 9.1 ± 0.4* DOES EARLY TOTAL PARENTERAL NUTRITION IMPROVE
proliferation (%) POST-OPERATIVE OUTCOME FOR INTESTINAL
Jejunal cell 1.0 ± 0.1 2.1 ± 0.4* 2.0 ± 0.2* 2.5 ± 0.3* 2.3 ± 0.2* OBSTRUCTION? – A RANDOMIZED CONTROLLED TRIAL
apoptosis (%)
V. Wong1 *, M. Y. Yung1, L. Chan1, J. Lee1, K. F. Lee1, P. Chiu1,
Mean ± SE, *P < 0.05 vs. C, ANOVA. S. Wong1, E. Ng1. 1Department of Surgery, The Chinese
University of Hong Kong, Hong Kong, Hong Kong
No significant differences in phenotypic percentages were
observed among these groups. Intestinal IgA levels tended to be Rationale: Patients suffering from intestinal obstruction also
lower in the F than in the other groups. suffers from malnutrition due to intolerance to oral intake,
Conclusion: Fasting causes rapid immunological and morpho- potentially affecting surgical outcome. This study aims to
logical atrophy in the gut. However, CHO at 2 h reverses determine whether early administration of total parenteral
partially these changes. nutrition (TPN) in patients that have received laparotomy for
intestinal obstruction would decrease post-operative twelve months after BS correlated inversely with initial excess
complications. weight (r = −0.714, p = 0.047 and r = −0.681, p = 0.014,
Methods: Single-center randomized controlled trial studying respectively). Logistic regression analysis showed that the
patients or age 18 and above who received emergency predictors of PEWat 12 months post BS were patient’s age and %
laparotomy for intestinal obstruction of all causes. Patients PEW at one month.
who received surgery for intestinal obstruction were rando- Conclusion: REE in patients with EO after BS was reduced by
mized post-operatively to either the ‘TPN group’ (receiving 33% at one month in the studied patients and, despite weight
TPN right after operation) or the control ‘IVF group’ (receiving loss, this reduction remained without significant changes
plain intravenous fluids only until 7 days of fasting). Patients during the 12-months study period. Baseline REE is not a
with carcinomatosis, or metastatic disease and KPS less than 50 predictor of weight loss at one year after BS.
were excluded. Subjects’ baseline data, post-operative blood Disclosure of Interest: None declared.
test results, recovery and complication details were recorded.
Data were analysed by intention-to-treat, using the SPSS
OR40
software.
REDUCED DUODENAL BCO1 AND RBP4 GENE EXPRESSION
Results: From October 2013 to January 2017, 100 patients
AFTER ROUX-EN-Y GASTRIC BYPASS SUGGESTS A POTENTIAL
(mean age 64.54 ± 15.32, 62 males) were randomized. These
MECHANISM CONTRIBUTING FOR POSTOPERATIVE VITAMIN A
patients are similar at baseline demographic data and pre-
DEFICIENCY
operative nutritional screening. There is no significant differ-
ence in terms of recovery, surgical complications, medical P. Sala1, P. Garla1 *, R. S. M. M. Torrinhas1, N. M. Machado1,
complications, or catheter-related complications. Biochemical D. C. Fonseca1, G. Belarmino1, M. M. Silva1, S. Barcelos1,
data showed that patients in TPN group had a significantly D. Seiva1, R. Ishida1, I. F. M. S. Guarda1, E. G. H. Moura1,
higher ALP and triglyceride at post-operative days 4 and 7, but P. Sakai1, M. A. Santo1, C. C. A. Pereira2, I. D. C. G. Silva2,
results still lie within the normal range and pose no clinical S. B. Heymsfield3, D. Giannella Neto4, D. L. Waitzberg1.
1
significance. University of São Paulo - Medical School, 2UNIFESP, São Paulo,
Conclusion: Immediate post-operative use of total parenteral Brazil, 3Pennington Biomedical Research Center, Baton Rouge,
nutrition in patients suffering from intestinal obstruction that United States, 4University Nove de Julho, São Paulo, Brazil
requires emergency surgery does not decrease post-operative
Rationale: Roux-en-Y gastric bypass (RYGB) remains an
complication rate, compared with its use after 7 days of fasting.
important treatment option for obese patients. The one year
Disclosure of Interest: None declared. prevalence of vitamin A deficiency after RYGB is about 11%. The
absorption of vitamin A occurs mainly in duodenum. The
OR39 protein encoded by the beta-carotene oxygenase 1 (BCO1)
CHANGES IN RESTING ENERGY EXPENDITURE IN PATIENTS gene is a key enzyme in the conversion of beta-carotene to
WITH EXTREME OBESITY AFTER BARIATRIC SURGERY vitamin A. RBP4 encode a specific carrier for vitamin A,
M. Giribes1, G. Cárdenas2 *, E. Fidilio1, M. Guerrero3, responsible for transport vitamin A to the circulation.
M. Velasquez4, A. Ortiz3, D. Romero3, J. Mesa3, A. Ciudin3, Aim: To examine potential mechanisms associated with early
H. Segurola1, R. Burgos1. 1Nutritional Support Unit, vitamin A deficiency after RYGB.
Universitary Hospital Vall d’Hebron, 2Nutritional Support Unit, Methods: Intestinal biopsies were acquired through double-
University Vall d’Hebron Hospital, 3Nutritional Support Unit, balloon endoscopy in 20 obese women (age, 46.9 ± 6.2 yrs; BMI,
4
Nutriotional Support Unit, University Hospital Vall d’Hebron, 46.5 ± 5.3 kg/m2) before and three months after RYGB (BMI,
Barcelona, Spain 38.2 ± 4.2 kg/m2). Gene microarray analysis was performed in
samples using a Affymetrix Human GeneChip 1.0 ST array.
Rationale: Patients with extreme obesity (EO) are very difficult Vitamin A intake was assessed from seven-day food records
to estimate their resting energy expenditure (REE), necessary (7dR) analyzed with Virtual Nutri Plus software. Serum vitamin
for a correct dietary approach. Major metabolic changes occur A levels were evaluated by high performance liquid
after bariatric surgery (BS), some of them even before chromatography.
significant weight loss. The evolution of REE is unknown in Results: BCO1 and RBP4 gene expression were significantly
these patients. To know the changes of REE in patients with EO decreased in duodenum: BCO -0.455 fold change, RBP4 -0.103
by indirect calorimetry (IC) after BS. To evaluate the fold change ( p < 0.05). There was no significant change in
correlation between REE measured by CI and the percentage vitamin A intake (783.6 ± 694.2 RE pre-op vs. 808.6 ± 752.7 RE
of excess weight lost (% PEW) after one and 12 months post BS. post-op period) both higher than the minimum value recom-
Methods: Prospective study in patients with EO. REE was mended by the DRIs (700 RE/day).1 The patients were routinely
determined by IC in 39 patients (SensorMedica Vmax). supplemented with 3.500 UI/day of oral vitamin A. However,
Furthermore, in 12 cases the REE was determined also at one even with vitamin A supplementation, the serum concentration
month and at 12 months post BS. Statistical study SPSS 14.0. was lower in the post-op period ( pre-op 0.523 ± 0.325 mg/L vs.
Results: Mean age 46.5 ± 11.7 years, 25 women. BMI pre BS: post-op 0.348 ± 0.135 mg/L – P < 0.05).
56.2 ± 5.6 kg/m2 and baseline REE: 2,320.4 ± 750.8 kcal/day. Conclusion: After RYGB, the conversion of beta-carotene to
At one month of BS the REE decreased to 1,537.6 ± 117.5 Kcal/ vitamin A and its transporter may be impaired and could
day ( p = 0.023 vs baseline) and remained similar at 12 months contribute to vitamin A deficiency.
(1,526.00 ± 123.3 Kcal/day, p = 0.682). The mean BMI at the FAPESP 2011/09612-3 and Scholarship 2016/19170-1.
first month was 47.7 ± 7.5 kg/m2 and 36.2 ± 5.2 kg/m2 at 12
months with a % PEW per year of 60.38 ± 17.93%. REE at one and
Oral Communication V: Paediatrics S17
Reference Oral Communication V: Paediatrics

1. Dietary Reference Intakes. Washington DC: National Academy Press,
2003. OR42
Disclosure of Interest: None declared. IS THERE ANY EFFECT OF DIETARY GLYCEMIC INDEX AND LOAD
DURING PREGNANCY ON BIRTH WEIGHT OF INFANT IN WOMEN
WITH AND WITHOUT GESTATIONAL DIABETES MELLITUS?
OR41
WEIGHT GAIN AND OBESITY ARE RELATED TO EATING G. Ede1 *, G. Samur1. 1Nutrition and Dietetics, Hacettepe
BEHAVIOR AND FOOD CRAVING AFTER LIVER University, Ankara, Turkey
TRANSPLANTATION
Rationale: Maternal diet during pregnancy, as measured by the
S. C. Ferreira1, L. Anastácio2, F. Penaforte3, A. Cardoso4, glycemic index (GI) and load (GL), may influence fetal growth
M. Silva4, A. Lima5, M. I. Correia5 *. 1Food Science Post- and infant birth weight. Maternal diet with a high GI and GL is
Graduation Program, 2Food Department, Federal University of associated with fetal overgrowth and higher infant body
Minas Gerais, Belo Horizonte, 3Nutrition Department, Federal adiposity. This study aimed to examine the association
University of Triângulo Mineiro, Uberaba, 4Nutrition between birth weight and dietary GI, GL during pregnancy.
Department, 5Surgery Department, Federal University of Methods: This study included 40 women with gestational
Minas Gerais, Belo Horizonte, Brazil diabetes mellitus (GDM) diagnosed with two-step oral glucose
tolerance test and 40 healthy pregnant recruited from the
Rationale: Excessive weight gain (WG) and obesity are frequent
Department of Obstetrics and Gynecology of Gulhane Military
in patients who have undergone liver transplantation (LTx).
Medical Academy. Participants with polycystic ovary syndrome,
Methods of assessing dietary intake failed to demonstrate an
kidney disease, thyroid disease, pre-GDM, or multiple preg-
association between these problems and dietary intake. Eating
nancies were excluded. Dietary information was obtained by
behavior (EB) and food craving (FC) are unknown in these
mean intakes of a 3-day food record on 2 weekdays and 1
patients.
weekend day. Dietary GI and GL were calculated with food
Methods: Cross-sectional study. Post LTx patients and >18 y were
records and International Tables of GI and GLValues: 2008.
evaluated in relation to EB (Three Factor Eating Questionnaire-
Results: The mean maternal age was 32.1 ± 4.9 vs. 28.7 ± 4.9
21-TFEQ-21) and FC (Food Cravings Questionnaire (FCQ)-State
years in cases and controls, respectively. Average dietary GI
e Trait). Punctuation of TFEQ-21 for main EB [emotional eating
(80.2 ± 9.9 vs. 62.3 ± 9.7, p < 0.05) and GL (253.8 ± 8 versus
(EE), uncontrolled eating (UE) and cognitive restraint (CR)]
145.0 ± 34.59, p < 0.05) were higher in the case group than in
was determined. WG was assessed by the difference between
the control group. There was a strong positive correlation
the current weight and the first post-LTx outpatient weight.
between birth weight and dietary GI (r = 0.72, p < 0.05). Mean
Obesity was classified as a BMI ≥ 30 kg/m2. The data were
infant birth weight (g) was 3,448 ± 369.5 vs. 3,624 ± 443.1 in
evaluated using SPSS 17.0. Correlation between post-LTx WG,
low and high GI group ( p < 0.05), respectively. Mean infant birth
the different EB and FC was assessed using the Pearson or
weight (g) was higher in high GL group than in low GL group
Spearman tests. The association between EB, FC and obesity
(3,568 ± 491.2 vs. 3,411 ± 144.6, p < 0.05, respectively).
were assessed using Student’s t test or Mann-Whitney test. The
Conclusion: In this study, we found a significant positive
level of significance was 5%.
relation between dietary GI, GL and infant birth weight.
Results: A total of 301 patients (age of 55.1 ± 12.7 y, time since
Healthy nutritional habits and medical nutritional therapy are
LTx 6.6 ± 4.4 y, 64.1% men) who had as the most frequent
feasible for preventing and management of complications
indications for LTx ethanolic (29.2%) and hepatitis C virus
related to increased birth weight.
cirrhosis (26.2%) were assessed. The observed WG was
8.1 ± 9.7 kg and the mean BMI was 26.2 ± 5.1 kg/m2. EB and FC Disclosure of Interest: None declared.
in relation to obesity and WG after LTx are depicted in Table 1.
OR43
Table 1: Eating behavior and food craving in relation to obesity and weight gain
after LTx.
STEROID TREATMENT, CRANIAL IRRADIATION AND RISK OF
OVERWEIGHT AFTER CHILDHOOD CANCER
All Obesity Weight
Gain F. N. Belle1,2 *, R. Kasteler1, C. Schindera1, M. Bochud2,
No (n = 256) Yes (n = 45) R. A. Ammann3, N. von der Weid4, C. E. Kuehni1,5. 1Swiss
EB EU 19.4 ± 17.6 5.0(0–100) 25.0(0–70)** R = 0.297** Childhood Cancer Registry, Institute of Social and Preventive
CR 53.5 ± 27.5 52.3 ± 28.1 60.7 ± 23.0* R = 0.045 Medicine, University of Bern, Bern, 2Division of Chronic
EE 16.2 ± 22.0 14.0(0–85) 16.0(0–100)** R = 0.277**
FC FCQ-Trait 73.5 ± 25.1 68.0(39–163) 72.0 (39–128) R = 0.137*
Diseases, Institute of Social and Preventive Medicine,
FCQ-Stait 33.6 ± 9.0 33.7 ± 9.0 33.0 ± 9.3 R = 0.061 Lausanne University Hospital, Lausanne, 3Department of
Paediatrics, Inselspital, Bern University Hospital, University of
*p < 0.05;**p < 0.01. Bern, Bern, 4University Children’s Hospital Basel (UKBB),
Conclusion: Post-LTx WG was related to behavioral patterns of Basel, 5Children’s University Hospital of Bern, University of
UE, EE and FCQ-trait. Individuals with obesity had higher scores Bern, Bern, Switzerland
of all EB than the others.
Rationale: Childhood cancer survivors (CCS) treated with
Disclosure of Interest: None declared. cranial radiation therapy (CRT) have an increased risk to
become overweight, but less is known about other treatment
effects like steroids. This study investigated the association
between treatment with steroids and CRT and development of significantly longer than in older patients ( p < 0.05). The
overweight in a national cohort study of long-term CCS. median iron and ferritin concentration was very low in the
Methods: As part of the Swiss Childhood Cancer Survivor Study, whole group of patients – 41 µg/dl (range 18–147) and 19,2 ng/
we sent a questionnaire to all Swiss resident CCS diagnosed ml (range 3–253) respectively. Iron and ferritin concentration
1976–2005 aged <21 yrs at diagnosis who had survived ≥5 yrs. was significantly correlated with MCV, MCH, RBC and TIBC
We assessed CRT (≥20 Gray) and cumulative doses of steroids especially in group of the youngest children(<2 y.o. – p < 0,05).
( prednisone and dexamethasone) from study protocols and In group of patients who recived oral iron supplementation we
medical records and calculated BMI from self-reported heights did not observe an improvement of anemia and iron status but
and weights at the time of the survey. We compared prevalence the doses of iron administered were low (median 1,9 mg/kg/d).
of overweight between CCS, their siblings, and participants Conclusion: Iron deficiency anemia is common in children on
from the Swiss Health Survey (SHS), a representative survey of long term parenteral nutrition, especially in those who are
the general population. The association of overweight with older than 24 months. The supplementation of iron with low
treatment-related risk factors was explored by ordinal multi- doses of oral formulations is not efficient in these patients.
variable logistic regression. Disclosure of Interest: None declared.
Results: The study included 2,365 CCS, 819 siblings, and 9,591
SHS participants. Mean (sd) age at survey was 24 (9), 26 (9), and
OR45
31 (9) yrs. At survey, in average 15 yrs after diagnosis (IQR 10–
DOES FOOD INSULIN INDEX IN THE CONTEXT OF MIXED MEALS
21), 22% of siblings and 25% of the SHS participants were
AFFECT METABOLIC PARAMETERS IN OBESE ADOLESCENTS?
overweight, and 23% of CCS treated with no CRT or steroids
(n = 1,068), and 25% with steroids only (n = 801). Prevalence of Z. Caferoglu1 *, N. Hatipoglu2, H. Gokmen Ozel3. 1Department
overweight was higher in CCS treated with CRT (34%, n = 141), of Nutrition and Dietetics, Erciyes University Faculty of Health
or CRT plus steroids (47%, n = 102), p < 0.001. After age and Science, 2Department of Pediatric Endocrinology, Erciyes
gender adjustment, overweight was not associated with University Faculty of Medicine, Kayseri, 3Department of
steroids only (OR = 1.1, 95% 0.9; 1.4, 4,963 ± 4,340 mg/m2), Nutrition and Dietetics, Hacettepe University Faculty of
but with CRT only (1.8, 1.2; 2.6), and both steroids and CRT Health Science, Ankara, Turkey
(2.2, 1.4; 3.3, 6,382 ± 5,043 mg/m2), compared to those CCS
Rationale: The food insulin index (FII) is a more accurate
who did not get steroids and CRT.
predictor of postprandial insulin responses to composite meals
Conclusion: Long-term CCS treated with CRT only, or CRT plus
than carbohydrate content in both healthy and obese subjects.
steroids were at increased risk of being overweight 15 yrs after
This study aimed to compare the postprandial glucose, insulin
diagnosis compared to peers.
and c-peptide responses to two nutrient-matched meals either
Disclosure of Interest: None declared. high or low FII in obese adolescents with insulin resistance (IR).
Methods: A randomized crossover trial included 15 obese
OR44 adolescents aged 12–18 years (median = 15 years) with IR. All
IRON DEFICIENCY ANEMIA IN CHILDREN IN HOME PARENTERAL participants were submitted two different breakfasts: low
NUTRITION PROGRAMME glycemic index, low insulin index (LGI-LII) and low glycemic
A. Zyla-Pawlak1 *, M. Danko2, K. Popińska1, M. Sibilska1, index, high insulin index (LGI-HII), with a 1-week washout
K. Olszewska1, J. Żydak1, J. Książyk1. 1The Children’s Memorial period between meals. The two meals were matched for
Health Institute, Warsaw, 2The Children’s Memorial Health energy, macronutrients and GI but had a 2-fold difference in II.
Institute, Warszawa, Poland At time 0 ( just before breakfast), 15, 30, 45, 60, 90, 120, 180
and 240 minutes after the meal, serum glucose, insulin and c-
Rationale: The intravenous trace elements formulations peptide levels were measured. Postprandial responses were
available for children in Poland are Peditrace(Fresenius- quantified as area under the curve, which was calculated
Kabi®) which does not contain iron and Addamel(Fresenius- according to the trapezoidal rule. Student’s 2-tailed t test for
Kabi®) which contains 2 µg Fe/ml but is registered for children paired data was applied to determine statistical differences
with body weight >15 kg. between the meals.
The aim of the study was to assess iron deficiency anemia in Results: Early (0–30 min) postprandial glucose and C-peptide
children on long-term parenteral nutrition. responses were found similar after LGI-LII and LGI-HII meals
Methods: 24 children (age 5–168 months, median 34 months) on ( p > 0.05). Similarly, there was not a difference between LGI-LII
long-term parenteral nutrition were included into the study. 16 and LGI-HII meals in late (45–240 min) and total (0–240 min)
patients were additionally supplemented with oral iron postprandial glucose and C-peptide responses. However, early
formulation. All patients received Peditrace as an intravenous postprandial insulin response was lower by 40.1% after LGI-LII
trace elements formulation. Laboratory parameters of RBC, meal vs LGI-HII meal ( p = 0.003). Also, late and total
haemoglobin, ferritin and iron concentration, MCV, MCH, MCHC postprandial insulin responses were lower by 23.9% and 25.1%
and TIBC, were analyzed using Mann-Whitney test and after LGI-LII meal vs LGI-HII meal ( p = 0.007 and p = 0.008,
Spearman correlation. respectively).
Results: The prevalence of anemia in the whole group was Conclusion: The calculating FII of meals or diets may be a
41,6%(10 out of 24) and was the highest in the group of children useful approach for reducing postprandial hyperinsulinemia in
older than 2 years– 61,5%(8 out of 13). Only 2(18%) children out obese adolescents, thereby potentially improving IR and
of 11 below the age of two had haemoglobin concentration preventing from type 2 diabetes.
lower than normal for the age. In children <2 y.o. with short Disclosure of Interest: None declared.
bowel syndrome the length of remnant small intestine was
Oral Communication V: Paediatrics S19
OR46 to define and document cerebral changes and abnormalities in

ESPEN SURVEY ON CHRONIC INTESTINAL FAILURE (CIF) IN a sample of infants with kwashiorkor using brain imaging.
CHILDREN Methods: Prospective cohort study included 20 infants had
L. Pironi1 *, on behalf of Home Artificial Nutrition & Chronic admitted to the children hospital Ain Shams University, Cairo,
Intestinal Failure Special Interest Group of ESPEN. 1University Egypt for the treatment of Kwashiorkor aged 4–18 months
of Bologna, Bologna, Italy compared to 5 normal weight matched age infants as a control.
Clinical assessment, laboratory investigation, brain computed
Rationale: To investigate the current clinical feature of CIF and tomography and 99m-HMPAO brain SPECT was done for all
HPN management in children (age < 18 yr), a cross sectional infants twice; first on admission and repeated after 10–12
international multicenter study was carried out using the weeks of nutritional rehabilitation.
structured database devised for the ESPEN ‘CIF Action Day’. Results: Most infants with moderate disease and all infants
Methods: Seventeen pediatric centers from Croatia, Finland, with severe disease showed significant cerebral changes and
France, Israel, Italy, The Netherlands and United Kingdom hypoperfusion in certain areas of the brain, which significantly
enrolled all the patients who were on home parenteral resolved after nutritional rehabilitation in all infants except
nutrition (HPN) for CIF on March 1st 2016. Anagraphic and one with sever disease. A positive correlation was found
anthropometric data, CIF mechanism, underlying disease, HPN between severity of the disease and extent of cerebral
characteristics were recorded. HPN provider was categorized hypoperfusion.
as by health care system local pharmacy (LP) or by home care Conclusion: Kwashiorkor is associated with cerebral atrophy
company (HCC). Intravenous supplementation (IVS) type was and impaired dynamic functional activity of the brain that may
categorized as fluids and electrolytes alone (FE) or parenteral be detrimental to intellectual development; brain SPECT is
nutrition admixture either commercially premixed (PA) or more accurate in assessing deleterious effect of PEM on growing
customized to the individual patient (CA). Statistics: median, brain.
Spearman regression. Disclosure of Interest: None declared.
Results: A total of 428 patients were included: females 41%,
age 5.1 yrs (<1, 8%; 2–5, 41%; 5–10, 23%; >10, 28%), HPN OR48
duration 37 mos (<12, 20%; 12–36, 29%; 36–60, 17%; 60–120, NONALCOHOLIC FATTY LIVER DISEASE IN CHILDREN WITH
21%; >120, 14%), body weight (BW) 17 kg and height 104 cm.
EXCESS OF WEIGHT
Pathophysiological mechanism of CIF: short bowel 51% (with
end-jejunostomy 16%); dysmotility 21%, mucosal disease 24%, R. Blais1, A. Lienhardt-Roussie1, P. Fayemendy2,3,4,
mechanical occlusion 4%. HPN provider: LP 56%, HCC 44%. IVS J. C. Desport2,3,4,5 *, P. Jésus2,3,4,5. 1Pediatric Department,
2
type: PA 12%, CA 88%. Days of IVS, 5/week. IVS volume, 60 mL/ Nutrition Unit, University Hospital of Limoges, 3INSERM,
kg BW. IVS energy, 50 kcal/kg BW. Correlation between IVS vol/ U1094, Tropical Neuroepidemiology, School of Medicine,
4
kg and energy/kg, r = 0.81 (P < 0.001). UMR_S 1094, Tropical Neuroepidemiology, Institute of
Conclusion: The spectrum of CIF in children observed by this Neuroepidemiology and Tropical Neurology, CNRS FR 3503
multicenter survey is similar to those previously described by GEIST, University of Limoges, 5Specialized Center of Obesity of
individual center cohorts. HPN characteristics shows that an Limousin, University Hospital of Limoges, Limoges, France
IVS-admixture customized to the individual patient is used in
Rationale: Obesity in children is a public health problem.
almost all the cases. The good correlation between IVS fluid
Obesity can be complicated by liver damage. The aim of our
and energy requirements suggest that either the one or the
study was to investigate the nonalcoholic fatty liver disease
other can be used to devise a clinical classification of CIF such
(NAFLD) in children with excess of weight and factors
as in adults [1].
associated with NAFLD.
Reference Methods: Children with overweight and obesity had measures
1. Clinical Nutrition 34 (2015) 171–180. of body mass index (BMI), waist circumference (WC), blood
Disclosure of Interest: None declared. pressure (BP), fasting serum glucose and lipids (total choles-
terol, HDL-c, LDL-c and triglycerides) and hepatic function
(ASAT, ALAT, γGT). The NAFLD was researched with ultrasound
OR47
and predictive score of NAFLD was calculated : hepatic
NUCLEAR TOMOGRAPHIC IMAGING AND NUTRITIONAL
steatosis index (HSI). Metabolic syndrome was diagnosed with
REHABILITATION FOR CEREBRAL FUNCTIONS FOLLOW UP IN
WC, BP, serum glucose, HDL-c and triglycerides. Statistical
KWASHIORKOR
analysis used Student’s t tests, Chi2 and logistic regression.
E. R. Abdelhamid1 *, S. Y. Shaaban2, R. G. Helal1, Results: Seventy-six children were included, 46% of males with
Y. G. El-gendy2, L. F. Matta3, H. M. Elshakankiry4, A. Bayoumy4. a mean age of 11.3 ± 3.4 years. The mean BMI was of
1
Child Health Department, National Research Center, 29.1 ± 5.9 kg/m2 and 77.6% of children were obese. The
2
Pediatrics Department, 3Radiotherapy Department, serum glucose and lipid levels were no different between
4
Pediatrics, Ain Shams University, Cairo, Egypt overweight and obese children. In contrast, the ALAT/ASATratio
was higher in obese (1.0 ± 0.4 vs. 0.8 ± 0.3, p = 0.02). The HSI
Rationale: Kwashiorkor represents a group of related disorders score was higher in obese (40.0 ± 7.0 vs. 30.2 ± 6.8, p < 0.0001).
known as protein-energy malnutrition (PEM), it is associated With ultrasound NAFLD was found in 38.2%, 43.4% in obesity.
with cerebral changes which consequently would give rise to Metabolic syndrome was found in 50.0% in children with NAFLD.
intellectual and developmental delay. The present study seeks The HSI was positive in 92.0% in children with NAFLD. WC
(OR = 1.09 [95% CI: 1.09–1.16]; p = 0.0034), systolic BP
(OR = 1.06 [95% CI: 1.01–1.12]; p = 0.03) and triglycerides OR50

(OR = 1.03 [95% CI 1.001–1.05]; p = 0.016) were positively OVERWEIGHT IN CHILDHOOD CANCER PATIENTS AT
associated with NAFLD. DIAGNOSIS AND THROUGHOUT THERAPY: A MULTICENTRE
Conclusion: Over one third of children had a NAFLD. NAFLD was COHORT STUDY
two time more present in obesity. Criteria of metabolic F. N. Belle1,2 *, J. Wenke-Zobler3, E. Cignacco3, R. A. Ammann4,
syndrome (WC, systolic BP and triglyceride) were positively C. E. Kuehni2,5, K. Zimmermann3,6. 1Division of Chronic
associated with NAFLD. Considering the risk of progression, it Diseases, Institute of Social and Preventive Medicine,
seems essential to follow these children mainly in case of Lausanne University Hospital, Lausanne, 2Swiss Childhood
obesity with metabolic syndrome and continue this follow up in Cancer Registry, Institute of Social and Preventive Medicine,
adulthood. University of Bern, Bern, 3Nursing Science (INS), Department
Disclosure of Interest: None declared. Public Health (DPH), Faculty of Medicine, University of
Basel, Basel, 4Department of Paediatrics, Inselspital, Bern
OR49 University Hospital, 5Children’s University Hospital of Bern,
COST STUDY OF THE MULTICENTER RANDOMIZED University of Bern, Bern, 6Children’s Research Center,
CONTROLLED TRIAL ‘EARLY VERSUS LATE PARENTERAL University Children’s Hospital of Zurich, University of Zurich,
NUTRITION IN CRITICALLY ILL CHILDREN’ Zurich, Switzerland
E. Van Puffelen1 *, S. Polinder2, I. Vanhorebeek3, P. J. Wouters3, Rationale: Some childhood cancer patients (CCP) have
N. Bossche4, G. Peers5, S. Verstraete3, K. F. Joosten1, been reported to be at increased risk of becoming
G. Van den Berghe3, S. C. Verbruggen1, D. Mesotten3. 1Pediatric overweight during treatment. We assessed prevalence of
and Pediatric Surgery, 2Public Health, ERASMUS MC, overweight in CCP at diagnosis and at the end of treatment,
Rotterdam, Netherlands, 3Cellular and Molecular Medicine, KU identified weight change during treatment by type of cancer,
Leuven, Leuven, Belgium, 4Control and Compliance, ERASMUS and determined risk factors for being overweight at end of
MC, Rotterdam, Netherlands, 5Medical Administration, treatment.
University Hospitals Leuven, Leuven, Belgium Methods: In a multicentre cohort study, we collected
height and weight measurements of CCP at diagnosis and
Rationale: The multicenter randomized controlled trial ‘early
repeatedly during treatment. We calculated age and sex
versus late parenteral nutrition in critically ill children
adjusted BMI z-scores using International references of the
(PEPaNIC)’ showed that omitting parenteral nutrition (PN)
International Obesity Taskforce for children. Weight change
during the first week in critically ill children was clinically
during treatment was described by segmented linear regres-
superior to providing early PN. This study describes the direct
sion, and risk factors for overweight by multivariable logistic
medical costs of early versus late PN from a hospital
regression.
perspective in an international context, provides a detailed
Results: The study included 327 CCP with a median age of 7
insight into the distribution of cost components, and assesses
years (IQR 3–12) at diagnosis (55% males). Diagnoses included
the impact of acquiring a new infection on hospital costs.
acute lymphoblastic leukaemia (ALL, 29%), lymphoma (16%),
Methods: The direct medical costs were calculated, using a
central nervous system (CNS) tumours (13%), sarcoma (18%),
micro-costing approach. We compared the mean costs of late
and other types of cancer (24%). At diagnosis, 27 CCP (8%)
PN (n = 673) with those of early PN (n = 670) in the Belgian and
were overweight. This increased to 43 (13%) at end of
Dutch patients, aged 0–17 years. Costs were divided into 10 cost
treatment in average 0.7 years after diagnosis (IQR 0.4–1.8).
categories (PICU hospitalization, post-PICU hospitalization,
In ALL and lymphoma patients BMI z-scores increased
PN, medication, laboratory diagnostics, other diagnostics,
continuously during treatment (coef= 0.3, 95% CI 0.2; 0.3,
ventilator support, renal replacement therapy and mechanical
p < 0.001). In older patients (≥10 years at diagnosis) BMI-Z-
hemodynamic support, surgery, and consultations). Main cost
score dropped shortly after diagnosis (coef = −5.2, 95% CI
drivers were identified and the impact of new infections on the
−9.1; −1.2, p = 0.011) after which an increase was seen. In
total costs was explored.
patients diagnosed with CNS tumours and sarcoma BMI z-
Results: Mean direct medical costs of patients receiving late PN
scores dropped during the first months after diagnosis, but
(€26.680) were 21% lower (€-7.180, p = 0.003) than of patients
increased afterwards (all p < 0.05). Body mass index at
receiving early PN (€33.860). The costs for PN contributed only
diagnosis was the strongest predictor of overweight at end
2.1% in the total cost reduction. Main cost driver was PICU
of treatment (OR = 50, 95% CI 16–155).
hospitalization costs (€-4.120, p = 0.003). The 14% patients who
Conclusion: CCP diagnosed with ALL or lymphoma, and
acquired a new infection were responsible for 41% of the costs.
those who are overweight at diagnosis are at increased risk of
The incremental cost-effectiveness ratio was €-96.480 per
weight gain during treatment, and might need special
prevented new infection, meaning that late PN is more
attention.
effective and less costly than early PN and thus highly cost-
effective. Disclosure of Interest: None declared.
Conclusion: Late initiation of PN decreased the direct medical
costs in critically ill children, beyond the expected lower costs
for PN during the first week. Avoiding new infections yielded a
large cost reduction.
Oral Communication VI: Liver, Gastrointestinal Tract and Cancer S21
Oral Communication VI: Liver, approaches: restricted and unrestricted oral intake in this
group of patients
Gastrointestinal Tract and Cancer Methods: Twenty patients were involved into the study (2015
OR51 and 2016 yr) and divided into two groups according to their
SHORT-TERM OUTCOME OF PATIENTS ON HOME PARENTERAL preference: A – oral intake restricted to keep stoma output
NUTRITION (HPN) FOR CHRONIC INTESTINAL FAILURE (CIF) under 1,000 ml, B- unrestricted oral intake. The following
parameters were evaluated: output, self-estimation of condi-
L. Pironi1 *,
tion, body weight gain in 6 months, bilirubin, creatinine,
on behalf of Home Artificial Nutrition & Chronic Intestinal
number of hospitalizations prior to surgery, need to empty
Failure Special Interest Group of ESPEN. 1University of Bologna,
ostomy bag at nighttime, filing of hunger and thirst in the
Bologna, Italy
daytime, time to reconstructive surgery.
Rationale: To investigate the clinical predictive factors for Results: Patients in group B experienced lower quality of life
short-term outcome on HPN for CIF, a one year prospective (QoL) and more HPN complications
international multicenter study was carried out using the
structured database devised for the ESPEN ‘CIF Action Day’. A B
Methods: In March 2015, 65 centers enrolled 3,239 adult
No of pts 10 10
patients (benign disease 90%, cancer 10%), recording M/F 6/4 5/5
anagraphic data, body mass index (BMI), CIF mechanism, Ostomy output at admission to clinic (ml) 3,500 3,200
underlying disease, intravenous supplementation (IVS) Ostomy output in 1st month on HPN (ml) 850 2,800
Nil per os (no of patients) 5 0
characteristics. Patient outcome on March 2016 was classified Volume of HPN (ml) 3,150 4,850
as still on HPN (stillHPN), weaned off HPN (WEA) or deceased Need for empty ostomy bag at nighttime (times) 0 1,8 (2–5)
(DEC) and was analyzed for the following factors: patient age Filling of thirst or hunger in the daytime +/− +++
Weakness (self estimation) − +++
and BMI categories, HPN-duration categories, CIF pathophysio-
Wait gain in 6th month on HPN (kg) 5,5 2,1
logical mechanisms and IVS. IVS was classified as fluid and Bilirubin in 6th month on HPN (mg%) 1,3 2,8
electrolyte alone (FE) or parenteral nutrition (PN). PN was Creatinine in 6th month on HPN (mg%) 0,9 3,4
categorized by daily volume: <1, 1–2, 2–3, >3 L/day. Statistics: No of hospitalizations prior to surgery 0,5 3,2
Deaths before surgery qualification 0 1
nominal regression analysis to investigate factors independ- Time to surgery (months) 7,5 22,1
ently associated with probability of WEA or DEC.
Results: One year outcome was available for 2,221 benign and
302 cancer CIF. In benign (%): stillHPN 77, WEA 13, DEC 8, lost Conclusion: Restricted oral intake seems to be more effective
2. In cancer (%): stillHPN 41, WEA 15, DEC 41, lost 3. for prevention of HPN complications and shortening of time to
In benign CIF, WEA probability was negatively associated with surgery. Oral intake increase stoma output, does not reduce
age ( p < 0.002) and duration of HPN ( p < 0.001) and positively hunger or thirst, but alters QoL. Psychological support for these
with BMI ( p < 0.001) and PN < 1 L/day ( p < 0.003), whereas DEC patients is crucial to reach nutritional goals.
probability was negatively associated with BMI ( p < 0.048),
duration of HPN ( p < 0.001) and FE ( p < 0.021) and positively
with age ( p < 0.001).
In cancer CIF, WEA probability was negatively associated with OR53
duration of HPN ( p < 0.001) and DEC probability was negatively A MULTICENTER, RANDOMIZED, DOUBLE-BLIND, PLACEBO-
associated with BMI ( p < 0.004), duration of HPN ( p < 0.001) CONTROLLED TRIAL OF EXTRACT OF HERBAL MEDICINE
and PN < 1 L/day ( p < 0.004). DAIKENCHUTO TO PREVENT BOWEL DYSFUNCTION AFTER
Conclusion: The results indicate that in patients on HPN for CIF, ADULT LIVER TRANSPLANTATION
patient age and BMI, duration of the ongoing HPN and IVS T. Kaido1 *, M. Yamamoto2, S. Morita2, S. Uemoto1,
characteristics are independent predictive factors for short- on behalf of DKB 14 study group. 1Hepato-Biliary-Pancreatic
term probability of intestinal rehabilitation and of risk of and Transplant Surgery, Kyoto University, 2Advancement of
death. Clinical and Translational Science, Kyoto University Hospital,
Disclosure of Interest: None declared. Kyoto, Japan
Rationale: Postoperative early oral or enteral intake is a crucial

OR52 element of the Enhanced Recovery After Surgery (ERAS)
RESTRICTED VS UNRESTRICTED ORAL INTAKE IN HIGH protocol. However, normal food intake or enteral feeding
OUTPUT END JEJUNOSTOMY SYNDROME PATIENTS cannot be started when a patient has bowel dysfunction,
J. Sobocki1 *, P. Jurczak1, K. Lachowicz1, K. Majewska1. especially after liver transplantation (LT). Therefore, we
1
Department of General Surgery and Clinical Nutrition, conducted a multicenter, randomized, double-blind, placebo-
Medical University of Warsaw, Warsaw, Poland controlled trial to determine the enhancement effects of
Daikenchuto (DKT) upon oral/enteral caloric intake in patients
Rationale: There is a different approach to high output end undergoing LT (UMIN000014326).
jejunostomy syndrome patients with regard to oral intake. Methods: One hundred and twelve patients undergoing LTat 14
Some centers arguing that restriction of oral intake is leading Japanese centers were enrolled. Patients were
unacceptable for patient and patient should be allowed to randomly assigned to receive either DKT (15.0 g/day) or
eat ad libitum. The aim of the study is to estimate result of two matching placebo from postoperative day (POD) 1 to 14.
Primary endpoints were total oral/enteral caloric intake, increase in Enterobacteriaceae induced by fructose.
abdominal distension and pain on POD 7. Secondary endpoints Enterobacteriaceae were positively correlated (r = 0.55 p =
included sequential changes of total oral/enteral caloric intake 0.008) with the hepatic expression of MCP1.
after LT, numeric rating scales for abdominal distention and Conclusion: Our findings suggest that the different effect of
pain, portal venous flow and speed to the graft and so on. WB and WBs on hepatic inflammation could be attributed to the
Results: A total of 104 patients (DKT, n = 55; placebo, n = 49) different impact exerted on the gut microbiota. It is worth
were included and evaluated in the statistical analysis. There noticing that, reducing Enterobacteriaceae levels may reflect
were no significant differences between the two groups in the anti-inflammatory properties of WBs.
terms of primary endpoints. However, postoperative total Disclosure of Interest: None declared.
oral/enteral calorie intake was significantly accelerated in
the DKT group than in the placebo group ( p = 0.023).
OR55
Moreover, portal venous flow (POD 10, 14) and speed (POD
DISTURBED ENTEROHEPATIC BILE SALT SIGNALING IN
14) were significantly higher in the DKT group compared
INTENSIVE CARE PATIENTS WITH DIARRHEA
with the placebo group ( p = 0.047, p = 0.025, p = 0.014,
respectively). R. van Gassel1,2,3 *, F. Schaap1,3, K. Koelfat1,3, M. Baggerman2,
Conclusion: Postoperative administration of DKT effectively M. Bol2, G. Nicolaes4, D. Beurskens4, M. van de Poll1,2,3,
enhances total oral/enteral calorie intake after LT and would S. Olde Damink1,3. 1NUTRIM School of Nutrition and
contribute to performance of ERAS. Translational Research in Metabolism, Maastricht University,
2
Intensive Care Medicine, 3General Surgery, Maastricht
Disclosure of Interest: T. Kaido Grant/Research Support from: Tsumura
University Medical Centre, 4Biochemistry, CARIM
& Co., Tokyo, Japan, M. Yamamoto Grant/Research Support from:
Cardiovascular Research Institute Maastricht, Maastricht
Tsumura & Co., Tokyo, Japan, S. Morita Grant/Research Support from:
Tsumura & Co., Tokyo, Japan, S. Uemoto Grant/Research Support from: University, Maastricht, Netherlands
Tsumura & Co., Tokyo, Japan.
Rationale: Diarrhea occurs in over 60% of critically ill patients
admitted to the intensive care unit for 7 days or more and is an
OR54 independent risk factor for cholestatic liver injury. We
EFFECTS OF FIBERS DERIVED FROM CEREALS IN THE hypothesize that diarrhea disturbs the enterohepatic circula-
MODULATION OF INFLAMMATION INDUCED BY AN OVER- tion of bile salts, potentially contributing to the development
CONSUMPTION OF FRUCTOSE: IMPLICATION OF THE GUT of liver injury.
MICROBIOTA Methods: We investigated plasma levels of bile salts, FGF19 (a
F. Suriano1 *, A. Neyrinck1, J. Verspreet2, C. Courtin2, P. Cani1, bile salt-induced gut hormone controlling hepatic bile salt
L. Bindels1, N. Delzenne1. 1LDRI-Metabolism and Nutrition synthesis) and C4 (a marker of bile salt synthesis) in critically ill
Research Group, Université catolique de Louvain, Brussels, patients. Following inclusion, allocation to the diarrhea group
2
Laboratory of Food Chemistry and Biochemistry, Leuven Food (N = 12) or no diarrhea group (N = 18) was based on 24 hour fecal
Science and Nutrition Research Center (LFoRCe), KU Leuven, production ≥350 mg/day. Data were tested for normality and
Leuven, Belgium are presented as median [IQR] or mean ± SD. Mann-Whitney or
t-tests were used as appropriate to test for statistical
Rationale: The prevalence of non-alcoholic fatty liver disease significance.
(NAFLD) has increased in parallel to a rapid rise in fructose Results: Decreased FGF-19 levels were observed in the
consumption. In this study we evaluated the effects of two diarrhea group (0.20 ± 0.12 vs. 0.29 ± 0.10 ng/mL, p = 0.03)
wheat fractions characterized by different particle size on indicating disturbed enterohepatic signaling. Plasma bile salt
hepatic inflammation induced by fructose, in relationship with levels were increased in patients with diarrhea (9.8 [5.0–23.9]
their potential effect on the gut microbiota. vs. 4.5 [2.9–7.4] µmol/L, p = 0.01]), while C4 levels were not
Methods: Mice were divided in 4 groups (n = 6/group) receiving different between the two groups (6.8 ± 4.0 vs. 6.4 ± 3.6 ng/
a control diet (CT), a CT diet plus fructose 30% w/v in the ml, p = 0.77). Bilirubin, alkaline phosphatase (ALP) and
drinking water (F), a CT diet supplemented with 5% of crude gamma-GT levels also were not different between the two
wheat bran plus 30% fructose in water (normal particle size groups.
1,690 µm, F + WB; WB with small particle size 150 µm, F + WBs) Conclusion: Diarrhea in critical illness disturbs the normal
for 8 weeks. enterohepatic circulation of bile salts, as evidenced by reduced
Results: Fructose supplementation significantly increased the plasma levels of FGF-19. There was no anticipated elevation of
expression -at the mRNA level- of key inflammatory genes plasma C4 levels, suggesting that hepatic bile salt synthesis is
(MCP-1, TNFα, TLR2) and macrophage-related markers (CD11c) not increased in patients with diarrhea. Furthermore,
in the liver compared to the CT group. Neither fructose nor WB increased systemic bile salt levels suggest that hepatic
fractions significantly modified the expression of markers of uptake is affected in critically ill patients with diarrhea. The
inflammation, intestinal immune function or barrier function in consequences of these disturbances in bile salt signaling and
the ileum and colon. WBs was the sole fraction to reduce their relation gut function and cholestatic liver injury during
hepatic (mRNA) and systemic ( protein-multiplex immunoassay) critical illness requires further investigation.
markers of inflammation (IL1β, IL6, IL10, IFNγ, MCP1, TNFα).
Moreover, gut microbiota analyses (qPCR of 16SrDNA) revealed
that both wheat bran fractions differently affected the gut
microbiota. WB increased Akkermansia muciniphila caecal
level, whereas only WBs significantly counteracted the
Oral Communication VI: Liver, Gastrointestinal Tract and Cancer S23
OR56 amino-acid reflecting enterocyte health, in patients before

EARLY PER ORAL FOOD INTAKE DOES NOT INCREASE allo-SCT procedure.
THE INCIDENCE OF COMPLICATIONS AFTER Methods: Plasma citrulline levels were assessed by high
PANCREATODUODENECTOMY performance liquid chromatography combined with mass
M. Bezmarevic1 *, M. Panisic-Sekeljic1, A. Popadic2, spectrometry. Characteristics of hematological malignancy,
I. Soldatovic3, M. Mitrovic1, D. Mirkovic1. 1Clinic for General previous chemotherapies, and allo-SCT procedure were
Surgery, 2Clinic of Anesthesiology and Intensive Care, Military noticed. The incidence of GVH, non-relapse mortality (NRM)
Medical Academy, 3Institute of Statistic and Informatics, and overall survival (OS) at 2 years after transplantation were
Faculty of Medicine, University of Belgrade, Belgrade, Serbia also recorded. Patients with GVH III-IV were compared to those
with GVH 0-II according to citrulline levels.
Rationale: Pancreatoduodenectomy (PD) is associated with Results: Between 2013 and 2015, 192 patients were included.
significant incidence of morbidity, including postoperative Thirty-eight patients developed GVH III-IV and 154 did not (GVH
pancreatic and biliary fistula (POPF and POBF), delayed 0-II). Mortality at 2 years was 37%, 26%, 34%, 65% and 96% from
gastric emptying (DGE), and other major and minor surgical grade 0 to grade IV, respectively. Citrulline (mean ± SE, μmoL/
and general complications which affecting the need for L) was lower in the GVH grade III-IV group (24 ± 8) compared to
nutritional support and prolonged hospital stay. The reluctance the GVH 0-II group (29 ± 9), p = 0.0004. To discriminate both
to initiate early oral feeding arises from the fear of an increased groups, a citrulline threshold (26 μmoL/L) was determined
risk for postoperative complications. using ROC procedure (AUC = 0.68; p = 0.0006). Under this cut-
Methods: The prospective observational study included 72 off, GVH III-IV incidence increased (log-rank test, p = 0.005).
patients underwent PD due to pancreatic cancer. Patients were Conversely, both NRM and OS decreased (log-rank test,
divided into 2 groups regarding introduction of per oral food p = 0.033 and p = 0.047). The multivariate cox model analysis
intake (A from 3–5 and B >5 postoperative day). The groups were confirmed that citrulline was an independent predictive
compared in relation to the occurrence of POPF, POBF, DGE and biomarker of GVH III-IV (Hazard ratio = 2.68, 95%CI [1.21–
the Clavien-Dindo grade. ations. 65.96], p = 0.015).
Results: Group A included 24 (33%), and group B included 48 Conclusion: This finding supports the beneficial effect of
(67%) patients. POPF (grade A to C) occurred in 15 (20%) enteral nutrition in strengthening intestinal barrier during allo-
patients. POBF occurred in 6 (8%) patients. DGE was present in SCT procedure and in limiting GVH incidence and severity.
16 (22%) patients. POPF had 5 (21%) patients in group A and 10 Disclosure of Interest: None declared.
(21%) patients in group B, ( p = 1). POBF had 0 patients in group
A and 6 (12%) patients in group B, ( p = 0.17). DGE had one (4%)
OR58
patient in group A and 15 (31%) patients in group B, ( p = 0.001).
MICRO RNA ANALYSIS FROM A PHASE II TRIAL INTO
Clavien-Dindo grade ≥3 had 4 (17%) patients in group A and 21
INTRAVENOUS OMEGA 3 AND CONVENTIONAL
(44%) patients, ( p = 0.001). The presence of Clavien-Dindo
CHEMOTHERAPY IN PALLIATIVE OESOPHAGOGASTRIC
grade ≥3 was associate with delayed introduction of per oral
CANCER PATIENTS
food intake ( p = 0.009). Significant correlation between
Clavien-Dindo grade and time of the introduction of per oral J. Isherwood1 *, W. Chung1, A. El-Tweri1, C. Pollard1,
food intake was found ( p < 0.001). J. Thompson2, W. Chi-Sheng3, Y.-S. Chang3, A. Dennison1.
1
Conclusion: Early introduction of per oral food intake in Department of Hepatobiliary and Pancreatic Surgery,
patients after PD has no impact on POPF and POBP occurrence, Leicester General Hospital, 2Department of Health Sciences,
but delayed introduction of per oral food intake is associate College of Medicine, Biological Sciences and Psychology,
with the presence of DGE and Clavien-Dindo grade ≥3. University of Leicester, Leicester, United Kingdom, 3Molecular
Medicine Research Cente, Chang Gung University, Taipei,
Disclosure of Interest: None declared. Taiwan, Province of China
OR57 Rationale: Oesophagogastric carcinoma (OC) is a devastating

CITRULLINE, AN EARLY PREDICTIVE MARKER OF HIGH-GRADE disease that is often detected late and has an extremely poor
ACUTE GRAFT-VERSUS-HOST DISEASE prognosis. Micro RNAs (miRNAs) are a group of single stranded,
T. Hueso1 *, M. Joncquel Chevalier Curt2, J. Gauthier3, short (19–25 ribonucleotides) non-coding RNA transcripts.
B. Carpentier3, R. Dulery4, I. Yakoub-Agha3, D. Seguy5. 1LIRIC MiRNAs have been shown to play a role in the diagnosis,
UMR 995, 2Department of Biochemistry, 3Stem Cell response to treatment, disease progression and chemoresis-
Transplantation Department, CHR Lille, Lille, 4Stem Cell tance in OC.
Transplantation Department, Saint Antoine Hospital, Paris, Methods: This was a prospective, single arm phase II clinical
5
Department of Nutrition, CHR Lille, Lille, France trial; evaluating the effect of adding an intravenous (IV)
omega-3 to conventional platinum-based palliative chemo-
Rationale: Acute graft-versus-host disease (GVH) is the main therapy in participants with advanced oesophagogastric
complication within the 3 months following allogeneic hem- cancer. Patients were treated for 3 weeks followed by a rest
atopoietic stem-cell transplantation (allo-SCT). Over 70% of week for up to eight cycles. Data was analysed using a mixed
patients who develop high-grade intestinal GVH (Grade III-IV) effects logistic regression model with STATA(v14.0). 46 micro
die within 6 months from allo-SCT. To date, risk factors are well RNAs were investigated. 250 times points in 21 patients were
known but no accessible biomarker suitable to predict GVH III- analysed for each miRNA.
IV before allo-SCT is available. We investigated citrulline, an Results: Twenty-one patients were included in the analysis (5
female and 16 male). Median age at presentation was 67 years
old. Thirty-nine of forty-six miRNAs were significantly changed Conclusion: In HNC patients undergoing RT or RT plus systemic
during the weekly treatment over a cycle (33 were down treatment, and receiving nutritional counseling, weight loss
regulated and 3 were up regulated). Two miRNA were could not be completely prevented, but the use of ONS resulted
significantly down regulated in all patients over treatment: in better weight maintenance, increased protein-calorie
miRNA-143 (P = 0.03, 95% CI = −0.154 to −0.041) & miRNA-27b intake, improved quality of life and was associated with
(P = 0.04, 95% CI = −0.184 to −0.047). MirRNA-451 showed a better anti-cancer treatment tolerance.
decreasing trend and this correlated with improved progression References: Supported by a grant from ESPEN (Research
free survival (P = 0.002). Fellowship 2013)
Conclusion: Intravenous omega-3 in combination with conven- Disclosure of Interest: None declared.
tional chemotherapy significantly reduces miRNA-143 and
miRNA-27b. MiRNA-143 is implicated in tumour invasion and
lymph node metastasis. MirRNA-27b has been shown to play a
role in chemo resistance. A reduction in miRNA-451 levels
Oral Communication VII: Critical Care
correlated with progression free survival, this miRNA has been OR60
implicated in invasion and metastasis. A randomised trial is GASTROINTESTINAL ORGAN FAILURE SYMPTOMS INCLUDED IN
indicated to investigate this further. SOFA SCORES IMPROVE MORTALITY PREDICTION IN THE ICU: A
Disclosure of Interest: None declared. MATHEMATICAL APPROACH
P. Singer1 *, L. Cohen Fox2, Y. Aperstein2, J. Cohen1, M. Theilla1,
OR59 I. Kagan1. 1Intensive Care Department and Institute for
NUTRITIONAL COUNSELING WITH OR WITHOUT SYSTEMATIC Nutrition Research, RABIN MEDICAL CENTER, Petah Tikva,
2
USE OF ORAL NUTRITIONAL SUPPLEMENTS IN HEAD AND Afeka Tel Aviv Academic College of Engineering, Tel Aviv, Israel
NECK CANCER PATIENTS UNDERGOING RADIOTHERAPY
E. Cereda1 *, S. Cappello1, S. Colombo2, C. Klersy3, I. Imarisio4, Rationale: SOFA (Sequential Organ Failure Assessment) score
A. Turri1, M. Caraccia1, T. Monaco4, M. Benazzo5, P. Pedrazzoli4, predicts mortality in critically ill patients but does not include
F. Corbella2, R. Caccialanza1. 1Nutrition and Dietetics Service, gastrointestinal tract (GIT) organ dysfunction. Previous inclu-
2
Division of Radiation Oncology, Department of Hemato- sion of this organ to the 6 organs assessment of SOFA did not
Oncology, 3Biometry and Statistics Service, 4Division of Medical improve the predictive value of the score (1), reaching only
Oncology, Department of Hemato-Oncology, Fondazione IRCCS 70%. Consecutive evaluation of daily SOFA added to GIT
Policlinico San Matteo, 5Department of Otolaryngology Head symptoms (SOFA i) has never been tested. We evaluated 3
Neck Surgery, University of Pavia and Fondazione IRCCS days (SOFA i to improve the predictive value of SOFA.
Policlinico San Matteo, Pavia, Italy Methods: A cohort of 2,709 ICU patients was included from our
ICU database to assess SOFA scores, after IRB approval. 1.304
Rationale: To evaluate the benefit of oral nutritional supple- patients with 3 SOFA scores and 3 GIT available symptoms
ments (ONS) in addition to nutritional counseling in head and (vomiting, bowel movements and reaching REE through enteral
neck cancer (HNC) patients undergoing radiotherapy (RT). feeding) were analyzed (20 × 106 items) for mortality predic-
Methods: In a single-center, randomized, pragmatic, parallel- tion. Area under the curve (AUC) was evaluated for the
group controlled trial (NCT02055833), 159 newly diagnosed following analysis: ANN (artificial neural network), SVM
HNC patients suitable for to RT regardless of previous surgery (support vector machine), Linear Regression, Logistic
and induction chemotherapy were randomly assigned to Regression.
nutritional counseling in combination with omega-3 enriched Results: From the 1,304 patients included, 909 survived and
ONS (N = 78) or without ONS (N = 81) from the start of RT and 394 died. The best predictive AUC values (0.91 and 0.93) were
continuing for up to 3 months after its end. The primary obtained using the association of linear regression and logistic
endpoint was the change in body weight at the end of RT. regression, and ANN and linear regression respectively, when
Secondary endpoints included changes in protein-calorie SOFA i was used. These results are reaching a much stronger
intake, muscle strength, phase angle and quality of life (QoL) predictive value than those previously published in a compar-
over the study time points and anti-cancer treatment able population. Sensitivity was 84.7%, Specificity 86.3%,
tolerance. Accuracy 85.6%, Positive predictive value and Negative
Results: In patients in whom all the variables could be predictive value were respectively 84.7% and 13.7%.
assessed, counseling plus ONS (N = 67) resulted in smaller loss Conclusion: Our results suggest that SOFA score predictive
of body weight than nutritional counseling alone (N = 69; mean value for mortality can be improved when GIT symptoms are
difference, 1.6 kg [95%CI, 0.5–2.7]; P = 0.006). Imputation of included. A new SOFAi score should be considered. The
missing outcomes provided consistent findings. In the ONS- importance of GIT failure is stressed.
supplemented group, higher protein-calorie intake and Reference
improvement in QoL over time were also observed (P < 0.001 1. Blaser Reintam A, et al. Gastrointestinal symptoms during the first
for all). The use of ONS reduced the need for changes in week of intensive care are associated with poor outcome: a
scheduled anti-cancer treatments (i.e. for RT and/or systemic prospective multicentre study. Intensive Care Medicine 2013; 39:
treatment dose reduction or complete suspension, HR = 0.40 899–909.
[95%CI, 0.18–0.91], P = 0.029). Nine patients reported gastro- Disclosure of Interest: None declared.
intestinal intolerance to ONS.
Oral Communication VII: Critical Care S25
OR61 ‘obesity paradox’ has been described. In a large group of

VISCERAL ADIPOSE TISSUE PROTECTS AGAINST MUSCLE LOSS intensive care patients we assessed whether a potential
IN SEPSIS beneficial effect of a high body mass is also seen in ESRD
M. R. Baggerman1 *, D. P. van Dijk2,3, M. J. Ariës1, M. E. Bol1, patients with critical illness.
R. van Gassel1,2,3, E. E. Blaak3,4, R. M. Schnabel1, F. C. Bakers5, Methods: In a retrospective analysis of a prospectively
S. W. Olde Damink2,3, M. C. van de Poll1,2,3. 1Department of collected data base of 82,323 patients from 98 Austrian
Intensive Care Medicine, 2Department of Surgery, Maastricht intensive care units (ICUs) in whom BMI was available, in
UMC+, 3School of Nutrition and Translational Medicine in 9,869 patients with ESRD the association of 6 groups of BMI and
Metabolism (NUTRIM), 4Department of Human Biology, outcome was assessed. Results were adjusted for severity of
Maastricht University, 5Department of Radiology, Maastricht disease, age, sex and other acute and chronic comorbidities.
UMC+, Maastricht, Netherlands Results: The 9,869 patients with ESRD were older, sicker, had a
longer ICU stay and a higher ICU and hospital mortality. Within
Rationale: Low skeletal muscle mass is associated with the group of ESRD patients a high BMI (>25) was associated with
increased mortality, whereas obesity appears to be protective an improved survival in a multivariate analysis (BMI 25–30: OR
in critical illness. We hypothesize that this is due to changes in 0.88, CI 0.77–0.99; 30–35: OR 0.8; CI 0.68–0.93; 35–40, OR 0.74,
metabolic responsiveness in obesity, leading to resistance to CI 0.6–0.92) but this was not seen in morbidly obese patients
catabolic stimuli. This metabolic inflexibility may particularly with a BMI > 40. The association was significant in patients
be mediated by visceral adipose tissue. with the highest disease severity (SAPS-3 Score >56) but
We aimed to study the effect of body composition on muscle remarkably, also in those patients without systemic inflamma-
loss in septic patients. tory response syndrome (SIRS) and those not requiring
Methods: We assessed 60 patients (29 male) with abdominal mechanical ventilation.
sepsis. All patients underwent abdominal CTscanning between 8 Conclusion: Also in ESRD patients who have acquired an acute
days before and 2 days after ICU admission, and repeated CT intermittent diseases and are admitted to an ICU an increased
scanning 8–20 days thereafter. Areas of muscle, visceral and BMI is associated with an improved outcome. This association
subcutaneous adipose tissue were measured at the level of L3 however, is not seen in morbidly obese patients with a BMI > 40.
and ajdusted to height (area (cm2)/height (m2)) according to This improved tolerance to acute disease processes may in part
established methods. Patients were divided into groups with explain the ‘obesity paradox’ observed in ESRD patients.
either a high or low visceral adipose tissue index (VATi) using sex- Disclosure of Interest: None declared.
specific group medians as cut-off values. Changes in muscle and
adipose tissue indexes were expressed as loss from baseline (%)
OR63
and tested using a t-test. This was repeated using subcutaneous
EFFECT OF COMBINED PROTEIN ENRICHED ENTERAL FEEDING
and total adipose tissue indexes (SATi, TATi) as grouping factors.
AND EARLY CYCLE ERGOMETRY IN MECHANICALLY
Results: At baseline mean ± SE skeletal muscle mass in patients
VENTILATED CRITICALLY ILL PATIENTS: A PROSPECTIVE,
with a low or high VATi was similar (44.2 ± 1.7 vs. 44.6 ± 1.5
RANDOMIZED, COMPARATIVE, SINGLE-BLIND CONTROLLED
cm2/m2; p = 0.8). Also the timepoint of the second CT-scan was
STUDY
similar between groups (13.2 ± 0.6 vs. 12.1 ± 0.6 days; p = 0.2).
Muscle loss was higher in patients with a low VATi (8.3 ± 1.9%) I. Kagan1 *, S. Kremer2, M. Theilla1, I. Bendavid1, P. Singer1,
than in patients with a high VATi (2.0 ± 2.3%; p = 0.041). Other J. Cohen1. 1Intensive Care Department and Institute for
changes in body composition were unrelated to baseline VATi. Nutrition Research, 2Physiotherapy Department, Rabin
When SATi or TATi were used as a grouping factor no significant Medical Center, Petah Tikva, Israel
differences in muscle loss were found.
Rationale: High protein intake associated with physical can
Conclusion: Skeletal muscle loss in sepsis is blunted in patients
overcome anabolic resistance. In the ICU, a stationary bicycle
with a higher visceral adipose tissue mass. This supports the
with a motor enabling passive and/or active movement of the
hypothesis that metabolic inflexibility in obesity protects
lower extremities has been shown to be safe. We studied the
against catabolic stimuli in sepsis.
use of cycle ergometry (CE) associated with high protein
Disclosure of Interest: None declared. enteral intake on duration of mechanical ventilation, length of
stay and mortality.
OR62 Methods: 75 ventilated patients (>48 h) expected to be
ASSOCIATION OF BODY MASS INDEX AND OUTCOME IN ventilated for the next 7 days were intended to be included.
CHRONIC HEMODIALYSIS PATIENTS REQUIRING INTENSIVE BMI > 45 kg/m2, open abdominal wounds, and conditions
CARE THERAPY impairing cycling were exclusion criteria. After consent,
W. Druml1 *, W. Winnicki1, P. Metnitz2, P. Zajic3, T. Fellinger4, patients were prospectively randomized in a control group
B. Metnitz4. 1Klinik für Innere Medizin III, Nephrologie, Wien, receiving conventional physiotherapy and a regular enteral
2
Department of Anaesthesiology and Intensive Care Medicine, feeding (Jevity, Abbott, USA) (G1). The second group received
Medical University of Graz, 3Department of Anaesthesiology the same formula with CE (20 min/d) (G2). The third group (G3)
and Intensive Care Medicine, Medical University of Graz, Graz, had same CE training with a protein enriched formula (Promote,
4
Austrian Centre for Documentation and Quality Assurance in Abbott, USA). Patients received 80% REE. Successful weaning
Intensive Care, Wien, Austria was defined if the patient was breathing for 48 hours without
support. One way ANOVA was used for statistical analysis.
Rationale: In patients with end-stage renal disease (ESRD) a Results: There was no difference between the groups regarding
positive association of body mass index (BMI) and outcome, the demographic, APACHE II, SOFA, REE. Group 3 (n = 19) received
83 ± 25 g/d protein, significantly more than G1 (n = 22) and G2 OR65

(n = 21) ( p < 0.02). ICU LOV was 20 ± 19, 23 ± 17 and 22 ± 22 days A RANDOMIZED TRIAL OF SELENIUM SUPPLEMENTATION IN
for the 3 ITT groups respectively (NS). A lower rate of HIGH-RISK CARDIAC SURGERY PATIENTS: RESULTS OF A
pneumonia (37%) in G3 was observed compared to G1 (43%) MULTICENTRE PILOT STUDY
and G3 (72%) ( p = 0.06). No difference was found in hospital LOS C. Stoppe1 *, B. Mcdonald2, A. Goetzenich3, M. Lemieux4,
or mortality. Patients successfully extubated were 10, 8 and 10 D. Heyland4. 1Intensive Care Medicine, RWTH Aachen
respectively (NS). University, Aachen, Germany, 2Division of Cardiac
Conclusion: A high protein regimen associated with cycle Anesthesiology and Critical Care Medicine, University of
ergometry showed a trend to VAP decrease but did not show a Ottawa Heart Institute, Ottawa, Canada, 3Department of
decrease in length of ventilation, length of stay or mortality in Thoracic, Cardiac and Vascular Surgery, RWTH Aachen
ICU ventilated patients. University, Aachen, Germany, 4Clinical Evaluation
Disclosure of Interest: I. Kagan: None declared, S. Kremer: None Research Unit, Kingston General Hospital, Kingston,
declared, M. Theilla: None declared, I. Bendavid: None declared, Kingston, Canada
P. Singer Grant/Research Support from: Abbott research grant,
J. Cohen: None declared. Rationale: The development of organ failure frequently occurs
after cardiac surgery, particularly in high-risk patients with
OR64 complex procedures. Selenium is considered as cornerstone of
FASTING IS THE STRONGEST RISK FACTOR FOR HOSPITAL antioxidant defense mechanisms and its perioperative supple-
MORTALITY IN CRITICALLY ILL UNDERWEIGHT PATIENTS mentation may offer therapeutic benefits. Prior to launching a
M. V. Viana1,2, L. V. Viana3,4 *, L. A. Gross5, V. L. Costa5, large-scale trial we conducted a multicenter, randomized pilot
A. L. J. Tavares5, T. A. Tonietto2,6, R. B. Moraes6, M. J. Azevedo3. trial to determine its feasibility.
1
Critical Care, Hospital de Clinicas de Porto Alegre, 2Critical Methods: Patients scheduled to undergo elective cardiac
Care, Hospital Nossa Senhora da Conceição, 3Endocrinology surgery with a high perioperative risk profile were randomized
Division, 4Medical Nutrition Division, 5Universidade Federal do to receive placebo or high dose IV selenium supplementation
Rio Grande do Sul, 6Critical Care, Hospital de Clinicas de Porto (2,000 µg prior sugery, 2,000 µg postoperative and 1,000 µg
Alegre, Porto Alegre, Brazil daily in ICU). Patients with severe renal dysfunction, chronic
liver disease, heart transplant or LVAD insertion were excluded.
Rationale: Critically ill underweight patients have worse The 3 main outcomes of the pilot study were to determine
outcomes than normal or overweight patients. The impact of feasibility, recruitment rates, adherence to the protocol and
fasting in this population is not stablished. contamination. We plan to roll the pilot study into a large-scale
Methods: Prospective, two-center, observational study, was trial and therefore, only cohort data will be reported.
designed to assess the effect of fasting in underweight critically Results: 73 patients from 6 ICUs were enrolled in Canada and
ill patients. All patients consecutively admitted (November Germany. The recruitment rate was 2.6 patients/month (0.9–
2015 to February 2017) to general intensive care units (ICU) 2.3). The average duration of the study intervention was 5.0
with IMC <20 kg/m2 were included. Exclusion criteria were: days [3.0, 12.0] and there was a 94% compliance with dose
palliative care, exclusively oral nutrition, pregnancy, life administration. Three (4.1%) patients died by day 30 and 30-day
expectancy <24 h and discharge before day 5 of ICU admission. post-op organ dysfunction plus death was 4 (5.5%). Selenium
Patients had their fasting status evaluated after ICU admission levels (434 µg/ml) remained multiple times below the refer-
between days 2 and 3 (1st evaluation) and 5 and 7 (2nd ence range of 1,000 µg/ml. 50% of patients showed a significant
evaluation). Patients were divided into two groups: fasting intraoperative decrease of selenium and selenoprotein-P
group those that did not receive nutrition support at least in (SePP), whereas 50% demonstrated a intraoperative increase.
one evaluation and fed group those that received nutrition Explorative correlation analysis revealed a significant inverse
support both evaluations. Patients were followed until hospital correlation between SePP and IL-6 ( p < 0.001).
discharge. Conclusion: Selenium supplementation in cardiac surgery
Results: The hospital mortality rate of 189 included patients patients seems feasible based on the multi-centre inter-
was 60.8% after 10(6–26) days of follow-up (age 54.2 ± 16.8 national pilot study. A larger, definitive trial is warranted and
years, male 114(60.3%), SAPS3 68.4 ± 13.3, BMI 17.5 ± 2.2, currently being launched.
NUTRIC 4.4 ± 1.7). The fasting group had higher NUTRIC scores Disclosure of Interest: None declared.
(4.9 ± 1.8 vs 4.2 ± 1.6 p = 0.012) and were more commonly
surgical patients (69.9% vs 56.4% p = 0.001) compared with the OR66
fed group. The fasting group had higher lactate levels (mmol/L) REGULATION OF POSTNATAL MYONUCLEAR ACCRETION
(1.6[1–2.6] vs 1.3 [1.0–1.8] p = 0.046) compared to the fed ASSESSED BY A NOVEL IN VITRO MODEL
group. There was no difference between fasting and fed group
A. E. M. Kneppers1 *, L. B. Verdijk2, C. C. de Theije1,
regarding SAPS3 score, BMI and gender. In cox regression
L. J. C. van Loon2, A. M. W. J. Schols1, R. C. J. Langen1.
multivariate regression model (HR, 95%), fasting was inde- 1
Respiratory Medicine, 2Human Biology and Movement
pendently associated with mortality (fasting 2.08[1.33–3.27];
Sciences, NUTRIM School of Nutrition and Translational
SAPS3 1.01[0.99–1.03]; NUTRIC 1.14[0.99–1.30]; surgical
Research in Metabolism, Maastricht University
admission 0.94 [0.44–2.0]; lactate 1.13[1.06–1.21]).
Medical Centre+, Maastricht, Netherlands
Conclusion: In underweight critically ill patients fasting was
the strongest predictor for in-hospital mortality. Rationale: Postnatal myogenesis is an essential process for
Disclosure of Interest: None declared. muscle maintenance, and is facilitated by satellite cells.
Oral Communication VII: Critical Care S27
Alterations in myogenesis markers have been shown in skeletal patients presented caloric deficit with a mean (SD) of 1,812
muscle biopsies of patients affected by sarcopenia. Although ± 850 kcal in 5 days. Twenty-three (27.0%) presented a deficit
satellite cell proliferation and differentiation have been greater than 480 kcal/day. The mean (SD) protein deficit was
studied in vivo and in vitro, the regulation of fusion with 94.6 ± 45.9 g in 5 days and 34 (40%) patients had protein déficit
muscle fibres (i.e. postnatal myonuclear accretion) remains above 20 g/day. Both caloric and protein deficits were
largely unexplored because of methodological limitations. We associated with greater amount of IVF and higher infusion of
developed an in vitro model of postnatal myonuclear accretion sodium ( p < 0.001). Patients with caloric deficit >480 kcal/day
and explored the responses to regulatory cues of muscle growth received approximately 1.5 L of IVF and 10 g of NaCl more than
and recovery. others. Patients with protein deficit >20 g/day received
Methods: We established a Cre/LoxP-based reporter system, approximately 3 L of IVF and 25 g of NaCl more than others.
which allows the expression of luciferase only after fusion of Conclusion: In critically ill patients receiving enteral nutrition
LoxP-Luc myoblasts (MB) with 4 days differentiated Cre the amount of intravenous fluids may influence the delivery of
myotubes (MT). Luciferase activity was assessed luminome- the diet and increase the deficit of both calories and protein.
trically as a measure of postnatal myonuclear accretion. Disclosure of Interest: None declared.
Results: Treatment of co-cultures with the myogenic factor
IGF-I ( p < 0.001), the metabolic cue Eicosapentaenoic acid
OR68
( p < 0.001), and the cytokines IL-13 and IL-4 ( p < 0.05, p <
PARENTERAL OMEGA-3 REDUCED LEVELS OF PRO-
0.001) increased myonuclear accretion, while treatment with
INFLAMMATORY INTERLEUKIN-17, RESULTS OF A
the myogenic inhibitor Myostatin ( p < 0.05), and TNF-α ( p <
RANDOMISED CONTROLLED TRIAL IN CRITICALLY ILL
0.001) decreased myonuclear accretion. Furthermore, recov-
PATIENTS WITH SEPSIS
ery from MT atrophy and damage (induced by LY294002 and
electrical stimulation resp.) was accompanied by increased D. K. Bilku1 *, T. Hall1, D. Al-Leswas1, C. Horst1, J. Cooke1,
myonuclear accretion ( p < 0.001, p = 0.052 resp.). M. Metcalfe1, A. Dennison1. 1University Hospitals of Leicester
Conclusion: We developed a physiologically relevant, sensi- NHS Trust, Leicester, United Kingdom
tive, high throughput in vitro cell system for quantitative
Rationale: Severe sepsis in Intensive Care Units (ICU) is
assessment of postnatal myonuclear accretion, which will
associated with high mortality (40%). Omega-3 (ω-3) has been
contribute to a better comprehension of the molecular
shown to attenuate uncontrolled inflammation and produce
regulation of myonuclear accretion and the modulatory
clinical benefit. This study explores the role of omega-3 in
effects of metabolic cues, and as such, will help optimize
sepsis.
current and develop new interventions for sarcopenia.
Methods: 60 consecutive septic patients in ICU were rando-
Disclosure of Interest: None declared. mised to receive either parenteral ω-3 or standard medical
therapy. The primary outcome was effect of ω-3 on cytokine
OR67 profile. The secondary outcome was to examine the association
EFFECTS OF THE INFUSION OF INTRAVENOUS FLUIDS ON THE between cytokine concentrations, maximum Sequential Organ
CALORIC AND PROTEIN DEFICITS IN CRITICALLY ILL PATIENTS Failure Assessment (max-SOFA) score and 28-day mortality.
S. Arantes1, J. E. De Aguilar-Nascimento1 *, Data was analysed using mixed linear regression.
D. B. Dock-Nascimento2. 1Varzea Grande University (UNIVAG), Results: Omega-3 significantly reduced Interleukin (IL-17) in
2
Federal University of Mato Grosso, Cuiaba, Brazil ω-3 group ( p = 0.035). Also, concentration of other pro-
inflammatory cytokines (E-selectin, VCAM, ICAM, TNFR1,
Rationale: Overload of intravenous fluids (IVF) may lead to TNF-α, IL-17, IL-12, IL-6, IL-1b) were higher in the control (C)
dismotility that may impair the delivery of early enteral group as compared to the fish oil (FO) group. Max-SOFA scores
nutrition (EEN). The aim of this study was to correlate the for cytokines IL1RA ( p = 0.001), IL-6 (0.01) and TNFR1 ( p <
amount of volume of IVF with the occurrence of caloric and 0.001) were significantly associated with cytokine concentra-
protein deficits in ICU patients tion. There was significant association between 28-day
Methods: This is a cohort study involving 86 (39 males) mortality and concentration of VCAM on day 1 (0.05) and day
mechanical ventilated critically ill patients (mean SAPS III: 5 (0.03). Similarly, significant association was observed
62 ± 10) with a mean age 68 (18–91) years old. EEN was initiated between mortality and concentration of IL-17 on day 3
in all patients aiming to a goal of 25–30 kcal/kg/day and 1.25– (0.02). ICAM and 28-day mortality were associated on day 1
2.0 g of protein/kg/day. Patients were divided in those with (0.05) and day 5 (0.05).
caloric deficit below or above 480 kcal/day and with protein Conclusion: Cytokine IL-17 was the best predictor of patient
deficit below or above 20 g of protein/day. The endpoint of the outcome and its concentration was significantly affected by ω-
study was to correlate the amount of IVF infused with the 3. In future, it may be used as a marker of patient severity and
deficit caloric and protein. Comparisons were done using to measure the effect of FO on the patient. There was
unpaired T Student test with a significance level of 5% significant association between Max-SOFA, 28-day mortality
( p < 0.05). and concentration of some cytokines.
Results: Patients received a median of 2,969 (920–5,960) Disclosure of Interest: None declared.
ml/day of IVF, which corresponded to a median of 41.6 (17.0–
88.2) ml/kg/day and 10.7 (3.31–21.45) g of sodium/day. All
Clinical Nutrition
Poster tours
assessment cannot be used as a proxy for overall muscle
Poster Tour 1: Geriatrics
strength. Further studies are warranted to identify if measure-
PT01.1 ment of HGS and QS predict the same health outcomes in
AGREEMENT OF HANDGRIP STRENGTH AND QUADRICEPS clinical practice.
STRENGTH DEPENDENT ON AGE AND HEALTH STATUS Disclosure of Interest: None declared.
S. S. Y. Yeung1,2 *, E. M. Reijnierse2, M. C. Trappenburg3,4,
J.-Y. Hogrel5, J. S. Mcphee6, M. Piasecki6, S. Sipila7, PT01.2
A. Salpakoski8, C. G. M. Meskers1,9, A. B. Maier1,2. 1Human ASSOCIATION BETWEEN CLINICAL VARIABLES AND
Movement Sciences, MOVE Research Institute Amsterdam, NUTRITIONAL STATUS WITH EVOLUTION TO DEATH FOR
Vrije Universiteit, Amsterdam, Netherlands, 2Medicine and ELDERLY CANCER PATIENTS – A MULTICENTRIC STUDY
Aged Care, University of Melbourne, Melbourne, Australia, C. D’almeida1,2 *, R. B. Martucci1,3, V. D. Rodrigues1, N. Pinho1,
3
Internal Medicine, Section of Gerontology and Geriatrics, VU W. Peres2, A. Ramalho2. 1Nutrition and Dietetics, National
University Medical Center, Amsterdam, 4Internal Medicine, Cancer Institute, Brazil, 2Nutrition Institute, Federal
Amstelland Hospital, Amstelveen, Netherlands, University of Rio de Janeiro, 3Nutrition Institute, State
5
Neuromuscular Physiology Laboratory, Institut de Myologie, University of Rio de Janeiro, Rio de Janeiro, Brazil
Paris, France, 6School of Healthcare Science, Manchester
Metropolitan University, Manchester, United Kingdom, Rationale: Nutritional assessment and intervention plays an
7
Gerontology Research Centre, Faculty of Sport and Health important role in the treatment of elderly cancer patients. The
Sciences, University of Jyvaskyla, Jyvaskyla, 8Research and objective was to evaluate the association between clinical and
Development, Mikkeli University of Applied Sciences, Mikkeli, nutritional status variables with death evolution in elderly
Finland, 9Rehabilitation Medicine, VU University Medical cancer patients.
Center, Amsterdam, Netherlands Methods: Multicenter, hospital-based cohort study, included 44
institutions. 3,061 elderly cancer hospitalized individuals were
Rationale: Low muscle strength, i.e. dynapenia is predictive submitted to Mini Nutritional Assessment-Short Form (MNA-SF)
for various negative health outcomes and usually assessed by within 24 hours after hospitalization date. Both genders, over
hand held dynamometry (handgrip strength - HGS). However 65 years old, cancer diagnosis, regardless of location or staging
whether HGS can be used as a proxy for overall muscle strength disease, were included. A univariate analysis was performed to
and whether this depends on age and health status is unknown. identify the explanatory variables related to the death
This study aimed to assess the agreement between HGS and outcome in up to 30 days; Considering gender, age range, Calf
quadriceps strength (QS) in various populations of individuals Circumference (CC), MNA-SF score and classification. Results
differing in age and health status. were expressed as frequency and percentage or mean and
Methods: Five cohorts (in total 960 individuals) encompassing standard deviation. The relative risk (RR) was calculated
young and old healthy individuals and geriatric outpatients of according to logistic regression individually.
which both HGS and QS data were available were included. Results: The mean age was 73.4 ± 6.6 years, mean CC
Pearson correlation coefficients were calculated to analyse the 32.0 ± 4.2 cm. 1,339 women (43.7%) and 1,722 men (56.3%)
overall association between HGS and QS. To allow further were identified. According to MNA-SF, 33.5% patients were
comparison between HGS and QS, HGS and QS were standar- malnourished, while 39.3% were nutritional risk and 27.2% were
dized into z-scores. Intraclass correlation coefficients (ICC) classified normal nutritional status. CC values were obtained in
were subsequently calculated to examine the agreement 92% of the cases, where 33.5% presented values <31 cm and
between z-score of HGS and z-score of QS at population level. ≥31 cm were 58.5%. Of all the variables studied, those
Results: Pearson correlation coefficients were between 0.45 associated with death within 30 days, were the female
and 0.73 in healthy young, 0.36 and 0.68 in healthy old, and gender (RR = 1.54, 1.19–2.01 CI95%, p = 0.001); Age range ≥75
0.60 and 0.73 in geriatric outpatients ( p < 0.05 for all cohorts). years (RR = 1.63, 1.18–2.26 CI95%, p = 0.003); CC <31 cm
ICC values were weak to moderate over all populations: i.e. (RR = 2.65, 2.00–3.53 CI95%, p < 0.0001); MNA-SF score ≤7
healthy young (0.41–0.45), healthy old individuals (0.36–0.41) points (RR = 8.60, 6.25–11.7 CI95%, p < 0.0001) and malnutri-
and geriatric outpatients (0.54). tion according to MNA-SF (RR = 17.2, 9.29–31.8 CI95%,
Conclusion: Based on both Pearson correlation coefficients and p < 0.0001).
ICC, HGS and QS show overall insufficient agreement. HGS
S30 Poster tours
Conclusion: The MNA-SF classification and Score, and the CC Rationale: An unfavorable change in body composition with
were shown to be an efficient nutritional indicator capable of increasing age, i.e. loss of muscle mass, will influence
identifying the 30-day mortality risk in this population. functionality and risk of developing sarcopenia. However
Disclosure of Interest: None declared. there are indications that macronutrient (e.g. protein) may
affect protein turn-over in skeletal muscle. Against this
background we examined how energy and macronutrient
PT01.3
intake at age 70 was associated to sarcopenia approximately
A REVIEW OF NUTRITIONAL SCREENING TOOLS USED IN
18 years later.
OLDER ADULTS
Methods: The participants are part of a larger study population
L. C. Power1,2 *, D. Mullally1,2, M. A. de van der Schueren3,4, of men (Uppsala Longitudinal Study of Adult Men) born
E. R. Gibney2,5, M. Clarke2,5, L. A. Bardon2,5, C. Corish1,2, between 1920 and 1924, living in Uppsala county, Sweden.
on behalf of the MaNuEL Consortium. 1School of Public Health, Dietary intake at age 70 was determined by a 7-day estimated
Physiotherapy and Sports Science, 2Institute of Food and food record. Dual-energy X-ray absorptiometry (DXA), gait-
Health, University College Dublin, Dublin, Ireland, speed and handgrip strength were examined approximately 18
3
Department of Nutrition and Dietetics, VU University Medical years later. The criteria established by the European Working
Centre, Amsterdam, 4Department of Nutrition and Health, Group on Sarcopenia in Older People were used to define
HAN University of Applied Sciences, Nijmegen, Netherlands, sarcopenia. T-test was used for statistical analysis.
5
Department of Agriculture and Food Science, University Results: A total of 255 elderly men, identified as adequate
College Dublin, Dublin, Ireland dietary reporters, (mean age 86.6 ± 1.0 year, BMI 25.6 ± 3.5 kg/m2
and weight 76.3 ± 11.4 kg) were include of which 54 men
Rationale: Many nutritional screening tools (NSTs) are used in
(21.2%) were defined as sarcopenic (mean age 86.6 ± 1.0 year,
older adults (>65 years), each containing a diverse range of
BMI 23.4 ± 2.6 kg/m2 and weight 67.9 ± 9.1 kg). The non-
parameters and validated against different standards. An
sarcopenic men (n = 201, mean age 86.6 ± 1.0 year, BMI 26.2 ±
objective of the EU Malnutrition in the Elderly Knowledge
3.4 kg/m2 and weight 78.6 ± 10.9 kg) had a significantly
hub (MaNuEL) project is to review existing NSTs used in older
higher ( p = 0.0001) BMI and body weight compared to the
adults in various healthcare settings.
sarcopenic men.
Methods: A literature review using a systematic approach was
There was no significant difference in the intake of energy or
conducted. Electronic searches were performed in the following
macronutrients between the sarcopenic (energy 1,803 ± 447
databases; PubMed Central, CINAHL Plus and Science Direct.
kcal, fat 70.8 ± 23.1 g, carbohydrate 216.5 ± 59.8 g and protein
Results: 48 NSTs and 110 validation studies were identified.
68.2 ± 17.3 g) and non-sarcopenic men (energy 1,870 ± 439
Validation results vary greatly, with sensitivities and specifi-
kcal, fat 73.3 ± 20.5 g, carbohydrate 225.7 ± 60.4 g and protein
cities ranging from 0.06–1.0 and 0.12–1.0 respectively. Poor
69.5 ± 15.8 g).
study designs (i.e. tools not validated against an appropriate
Conclusion: We found no correlation between energy or
‘gold standard’ method) were apparent for many of the tools.
macronutrient intake at age 70 and the prevalence of
Twenty-three (47%) tools were designed specifically for older
sarcopenia 18 years later in this cohort of community dwelling
adults (e.g. MNA-SF) and twenty-five (53%) were designed for
men.
general adult use (e.g. NRS-2002, MUST). Furthermore, each
tool included different parameters (54 different parameters Disclosure of Interest: None declared.
were identified), some of which are considered more appro-
priate for malnutrition screening in older adults (e.g. weight PT01.5
loss) than others (e.g. serum albumin). LONGITUDINAL ASSOCIATIONS BETWEEN VITAMIN D
Conclusion: Although many NSTs are recommended for use in METABOLITES AND SARCOPENIA IN OLDER AUSTRALIAN MEN:
older adults, their derivation and/or validation in younger THE CONCORD HEALTH AND AGEING IN MEN PROJECT
populations mean that they may not be reliable in older adults V. Hirani1 *, F. Blyth2, V. Naganathan2, R. Cumming3. 1School of
or in settings outside those in which they have been validated. Life and Environmental Sciences, Faculty of Science, 2Concord
Further work of the MaNuEL project involves the creation of a Clinical School, 3School of Public Health, University of Sydney,
scoring system to determine the most appropriate NSTs for use Sydney, Australia
in older adults.
This work was supported by funding from the Department of Rationale: Sarcopenia, an age associated reduction in skeletal
Agriculture, Food and the Marine and Health Research Board muscle mass and strength as well as hypovitaminosis D are
through the Joint Programming Initiative – A Healthy Diet for a major clinical problems among older people. The aims of this
Healthy Life (JPI HDHL) Knowledge Hub on Malnutrition in the study are to explore the associations between serum 25-
Elderly (MaNuEL). hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D)
Disclosure of Interest: None declared. levels at baseline and incidence of sarcopenia over time in
older Australian community-dwelling older men.
Methods: Men aged ≥70 years (2005–07) from the Concord
PT01.4
Health and Ageing in Men Project were assesed at baseline, two
ENERGY AND MACRONUTRIENT INTAKE AT AGE 70 IS NOT
year and five year follow up. The main outcome measurement
ASSOCIATED WITH PREVALENCE OF SARCOPENIA AT AGE 88
was the incidence of sarcopenia defined as appendicular lean
M. Karlsson1 *, T. Cederholm1, W. Becker1, P. Sjogren1. mass adjusted for body mass index <0.789 and grip strength <
1
Department of Public Health and Caring Sciences, Uppsala 26.0 kg using the Foundation for the National Institutes of
University, Clinical Nutrition and Metabolism, Uppsala, Sweden Health definition of sarcopenia. Serum 25D and 1,25D levels
Poster Tour 2: Liver and GI S31
were measured at baseline by radioimmunoassay (Diasorin, Conclusion: Geriatric outpatients using specific drug groups
Stillwater, MN, USA) and categorised into quartiles as predictor had significantly lower magnesium levels compared to non-
variables. Covariates included age, income, season of blood users. For further research, routine magnesium measurement
collection, physical activity, vitamin D supplement and in patient populations may provide deeper insight in effects of
medication use, measures of health, serum parathyroid drug use and other risk factors of hypomagnesemia and in
hormone and estimated glomerular filtration rate. clinical implications.
Results: Incidence of sarcopenia was 3.9% at the 2-year follow- Disclosure of Interest: None declared.
up and 8.6% at 5-year follow-up. Vitamin D levels in the lowest
quartiles (25D < 40 nmol/l;1,25D < 62 pmol/l) were associated
with the incidence of sarcopenia over 5 years after adjustment
for potential confounders and covariates of clinical signifi-
Poster Tour 2: Liver and GI
cance (25D:OR 2.53 (95%CI 1.14, 5.64) p = 0.02;1,25D:OR 2.67 PT02.1
(95%CI 1.28, 5.60) p = 0.01). DYSREGULATED BILE SALT HOMEOSTASIS IN ADULT PATIENTS
Conclusion: Low serum 25D and 1,25D concentrations at WITH CHRONIC INTESTINAL FAILURE
baseline are independently associated with the incidence of
A. Huijbers1 *, K. V. Koelfat2, F. G. Schaap2, M. Lenicek3,
sarcopenia over the subsequent five years. Although our data
G. J. Wanten1, S. W. Olde Damink2. 1Department of
do not prove any causal relationship, it is conceivable that
Gastroenterology & Hepatology, Radboud University Medical
maintaining vitamin D sufficiency may reduce the incidence of
Center, Nijmegen, 2Maastricht University Medical Center and
sarcopenia in ageing men.
NUTRIM School of Nutrition and Translational Research in
Disclosure of Interest: None declared. Metabolism, Maastricht University, Maastricht, Netherlands,
3
Department of Medical Biochemistry and Laboratory
PT01.6 Diagnostics, Charles University, Prague, Czech Republic
DRUG USE AND SERUM MAGNESIUM IN DUTCH GERIATRIC
OUTPATIENTS Rationale: Patients with chronic intestinal failure (CIF) can
A. C. B. van Orten-Luiten1,2 *, A. Janse2,3, develop Intestinal Failure Associated Liver Disease (IFALD).
E. M. Brouwer-Brolsma1, R. F. Witkamp1,2. 1Human Nutrition, Dysregulation of the ileal bile salt receptor FXR/FGF19 axis that
Wageningen University, Wageningen, 2Nutrition Alliance controls hepatic bile salt synthesis is implicated in the etiology
Gelderse Vallei, 3Geriatric Medicine, Gelderse Vallei Hospital, of pediatric IFALD. The objective of this study was to explore
Ede, Netherlands this axis in adult CIF patients.
Methods: In 77 adult CIF patients, plasma levels of total bile
Rationale: This study aims to identify drug groups associated salts (TBS), C4 (a bile salt synthesis marker) and FGF19 were
with hypomagnesemia and to quantify the impact of their determined. Comparisons were made between groups of
usage on blood magnesium level. More knowledge on this type patients with and without terminal ileum. Correlations were
of drug-nutrient interactions might be clinically relevant, as evaluated by Spearman (ρ) correlation coefficient. Multiple
low magnesium levels are related to cardiovascular problems, linear regression analysis was performed to evaluate the
diabetes, and other clinical problems. independent relationship of the studied variables. Data are
Methods: Cross-sectional data of 358 geriatric outpatients of a expressed as median [IQR].
Dutch general hospital were analysed by multivariate linear Results: The main reason for home parenteral nutrition (HPN)
and logistic regression. Magnesium level and hypomagnesemia in the resection group (n = 36) was short bowel syndrome (78%).
(serum magnesium <0.70 mmol/l) in users of 22 different drug Intestinal dysmotility was the main reason (68%) for HPN in the
groups were compared to the magnesium status of non-users. group without terminal ileum resection (n = 41). ALP levels
Drug groups were coded according to the Anatomical were higher in the resection group (127 [103–163] vs. 98 [71–
Therapeutic Chemical Classification System. 120] IU/L, P < 0.001). Plasma FGF19 was markedly lower (14 [8–
Results: Mean serum magnesium level was 0.80 ± 0.11 mmol/l, 33] vs. 148 [88–400] pg/mL, P < 0.0001), while C4 was notably
overall prevalence of hypomagnesemia 12%, in males and higher (171 [107–302] vs. 11.4 [5.0–27.1] ng/mL, P < 0.0001]) in
females 9% and 15%, respectively; 68% of the subjects used ≥5 the resection group, in line with loss of FGF19-mediated
medications ( polypharmacy). Associations between drug use repression of bile salt synthesis. C4 and FGF19 levels were
and hypomagnesemia were observed for proton pump inhibi- negatively correlated (ρ = −0.80, P < 0.0001). Plasma TBS was
tors ( prevalence odds ratio (POR) 2.09; 95% CI 1.03–4.24), comparable in both groups. Frequency of HPN use was
insulins (POR 4.99; 95% CI 1.64–15.20), metformin (POR 4.21; independently associated with FGF19 levels (P = 0.02) in CIF
95% CI 1.89–9.37), vitamin K antagonists (POR 2.78; 95% CI 1.25– patients with terminal ileum resection.
6.17), and selective beta blockers (POR 2.19; 95% CI 1.10–4.36) Conclusion: This study indicates that disruption of the
after adjustment for gender, age, body mass index, Mini enterohepatic circulation in CIF patients without terminal
Nutrition Assessment screening score, glomerular filtration ileum, results in and potentially promotes liver injury.
rate, and sodium blood level. Compared to non-users, users of Restoring control of bile salt synthesis could be a therapeutical
these drug groups had lower magnesium levels of respectively option in these patients.
0.03 mmol/l ( p = 0.01), 0.07 mmol/l ( p = 0.01), 0.10 mmol/l Disclosure of Interest: None declared.
( p < 0.01), 0.03 mmol/l ( p = 0.04), and 0.03 mmol/l ( p = 0.04).
S32 Poster tours
PT02.2 Methods: Twenty patients with suspected NCGS (14F/6M, age

TREATMENT OF ENTEROATMOSPHERIC FISTULAS BY CHYME range: 21–62 y) were included. All patients went through four
REINFUSION IN 43 CONSECUTIVE PATIENTS periods of double-blind provocation with gluten/placebo. They
D. Picot1 *, S. Layec1, L. Dussaulx1, F. Trivin1, M. Carsin1. randomly received two packages of muffin-mix with gluten,
1
Digestive and Nutritional Rehabilitation Unit, Clinique Saint and two packages with placebo, and were instructed to eat two
Yves, Rennes Cedex, France muffins a day (11 g gluten) for four days, followed by a three
days’ wash-out. Gastrointestinal symptoms were recorded with
Rationale: In case of enteroatmospheric (or exposed) fistula symptom the questionnaires IBS-SSS and IBS-SQ after each
(EAF), small bowel is completely interrupted. If enteric outputs provocation.
are high, parenteral nutrition (PN) is proposed. Otherwise, Results: Four out of twenty patients (20%) correctly identified
chyme reinfusion (CR) is a technique of enteral nutrition (EN) the two periods when they received muffins containing gluten
that artificially restores digestive continuity and functions till as relapse of abdominal symptoms, hence were diagnosed with
the surgical repair (SR). NCGS. The diagnosed group showed higher symptom scores
Aims: to study the efficacy of CR in 43 patients ( pts) with EAF than the not-diagnosed group both at baseline, after gluten
regarding intestinal function, nutritional status and reduction exposure and after placebo, and there was a significant
of parenteral nutrition (PN). difference in gastrointestinal symptoms between the two
Methods: Retrospective study of 43 pts admitted for EAF and groups after provocation with gluten ( p = 0.047). The not-
treated by CR from 1996 to 2016. Durations (d) were expressed diagnosed group showed the most severe symptoms after
as medians ± interquartile ranges. Albumin (g/L), Nutritional placebo. Symptom severity increased significantly from base-
Risk Index (NRl = albumin × 1.519 + 41.77 × current weigh/usual line to after gluten for the diagnosed group ( p = 0.045) and
weight; severe undernutrition if <83.5) were compared by from baseline to after placebo for the not-diagnosed group
paired Student’s t test and distribution of NRI by Chi2 test. ( p = 0.032).
Results: Location of EAF: jejunum (32), ileum (11). Origin of Conclusion: This randomized, double-blind placebo-controlled
fistulas was cancer (5), mechanical (16), infection (22). Mean challenge identified symptom relapse in accordance with
fistula outputs were 1,686 ± 813 ml/24 h (max 4,022), nitrogen gluten intake in a small group of patients with suspected
absorption was 53% of ingesta. CR was begun 8 ± 12 d after NCGS. Baseline symptom severity may identify reliably the
admission and continued for 38 patients until SR (86 ± 80 d). subgroup of patients confirmed to be true non-coeliac gluten
During CR, 21 pts were exclusively fed orally, 4 had exclusive intolerant.
EN, 18 had supplemental EN (total ingesta 35.6 ± 12.8 kcal/kg/ Disclosure of Interest: None declared.
d, 1,7 ± 0.6 g/kg/d proteins). PN (n = 39) was stopped in 28 pts,
5 ± 15 d after the beginning of CR, saving 1,119 d of PN. The
PT02.4
nutritional status improved: albumin (37 pairs, +4.7 ± 6.4 g/L,
LATE EVENING SNACK WITH BRANCHED CHAIN AMINO ACID
p < 0.001), NRI (32 pairs, +7,0 ± 10, p < 0.001). The number of
IMPROVES FISCHER RATIO AT FASTING, IN THE NEXT MORNING
severely malnourished pts fell from 22/32 to 8/32 ( p < 0.01).
The CR was stopped after healing without surgery (1) and H. Maki1 *, H. Yamanaka-Okumura2, T. Katayama3, Y. Ozawa4,
because of cancer relapse (2). All others had a SR. A. Hosoda1, N. Kurata5, F. Amemiya6. 1Department of
Conclusion: When the efferent part of the small bowel is Pharmacy, Kofu Municipal Hospital, Kofu, 2Department of
accessible, CR is a safe and inexpensive method of EN that Clinical Nutrition and Food Management, Institute of
restores bowel function. In most cases, it enables stopping PN Biomedical Sciences, Tokushima University Graduate School,
and helps to improve the nutritional status until surgical Tokushima, 3Departments of Statistics and Computer Science,
reconstruction. College of Nursing Art and Science, University of Hyogo,
Akashi, 4Department of Nutrition management, Kofu
Disclosure of Interest: None declared. Municipal Hospital, Kofu, 5Department of Healthcare and
Regulatory Sciences, Showa University School of Pharmacy,
PT02.3 Tokyo, 6Department of Internal Medicine, Kofu Municipal
THE EFFECT OF A CONTROLLED GLUTEN CHALLENGE IN Hospital, Kofu, Japan
PATIENTS WITH SUSPECTED NON-COELIAC GLUTEN
SENSITIVITY: A RANDOMIZED, DOUBLE-BLIND PLACEBO- Rationale: Late evening snack (LES) is recommended to
CONTROLLED CHALLENGE improve liver cirrhosis, in early starvation. In patients with
H. F. Dale1 *, J. G. Hatlebakk1,2,3, N. Hovdenak3, S. O. Ystad1,2, liver cirrhosis, it is important to maintain branched chain amino
G. A. Lied1,2,3. 1Centre for Nutrition, Department of Clinical acid (BCAA) because muscles are synthesized at night.
Medicine, Faculty of Medicine and Dentistry, University of Therefore, we investigated the effects of LES with BCAA on
Bergen, 2National Centre of Functional Gastrointestinal Fischer ratio of liver cirrhosis patients.
Disorders, 3Section of Gastroenterology, Department of Methods: Ten patients with liver cirrhosis were enrolled in
Medicine, Haukeland University Hospital, Bergen, Norway this study. They were outpatients without LES. The patient
characteristics were age, 73.1 ± 8.9 years; Male/Female, 5/5;
Rationale: Non-coeliac gluten sensitivity (NCGS) is a new entity and BMI, 23.3 ± 2.4 kg/m2. The etiology was eight HCV and two
with unknown prevalence and mechanisms, and there is a need alcoholic. We measured the amino acid levels at four instances:
for a standardized procedure to confirm the diagnosis. The (1) before LES (Control) and after 1 month for each level of
objective of this study was to identify NCGS in a patient group BCAA given. (2) Aminoleban EN® as a LES with 6.1 g BCAA (LES).
without coeliac disease or wheat allergy, who reported (3) LIVACT® 2 packs a day and Aminoleban EN® until dinner with
improvement of symptoms while on a gluten-free diet. 14.1 g BCAA (BCAA-no LES). (4) LIVACT® 2 packs a day and
Poster Tour 2: Liver and GI S33
Aminoleban EN® as a LES with 14.1 g BCAA (BCAA-LES). The

0% Colon/ ≥50% Colon-in- Other Bowel
Friedman non-parametric test with post-hoc Dunn multiple Stoma Continuity/No Stoma Anatomy
comparison was used for statistical analyses.
Change at TED, PBO, TED, PBO, TED, PBO,
Results: There were no significant changes in the body weight
Wk24, n = 17* n = 16† n = 18 n = 20 n=7 n = 7‡
and serum albumin. Valine significantly increased in LES and Mean (SD)
BCAA-LES compared to that in Control. Isoleucine significantly
PS Volume
elevated in BCAA-LES compared to that in Control. There was mL/day −919 (644)§ −340 (436) −355 (306) −327 (349) −728 (532) −297 (498)
no significant difference in leucine and phenylalanine levels % −40 (18)# −19 (29) −23 (16) −24 (22) −40 (19) −19 (31)
among groups. Tyrosine significantly decreased in LES and Citrulline
µM 30.1 (18.9)§ 2.2 (6.9) 11.8 (9.9)§ 0.8 (5.3) 24.0 (20.9)§ −2.7 (7.6)
BCAA-LES compared to that in Control. Fischer ratio in LES and % 138 (50) § 8 (31) 87 (63) § 21 (71) 116 (85) § −1 (40)
BCAA-LES was significantly higher than that in Control, but
there was no significant difference from BCAA-no LES. *n = 14 with data; †n = 13 with data; ‡n = 6 with data; §P ≤ 0.01; #P < 0.05.
Furthermore, Fischer ratio was significantly higher in BCAA- Disclosure of Interest: P. Jeppesen Consultant for: Shire, Speaker
LES than that in BCAA-no LES. The Fisher ratios were as follows: Bureau of: Shire, S. Gabe Consultant for: Shire, D. Seidner Consultant
control, 1.8 ± 0.6; LES, 2.2 ± 0.8; BCAA-no LES, 1.8 ± 0.7; and for: Shire, H.-M. Lee Other: Employee for Shire, C. Olivier Other:
BCAA-LES, 2.3 ± 0.8. Employee for Shire.
Conclusion: These results suggested that it is not the BCAA
content, but LES, which is needed to improve Fischer ratio at PT02.6
fasting. CRITICAL ILLNESS IS ASSOCIATED WITH COMPROMISED FGF19
Disclosure of Interest: None declared. RESPONSE AFTER LIPID STIMULATION: AN OBSERVATIONAL
COMPARISON STUDY
PT02.5 K. V. Koelfat1,2 *, M. P. Plummer3,4, F. G. Schaap1,2, M. Lenicek5,
POST HOC ANALYSIS OF THE RELATIONSHIP BETWEEN A. M. Deane4,6, S. W. Olde Damink1,2,7. 1General Surgery,
PLASMA CITRULLINE AND PARENTERAL SUPPORT NEEDS IN Maastricht University Medical Center+, 2NUTRIM School for
PATIENTS WITH SHORT BOWEL SYNDROME WITH INTESTINAL Nutrition and Translational Research in Metabolism,
FAILURE (SBS–IF) RECEIVING TEDUGLUTIDE Maastricht, Netherlands, 3Discipline of Acute Care Medicine,
P. B. Jeppesen1 *, S. M. Gabe2, D. L. Seidner3, H.-M. Lee4, University of Adelaide, 4Department of Critical Care Services,
C. Olivier5. 1Rigshospitalet, Copenhagen, Denmark, 2St Mark’s Royal Adelaide Hospital, Adelaide, Australia, 5Department of
Hospital, Northwick Park, United Kingdom, 3Vanderbilt Clinical Biochemistry and Laboratory Diagnostics, First Faculty
University Medical Center, Nashville, 4Shire Human Genetic of Medicine, Charles University in Prague, Prague, Czech
Therapies, Inc., Lexington, United States, 5Shire International Republic, 6Discipline of Acute Care Medicine, Royal Adelaide
GmbH, Zug, Switzerland Hospital, Adelaide, Australia, 7Institute for Liver and Digestive
Health, University College London, London, United Kingdom
Rationale: Plasma citrulline ( p-cit) has been proposed as a
biomarker for remnant intestinal length, but it is unclear if p- Rationale: Gallbladder contraction and emptying is frequently
cit levels reflect intestinal absorptive function. This post hoc impaired in critical illness, and gallbladder dysmotility is
analysis investigated the relationship between parenteral associated with biliary sludge and its pancreatobiliary compli-
support (PS) volume reductions and p-cit changes with cations. Impaired gallbladder contraction can result in reduced
teduglutide (TED) in patients ( pts) with SBS–IF. intestinal delivery of bile salts, likely impacting signaling via
Methods: STEPS (NCT00798967; EudraCT2008-006193-15) was nuclear bile salt receptors (e.g. FXR) within the enterohepatic
a 24-week, placebo (PBO)–controlled study of TED 0.05 mg/kg/ tissues. In this study, serum excursions of bile salts and the FXR-
day in pts with SBS−IF. P-cit levels were assessed at baseline regulated enterokine FGF19 were studied in critically ill
(BL) and Wk24 in all pts randomized to TED and in pts stratified patients and controls following intraduodenal lipid challenge
by bowel anatomy. to induce gallbladder contraction.
Results: In the TED arm (n = 42), p-cit levels at BL were Methods: Total bile salts, FGF19 (negative regulator of bile salt
significantly correlated with remnant small bowel length synthesis) and C4 (marker for bile salt synthesis) were assayed
(R2 = 0.14; P = 0.02; n = 36) but not with BL PS volume in plasma of 24 critically ill patients (ICU) and 12 healthy
(R2 = 0.03; P = 0.30; n = 39). The correlation between BL p-cit controls (HC) during the course of a standardized intraduodenal
and p-cit change at Wk24 was significant (R2 = 0.80; P < 0.0001; lipid infusion (20% intralipid). Blood was sampled after an 8
n = 39). No correlation was found between change in p-cit hour fast, and 30 min intervals during lipid infusion (0–120 min)
levels and change in PS volume at Wk24 with TED (R2 = 0.05; until 1 hour thereafter. Differences between groups were
P = 0.16; n = 39). When pts were analyzed by bowel anatomy analyzed using Mann-Whitney U test.
subgroups, significant increases in p-cit were seen with TED but Results: At baseline, bile salts were increased in ICU patients
not PBO (Table). compared to the HC group (1.5 vs 3.3 μmol/l, p < 0.01), while
Conclusion: P-cit may serve as a marker of remnant small FGF19 and C4 levels were similar. In controls, lipid infusion
bowel length in pts with SBS–IF, but p-cit does not predict PS induced elevations of bile salts ( peak 90 min) and FGF19
volume reductions with TED. P-cit changes with TED may ( peak > 180 min). ICU patients had a similar rise in bile salts,
reflect increased enterocyte mass. but the FGF19 response was blunted, as reflected by declined
AUC ( p < 0.01). C4 levels were unchanged during the course of
lipid infusion.
S34 Poster tours
Conclusion: Serum FGF19 response following intraduodenal the lowest values of cREE, and the highest for percentage of
lipid infusion is significantly blunted in critically ill patients. hypermetabolism and REE variation.
Further studies are required to delineate functional conse- Conclusion: Compared to control populations, hypermetabo-
quences of reduced prandial FGF19 levels in ICU patients, and lism is confirmed in ALS patients. It is present with the six REE
whether potentiation of intestinal FXR has therapeutic predictive formulas used, but Mifflin equation seems the least
potential in this vulnerable patient group. adapted.
Disclosure of Interest: None declared. Disclosure of Interest: None declared.
PT03.2
Poster Tour 3: Nutrition and Chronic HIGH INTENSITY RESISTANCE EXERCISE INDUCES WHOLE
Disease 1 BODY PROTEIN CATABOLISM IN PATIENTS WITH CHRONIC
OBSTRUCTIVE PULMONARY DISEASE
PT03.1 C. Cruthirds1 *, N. Deutz1, E. Veley2, R. Harrykissoon3,
HYPERMETABOLISM IN AMYOTROPHIC LATERAL SCLEROSIS M. Engelen1. 1Healthy and Kinesiology, Texas A&M University,
PATIENTS; A CONFIRMATION BY A STUDY VERSUS CONTROL 2
Pulmonary and Critical Care, Scott and White Memorial
AND USING DIFFERENT FORMULAS FOR CALCULATING Hospital, 3Pulmonary, Critical Care & Sleep Medicine, College
THEORETICAL RESTING ENERGY EXPENDITURE LEVEL Station Medical Center, College Station, United States
P. Jésus1,2,3, P. Fayemendy1,2,3, M. Nicol2,3,4, H. Sourisseau1,
Y. Boirie5,6, S. Walrand6, M. Coëffier7,8, P. M. Preux2,3,9, Rationale: Altered protein metabolism and exercise intoler-
B. Marin2,3,9, P. Couratier2,3,4, J. C. Desport1,2,3 *. 1Nutrition ance are commonly present in patients with Chronic
Unit, University Hospital of Limoges, 2INSERM, U1094, Tropical Obstructive Pulmonary Disease (COPD). It remains unclear
Neuroepidemiology, School of Medicine, 3UMR_S 1094, Tropical whether a high intensity resistance exercise session, as
Neuroepidemiology, Institute of Neuroepidemiology and metabolic stressor, affects protein metabolism differently in
Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, COPD patients as compared to healthy older adults.
4
ALS Center, University Hospital of Limoges, Limoges, 5Clinical Methods: In 14 patients with moderate to severe COPD (FEV1:
Nutrition Unit, University Hospital of Clermont-Ferrand, 6INRA 42.5 ± 4.6% pred) and 11 healthy control subjects, whole body
UMR 1019, Human Nutrition Unit, School of Medicine, protein breakdown (PB) rate was measured and netPB assessed,
Clermont-Ferrand, 7INSERM UMR 1073, Nutrition, as marker of protein catabolism, via pulse IV infusion of L-[ring-
Inflammation and Gut-Brain Axis Dysfunction, School of 13C6]-Phenylalanine and L-[ring-D4]Tyrosine, before and twice
Medicine, 8Clinical Nutrition Unit, University Hospital of (1 and 24 h) after a whole body resistance exercise session
Rouen, Rouen, 9Center of Epidemiology, Biostatistics and consisting of 8 × 3 repetitions of maximal extensions and
Research Methodology (CEBIMER), University Hospital of flexions for each arm and leg limb using isokinetic dynamo-
Limoges, Limoges, France metry (KinCom). Fat-free mass was measured by DEXA, isotope
enrichments by LC-MS/MS and statistics (SE) by two-way
Rationale: In Amyotrophic Lateral Sclerosis (ALS) hypermeta- ANOVA/unpaired t-test. Significance was set at p < 0.05.
bolism is find in 50–60%, defined as an excessive level of resting Results: The COPD patients completed less total work per kg
energy expenditure (REE) >10% of theoretical value. 1919 FFM than the healthy controls during the resistance exercise
Harris and Benedict’s (HB) formulas are the main ones used to protocol [114.0 ± 6.3 J/kg ffm vs. 164.8 ± 13.9 J/kg ffm,
obtain the theoretical values, but other predictive formulas are respectively, p = 0.0016]. Resistance exercise did not induce
also used in current practice. The aim of the study was to assess significant changes in PB and netPB in the control group at 1 h
the level of REE in ALS patients compared to control population or 24 hr post-exercise. Also in the COPD group, exercise did not
and using six predictive formulas of theoretical REE. increase PB (Δ1h post-pre: −2.4 ± 5.3 µmol/kg ffm/h, ns) or
Methods: Nutritional assessments were performed in ALS netPB (Δ1h post-pre: −0.4 ± 0.4 µmol/kg ffm/h, ns) one hour
patient and in two control populations without hypermetabo- after exercise. However, 24 hours after exercise both PB (Δ24h
lism: (control 1 and 2). Weight, height and body composition by post-pre: 15.4 ± 5.1 µmol/kg ffm/h, p < 0.001) and netPB (Δ24h
bioimpedance analysis were assessed. REE was measured post-pre:1.3 ± 0.4 µmol/kg ffm/h, p < 0.001) were significantly
(mREE) by indirect calorimetry and calculated (cREE) using increased in COPD.
1919 HB’s and 1984 HB’s formulas, and World Schofield, De Conclusion: Despite completing less work, high intensity
Lorenzo, Johnstone and Mifflin St. Jeor formulas. Mann- resistance exercise induces whole body protein catabolism 24
Whitney and Chi2 tests were used for statistical analysis. hours post-exercise in patients with COPD but not healthy
Results: 315 ALS patients, 80 control 1 and 54 control 2 were controls.
analysed. mREE was 1,503 kcal/24 h in ALS patients, Disclosure of Interest: None declared.
1,220 kcal/24 h in control 1 and 1,344 kcal/24 h in control 2,
higher in ALS patients vs. cREE with all formulas ( p < 0.0001)
PT03.3
and higher vs. control 1 and control 2 (respectively p < 0.0002
HYPERMETABOLISM IS A DELETERIOUS PROGNOSTIC FACTOR
and <0.0001). Depending on the predictive equation, hyper-
IN PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS
metabolism was found in 46.7% to 73.7% of ALS patients, with
REE variation of +8.1% to +19.0%. Percentage of hypermetabo- P. Jésus1,2,3, P. Fayemendy1,2,3, M. Nicol2,3,4, G. Lautrette4,
lism and REE variation with the six formulas were higher in ALS H. Sourisseau1, P. M. Preux2,3,5, J. C. Desport1,2,3 *,
patients versus control ( p < 0.0001). Mifflin formulas produced B. Marin2,3,5, P. Couratier2,3,4. 1Nutrition Unit, University
Hospital of Limoges, 2INSERM, U1094, Tropical
Poster Tour 3: Nutrition and Chronic Disease 1 S35
Neuroepidemiology, School of Medicine, 3UMR_S 1094, Tropical Methods: A single-blind, randomized-controlled trial was
Neuroepidemiology, Institute of Neuroepidemiology and conducted in 30 incident PD patients. Patients were rando-
Tropical Neurology, CNRS FR 3503 GEIST, University of Limoges, mized to: group A in which one of the PD dwells was substituted
4
ALS Center, 5Center of Epidemiology, Biostatistics and with a modified PD solution (220 ml of 10% amino acid solution,
Research Methodology (CEBIMER), University Hospital of 1 g of L-carnitine, and a final dextrose concentration of 1.07%),
Limoges, Limoges, France or group B (standard care). Patients received the solutions for
one week. Biochemical (e.g., albumin and transferrin) and
Rationale: Hypermetabolism, defined as an excessive level of functional (hand-grip dynamometry) markers of nutritional
resting energy expenditure (REE) has been reported in 50–60% status were assessed. Data was analysed using a repeated-
of patients with amyotrophic lateral sclerosis (ALS). The aim of measures ANOVA in SPSS version 24.
this study was to investigate a large cohort of ALS patients in Results: Albumin and transferrin were increased after a one-
order to determine their nutritional, neurological and respira- week use of the modified PD solution in group A, but not after
tory parameters and their survival according to the metabolic the standard PD solution. Similarly, hand grip dynamometry
level. from both hands improved in group A, but not B. No changes in
Methods: Nutritional, neurological and respiratory assess- other biochemical parameters.
ments were prospectively recorded. Nutritional evaluation
included body mass index, REE measured by indirect calorim-
Variable Group A (mean ± SEM) Group B (mean ± SEM) P
etry (hypermetabolism if REE variation [ΔREE] >10%) and fat interaction
mass (FM) using impedancemetry. Neurological evaluation Pre Post Pre Post
included ALS phenotype at time of diagnosis, site at onset, Albumin 2.03 ± 0.13 2.21 ± 0.13 2.56 ± 0.13 2.28 ± 0.13 0.001
ALSFRS-R score. Respiratory evaluation included vital capacity (g/dl)
and SNIFF test. Survival analysis used the Kaplan-Meier method Transferrin 128.38 ± 10.07 138.5 ± 9.7 130.41 ± 10.07 119.8 ± 9.7 <0.001
(mg/dl)
and the multivariate Cox model.
HGD (kg) 13.23 ± 1.59 17.76 ± 1.48 11.66 ± 1.59 8.96 ± 1.48 <0.0001
Results: 315 patients were analysed. Median age at diagnosis
was 65.9 years. 55.2% of patients were hypermetabolic. SEM, standard error of the mean; HGD, hand-grip dynamometry.
According to the metabolic level (ΔREE < 10%, 10–20% and
>20%), patients with a ΔREE >20% initially had a lower FM,
Conclusion: The implementation of a dialysis bag based on
29.7% vs. 32.1% in those ≤10% ( p = 0.0054). SNIFF test tended
dextrose, AA and L-carnitine was able to improve the
to be lower in ALS patients with ΔREE >20% ( p = 0.07). During
nutritional status of incident PD patients compared with
follow-up, nutritional status did not differ between the three
conventional PD solution. Further studies are needed to
groups, The median slope of ALSFRS-R tended to evolve more
assess the long-term effects of modified PD solutions and
severely in patients with ΔREE >20%, −1.4 points/month vs.
their ability to reduce protein-energy wasting in PD patients
−1.0 points/month in those ≤10% ( p = 0.07). Overall median
survival since diagnosis was 18.4 months. ΔREE >20% tended to Disclosure of Interest: None declared.
increase the risk of dying compared to ≤10% (HR = 1.33,
p = 0.055). In multivariate analysis, an increased REE/FM ratio PT03.5
was independently associated with death (HR = 1.005, SMALL INTESTINAL ABSORPTION IN PATIENTS WITH CHRONIC
p = 0.001). OBSTRUCTIVE PULMONARY DISEASE COMPLICATED BY COR
Conclusion: Hypermetabolism is present in more than half of PULMONALE – A PILOT STUDY
ALS patients. It modifies the body composition at diagnosis, and S. K. Andersen1 *, A. L. S. Hardis1, O. Tupper2, A. M. B. Soja3,
patients with hypermetabolism >20% have a worse prognosis. B. Nilsson3, C. S. Ulrik2,4, J. R. Andersen1. 1Department of
Disclosure of Interest: None declared. Nutrition, Exercise and Sports, University of Copenhagen,
2
Department of Pulmonary Medicine, 3Department of
PT03.4 Cardiology, Hvidovre Hospital, 4Institute of Clinical Medicine,
EFFECTS OF A DEXTROSE, AMINO ACID, AND L-CARNITINE- University of Copenhagen, Copenhagen, Denmark
BASED PERITONEAL DIALYSIS SOLUTION ON NUTRITIONAL
BIOMARKERS IN INCIDENT PERITONEAL DIALYSIS PATIENTS Rationale: Cor pulmonale is a common complication to Chronic
Obstructive Pulmonary Disease (COPD), and may result in
L. S. Cervantes1 *, J. A. Leyva1, R. A. Cortina1,
increased pressure in the inferior caval vein and stasis of the
I. Martinez Del Rio1, J. León1, O. O. Olea1, A. Biruete1,2.
1 liver. The chronic pulmonary hypertension may lead to stasis in
Clinical Nutrition Department, Hospital Lic. Adolfo López
the veins from the small intestine and thereby compromise
Mateos ISSSTE, Mexico DF, Mexico, 2Nutritional Sciences,
absorption of nutrients. We wanted to investigate whether
University Illinois, Urbana, United States
patients with pulmonary hypertension have reduced absorption
Rationale: Chronic Kidney Disease (CKD) is a worldwide public capacity compared to COPD patients without of cor pulmonale.
health problem. It has been estimated that 30–70% of Methods: Absorption of D-xylose (25 g) and zinc (132 mg),
peritoneal dialysis (PD) patients are malnourished, being a administered as a single dose, was tested in 14 COPD patients,
predictor of morbidity and mortality. Our objective was to seven with and seven without cor pulmonale. The presence of
evaluate the effects of a modified PD solution based on cor pulmonale was determined by echocardiography. The
dextrose, amino acids, and L-carnitine on nutritional status in concentration of D-xylose and zinc were measured in periph-
incident PD patient eral blood one, two and three hours after ingestion and used as
marker of absorption. Furthermore, urine was collected for five
hours to determine the amount of excreted D-xylose.
S36 Poster tours
Results: No significant difference in absorption of D-xylose Poster Tour 4: Obesity and Metabolic
( p = 0.28) or zinc ( p = 0.51) was found between the two groups.
However, a trend towards a delay in D-xylose absorption, as
Syndrome
assessed by time-to-peak concentration, was observed in PT04.1
patients with cor pulmonale ( p = 0.08). There was no signifi- MATERNAL BMI AND FADS POLYMORPHISMS AFFECT PUFAS IN
cant difference in the amount of excreted D-xylose in the urine BREAST MILK – THE PREOBE FOLLOW UP
between the groups ( p = 0.52). No correlation was found
A. de la Garza Puentes1,2 *, A. M. Chisaguano Tonato3,
between the tricuspid regurgitation gradient and the absorp-
R. Montes Goyanes4,5, I. Salas Lorenzo1,2,
tion of both test-markers (rs = 0.34 and rs = −0.25). Likewise,
M. L. García-Valdés6,7,8, M. T. Segura Moreno6,7,8,
no correlations were found between the inferior caval pressure
M. García-Bermudez6,7,8, A. I. Castellote1,5, C. Campoy6,7,8,
during the in- and expiration phases and the absorption of D-
M. C. López-Sabater1,5, on behalf of PREOBE team. 1Nutrition,
xylose (rs = −0.09, rs = 0.23) or zinc (rs = −0.39, rs = −0.39).
Food Sciences and Gastronomy, University of Barcelona,
Conclusion: We found no indications that small intestinal 2
Institute for Research on Nutrition and Food Safety (INSA-UB),
absorption is affected in a clinically relevant degree in patients
Barcelona, Spain, 3Nutrition, University of San Francisco de
with cor pulmonale.
Quito, Quito, Ecuador, 4Nutritional Research and Analysis
Disclosure of Interest: None declared. Institute, University of Santiago de Compostela, Santiago de
Compostela, 5CIBER Physiopathology of Obesity and Nutrition
PT03.6 (CIBERobn), Institute of Health Carlos III, Madrid, 6Centre of
RESISTANCE EXERCISE INDUCES ALTERATIONS IN WHOLE Excellence for Paediatric Research (EURISTIKOS), 7Paediatrics,
BODY BRANCHED CHAIN AMINO ACIDS (BCAA), KETO ACIDS University of Granada, Granada, 8CIBER Epidemiology and
(BCKA), AND Β-HYDROXY-Β-METHYLBUTYRATE (HMB) Public Health (CIBEResp), Institute of Health Carlos III,
METABOLISM IN PATIENTS WITH CHRONIC OBSTRUCTIVE Madrid, Spain
PULMONARY DISEASE
C. Cruthirds1 *, N. Deutz1, D. Walker1, M. Engelen1. 1Healthy Rationale: The aim of this study was to analyze the differences
and Kinesiology, Texas A&M University, College Station, of breast milk polyunsaturated fatty acids (PUFAs) according to
United States maternal pre-pregnancy body mass index (BMI) and fatty acid
desaturase (FADS) genotype.
Rationale: BCAA, BCKA, and HMB are understudied pathways of Methods: Women (n = 61) from the PREOBE cohort were divided
the metabolic profile in Chronic Obstructive Pulmonary Disease in normal-weight (BMI: 18.5–24.9) and overweight/obese
(COPD). It remains unclear if BCAA, BCKA and HMB metabolism (BMI ≥ 25) groups. Colostrum was collected 2–4 days post-
is different in COPD patients as compared to healthy older partum and used to analyze PUFAs that were expressed as
adults when recovering from a metabolic stressor such as percentages of the total amount of FAs. Tag SNPs were
exercise. genotyped (3 in FADS1 and 3 in FADS2).
Methods: In 14 normal weight patients with moderate to severe Results: Women with high BMI were associated with LC-PUFAn6
COPD (GOLD II-IV) and 11 healthy control subjects, whole body (β = 0.70, P = 0.003) and DHA:AA (β = −0.55, P = 0.016). Among
rates of appearance (Ra) of the BCAA (leucine (LEU), valine women who carried two major alleles, normal-weight group
(VAL), isoleucine (ILE)), and BCKA (ketoisovaleric acid (KIV), had higher concentrations of EPA (0.05 vs. 0.03%), DHA (0.46 vs.
ketomethylpentanoate (KMV)), and HMB were measured via 0.33%), EPA:AA (0.08 vs. 0.05%) and DHA:AA (0.73 vs. 0.50%)
pulse IV infusion of their stable tracers before and twice (1 and and lower LC-PUFA n6:n3 (3.29 vs. 4.83%) than overweight/
24 h) after a high intensity whole body resistance exercise obese women. These differences were lost in minor allele
session on an isokinetic dynamometer (KinCom). Fat-free mass carriers since PUFAs responded differently in BMI groups.
was measured by DEXA, enrichments by GC- and LC-MS/MS, and Normal-weight women who carried minor alleles showed a
statistics (SE; p < 0.05) by two-way ANOVA/unpaired t-test. tendency to decrease LC-PUFAs; they had lower levels of DHA
Results: Patients with COPD completed less total work per kg (0.46 vs. 0.33%) and AA:DGLA (1.24 vs. 0.97%) than major
FFM than the controls during the resistance exercise protocol homozygotes. Contrary, overweight/obese women who were
[114 ± 6.3 vs. 164.8 ± 13.9 J/kg ffm, p = 0.0016]. 24 h after minor allele carriers had higher EPA (0.03 vs. 0.05%), EPA:ALA
exercise, ILE Ra was similarly increased in both groups [COPD (0.07 vs. 0.11%) and EPA:AA (0.05 vs. 0.08%) than major
Δ24h post-pre: 27.6 ± 13.6 µmol/kg ffm/h, p < 0.002], [Healthy homozygotes (P = 0.05). Dietary intake of DHA in late preg-
Δ24h post-pre:: 37.5 ± 10.7 µmol/kg ffm/h, p < 0.0001]. In the nancy correlated (R = 0.32, P = 0.035) with DHA level in
COPD group only, LEU and HMB Ra were significantly increased colostrum.
24 h post-exercise [Δ24h post-pre: 31.4 ± 11.6 µmol/kg ffm/h, Conclusion: In conclusion, women with high BMI were
p < 0.01, and Δ24h post-pre: 0.43 ± 0.31 µmol/kg ffm/h, p = associated with altered FAs; however, FADS genotype modified
0.07, respectively]. these results. Contrary to normal-weight group, overweight
Conclusion: High intensity whole body resistance exercise and obese women could benefit from the FADS genetic variants
alters BCAA, BCKA, and HMB metabolism in patients with COPD. measured in this study. A high dietary DHA intake could prevent
Grants: ESPEN Fellowship 2016 the reduction of DHA in colostrum caused by overweight/
obesity or the presence of FADS minor alleles in normal-weight
women. Further research is needed to continue exploring gene-
BMI interaction.
Poster Tour 4: Obesity and Metabolic Syndrome S37
PT04.2 Methods: A sample of T2D patients was prospectively and

IS TESTING FOR POSTPRANDIAL HYPERINSULINEMIC consecutively recruited. Participants underwent a comprehen-
HYPOGLYCEMIA AFTER GASTRIC BYPASS NECESSARY? sive examination, including ophthalmoscopy of the posterior
E. Aubry1 *, M. Gasser2, C. Meier2, S. Herren2, R. Steffen2, segment after pharmacological mydriasis, optical coherence
Z. Stanga1. 1Department of Diabetes, Endocrinology, tomography (OCT) and anthropometric measurements. They
Nutritional Medicine and Metabolism, Bern University Hospital were divided into two groups according to the presence or
and University of Bern, 2European Center of Excellence for absence of DME, defined as macular central thickness ≥320 µm
Bariatric and Metabolic Surgery, Bern, Switzerland in men and ≥305 µm in women using OCT. Since variables did
not follow a normal distribution, nonparametric Mann-Whitney
Rationale: Bariatric surgery is the most efficient and only U test was applied.
durable treatment of severe obesity. Most long-term sequels Results: Non-DME patients had a mean age of 67.65 ± 8.29 years
are well known and require a lifelong patient follow-up. One and a BMI of 30.21 ± 5.63 kg/m2. DME subjects were
increasingly reported complication is the postprandial hyper- 66.64 ± 6.98 years old and had a BMI of 31.61 ± 5.17 kg/m2.
insulimic hypoglycemia ( pHH) which can cause life threatening There were no statistically significant differences in age
emergencies without warning symptoms. Provocative testing ( p = 0.419) and BMI ( p = 0.08) between both groups. The
can detect patients at risk. The aim of this study was to parameters of visceral adiposity are shown in the table
determine the prevalence of pHH after Roux-en-Y gastric segregated by sex.
bypass (RYGB) with or without symptoms of hypoglycemia.
Methods: Cohort study of consecutive, unselected patients Non-DME DME p
11–28 months after uncomplicated laparoscopic standard RYGP. Mean ± SD Mean ± SD
To simulate normal habits all patients received carbohydrate NC (cm) Male 42.42 ± 3.87 41.67 ± 3.78 0.461
rich standardized solid mixed meal. Insulin and glucose were NC (cm) Female 35.95 ± 3.33 38.99 ± 3.00 0.001
measured at 30, 60, 90, 120 and 150 min thereafter. Symptoms WC (cm) Male 107.13 ± 12.18 103.34 ± 10.51 0.245
WC (cm) Female 99.94 ± 12.55 113.96 ± 9.92 <0.001
were recorded and classified as autonomous or neuroglycope- WHR Male 1.03 ± 0.05 1.04 ± 0.04 0.791
nic. Patients with hypoglycemia, defined as blood glucose of WHR Female 0.94 ± 0.05 0.99 ± 0.05 0.003
<3.3 mmol/L, were tested a second time within a week with
protein rich standardized solid mixed meal.
Results: A total of 113 patients were included. Total Conclusion: Women with DME had higher NC, WC and WHR than
postoperative weight loss was 33.97 ± 9.3%. In 24.8% of patients women without DME. BMI was similar in both groups. No
glucose dropped to less than 3.3 mmol/L, 13.8% to less than differences in anthropometric measurements were found
3.0 mmol/L after carbohydrate solid mixed meal in contrast to between men with and without DME. Visceral adiposity could
only one patient after a protein rich meal (0% with less than be a predictor of DME in T2D women.
3.0 mmol/L). Only 40.7% showed hypoglycemic symptoms. One Disclosure of Interest: None declared.
patient needed emergency treatment after sudden loss of
consciousness 80 min after carbohydrate meal. Asymptomatic
PT04.4
patients carry significant risk ( p < 0.01) for pHH.
MR SPECTROSCOPY IN EXTREMELY OBESE PATIENTS: A PILOT
Conclusion: pHH after RYGB can be life threatening and occur
STUDY FOR THE EVALUATION OF INTRA- AND
without warning symptoms. Therefore, testing all patients is
EXTRAMYOCELLUAR LIPIDS AS POTENTIAL MARKER FOR
necessary. How, when and how often remains to be investi-
SIGNIFICANT WEIGHT LOSS
gated. Standardized solid food test is an option close to daily
life situations. Patients should advised to avoid carbohydrate- N. Oberänder1, M. Fischer1 *, A. Weimann1, on behalf of Kirsche
rich meals to prevent pHH according to the obtained results. V, Kaufmann J, Schäfer Ao. 1Adipositaszentrum, Klinikum
St. Georg gGmbH Leipzig, Leipzig, Germany
Rationale: Lipid accumulation in the muscle is common in
PT04.3 extreme obesity and associated with increased risks for insulin
VISCERAL ADIPOSITY IS A RISK MARKER OF DIABETIC resistance. We used magnetic resonance spectroscopy (MRS) to
MACULAR EDEMA IN WOMEN compare the intra- (IMCL) and extramyocellular lipid propor-
G. Verdes1 *, P. Calvo2, F. Bartol-Puyal2, M. Jiménez-Sanmartín2, tion (EMCL) in the Musculus tibialis anterior of obese patients
B. Abadía2, B. Lardiés3, I. Salas-García1, A. Ferreras2. 1alcañiz before and after weight loss.
Hospital, Alcañiz, 2Miguel Servet University Hospital, 3Royo Methods: 19 non-diabetic patients with a Body Mass Index
Villanova Hospital, Zaragoza, Spain (BMI) ≥40 kg/m2 that participated in a conservative multi-
modal weight loss program were recruited. Metabolite ratios of
Rationale: Some studies have reported a relationship between IMCL and EMCL (metabolite/creatin) were assessed using
diabetic retinopathy (DR) and obesity, although the results are 3Tesla-1Proton-MRS before and after 6 months therapy and
inconsistent. DR has also been associated with visceral fat compared with changes in BMI, Waist-to-Hip-ratio (WHR), blood
accumulation. Neck (NC) and waist (WC) circumference and pressure, body composition (BIA), functional exercise capacity
waist-to-hip ratio (WHR) are good markers of visceral adiposity. (6-min walking test, PWC-130), and quality of life (SF-36).
We hypothesized that type 2 diabetic (T2D) patients with Statistical analyses were conducted using SPSS; group differ-
diabetic macular edema (DME) have greater body mass index ences were tested (Wilcoxon rank test).
(BMI) and visceral adiposity than patients without DME.
S38 Poster tours
Results: After 6 months the relative weight loss was 24.8% analyses should allow a better understanding of this process
(127.6 kg, 48.5 kg/m2 vs. 96 kg, 36.5 kg/m2). WHR, blood in humans and whether this amino acid could potentially by
pressure, and fat mass were also significantly reduced. MRS used for such a purpose in DO elderly adults.
data from 10 patients could be analyzed and provided IMCL/Cr Disclosure of Interest: None declared.
and EMCL/Cr ratios with different resonance. IMCL13/Cr was
reduced by nearly 50% ( p < 0.05). The difference for EMCL15/
PT04.6
Cr was not significant. An explorative correlation analysis
GLYCEMIC HOMEOSTASIS AFTER ROUX-EN-Y GASTRIC BYPASS
between MRS data and the conventional parameters (WHR,
(RYGB) IS MORE ASSOCIATED WITH AN INCREASE IN GLP-1
BMI, weight etc.) did not reveal any significance.
THAN WEIGHT LOSS
Conclusion: A significant loss of IMCL following a Very Low
Calorie Diet is detectable by using MRS. This loss may indicate a D. C. Fonseca1, P. Garla1 *, P. Sala1, N. M. Machado1, R. Ishida1,
reduced risk of insulin resistance and therefore has the I. F. D. M. S. Guarda1, E. G. H. Moura1, P. Sakai1, M. A. Santo1,
potential to serve as an independent marker of significant I. D. C. G. Silva2, S. Heymsfield3, R. S. M. D. M. Torrinhas1,
weight loss. D. Giannella-Neto4, D. L. Waitzberg1. 1Gastroenteroly, Medical
Acknowledgement: This study was supported by Institut School of University of Sao Paulo, 2UNIFESP, Sao Paulo, Brazil,
3
Danone Ernährung für Gesundheit e.V. (grant nr. 2014/4) Pennington Biomedical Research Center, Baton Rouge, United
States, 4Nove de Julho University, Sao Paulo, Brazil
Rationale: Improvement of glycemic control in type 2 diabetes
PT04.5 (T2D) patients after Roux-en-Y gastric bypass (RYGB) has been
L-NAME INHIBITS CITRULLINE-INDUCED LYPOLYTIC EFFECTS frequently attributed to weight loss, but some patients do not
IN SUBCUTANEOUS ADIPOSE TISSUE FROM ELDERLY respond satisfactorily to surgery in relation to glycemic control
DYNAPENIC-OBESE PATIENTS even with significant weight loss. However, intestinal hormones
P. Noirez1,2 *, A. Meziani2,3, M. Dulac2,3, G. El Hajj Boutros2,3, have been associated with this benefic effect. Our aim was to
V. Marcangeli2,3, J. Morais4, C. Forest5, evaluate in 20 obese women with T2D, GLP-1 levels and if this
M. Aubertin-Leheudre2,3. 1UFR Staps, IRMES, EA7329, intestinal hormone is involved in glycemic control more than
Universite Paris Descartes, Paris, France, 2Département des weight loss.
Sciences de l’activité physique, UQAM, 3Centre de Recherche Methods: We collected blood samples in 20 obese women
l’Institut Universitaire de Gériatrie de Montréal, 4Geriatric (age, 46.9 ± 6.2 yrs; BMI, 46.5 ± 5.3 kg/m2) before and 3
Department, Mc-Gill Universitary Hospital, Montréal, Canada, months after RYGB. Blood samples were collected after 12-h
5
INSERM UMR-S 1124, Universite Paris Descartes, Paris, France fasts and 30, 60, 90, and 120 min after oral intake of 200 mL of a
liquid formula diet. The GLP-1 test was performed using
Rationale: In animal studies, Citrulline (CIT) induces lipolysis multiplex technique. After one year of RYGB the patients were
observed by the release of non-esterifed fatty acids (NEFA) separated into 2 groups according to the American Diabetes
from white adipose tissue. This effect was suppressed by Nω- Association criteria to characterize partial remission or total
Nitro-L-arginine methyl ester hydrochloride (L-NAME), a remission of T2D.
nonselective nitric oxide (NO) synthase inhibitor. We aimed to Results: After RYGB 12 patients were classified in total
evaluate the effect of an acute exposure (24 h) of human remission group (TRG) and 8 patients in partial remission
abdominal subcutaneous adipose tissue (SCAT) to CIT and L- group (PRG). Both groups presented significantly weight loss
NAME in elderly dynapenic-obese (DO) patients. after 3 months of RYGB ( p < 0.05) and there were no differences
Methods: Four women (w) (age: 69.6 ± 3.8 yrs; FM: 45.4 ± 5.5%; between groups (Table 1). Moreover, only TRG group, presented
handgrip strength/BodyWeight - HS/BW: 0.30 ± 0.06 kg/kg) and significantly increased in GLP-1 AUC after 3 months of RYGB.
5 men (m) (age: 67.1 ± 3.8 yrs; FM:34.4 ± 1.8%; HS/BW: 0.43 ±
Table 1: Weight and GLP-1 values in pre-operative and after 3 months of RYGB
0.09 kg/kg) dynapenic (HS/BW < 0.44 for women and <0.5 for
men) and obese (FM >30% for w and >25% for m) were recruited. Clinical Total remission group (TRG) Partial remission group (PRG)
Variable
SCAT biopsies from all participants were incubated in KREBS Preop. 3m P Preop. 3m P
medium with glucose (5 mM), enriched or not with CIT (2.5 mM) (n = 12) Postop. value (n = 8) Postop. value
(n = 12) (n = 8)
and L-NAME (1 mM) to evaluate whether NO was involved in CIT
effect. At 24 h of incubation, the medium was collected for the Weight (kg) 113.20 90.35 0.457 119.50 99.75 0.457
estimation of NEFA (mM · mg−1) and glycerol (g · L−1 · mg−1) GLP-1 AUC 769.358 1,649.468 0.0109 650.753 1,528.065 0.1906
release. Values in median.
Results: The analyses of lipolytic products in the medium
showed that CIT increased NEFA (0.35 ± 0.09 vs 0.17 ± 0.04) and Conclusion: Our data suggest that the glycemic control after
glycerol (0.22 ± 0.05 vs 0.10 ± 0.06) release from SCAT ( p < RYGB occurs not only in association with weight loss, but in
0.01). L-NAME abolished CIT effects on both NEFA (DOw: response of increase production of GLP-1.
0.184 ± 0.056 vs 0.329 ± 0.077; DOm: 0.190 ± 0.016 vs Disclosure of Interest: None declared.
0.368 ± 0.114) and glycerol (DOw: 0.130 ± 0.058 vs
0.227 ± 0.034; DOm: 0.074 ± 0.071 vs 0.215 ± 0.066) release
from SCAT of both gender ( p < 0.01).
Conclusion: As in animal studies, our human data show that CIT
stimulates the release of NEFA and glycerol from human SCAT in
a potential NO-dependent manner. Nevertheless, further
Poster Tour 5: Nutritional Assessment S39
Poster Tour 5: Nutritional Assessment clinical outcomes in oncology. Thus, our aim was to investigate
whether the skeletal muscle radiodensity range, when divided
PT05.1 in sub-ranges of low or high-radiodensity, improves the
PROPOSAL FOR NEW SELECTION CRITERIA CONSIDERING prediction of short-term survival in endometrial cancer (EC)
PRETRANSPLANT MUSCULARITY AND VISCERAL ADIPOSITY IN patients when compared to the mean muscle attenuation and
LIVING DONOR LIVER TRANSPLANTATION to the overall skeletal muscle radiodensity.
Y. Hamaguchi1 *, T. Kaido1, S. Okumura1, A. Kobayashi1, Methods: EC patients who had computed tomography (CT)
H. Shirai1, S. Yao1, S. Yagi1, N. Kamo1, H. Okajima1, S. Uemoto1. images available within 30 days before treatment were
1
Division of Hepato-Biliary-Pancreatic Surgery and enrolled (n = 208) in a retrospective cohort. CT images at the
Transplantation, Department of Surgery, Graduate School of third lumbar vertebra (L3) were used to assess overall skeletal
Medicine, Kyoto University, Kyoto, Japan muscle index (SMI), which was afterwards divided into sub-
ranges of radiation attenuation: low-radiodensity skeletal
Rationale: We recently reported that both pretransplant muscle index (LRSMI) and high-radiodensity skeletal muscle
skeletal muscle mass and low skeletal muscle quality (muscle index (HRSMI). The average muscle radiation attenuation
steatosis) are independent risk factors for death after living was also assessed. Sarcopenia was defined when SMI was
donor liver transplantation (LDLT). Based on this finding, for <=38.9 cm2/m2. One-yearsurvival was evaluated by Kaplan-
better outcomes after LDLT, we have added new indication into Meier method and Cox Regression.
our selection criteria for LT since 2013: patients who can walk Results: Sarcopenia was found in 26.4% of the patients. Roughly
unaided. In the present study, we investigated the significance 80% of the patients in the highest quartile of LRSMI were obese.
of muscularity as well as visceral adiposity, and aimed to All the skeletal muscle parameters were significantly asso-
establish more objective selection criteria including these ciated with shorter one-year survival, although HRSMI pre-
parameters. sented the strongest association (HR 5.91, Confidence Interval
Methods: Using computed tomography imaging in 657 donors 2.16–16.17).
for LDLT, skeletal muscle mass, muscle quality, and visceral Conclusion: Classifying the skeletal muscle into sub-ranges of
adiposity were evaluated by the skeletal muscle mass index radiodensity have an additional value then using the average
(SMI), intramuscular adipose tissue content (IMAC), and muscle attenuation of the overall skeletal muscle area.
visceral to subcutaneous adipose tissue area ratio (VSR), Disclosure of Interest: None declared.
respectively. The sex-specific cut-off values of SMI, IMAC, and
VSR were determined, and with evaluating their impact on
PT05.3
outcomes after LDLT in 277 recipients, we aimed to establish
THE TAUROLIDINE-CITRATE-HEPARIN CATHETER LOCK
the new selection criteria for LDLT.
REDUCES CATHETER-RELATED BLOODSTREAM INFECTIONS
Results: On the basis of the younger donor data, we
(CRBSIS) IN HIGH RISK, INTESTINAL FAILURE PATIENTS
determined the sex-specific cut-off values for the low SMI,
RECEIVING HOME PARENTERAL NUTRITION (HPN): A DOUBLE-
high IMAC, and high VSR (mean ± 2 standard deviations). The
BLINDED, RANDOMIZED AND PLACEBO-CONTROLLED
patients with all three factors showed the lowest survival rate
INVESTIGATION
after LDLT (41.2% in 1-year survival; P < 0.001). On multivariate
analysis, low SMI (P = 0.002), high IMAC (P = 0.002), and high S. Tribler1 *, C. F. Brandt1, K. A. Fuglsang1, A. H. Petersen2,
VSR (P = 0.001) were identified as independent risk factors for J. H. Petersen2, M. Staun1, P. Brøbech1, C. E. Moser3,
death after LDLT. Based on these findings, we have excluded P. B. Jeppesen1. 1Department of Medical Gastroenterology,
patients meeting these 3 factors (low SMI, high IMAC and high University of Copenhagen Hospital, Rigshospitalet,
2
VSR) from candidate for LDLT since October 2016. Department of Biostatistics, University of Copenhagen,
3
Conclusion: Using the cut-off values provided from healthy Department of Clinic Microbiology, University of Copenhagen
donors, we have established the new selection criteria for LDLT Hospital, Rigshospitalet, Copenhagen, Denmark
including body composition, which would improve post-
Rationale: CRBSIs inflict a frequent and major burden for HPN
transplant outcomes
patients. This study evaluated taurolidine-citrate-heparin
Disclosure of Interest: None declared. (TaurolockTMHep100) in preventing CRBSIs compared to
heparin.
PT05.2 Methods: Adult HPN patients with a previous mean CRBSI rate
HIGH-RADIODENSITY SKELETAL MUSCLE INDEX: A BETTER of 2.4 episodes/1,000 days (95% Poisson CL; 2.12–2.71) were
INDICATOR OF POOR PROGNOSIS THAN SKELETAL MUSCLE randomized, in a double-blinded, placebo-controlled trial. An
INDEX IN ENDOMETRIAL CANCER PATIENTS external stratified randomization was performed according to
C. S. Rodrigues1, G. V. Chaves1 *. 1Nutrition and Dietetics, age, gender and prior CRBSI rate. The primary endpoint was
Brazilian National Cancer Institute, Rio de Janeiro, Brazil difference in mean CRBSI rate. The maximum treatment period
was two years or until the occurrence of a CRBSI or right-
Rationale: To date, studies assessing the impact of low muscle censoring because of central venous catheter (CVC) removal.
radiation attenuation in cancer prognosis are based on Exact permutation tests were used to calculated p-values for
comparing average muscle attenuation, assuming that higher the log-rank tests, thereby eliminating small-sample issues.
average attenuation indicates lower muscle adipose tissue Results: Twenty patients received the taurolidine lock and 21
infiltration and higher muscle strength. It has not been heparin 100 IE/mL, with 9,622 and 6,956 treatment days,
described whether the magnitude of the cross-sectional area respectively. Zero CRBSIs occurred in the taurolidine arm versus
of high and low-radiodensity skeletal muscle is related to 7 in the heparin arm with a rate of 1.0/1,000 days (0.4–2.07)
S40 Poster tours
(P = 0.005). The CVC removal rates were 0.52 (0.17–1.21) and length of hospital stay, the duration of mechanic ventilation
1.72 (0.89–3.0) in the taurolidine and heparin arm, respect- and incidence of death were not associated with TAPM.
ively, tending to prolong CVC survival in the taurolidine arm Conclusion: The TAPM was positively associated with length of
(P = 0.06). Local infection rates were 0.49 (0.13–1.25) and 1.58 stay in SICU, but did not have a satisfactory accuracy to identify
(0.72–3.0) in the taurolidine and heparin arm, respectively undernutrition in surgical patients.
(P = 0.07). The costs per treatment year were lower in the Disclosure of Interest: None declared.
taurolidine arm (2,348 €) versus the heparin arm (6,744 €) due
to fewer admission days related to treatment of CVC-related
PT05.5
complications (P = 0.02).
PHASE ANGLE PREDICTS READMISSIONS AND LENGTH OF
Conclusion: The taurolidine-citrate-heparin catheter lock
HOSPITAL STAY IN PATIENTS WITH INTESTINAL FAILURE ON
(TaurolockTMHep100) demonstrates a clinically significant and
LONG-TERM PARENTERAL NUTRITION
cost-beneficial reduction of CRBSI occurrence in high risk HPN
patients compared to heparin. M. Køhler1 *, H. H. Rasmussen1,2, S. S. Olesen2,3. 1Center for
Nutrition and Bowel Disease, Aalborg University Hospital,
Disclosure of Interest: S. Tribler Grant/Research Support from: 2
Clinical Institute, Aalborg University, 3Center for Pancreatic
TauroPharm GmbH, Jägerstr. 5a, D-97297 Waldbüttelbrunn,
Diseases, Aalborg University Hospital, Aalborg, Denmark
Germany., C. Brandt: None declared, K. Fuglsang: None declared,
A. Petersen: None declared, J. Petersen: None declared, M. Staun:
None declared, P. Brøbech: None declared, C. Moser: None declared,
Rationale: Patients with intestinal failure type 3 (IF) are at risk
P. Jeppesen: None declared. of altered body composition and impaired muscle function
due to malnutrition, malabsorption and immobilization, which
may increase number of readmissions and length of hospital
PT05.4
stay (LOS). The aims of this study were to investigate the
PERFORMANCE OF THICKNESS OF THE ADDUCTOR POLLICIS
predictive value of body composition and muscle function on
MUSCLE (TAPM) TO PREDICT UNDERNUTRITION, MORBIDITY
readmission rates and LOS in IF patients on long-term
AND MORTALITY IN A SURGICAL INTENSIVE CARE UNIT
parenteral nutrition (HPN).
J. S. Fink1 *, T. G. Pereira2, A. Marcadenti3,4, E. I. Rabito5, Methods: In a prospective observational study, we observed IF
F. M. Silva6. 1Serviço de Nutrição e Dietética, Hospital Nossa patients treated with HPN for a minimum of 1 year during a
Senhora da Conceição, 2Hospital Moinhos De Vento, period of 6 years (2010–2016). At inclusion, we recorded
3
Departamento de Nutrição, Universidade Federal de Ciências gender, age, body mass index (BMI, kg/m2) and handgrip
da Saúde de Porto Alegre (UFCSPA), 4PPG Ciências da Saúde: strength (HGS, kg). Further, we recorded fat mass index (FMI,
Cardiologia, Instituto de Cardiologia/Fundação Universitária kg/m2), fat free mass index (FFMI, kg/m2) and phase angle (PA,
de Cardiologia (IC/FUC), Porto Alegre, 5Departamento de degrees) measured by bioelectrical impedance analysis (BIA).
Nutrição, Universidade Federal do Paraná, Curitiba, Outcome parameters were recorded as number of readmissions
6
Departamento de Nutrição, Universidade Federal de Minas and LOS.
Gerais, Belo Horizonte, Brazil Statistics: Age and gender adjusted univariate and stepwise
multivariate regression. Significance level: p < 0.05.
Rationale: There is not a simple and accurate method to
Results: We included 77 patients in the study (age 59 ± 15
identify undernutrition in surgical intensive care unit (SICU).
years, BMI 20.0 ± 4.2 kg/m2, female 73%). The average LOS was
This study aims to evaluate the performance of thickness of the
23.2 ± 23.6 days and the average number of readmissions was
adductor pollicis muscle (TAPM) to identify undernutrition and
2.0 ± 1.8 per year. In univariate analysis PA ( p = 0.009) and HGS
predict morbidity and mortality in critically surgical patients.
( p = 0.012) were associated with the number of readmissions.
Methods: A cohort study was performed in a SICU of a South
Multivariate analysis confirmed the independence and signifi-
Brazilian public hospital. Patients were evaluated in the first 72
cance of the association for PA (coefficient −0.5 [95% CI; −0.9
hours after SICU admission and then followed until hospital
to −0.2]; p = 0.007). In addition, PA was associated with LOS in
discharge. Patients with hand edema were excluded.
univariate analysis ( p = 0.019), while none of the remaining
Nutritional status was classified according to subjective
parameters were significantly associated with LOS
global assessment (SGA). The measurement of TAPM was
Conclusion: Phase angle significantly predicted number of
performed on right hand with the patients lying in bed. The
readmissions and length of hospital stay in patients with
outcomes of interest were length of stay in SICU, length of
intestinal failure on long-term parenteral nutrition. Further,
hospital stay, duration of mechanic ventilation and mortality.
we found an association between handgrip strength and
Results: The study included 65 patients (59.8 ± 17.0 years,
number of readmissions
70.8% males). The majority of them underwent to surgery
related to the digestive (n = 30, 46.2%) and cardiovascular Disclosure of Interest: None declared.
(n = 18, 27.7%) systems. The TAPM did not differ ( p = 0.203)
between patients classified as SGA-A (15.7 ± 3.9), SGA-B PT05.6
(14.5 ± 3.2), and SGA-C (13.4 ± 4.5) and the area of ROC curve ASSESSMENT OF RESTING ENERGY EXPENDITURE AND BODY
to assess the accuracy of TAPM to identify undernutrition was COMPOSITION IN UNDERWEIGHT MALES
not good [0.611 (IC95% 0.459–0.762]. Patients with length of R. Sammarco1 *, M. Marra1, C. De Caprio1, E. De Filippo1,
stay in SICU ≥ 3 days had TAPM significantly lower (13.1 ± 3.1 F. Pasanisi1, F. Contaldo1. 1Clinical Medicine and Surgery,
mm) than these with length of stay in SICU < 3 days (16.3 ± 3.8 University Federico II, Napoli, Italy
mm). The odds of length of stay in IUC ≥ 3 days was 5.494
( p = 0.002) times greater in patients with TAPM ≥ 15 mm. The Rationale: Despite the increased prevalence of anorexia
nervosa among males in both community and clinical
Poster Tour 6: Paediatrics S41
samples, limited data are available in the literature. The aim of Mann-Whitney, Fischer chi-square and logistic regression were
this study is to evaluate REE and body composition in anorectic applied. P-value <0.05 was considered significant.
patients and constitutional lean males compared with age- Results: Among 201 children included (median age 27 months,
matched control subjects. 63% male), 3.5% had PICS. Although not significant, children
Methods: we studied 17 anorectic (AN) males (age 22.3 ± 5.3 with PICS were older (43.8 vs. 26.7 months). At admission, 49
years, weight 51.8 ± 4.8 kg, BMI 17.1 ± 1.2 kg/m2), 15 consti- children had chronic complex conditions and none developed
tutional lean (CL) (age 23.3 ± 5.2 years, weight 56.1 ± 3.3 kg, PICS. Mortality was observed in 13% of the cohort. Children with
BMI 17.9 ± 0.6 kg/m2) and 18 control (CTR) subjects (age PICS had longer PICU length of stay (LOS) (29 vs. 7 days;
22.3 ± 3.7 years, weight 70.3 ± 6.5 kg, BMI 22.3 ± 1.7 kg/m2). p < 0.001), hospital LOS (59 vs. 21 days; p < 0.001) and duration
REE was measured by indirect calorimetry (V max29- of mechanical ventilation (26 vs. 5 days; p < 0.001). Prevalence
Sensormedics) and bioimpedance analysis was performed at of nosocomial infection was 43% in children with PICS and 25%
50 kHz (DS Medica) early in the morning. Phase angle (a without PICS ( p = 0.265). Clinical, NS and NT variables were not
bioimpedance variable related to nutritional status) was used associated with PICS. PICS was associated with mortality in
in order to differentiate the degree of malnutrition. crude (OR 5.44; p = 0.033) and adjusted analysis (OR 4.97;
Results: REE both in absolute value and corrected for FFM was p = 0.046).
significantly higher in CL and lower in AN than constitutional Conclusion: PICS was associated with mortality in critically ill
lean and controls. (REE: CL 1,726 ± 216 kcal/die, AN 1,150 ± children. More studies are needed to properly define PICS for
169 kcal/die, CTR 1,678 ± 167 kcal/die p < 0.05; REE/FFM: CL this population.
35.9 ± 6.2 kcal/kg, AN 25.2 ± 4.2 kcal/kg, CTR 30.0 ± 3.0 kcal/ Disclosure of Interest: None declared.
kg p < 0.05). Body composition is similar in AN and CL males
(FFM: 46.0 ± 5.2 vs 48.6 ± 4.4 kg, ns; FAT %: 10.3 ± 5. vs
PT06.2
13.6 ± 5.7%, ns). Phase angles is similar in CL and ctr
MATERNAL BODY MASS INDEX ALTERS BREAST MILK FATTY
(6.9 ± 0.6 vs 6.8 ± 0.4 degree, ns) whereas anorectic males
ACID COMPOSITION– THE PREOBE FOLLOW UP
had the lowest phase angle (5.8 ± 1.2 degree, p < 0.05 vs CL
and CTR). A. de la Garza Puentes1,2 *, A. M. Chisaguano Tonato3,
Conclusion: This study suggests that resting energy expend- R. Montes Goyanes4,5, M. Caballero Arredondo1,2,
iture was higher in constitutionally lean and the REE/FFM ratio M. L. García-Valdés6,7,8, M. T. Segura-Moreno6,7,8,
allows to differentiate between CL and AN, despite a similar M. García-Bermudez6,7,8, A. I. Castellote1,5, C. Campoy6,7,8,
BMI; phase angle appears to be an effective marker of M. C. López-Sabater1,5, on behalf of PREOBE Team. 1Nutrition,
qualitative changes in body composition and is able to Food Sciences and Gastronomy, University of Barcelona,
2
discriminate between these two different forms of under- Institute for Research on Nutrition and Food Safety (INSA-UB),
weight (AN and CL). Barcelona, Spain, 3Nutrition, University of San Francisco de
Quito, Quito, Ecuador, 4Nutritional Research and Analysis
Institute, University of Santiago de Compostela, Santiago de
Compostela, 5CIBER Physiopathology of Obesity and Nutrition
(CIBERobn), Institute of Health Carlos III, Madrid, 6Centre of
Poster Tour 6: Paediatrics Excellence for Paediatric Research (EURISTIKOS), 7Paediatrics,
University of Granada, Granada, 8CIBER Epidemiology and
PT06.1 Public Health (CIBEResp), Institute of Health Carlos III,
PERSISTENT INFLAMMATION, IMMUNOSUPPRESSION, AND Madrid, Spain
CATABOLISM SYNDROME (PICS) IN CRITICALLY ILL CHILDREN IS
ASSOCIATED WITH MORTALITY Rationale: Breast milk fatty acid (FA) composition plays an
D. B. Haushchild1, J. C. Ventura1, L. D. D. A. Oliveira1, important role in children’s growth and development, but there
M. S. Farias2, E. Barbosa2, N. L. Bresolin3, Y. M. F. Moreno1 *. is limited information about it corresponding to maternal
1
Nutrition, Federal University of Santa Catarina, 2Nutrition, nutritional status. The aim of this study was to analyze the
3
Pediatric Intensive Care Unit, Joana de Gusmão Children’s differences of mature breast milk FA composition in lactating
Hospital, Florianopolis, Brazil women of different pre-pregnancy body mass index (BMI).
Methods: Women (n = 65) from a population-based pregnancy
Rationale: PICS has most recently been described as a cohort of the PREOBE Project were divided in 3 different groups
persistent inflammation, immune suppression, and protein according to pre-pregnancy BMI; normal-weight (BMI: 18.5–
catabolism in critically ill adults, which may contribute to 24.9), overweight (BMI: 25–29.9) and obese (BMI ≥ 30).
unfavorable outcomes. However, PICS has not been evaluated Collection of mature breast milk was performed 28–32 days
in critically ill children. This study aimed to characterize postpartum and samples were used to analyze FAs that were
critically ill children with PICS and verify its association with expressed as percentages of the total amount of FAs.
mortality. Results: FA levels in breast milk differed according to maternal
Methods: Prospective study conducted in a Pediatric Intensive weight. Compared to normal-weight women, the obese group
Care Unit (PICU), with children aged between 1 month and 15 displayed higher levels of total saturated FAs (27.80 vs.
years. PICS was defined as >14 days in PICU, C-reactive protein 25.83%), C22:2n-6 (0.06 vs. 0.04%), C22:5n-6 (0.09 vs. 0.05%)
(CRP) >6 mg/dL, lymphocytes <25% and reduction in mid-upper and lower C18:1n-9 (36.63 vs. 39.69%), total monounsaturated
arm circumference (MUAC) z-score or MUAC <−2 z-score. FAs (40.74 vs. 43.73%) and C18:3n-3 (ALA) (0.46 vs. 0.59%).
Clinical, demographic, nutritional status (NS), nutritional Whereas overweight women showed higher levels of C22:5n-6
therapy (NT) parameters and clinical outcomes were assessed. (0.07 vs. 0.05%) and n6:n3 ratio (18.28 vs. 15.08%) and lower
S42 Poster tours
C22:6n-3 (DHA) (0.22 vs. 0.28%) and EPA:AA ratio (0.09 vs. Gastroenterology, University of Ghent, Ghent, Belgium,
3
0.12%) than normal-weight group. Significance level was Pediatric Gastroenterology, Academic Medical Center, Emma
established at a P value of 0.05. Children’s Hospital, Amsterdam, Netherlands, 4Pediatric
Conclusion: In conclusion, maternal weight affects FA con- Gastroenterology, Great Ormond Street NHS Foundation Trust,
centrations in mature breast milk. Our results suggest that the London, United Kingdom
quality of breast milk is compromised in women with a BMI ≥ 25
which could also affect the quality of nutrients supplied to the Rationale: We aimed to assess the clinical practice of pediatric
neonate. Since diet influences breast milk FAs, overweight and IF teams across Europe and compare the results to the current
obese women could benefit from dietary recommendations to guideline (1).
optimize breast milk FA composition. Methods: An online survey was sent to members of ESPGHAN
Network for IF and Transplantation in Europe, BSPGHAN and
members of the special interest group Pediatrics of ESPEN.
Results: Sixty-seven respondents completed the survey, repre-
PT06.3 senting 59 teams from 20 countries. The median number of
FACTORS ASSOCIATED WITH RAPID WEIGHT GAIN IN team members were as follows: 2 pediatric gastroenterologists
PRESCHOOL CHILDREN IN PUBLIC DAY CARE CENTERS, MOGI (min–max: 0–7), 2 pediatric surgeons (0–5), 1 dietician (0–4), 1
DAS CRUZES, SAO PAULO, BRAZIL nurse (0–8), 1 pharmacist (0–3). Table 1 shows the current
A. D. S. N. Lourenço1 *, F. L. C. Oliveira1, D. A. Neri1, clinical practice compared with the current guideline.
T. Konstantyner1, D. Palma1. 1Departamento de Pediatria,
Table 1: Recommendations by ESPEN/ESPGHAN guideline (1) and current clinical
Universidade Federal de São Paulo, São Paulo, Brazil
practice obtained from the survey.
Rationale: The growth of the child since intrauterine life can Care element Guideline Survey
be influenced by several factors, especially maternal nutrition Catheter lock Routine use of catheter 90% used catheter lock
and nutritional status of the first years of life, which may have solutions & lock solutions not solutions (taurolock/
an action on metabolic programming, increasing the risk of anticoagulation recommended. taurolidine/heparin).
Anticoagulation may be 46% used anticoagulation
chronic diseases. Thus, the objective of this study was to given
estimate the prevalence and identify factors associated with Bone health Bone densitometry 0.5–1 Yearly by 31% of teams,
rapid weight gain in preschool children. year interval never used in 21%
Nutritional Regular measurement of Weight (100%), height
Methods: A cross-sectional study was carried out with 136 assessment height, weight and head (98%), head
children between 24 and 35 months of age attending public circumference (if <3 yr) circumference (81%),
day-care centers in Mogi das Cruzes. Interviews were con- BMI (70%)
Micronutrient Zinc: 1–3 month interval Zinc: every 3 months by 41%
ducted with the mothers for clinical, sociodemographic and
assessment Vitamin A, E and D: 0.5–1 of teams Vitamin A, E
anthropometry characterization of the children. It was year interval and D according to
considered as rapid weight gain when the children presented guideline
difference greater than 0.67 between the z score of weight for
age from birth to the evaluation. A logistic regression model Conclusion: Practices of pediatric IF teams vary across Europe.
was adjusted for factors associated with rapid weight gain. Compared to the guideline, the use of catheter lock solutions
Results: 50 children (36.8%) presented rapid weight gain and 36 and monitoring of bone health varied most. This survey shows
(26.5%) were overweight. Of these, 22 children were in the the need for evaluation of the existing guideline. Moreover,
rapid weight gain group. The logistic model showed the highest expert-based practical protocols are needed for optimizing
total breastfeeding time [OR = 0.94 (95% CI 0.88–0.99), p = care.
0.031] as protection factor and low socioeconomic level
Reference
[OR = 4.18 (95% CI 1.04–18.60), p = 0.044] as a risk factor for
rapid weight gain. 1. Koletzko B et al., J Pediatr Gastroenterol Nutr 2005;41.
Conclusion: There was a high prevalence of rapid weight gain Disclosure of Interest: None declared.
and overweight among preschoolers in the third year of life
attending a sample of public day care centers in Brazil.
PT06.5
Encouraging the practice of breastfeeding of children in the
BONE STATUS AND ADIPOKINE LEVELS IN CHILDREN ON
first years of life and guiding adequate food, especially for
VEGETARIAN AND OMNIVOROUS DIETS
families with low socioeconomic status, potentially contributes
to reduce rapid weight gain and, consequently, future J. Ambroszkiewicz1 *, M. Chełchowska1, W. Klemarczyk2,
metabolic complications of overweight. G. Rowicka1, J. Gajewska1. 1Screening Department,
2
Department of Nutrition, Institute of Mother and Child,
Warsaw, Poland
PT06.4 Rationale: Measurements of bone mineral density (BMD)

COMPARISON OF CLINICAL PRACTICE OF PEDIATRIC reflect bone status but not the dynamics of bone turnover.
INTESTINAL FAILURE TEAMS WITH ESPGHAN/ESPEN Biochemical markers, which show global skeletal activity, were
GUIDELINE: A EUROPEAN SURVEY validated for the assessment of bone formation and resorption
E. Neelis1, B. De Koning1, M. van Winckel2, M. Tabbers3, S. Hill4, processes. Adipokines play also a significant role in the
J. Hulst1 *. 1Pediatric Gastroenterology, Erasmus MC, Sophia regulation of bone metabolism. The aim of this study was to
Children’s Hospital, Rotterdam, Netherlands, 2Pediatric assess body composition, bone turnover markers and adipokine
levels in vegetarian and omnivorous children.
Methods: The study included 60 healthy prepubertal children HII meal, but the difference was not statistically significant
(median age 6.5 years) divided into two subgroups: 30 ( p = 0.228). It was not found a difference in other appetite
vegetarians and 30 omnivores. Body composition and BMD scores between test meals ( p > 0.05). On the other hand, it was
was assessed by dual-energy X-ray absorptiometry. Vitamin D not found a difference between LGI-LII and LGI-HII meals in
and parathormone (PTH) levels was measured by chemilumin- terms of energy and macronutrients intake during the
escence method. Total osteocalcin (OC), carboxylated osteo- subsequently ad libitum lunch ( p > 0.05).
calcin (c-OC), C-terminal cross-linking telopeptide of collagen Conclusion: These results were shown that only FII independ-
type I (CTX), leptin and adiponectin levels were determined by ent of GI or macronutrients in the context of mixed meal could
immunoenzymatic assays. Statistical analyses were done using affect the perceived hunger in obese adolescents with IR.
SPSS software. Disclosure of Interest: None declared.
Results: Both groups of children were comparable in term of
body composition, except of fat mass, which was lower
( p < 0.05) in vegetarians. Vegetarians had lower vitamin D
(21.6 vs. 27.8 ng/ml, p < 0.01), higher PTH (44.2 vs.31.0 pg/
Poster Tour 7: Nutrition and Chronic
ml, p < 0.05) and higher CTX (1.98 vs. 1.61 ng/ml, p < 0.05) Disease 2
levels than omnivores. Total osteocalcin concentrations were
PT07.1
comparable in both groups, however, c-OC was lower (27.4 vs.
TWO COMPONENTS OF THE NEW ESPEN DIAGNOSTIC
34.1 ng/ml, p < 0.05) in vegetarians. Leptin level was about
CRITERIA FOR MALNUTRITION ARE INDEPENDENT
2-fold lower in vegetarians, but adiponectin concentration was
PREDICTORS OF LUNG FUNCTION IN HOSPITALIZED PATIENTS
similar in both groups. Mean values of total BMD were lower
WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
( p < 0.05) in vegetarians than in omnivores.
Conclusion: Decreased vitamin D and c-OC levels coexisting A. R. Ingadottir1,2 *, A. M. Beck3,4, C. Baldwin5, C. E. Weekes5,
with increased PTH and CTX concentrations show disturbances O. G. Geirsdottir1,6, A. Ramel1, T. Gislason7,8,
in bone turnover and might lead to reduced bone mineral I. Gunnarsdottir1,2. 1Unit for Nutrition Research, Landspitali
density. Lower fat mass and serum leptin levels in vegetarians University Hospital & Faculty of Food Science and Nutrition,
may also influence bone metabolism. University of Iceland, 2Department of Clinical Nutrition,
Landspitali University Hospital, Reykjavik, Iceland,
Disclosure of Interest: None declared. 3
Department of Nutrition and Health, Faculty of Health and
Technology, Metropolitan University College, Copenhagen,
PT06.6 4
Research Unit for Nutrition, Herlev and Gentofte Hospital,
IS FOOD INSULIN INDEX ASSOCIATED WITH HUNGER IN OBESE Gentofte, Denmark, 5Division of Diabetes and Nutritional
ADOLESCENTS WITH INSULIN RESISTANCE? Sciences, King’s College London, London, United Kingdom,
Z. Caferoglu1 *, N. Hatipoglu2, H. Gokmen Ozel3. 1Department 6
The Icelandic Gerontological Research Center, Landspitali
of Nutrition and Dietetics, Erciyes University Faculty of Health University Hospital & University of Iceland, 7Faculty of
Science, 2Department of Pediatric Endocrinology, Erciyes Medicine, University of Iceland, 8Department of Respiratory
University Faculty of Medicine, Kayseri, 3Department of Medicine and Sleep, Landspitali University Hospital,
Nutrition and Dietetics, Hacettepe University Faculty of Reykjavik, Iceland
Health Science, Ankara, Turkey
Rationale: Low fat free mass index (FFMI) is a component of the
Rationale: The food insulin index (FII) is a novel classification ESPEN diagnosis criteria of malnutrition, that only when
for ranking foods based on their physiologic insulin demand accompanied with weight loss is considered to be a determin-
relative to an isoenergetic reference food and may be a valid ant of malnutrition. Our aims were to assess the prevalence of
predictor of appetite, hunger and satiety. The aim of this study malnutrition in patients with chronic obstructive pulmonary
was to determine the effect of FII on appetite in obese disease (COPD) applying the ESPEN criteria, and to examine the
adolescents with insulin resistance (IR). ability of different components of the criteria to predict COPD
Methods: A randomized crossover trial included 15 obese severity, length of stay (LOS), hospital readmissions within 30
adolescents aged 12–18 years (median = 15 years) with IR. All days and mortality.
participants were submitted two different breakfasts: low Methods: Subjects were COPD patients (n = 121) admitted to
glycemic index, low insulin index (LGI-LII) and low glycemic Landspitali University Hospital from March 2015–March 2016.
index, high insulin index (LGI-HII), with a 1-week washout period Patients were screened for nutritional risk using Icelandic
between meals. The two meals were matched for macronutrients screening tool (ISS) and NRS-2002. Body composition was
and GI but had a 2-fold difference in II. At time 0, 15, 30, 45, 60, measured by bioelectrical impedance analysis (BIA). Lung
90, 120, 180 and 240 minutes after the meal, appetite (hunger, function was measured by spirometry.
satiety, fullness, prospective food consumption and desire to Results: The prevalence of malnutrition according to the
eat something fatty, salty, sweet or savoury) was evaluated by ESPEN criteria was 21%. The association between nutritional
visual analog scale. At the end of four hours, participants were assessment, applying different components of the ESPEN
served ad libitum lunch meal. The foods eaten at lunch were criteria, and COPD severity was highly significant, with the
recorded. Energy and macronutrient intakes were calculated. highest risk being associated with low FFMI OR (95% CI) 4.77
Appetite scores were quantified as area under the curve. (2.03, 11.20; p < 0.001). There was a trend towards higher risk
Results: The feeling of hunger was lower by %21.6 after LGI-LII of hospitalization for >7 days in subjects with low FFMI (OR 2.46
meal compared to LGI-HII meal ( p = 0.037). Also, desire to eat 95% CI 0.92, 6.59; p = 0.074) and increased risk of 6 and 9
something sweet was lower by 14.5% after LGI-LII meal vs LGI- months’ mortality (OR 2.72 95% CI 0.88, 8.39, p = 0.082 and OR
S44 Poster tours
2.72 95% CI 0.94, 7.87, p = 0.065, respectively) in subjects Rationale: The study investigated the impacts of malnutrition
diagnosed as malnourished by the ESPEN criteria. in clinical outcomes and medical costs in chronic obstructive
Conclusion: Our study is the first to describe the prevalence of pulmonary disease (COPD) patients on prolonged mechanical
malnutrition in hospitalized COPD patients using the ESPEN ventilation.
criteria from 2015. It might be suggested that FFMI should be Methods: Data were retrieved from Taiwanese national health
used independent of weight loss for diagnosis of malnutrition in insurance research database which included COPD patients on
COPD patients. prolonged mechanical ventilation during 2009–2013. COPD
Disclosure of Interest: None declared. patients with/without malnutrition were defined by ICD-9-CM
codes. We applied the propensity score matching with a
conventional 1:4 ratio for statistics. The outcomes included
PT07.2
mortality rate, 30-day readmission, and medical expenditure.
ACCURACY OF REE PREDICTIVE EQUATION IN FEMALE
Survival curves were assessed by using Kaplan–Meier method,
PATIENTS WITH SEVERE ANOREXIA NERVOSA
and Cox proportional hazard regression models were used to
R. Sammarco1 *, M. Marra1, C. De Caprio1, E. De Filippo1, estimate the hazard ratios (HRs) of death with 95% CI. Medical
F. Pasanisi1, F. Contaldo1. 1Clinical Medicine and Surgery, utilization was estimated by two-part models and differences
University Federico II, Napoli, Italy in the regression-adjusted utilization were examined using t-
tests.
Rationale: The assessment of resting energy expenditure (REE)
Results: Among 4,40,305 COPD patients with prolonged
plays an important role in the management of severely
mechanical ventilation, 19,926 patients with malnutrition
underweight AN patients. The aim of this study is to evaluate
were identified, matched with 79,704 patients without
in female patients with a chronic condition of anorexia nervosa
malnutrition. We found COPD patients on prolonged mechan-
the accuracy of predictive equations for resting energy
ical ventilation with malnutrition were at a significantly higher
expenditure (REE) already described in the literature,
risk of death (HR2.256, p < 0.001). The 30-day readmission rate
derived from general population (Harris-Benedict equation)
and mortality rate were significantly increased for COPD
and from specific equation for AN patients.
patients on prolonged mechanical ventilation with malnutri-
Methods: Two-hundred and eighty two young girls (age 18–35 y,
tion, compared to those without malnutrition (39.51% vs.
mean 23.7 ± 4.6 y) with severe anorexia nervosa (weight
35.20%, p < 0.001, 23% vs. 10%, p < 0.001). For medical
36.5 ± 4.1 kg; BMI 14.2 ± 1.4 Kg/m2) were studied. REE was
expenditure, the total cost during the hospital stay was
misured (MREE) by indirect calorimetry (V max29-
significantly higher (1.7 times) for COPD patients on prolonged
Sensormedics) and predicted according to the Harris-
mechanical ventilation with malnutrition, compared to those
Benedict formula and Schebendach and Scalfi formula specif-
without malnutrition ( p < 0.001).
ically derived for anorexia nervosa.
Conclusion: Malnutrition in COPD patients on prolonged
Results: All the considered predictive equations underesti-
mechanical ventilation is associated with worse clinical out-
mated REE in AN patients (MREE: 883.5 ± 141.1 kcal/die vs
comes and higher medical costs than those without
786.6 ± 102.5 kcal/die with Schebendach and 832.5 ± 89.2
malnutrition.
kcal/die with Scalfi), whereas Harris Benedict significantly
overestimated REE vs MREE (1,207 ± 55 kcal/die, p < 0.05). Disclosure of Interest: None declared.
Schebendach reported an underestimation of −97 kcal/die
(−9.4%), Scalfi underestimated REE −51 kcal/die (−4%) PT07.4
whereas Harris Benedict overestimated REE 140 Kcal/die THE CLINICAL OUTCOMES AND MEDICAL COSTS IN NON-
(+40%). Finally, accuracy at 10% level was low (<50%) in all DIALYSIS CHRONIC KIDNEY DISEASE PATIENTS WITH AND
equations. None of the considered equations seems accurate to WITHOUT MALNUTRITION
predict REE in individual and therefore anorectic patients. C. Wen-Yi1, K.-Y. Hung2, C.-H. Tang3, C.-T. Chao4 *. 1Abbott
Conclusion: In severe anorectic patients, Scalfi equation Laboratories Services Corp., Taipei, 2Hsinchu Branch, National
appears the most accurate predictive equation for population Taiwan University Hospital, Hsinchu City, 3School of Health
studies whereas none of the equations seems to be accurate for Care Administration, College of Management, Taipei Medical
the prediction of REE in clinical practice. Therefore the University, Taipei, 4Jin-Shan Branch, National Taiwan
measurements of REE with indirect calorimetry is strongly University Hospital, New Taipei City, Taiwan, Province of China
recommended in these patients.
Disclosure of Interest: None declared. Rationale: This study was to elucidate the clinical outcomes
and health economic influence between non-dialysis chronic
kidney disease (CKD) patients with and without malnutrition.
PT07.3
Methods: Non-dialysis CKD treated by ACEIs and ARBs, with/
THE CLINICAL OUTCOMES AND MEDICAL COSTS IN CHRONIC
without malnutrition defined by ICD-9-CM were selected from
OBSTRUCTIVE PULMONARY DISEASE PATIENTS ON
Taiwanese national health insurance research database during
PROLONGED MECHANICAL VENTILATION WITH AND WITHOUT
2009–2013. A propensity matching is based on a conventional
MALNUTRITION
1:4 ratio for statistics. The mortality rate, 30-day readmission,
C. Wen-Yi1 *, K.-Y. Hung2, C.-H. Tang3. 1Abbott Laboratories and health expenditure were examined. Survival curves were
Services Corp., Taipei, 2Hsinchu Branch, National Taiwan analyzed by the Kaplan–Meier method, and Cox proportional
University Hospital, Hsinchu City, 3School of Health Care hazard regression models were used to calculate the hazard
Administration, College of Management, Taipei Medical ratios (HRs) of death with 95% CI. Medical utilization was
University, Taipei, Taiwan, Province of China
determined by two-part models and differences in the schizophrenia patients were sedantary, 63.2% of healthy
regression-adjusted utilization were assessed using t-tests. controls were moderately or vigorously active ( p < 0.01).
Results: 67,915 non-dialysis CKD patients were enrolled; Conclusion: These findings suggest that physical activity habits
among them 1,087 patients with malnutrition were identified. of patients with schizophrenia be partly responsible for an
They’re matched with 4,348 patients without malnutrition for adverse metabolic profile. Increasing physical activity and
statistical analysis. The results showed that non-dialysis CKD reducing sedantary behaviour for people with schizophrenia
patients with malnutrition were at a significantly greater risk of who take atypical antipsychotic may decrease the prevalence
death (HR2.97, p < 0.001) compared to those without malnu- of disease.
trition. The 30-day readmission rate and mortality rate were Disclosure of Interest: None declared.
significantly elevated for non-dialysis CKD patients with
malnutrition, compared to those without malnutrition
PT07.6
(36.75% vs. 30.88%, p < 0.001, 19% vs. 7%, p < 0.001). For the
AGE RELATED MACULAR DEGENERATION AND DIETARY
health expenditure analysis, the entire cost during the hospital
GLYCEMIC INDEX AND GLYCEMIC LOAD
stay was significantly higher (1.6 times greater) for non-dialysis
CKD patients with malnutrition, compared to those patients S. Arslan1 *, S. Kadayıfçılar2, G. Samur1. 1Nutrition and
without malnutrition ( p < 0.001). Dietetics, 2Department of Ophthalmology, Hacettepe
Conclusion: Non-dialysis CKD patients using ACEIs and ARBs University, Ankara, Turkey
with malnutrition are associated with worse clinical outcomes
Rationale: Dietary factors are known risk factors for age-
and increased health economic cost compared to non-dialysis
related macular degeneration (AMD) the leading cause of visual
CKD patients without malnutrition.
loss among persons aged ≥50 y. High-glycemic-index diets and
Disclosure of Interest: None declared. dietary glycemic load have been hypothesized as a risk factor
for AMD, but prospective data are unavailable.
PT07.5 Methods: This study was carried out in Hacettepe University
EVALUATING THE EFFECTS OF PHYSICAL ACTIVITY STATUS ON Hospital Department of Ophthalmology Polyclinic between July
METABOLIC PROFILE IN PATIENTS WITH SCHIZOPHRENIA 2015 and February 2016. 200 individuals voluntarily partici-
I. Türkoğlu1 *, E. Akal Yıldız2, S. M. Mercanlıgil2, G. Yoca3, pated into the study including 100 patients diagnosed with AMD
K. Yazıcı4. 1Department of Nutrition and Dietetics, Hacettepe (50 women, 50 men) and 100 patients not diagnosed as AMD (50
University Faculty of Health Sciences, Ankara, Turkey, women, 50 men) as control group. In order to evaluate dietary
2
Department of Nutrition and Dietetics, East Mediterranean glycemic index and load, food intake records were taken for
University Faculty of Health Sciences, Famagusta, Cyprus, successively three days, one of which was in weekend. In the
3
Erbaa Government Hospital, Tokat, 4Department of statistical evaluation of data obtained from the study, SPSS
Psychiatry, Hacettepe University Faculty of Medicine, (Statistical Package for Social Science) 22.0 program was used.
Ankara, Turkey Results: From 200 participants included in the study 100 were
AMD patients with an average age of 68.1 ± 8.4 and 100 were
Rationale: High morbidity and mortality in schizophrenia may healthy control group with an average age of 67.3 ± 8.5. There
be attributed to an unhealthy lifestyle. Basic research about was statistically meaningful difference found among partici-
energy metabolism in patients using atypical antipsychotics has pants glycemic index values mean between AMD group
been neglected. The current study of patients with schizo- (78.6 ± 7.8) and control group (70.9 ± 6.4) ( p < 0.001). It was
phrenia taking atypical antipsychotic aimed to measure total found that dieatry glycemic load mean (183.2 ± 61.0) was
energy expenditure (TEE) and physical activity level (PAL) and higher in AMD group compared with control group (144.9 ± 33.2)
to assess the effects of physical activity level on metabolic ( p < 0.001).
profile in patients with schizophrenia. Conclusion: Consequently, in our study, dietary glycemic index
Methods: The study was conducted on 148 individuals with and load of individuals with AMD was found higher, compared
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) with healthy individuals. AMD is a multi-factorial disease and
diagnosis of schizophrenia or schizoaffective disorder and 77 the nutrition is one of the most important changeable risk
age, gender matched healthy controls. Sociodemographic and factor. Especially for people who is older than 50 years old, who
medical data were obtained through interviews and question- do not make a habit of sufficient and balanced nutrition, it is
naires. The energy expenditure and physical activity assessed inevitable that this disease, which occurs based on age and
by using 24-h physical activity record. causes blindness year after year, will become widespread.
Results: The patients and healthy controls were similar in age, Disclosure of Interest: None declared.
gender and there is no statistical difference on body mass index
between the groups ( p > 0.05). The total energy expenditure
was significantly higher in healthy controls than schizophrenia
patients, both in men and women. The physical activity level
was significantly less (respectively, male 1.54 ± 0.14, female
1.63 ± 0.15) in the schizophrenia group, than healthy controls
(respectively, male 1.83 ± 0.16, female 1.79 ± 0.17) ( p < 0.01).
When we examine individuals with the metabolic syndrome
according to IDF, it was found that although 82.3% of
S46 Poster tours
Poster Tour 8: Nutrition and Cancer previous study demonstrated ad libitum feeding of a low
carbohydrate-high fat diet(LCHFD) to worsen survival of mice
PT08.1 with carcinomatous peritonitis (CP). Because ad libitum LCHFD
DNA DAMAGE IN BLOOD CELLS IN RELATION TO increased body weight (BW) more than normal diet, whether
CHEMOTHERAPY AND NUTRITIONAL STATUS IN COLORECTAL overfeeding or LCHFD is detrimental in terms of survival
CANCER PATIENTS remains unclear.
A. S. Kværner1,2 *, J. Minaguchia1, N. E. Yamaniac1,3, Methods: Male C57BL/6J mice (8 weeks old, n = 28) were
C. Henriksen1, H. Ræder1,2, I. Paur1,2, H. B. Henriksen1, randomized to a normal diet (ND) (Protein: 15.0%, Fat: 9.0%,
T. M. Langleite1, G. Wiedswang4, S. Smeland5,6, R. Blomhoff1,5, Carbohydrate: 76.0%/kcal) or LCHFD (Protein: 18.2%, Fat:
A. R. Collins1, S. K. Bøhn1. 1Department of Nutrition, 62.2%, Carbohydrate:19.6%/kcal). Each group received either
2
Norwegian National Advisory Unit on Disease-Related ND or LCHFD isocaloric diet for the entire experimental period.
Malnutrition, University of Oslo, Oslo, 3Norwegian Institute for On day 8, mice were inoculated intraperitoneally with the
Air Research NILU, Health Effects Laboratory-MILK, Kjeller, Panc02 cell line, generated from pancreatic cancer cells
4
Department of Gastroenterological Surgery, 5Division of derived from C57BL/6 mice. Survival, BW and food intake was
Cancer Medicine, Oslo University Hospital, 6Institute of recorded.
Clinical Medicine, University of Oslo, Oslo, Norway Results: Survival after inoculation was poorer in the LCHFD
than in the ND group ( p < 0.01, log-rank test). There was a
Rationale: The toxicity and adverse events induced by significant difference in survival times between the LCHFD and
adjuvant chemotherapy may impair treatment compliance ND groups (LCHFD: 33.9 ± 0.95, ND: 38.6 ± 1.4, p = 0.0004, log-
and efficiency. It is not known whether chemotherapy-induced rank test). BW and food intake were similar in the two groups
genotoxicity is associated with malnutrition. In the current during throughout the entire observation period, reflecting
study, we assess chemotherapy-induced genotoxicity in isocaloric feeding (t-test).
patients with non-metastatic colorectal cancer (CRC) and
explore associations with nutritional status.
Methods: Chemotherapy-induced genotoxicity was assessed by LCHFD ND
comparing DNA damage in patients receiving chemotherapy Days Initial 15 25 35 45 Initial 15 25 35 45

(n = 24) with those not receiving chemotherapy (n = 20) using
No. of 19 19 19 9 0 19 19 19 14 1
the Mann-Whitney U Test. DNA damage was measured in frozen alive
whole blood by the comet assay. Associations between DNA mice
damage and various indicators of malnutrition were explored, BW(g) 25.2 ± 28.8 ± 27.8 ± 25.0 ± 24.6 ± 27.4 ± 26.1 ± 25.9 ± 27.8
0.3 0.4 0.6 1.2 0.2 0.3 0.5 0.8
including Patient Generated-Subjective Global Assessment (PG-
SGA), bioelectrical impedance analysis (BIA) and anthropomet- mean ± SE.
ric measurements, using multiple linear regression models.
Results: Patients on chemotherapy have higher levels of DNA Conclusion: LCHFD may reduce survival of CP mice due to its
damage in blood cells than patients not receiving chemother- specific dietary composition but not overfeeding. Further
apy (median of 16.9 and 7.9% tail DNA respectively, p = 0.001). research on how LCHFD affects cancer cell progression and
The malnourished patients (PG-SGA category B and C), anti-tumor immunity in host is needed.
representing 41% of the study population, have higher levels
of cellular DNA damage than patients with good nutritional
status (mean difference of 7.5% tail DNA, p = 0.033).
Conclusion: Adjuvant chemotherapy and malnutrition are both PT08.3
associated with increased levels of DNA damage in blood cells INCREASED AMINO ACID TURNOVER AND MYOFIBRILLAR
of CRC patients. Carefully controlled longitudinal studies or PROTEIN BREAKDOWN IN ADVANCED CANCER ARE
RCTs should be performed to determine whether a causal ASSOCIATED WITH DECREASED MUSCLE STRENGTH AND
relationship exists between good nutritional status and PHYSICAL FUNCTION
protection from chemotherapy-induced genotoxicity. B. S. Van Der Meij1,2,3 *, N. E. Deutz1, R. E. Rodriguez4,
Disclosure of Interest: None declared. F. Koeman1, T. C. Smit1, M. P. Engelen1. 1Center for
Translational Research in Aging and Longevity, Texas A&M
PT08.2 University, College Station, United States, 2Faculty of Health
DOES AMOUNT OF ENERGY INTAKE MATTER? -MECHANISM FOR Sciences and Medicine, Bond University, Gold Coast, 3Nutrition
POOR PROGNOSIS OF A LOW CARBOHYDRATE-HIGH FAT DIET and Dietetics, Mater Group, Brisbane, Australia, 4Division of
FED MICE WITH CARCINOMATOUS PERITONITIS Hematology/Oncology, Scott and White Memorial Hospital,
A. Watkins1 *, K. Fukatsu2, S. Murakoshi2, T. Watanabe3, College Station, United States
K. Higashizono4, M. Noguchi2, H. Yasuhara2. 1Surgical Sciences,
Rationale: Weight loss and muscle wasting are common in
Graduate School of Medicine, University of Tokyo, 2Surgical
cancer patients and negatively affect physical function and
Center, The University of Tokyo Hospital, Tokyo, 3Surgery,
quality of life. This study investigates the relationship between
National Defense Medical College, Saitama, 4Gastrointestinal
protein metabolism, muscle strength and physical function in
Surgery, Graduate School of Medicine, The University of Tokyo,
patients with advanced cancer.
Tokyo, Japan
Methods: In 16 patients with solid tumours (C) and 16 age- and
Rationale: Though high fat diets are recommended for gender-matched healthy controls (H), we assessed fasted
nutritional therapy of patients with cancer cachexia, our whole body net protein breakdown (netPB), myofibrillar PB
Poster Tour 8: Nutrition and Cancer S47
(MPB) and rate of appearance (Ra) by pulse IV administration of LC-MS/MS in positive ion mode, which enabled detection of
stable tracers ([2H3]tau-methylhistidine, 2H3-LEU, 2H2-GLY). fatty acids at <1 nmol/L.
We measured net protein synthesis (netPS), and protein Results: At baseline, before starting chemotherapy or fish oil
digestion (PD: gut function) after intake of a high-protein supplementation, all patients had detectable levels of 16:4(n-
meal with [1-13C]PHE and 15N-spirulina and primed continuous 3) ranging from 8 to 160 nmol/L. Fish oil users had higher
infusion of [ring-2H5]PHE and [13C9-15N]TYR. We tested FFM-i, absolute values of 16:4(n-3) than standard of care (mean = 47
handgrip, inspiratory,hand and leg muscle strength, physical vs 23 nmol/L; p = 0.03). Changes in 16:4(n-3) concentrations
activity by PASE and physical function by EORTC-QLQc30 after platinum based therapy were highly variable with some
questionnaires. Amino concentrations/enrichments by LC-MS/ patients increasing and others decreasing plasma 16:4(n-3).
MS, and statistics by unpaired t-tests and spearman correlation Conclusion: These preliminary results suggest that 16:4(n-3)
tests. may be present in NSCLC patients both before and after
Results: FFM-i, handgrip strength and physical activity were receiving platinum-based chemotherapy. It will be important to
similar in C and H, leg and inspiratory muscle strength were relate concentrations of 16:4(n-3) to chemotherapy response
lower in C ( p < 0.05). Fasted netPB (5.9 vs. 6.8 µmol/kg ffm/h), and survival in a larger sample of cancer patients.
fed netPS (40.2 vs. 43.9 µmol/kg ffm/h) and protein digestion Disclosure of Interest: None declared.
were not different, MPB and leucine Ra (0.29 vs.0.20 and 114.3
vs. 66.3 µmol/kg ffm/h) and clearance (0.07 vs. 0.04 and 1.42
PT08.5
vs. 0.78 L/min) and glycine clearance (1.3 vs. 0.9 L/min) were
ELEVATED C-REACTIVE PROTEIN, LOW SKELETAL MUSCLE
higher in C (P < 0.05). In C Ra-glycine was associated with leg
MASS, AND LOW VISCERAL ADIPOSE TISSUE ARE ASSOCIATED
extension strength (r = 0.51, P = 0.06), glycine clearance with
WITH REDUCED OVERALL SURVIVAL IN PATIENTS WITH
impaired physical function (r = −0.59, P = 0.04).
RESECTABLE COLORECTAL LIVER METASTASES
Conclusion: Patients with advanced cancer with preserved
muscle mass and physical activity have an increased amino acid D. P. J. Van Dijk1,2 *, M. Krill3, F. Farshidfar3, T. Li3,
turnover and myofibrillar protein breakdown, negatively S. S. Rensen1,2, S. W. M. Olde Damink1,2,4,5, V. C. Mazurak6,
impacting muscle strength and physical function. V. E. Baracos7, O. F. Bathe3. 1Department of Surgery, Maastricht
University Medical Centre, 2NUTRIM School of Nutrition and
Disclosure of Interest: B. Van Der Meij Grant/Research Support from:
Translational Research in Metabolism, Maastricht University,
ESPEN Research Fellowship, N. Deutz: None declared, R. Rodriguez:
None declared, F. Koeman: None declared, T. Smit: None declared,
Maastricht, Netherlands, 3Department of Surgery and
M. Engelen: None declared. Oncology, Tom Baker Cancer Center, Calgary, Canada,
4
Department of Visceral and Transplantation Surgery, RWTH
University Hospital Aachen, Aachen, Germany, 5Institute for
PT08.4
Liver and Digestive Health, University College London, London,
PLATINUM INDUCED FATTY ACIDS: ARE THEY PRESENT IN
United Kingdom, 6Division of Human Nutrition, Department of
PLASMA OF CANCER PATIENTS?
Agricultural, Food and Nutritional Science, 7Department of
V. C. Mazurak1 *, B. van der Meij2, R. Murphy3, A. Stanislaus4, Oncology, University of Alberta, Edmonton, Canada
V. Damaraju4, Q. Chu5, M. Sawyer5. 1Human Nutrition,
University of Alberta, Edmonton, Canada, 2Bond University, Rationale: A variety of factors have been identified which
Robina, Australia, 3University of British Columbia, Vancouver, influence survival following resection of colorectal liver
4
University of Alberta, Edmonton, Canada, 5Oncology, metastases (CRLM). In this study, we aimed to assess the
University of Alberta, Edmonton, Canada association between overall survival and manifestations of
cachexia: depletion of skeletal muscle mass, depletion of
Rationale: Preclinical studies suggest that hexadeca- visceral adipose tissue (VAT), and systemic inflammation in
4,7,10,13-tetraenoic [16:4(n-3)] induces resistance to plat- surgical patients with CRLM.
inum-based therapies. One study in healthy volunteers Methods: A prospective cohort of 87 patients with CRLM
reported increases in 16:4(n-3) after consuming fish oil with undergoing partial hepatectomy was studied. Systemic inflam-
levels returning to normal after 12 hours. No study has mation was assessed by measuring preoperative serum C-
measured in 16:4(n-3) levels in non-small cell lung cancer reactive protein (CRP). Skeletal muscle mass and VAT were
(NSCLC) patients receiving platinum based chemotherapy. This assessed using computed tomography (CT) scans at L3 level and
study aimed to determine plasma levels of 16:4(n-3) in NSCLC were adjusted for sex and age by calculating the Z-score
pts undergoing platinum-based chemotherapy in those using or (number of standard deviations above or below the sex- and
not using fish oil supplements. age-specific norms). Systemic inflammation was defined as a
Methods: A method to measure 16:4(n-3) in plasma of NSCLC CRP-level >5 mg/L. Low muscle mass and low VATwere defined
patients was developed and validated. Patients using fish oil as a Z-score <0 (below median).
(capsules or oil equivalent, n = 15) and on standard of care Results: Patients were divided into four groups according to
(n = 5) were selected for preliminary analysis. Plasma was CRP level, musculature and visceral adiposity: high CRP only
prospectively collected at baseline ( prior to receiving chemo- (n = 10); low muscle and/or VAT only (n = 31), high CRP
therapy) and after 2 cycles of platinum-based chemotherapy. combined with low muscle and/or VAT (n = 32), or none of
The plasma range of 16:4(n-3) at baseline and subsequently these factors (n = 14). Survival was lowest ( p = 0.01) in patients
following chemotherapy were compared between those taking with high CRP combined with low muscle and/or VAT (see
fish oil and those on standard of care. Plasma (80 µL) fatty acids Table). There was no survival difference among patients with
were extracted with iso-octane, derivatized and analyzed by only low muscle, only low VAT, or both factors combined
( p = 0.62).
S48 Poster tours
Risk factors n Median survival p-Value Poster Tour 9: Nutritional techniques

(months, 95%-CI)
PT09.1
None 14 110 (–) 0.01
Only high CRP or Only low muscle 32 79 (49–109)
LONG-TERM CLINICAL OUTCOMES OF PATIENTS ON HOME
and/or VAT PARENTERAL NUTRITION USING TAUROLIDINE
High CRP and low muscle and/or VAT 31 43 (29–58) CATHETER LOCKS
Y. Wouters1 *, B. Roosenboom1, W. Kievit2, G. Wanten1.
Conclusion: The presence of systemic inflammation in com- 1
Gastroenterology and Hepatology, 2Health Evidence,
bination with low muscle mass and/or VAT is associated with Radboudumc, Nijmegen, Netherlands
reduced survival in patients with CRLM. These findings stress
the importance of multidimensional phenotyping for adequate Rationale: Catheter-related complications (CRCs) in home
preoperative risk-assessment. parenteral nutrition (HPN) patients are a threat to both
Disclosure of Interest: None declared. catheter and patient survival. Taurolidine 2%, an antimicrobial
catheter lock solution (CLS), is an effective agent for the
PT08.6 prevention of catheter-related bloodstream infections (CRBSI).
FOOD EXPERIENCES AND TASTE DYSFUNCTION IN PATIENTS We evaluated long-term clinical outcomes of our HPN patient
UNDERGOING HEMATOPOIETIC STEM CELLTRANSPLANTATION cohort that uses the CLS taurolidine.
Methods: Between 2008 and 2016, all adult HPN patients
J. M. F. Sicchieri1 *, C. S. Meirelles1, B. P. Simões2, requiring a central venous catheter (CVC) or port-a-cath (PAC)
R. W. Diez-Garcia1. 1Division of Nutrition and Metabolism, who used taurolidine as CLS were included. CRC incidence
Department of Internal Medicine, 2Division of Hematology, rates/1,000 catheter days were described. Kaplan-Meier
Department of Internal Medicine, University Hospital, Faculty analysis was used to determine the time until a first CRC. Cox
of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao proportional hazard analysis was performed to identify risk
Preto, Brazil factors for a first CRC.
Results: In 221 HPN patients, 658 CVCs (418 Hickmans, 172
Rationale: The hematopoietic stem cell transplantation (HSCT)
PACs, and 28 non-tunneled CVCs) were inserted, comprising
is a procedure that causes severe susceptibility to infections,
2,61,252 catheter days. Median survival for Hickmans, PACs and
changes associated with the gastrointestinal tract and taste
non-tunneled catheters was 175 (43–544), 310 (61–827) and 14
and other comorbidities that impair food intake. This descrip-
(7–19) days, respectively. During eight years of follow-up, 176
tive study, based on a qualitative approach, aimed to explore
CRBSI occurred and 80 catheter-related occlusions (CRO).
the food experience and taste disturbance by chemotherapy in
CRBSI and CRO rates/1,000 catheter days were 0.74 and 0.34,
patients undergoing HSCT.
respectively. In 47% and 32% of patients, at least one CRBSI and
Methods: Semi-structured interviews were conducted with 20
CRO occurred, respectively. Median time to a first CRBSI or CRO
patients undergoing allogeneic HSCT in transplant specialized
was 246 (54–817) and 215 catheter days (5–2070). Numerically,
unit in a quaternary hospital. For data analysis, we used
but not significantly, CRBSI and CRO rates decreased over time.
the method of thematic analysis proposed by Braun and Clarke.
The sole use of intravenous fluids was associated with a
The analyzes carried out during the study will be explored from
significantly lower risk for CRBSI (RR 0.32). Twenty patients
the perspective of three theoretical frameworks: biographical
reported adverse events (5 grade 1, 13 grade 2 and 2 grade 3)
rupture, coping and hospital food service, allied with comple-
which were possibly related to the use of taurolidine.
mentary literature.
Conclusion: This study describes the largest cohort of HPN
Results: Analysis of the material allowed us to elaborate three
patients to date on long-term taurolidine 2% as CLS. Overall,
main themes: Diagnosis, Illness and treatment; Variation of
CRC incidence rates were low when compared with the
taste disturbance; Management of treatment and eating. The
literature. We found no evidence for a decreased effect of
first two themes address the experience of patients between
taurolidine over time.
diagnosis and the end of the transplant, bringing together
categories referring to attitudes changed by the HSCT. The Disclosure of Interest: Y. Wouters Grant/Research Support from:
third theme deals with aspects that were related to the way Research funding previously received from Geistlich Pharma AG,
patients deal with the treatment and the consequences of taste B. Roosenboom: None declared, W. Kievit: None declared, G. Wanten
Grant/Research Support from: Baxter, B. Braun, Geistlich Pharma AG and
changes. We also discuss in this theme the beliefs and ability
Fresenius, Consultant for: Baxter, B. Braun, Geistlich Pharma AG
related to treatment and the strategies associated to food. and Fresenius.
Another relevant aspect is the socializing blocks generated by
the transplant process and the role of support networks.
PT09.2
Conclusion: It is noticed impasses and adversities related to
TAUROLIDINE-CITRATE LOCK: RISK FACTORS ASSOCIATED
feeding during treatment, requiring a broad look at these
WITH A FAILURE OF CATHETER-RELATED BLOODSTREAM
aspects because knowledge of the characteristics of the
INFECTION PREVENTION IN HOME PARENTERAL NUTRITION
described experiences may help improve therapeutic and
IN ADULTS
dietary strategies to face treatment, improving the hospital-
ization experience and reduce the negative consequences of M. Lauverjat1, S. Naudin1, D. Barnoud1, C. Bergoin1, S. Ait1,
treatment. N. Voirin1, C. Chambrier1 *. 169, Hospices Civils de Lyon, Pierre
Benite, France
Rationale: Several studies have shown an efficacy of tauroli-
dine to decrease about 50% in catheter-related bloodstream
Poster Tour 9: Nutritional techniques S49
infection (CRBSI). In our practice, taurolidine-citrate lock (TCL) A p-value <0.05 was considered to indicate statistical
is used as primary and secondary prevention. The aim of this significance.
study was to analyse the risk factors associated with a failure Results: A significantly higher concentration of MDA was
of TCL. observed in plasma of long-term PN patients compared to the
Methods: 3-years retrospective study from 2012 including HPN control group. The activity of GSH-Px was comparable ( p >
patients with chronic intestinal failure (IF) with a TCL. Data 0.05). However, the activity of Se-GSHPx and of GST in plasma
collected included demographic, comorbidities, type of was significantly lower in patients on long-term PN compared
intestinal failure, HPN length, kind of IV catheter, previous to the controls ( p < 0.05).
catheter and CRBSI history. Patients and catheters were
described using median (min–max). Kaplan-Meier method was Parameters of Long-term Healthy
used to study CRBSI occurrence and a multivariate Poisson oxidative stress PN patients controls
regression was used to estimate adjusted incidence rate ratios
MDA [µM/L] 0.53 ± 0.25* 0.37 ± 0.20
(IRR) with their 95% confidence intervals (CI) of CRBSI. Se-GSHPx [U/ml] 66 ± 22# 78 ± 30
Results: 141 patients were included (61 males); 271 catheters GSH-Px [U/ml]] 130 ± 41 145 ± 45
(99,366 catheters-days): 115 Broviac, 89 PICC 1 lumen, 39 GST [U/ml] 200 ± 95# 242 ± 119
chambers and 24 PICC 2 lumens. Age was 57 years (18–86) and *
Significantly higher in patients’ blood in comparison with the control group,
indications of HPN included short bowel (68%) and CIPO (9%); p < 0.05.
#
54% had a stomy. HPN duration was 2 years (0.3–27.4) with 6 (2– Significantly lower in patients’ blood in comparison with control group, p < 0.05.
7) bags per week. 57 patients (90 catheters – 31,401 catheter-
days) had 119 CRBSI (1–9), corresponding to a CRBSI incidence Conclusion: Conclusions: Long-term parenterally fed patients
rate of 1.2/1,000 catheter-days (95%CI 1.0–1.4). Multivariate exhibit lower activity of antioxidant enzymes and higher
analysis indicated that PICC 2 lumens (IRR 14.4, 95%CI 4.9– concentration of MDA in plasma. The results indicate that the
42.3), PICC 1 lumen (IRR 3.1, 95%CI 1.2–8.3), more than 4 bags oxidant/antioxidant balance system is disturbed in patients on
per week (IRR 3.5, 95%CI 1.7–7.1) and non-compounding PN bag long-term PN. The decrease of plasma Se-dependent enzyme
(IRR 1.5, 95%CI 1.0–2.3) were statistically and independently could also be a sign of too low selenium supply in those
associated with an increased risk of CRBSI. patients.
Conclusion: Among HPN patients with IF, risk factors associated Disclosure of Interest: None declared.
with TCL failure are mostly in relation with venous access
(catheter type, frequency and kind of PN) rather than with the
PT09.4
nature of IF or comorbidities per se.
CORTRAK® DUODENAL TUBE PLACEMENTS: A SOLUTION FOR
Disclosure of Interest: M. Lauverjat: None declared, S. Naudin: None ALL PATIENTS? A PRELIMINARY SURVEY TO THE
declared, D. Barnoud: None declared, C. Bergoin: None declared, INTRODUCTION OF ELECTROMAGNETIC-GUIDED PLACEMENT
S. AIT: None declared, N. Voirin: None declared, C. Chambrier Grant/
OF NASO-DUODENAL FEEDING TUBES
Research Support from: PHAROLY, THERADIAL, Consultant for:
AGUETTANT, BAXTER, SHIRE. W. Arjaans1 *, M. Ouwehand1, G. Bouma2, T. Meulen van der2,
M. Schueren de van der1. 1Nutrition Support Team, Nutrition
PT09.3 and Dietetics, 2Gastroenterology, VU Medical Centre,
DETERMINATION OF OXIDATIVE STRESS MARKERS IN THE Amsterdam, Netherlands
BLOOD OF PATIENTS RECEIVING PARENTAL NUTRITION
Rationale: The Cortrak® feeding tube, an electromagnetic
SUPPORT
guided feeding tube which is placed by a trained nurse at the
J. Rogulska1 *, S. Osowska1, J. Giebułtowicz2, M. Kunecki3, patient’s bedside, is reported to be a safe, patient friendly and
J. Tokarczyk4, K. Majewska1, P. Wroczyński2, J. Sobocki1. cost effective answer to the disadvantages of endoscopic
1
Warsaw Medical University, Warsaw, Poland, 2Pharmacy, placement of naso-duodenal feeding tubes. This study aims to
Warsaw Medical University, Warsaw, 3Pirogow Hospital, Łódz,́ evaluate whether introducing Cortrak® feeding tube placement
Poland, 4Clinical Nutrition, Pirogow Hospital, Łódz,́ Poland would be profitable in our hospital.
Methods: We re-evaluated all endoscopically placed post-
Rationale: The aim of the study was to examine parameters of
pyloric feeding tubes in the years 2012–2013. Taking into
oxidative stress in the plasma of patients receiving parenteral
consideration a learning curve for nurses placing Cortrak®, only
nutrition (PN).
tube placements in patients with normal GI anatomy and non-
Methods: We obtained blood samples from 50 patients with
ICU admitted patients were evaluated for the initial phase. As a
intestinal failure on long-term PN and 50 sex- and age-matched
secondary analysis we also evaluated ICU patients who were
healthy controls. The patients were on PN for more than 2
referred for duodenal tube placement.
years. Patients with ongoing acute infections were excluded
Results: Patient records of 506 duodenal feeding tube
from the study. Total glutathione peroxidase (GSH-Px),
placements in 330 patients were evaluated; 135 placements
selenium dependent glutathione peroxidase (Se-GSHPx) and
(104 patients) where included. Exclusion criteria: ICU stay,
glutathione S-transferase (GST) from plasma were assayed by
abnormalities of the upper GI tract, or endoscopy for diagnostic
spectrophotometry. Oxidative stress was assessed by deter-
reasons only. Main indications for placements were gastropar-
mining the concentration of malondialdehyde (MDA) in plasma
esis (36%) or insufficient food intake (19%). For the secondary
by high performance liquid chromatography. Statistical analysis
analysis, 81 placements in 77 ICU patients were re-evaluated,
was performed using Student’s t-test and Manna-Whitney test.
with main indication gastroparesis (62%)
S50 Poster tours
Conclusion: Only one-third of patients referred for duodenal Poster Tour 10: Micronutrients
tube placement would have been a possible candidate for
Cortrak® in the initial phase. This would add up to 1–2 PT10.1
placements per week. If ICU patients would be eligible for ADAPTING BURN TRACE ELEMENT REPLETION: A NEW BURN
placement too, this would add up to 3 placements per week. WOUND EXUDATE COLLECTION METHOD CONFIRMS
This study help to decide on the profitability of introducing this IMPORTANT CU LOSSES
method in our hospital as still two-thirds of patients require P. Jafari1 *, O. Pantet1, M. Augsburger1, A. Thomas1,
traditional endoscopic treatment. The advice to the GI W. Raffoul1, L. A. Applegate1, M. M. Berger1. 1Lausanne
department is to make an business case based on the results University Hospital, Lausanne, Switzerland
and conclusion with cost-benefit before introducing the
Cortrak®. Rationale: Major burn patients develop metabolic alterations
Disclosure of Interest: None declared. which increase their nutrient requirements. Exudative losses of
trace elements (TE) complicate the assessment of their
requirements and have been shown to cause acute deficien-
PT09.5
cies. Cu, Se and Zn repletion protocols have been associated
STABILITY ASSESSMENT OF PAEDIATRIC PARENTERAL
with clinical benefits. We aimed at measuring with actual
NUTRITION ADMIXTURES CONTAINING HIGH CONCENTRATION
analytical methods the exact TE content of exudates to
OF TRACE ELEMENTS AND CARNITINE
improve the TE repletion.
M. L. Forchielli1 *, A. Bonoli2, A. Stancari3, L. L. Bruno3, F. Piro3, Methods: Inclusion of patients admitted to the burn-ICU of
A. Pession1, C. Puggioli3, G. Bersani4. 1Paediatrics, S. Orsola- Lausanne University Hospital. Intravenous TE administration
Malpighi Medical School, 2Civil, Environmental and Materials was by protocol in 7 most severly burned patients. Exudate
Engineering Department, University of Bologna, 3Pharmacy collection: wound bed was covered with an occlusive dressing
Service, S. Orsola-Malpighi Medical School, 4Consulting (under negative pressure) with a silicon drain placed under-
Pharmacist, Bologna, Italy neath and connected to a collecting bottle. Seventy TE were
measured in the samples by inductively coupled plasma mass
Rationale: High concentrations of trace elements, in particular
spectrometry. Losses were normalized for burned surface. Daily
zinc and selenium, along with carnitine are often added to
blood sampling was done.
parenteral admixtures in paediatric patients on long-term
Results: Fifteen patients aged 44.4 years (mean), burned 29
Parenteral Nutrition (PN). We aim to evaluate whether particle
+/−20% body surface were included. Average exudation period
diameters of these admixtures are maintained in the range of
was 5.5 days (3–8 days). Large losses of several TE were
chylomicra (0.4–1 micron), as PN admixtures require to be
observed. Serum levels of Zn and Cu were below or in the lower
safely infused to patients, according to European Guidelines.
limit of normal reference ranges despite repletion. Se supple-
Methods: Stability studies were carried out on six PN
ments (745 μg) normalized and even increased serum levels to
admixtures with carnitine, trace elements and electrolytes
upper normal value. Large exudative losses of B, Br and Mg
added in different contents, each compounded with five
were found, as well as of Fe and I. High levels of Al were
different lipid emulsions with and without fish oil. The analyses
measured in exudate and serum (mean 45 ± 47 ug/l and
were performed immediately at time 0 (t = 0) and 24, 48, 72, 96
34 ± 37 ug/l respectively).
(t = 96) hours after compounding. Particle diameter was
Conclusion: We show that the standardized IV doses of Cu and
determined by Light Scattering-Reverse Fourier Optics
Zn donot cover the requirements, while the Se doses seem too
Technique. Every sample was stored at 4°C and triple tested
high. This suggests revision of the supplementation protocols.
for a total of 450 analyses. Statistical significance was verified
Also several other essential TEs that are lost in high amount
by F-test.
in exudates should probably be included in burn nutritional
Results: Physicochemical stability did not change between t = 0
supplementation. The measured Al levels suggest more
and t = 96 and particle diameters were in the expected range of
investigation is required to determine the source of this trace
0.4–1.0 micron regardless of trace element and carnitine
element.
amounts, with the exception of the admixtures containing fish-
oil based emulsion and calcium concentration above 4.5 mmol/ Disclosure of Interest: None declared.
L. In these last admixtures, 12% of particle diameters were
larger than 1.0 micron and 2% exceeded 5.0 micron immedi- PT10.2
ately after compounding. These results matched our previous RE-FEEDING SYNDROME IN ADULTS RECEIVING TOTAL
observations. PARENTERAL NUTRITION: AN AUDIT IN A HIGHLY SPECIALIZED
Conclusion: Overall, high concentrations of trace elements and INTESTINE FAILURE UNIT
carnitine do not affect PN admixtures stability and can be F. Pantoja1,2 *, P. Patel1, N. Keane1, K. Fragkos1, M. Samaan1,
safely infused in long-term home-PN paediatric patients, I. Barnova1, S. Di Caro1, S. Mehta1, F. Rahman1. 1Department of
provided calcium concentrations and the presence of fish oil Gastroenterology, University College London Hospital, London,
based lipid emulsions are carefully considered. United Kingdom, 2Department of Clinical Nutrition, Hospital
Disclosure of Interest: None declared. Clinico San Borja Arriaran, Santiago, Chile
Rationale: The key for prevention of Re-feeding Syndrome (RS)

is the identification and management of patients at high risk.
The NCEPOD 2010 report identified inadequate clinical
assessment in 54.1% of patients prior to commencing
Poster Tour 10: Micronutrients S51
parenteral nutrition (PN). Thus, we aimed to evaluate our Cernevit® 4.7 ± 1.6 days/week (range 2–7) and Additrace®
clinical management of RS risk in patients starting PN in a high- 5.7 ± 1.6 days/week (range 2–7).
specialized Intestinal Failure Unit.
Methods: Prospective 7-day follow-up of patients commencing Measurement N Below % Normal % Above %
PN at University College London Hospital between 1st January
Vitamin A 74 26 72 3
and 30th of July 2015. 80 patients were categorized under RS Vitamin D 93 33 63 3
risk groups following NICE guidelines 2006. High (HRS) and low Vitamin E 72 13 81 7
(LRS) risk RS groups were compared focusing on the initial Vitamin B12 91 0 71 29
Folate 35 0 91 9
clinical approach and onset of biochemical features of RS
Zinc 88 19 57 24
(hypophosphatemia, hypokalemia and hypomagnesemia). Selenium 87 13 85 2
Results: 60 patients (75%) were at HRS and received lower
initial calories (12.8 [8.9–18.9] Kcal/Kg/Day, p < 0.05). All high
risk patients received a high potency vitamin preparation Current provision of micronutrients meets the needs of our
compared to 35% in the low risk group (65% C.I.:44.1% – 85.9%, population as most results fell within normal ranges. Vitamin A
p < 0.05). Daily phosphate, magnesium and potassium plasma and D concentrations were below normal in 26% and 33%
levels were monitored in 25%, 30% and 53.8% of patients, respectively and may require supplementation. No patients had
respectively. Hypophosphatemia, and, hypomagnesaemia and B12 or folate deficiency but monitoring is required to prevent
hypokalemia, developed in 30% and 27.5% patients, respect- excess provision which may have been due to over
ively. 67 (83.8%) patients had at least one electrolyte supplementation.
abnormality, occurring more frequently in HRS patients Conclusion: To our knowledge this is the largest survey of
( p < 0.05). micronutrient status in stable HPN patients. Our results suggest
Conclusion: The nutritional assessment, treatment, and follow daily provision of micronutrients is essential but ongoing
up of patients on PN were conducted in accordance with monitoring is required to identify deficiencies and toxicities.1
recommendations, though biochemical RS features occur References
despite following NICE Guidelines. HRS vs. LRS patients were
1. Pironi et al. (2016) Clin Nutr, 35:247.
more likely to have electrolyte abnormalities after receiving PN 2. Duncan et al. (2012) Am J Clin Nutr, 95:64.
regardless of precautions: irregular biochemistry monitoring
may have contributed to this and should be addressed. Further Disclosure of Interest: None declared.
research is required on the initial nutritional approach to
prevent RS in high risk patients. PT10.4
Disclosure of Interest: None declared. ARE HBA1C LEVELS AFFECTED BY IRON DEFICIENCY ANEMIA?
G. Kaner1 *, N. Seremet Kurklu2, G. Pamuk3. 1Department of
PT10.3 Nutrition and Dietetics, Faculty of Health Sciences, İzmir Katip
MICRONUTRIENTS-ARE OUR HOME PARENTERAL NUTRITION Çelebi University, İzmir, 2Department of Nutrition and
PATIENTS GETTING ENOUGH? Dietetics, Akdeniz University, Antalya School of Health,
Antalya, 3Department of Family Medicine, Faculty of
M. Pearson1, D. Brundrett1 *, S. M. Gabe2, A. Culkin1. 1Nutrition
Medicine, İzmir Katip Çelebi University, İzmir, Turkey
& Dietetics, 2Lennard-Jones Intestinal Failure Unit, St Mark’s
Hospital, London, United Kingdom Rationale: Iron deficiency is the most common nutritional
disorder in the world, it affects particularly women of
Rationale: Studies report a high prevalence of micronutrient
reproductive age. HbA1c is affected by iron deficiency and IDA
deficiencies in home parenteral nutrition (HPN) patients.1 We
with a spurious increase in HbA1c values. We aimed to investigate
audited the micronutrient status of patients in a tertiary
the effect of IDA on HbA1c levels in normoglycemic patients.
centre.
Methods: 63 women with IDA and 63 healthy controls aged 20–
Methods: A retrospective analysis was performed on patients
49 years, who applied to Diet Clinic were included in the study.
receiving HPN for a minimum of six months. This included
Fasting blood glucose (FBG), HbA1c, iron, ferritin, unsaturated
vitamins A, E, D, B12, Folate, Zinc and Selenium. Patients were
iron binding capacity (UIBC) were involved in the study.
excluded if they had undergone surgery or a change in
Hemoglobin levels <12 g/dL were accepted as IDA.
micronutrient provision in the past six months. Blood samples
Results: A statistically significance was found between the IDA
were excluded if C-reactive protein (CRP) >15 mg/L.2
and control group in hemoglobin (10.8 ± 0.87 g/dL and 13.2 ±
Demographic data was collected.
0.78 g/dL; respectively), iron (46.4 ± 23.18 µg/dL and 68.7 ±
Results: A total of 93 patient samples were included. Samples
27.67 µg/dL; respectively), UIBC (393.4 ± 76.12 µg/dL and
were excluded due to surgery (n = 8) or change in micronutrient
315.3 ± 59.43 µg/dL; respectively), and ferritin (7.8 ± 8.0 ng/
provision (n = 42) in the last 6 months or CRP >15 mg/L (n = 18).
mL and 15.0 ± 10.1 ng/mL, respectively) ( p < 0.01). There was
Mean age 54 ± 14 years, 33M:60F and mean BMI 21.8 ± 3.1 kg/m2.
no significant difference in FBG (88.7 ± 9.34 mg/dL and 90.1
Aetiologies included inflammatory bowel disease (n = 28),
± 8.77 mg/dL; respectively) and HbA1c (5.6 ± 0.41% and
mesenteric infarction (n = 23), motility disorder (n = 22),
5.5 ± 0.36%; respectively) between the groups ( p > 0.05). No
surgical complications (n = 6) and other (n = 14). Mean
correlation was found between hemoglobin and HbA1c levels,
number of days/week on HPN 5.7 ± 1.5 (range 2–7) with
while positive correlation was determined between UIBC and
HbA1c levels (r = 0.185, p = 0.038).
S52 Poster tours
Conclusion: In this study, no significant difference was found PT10.6

between IDA and healthy group in HbA1c levels. The positive TOTAL OXIDANT (TOC) AND ANTIOXIDANT (TAC) CAPACITY IN
relationship between HbA1c levels and UIBC supports that PREGNANT WOMEN AND NEONATES EXPOSED AND NO-
HbA1c levels may be affected by the IDA. EXPOSED ON TOBACCO SMOKE
Disclosure of Interest: None declared. M. Chełchowska1 *, J. Ambroszkiewicz1, L. Lewandowski2,
J. Gajewska1, T. M. Maciejewski2, J. Mazur3. 1Screening,
2
PT10.5 Obstetrics and Gynecology, 3Child and Adolescent Health,
DIETARY INTAKE OF INORGANIC PHOSPHORUS RATHER THAN Institute of Mother and Child, Warsaw, Poland
ORGANIC PHOSPHORUS IMPAIRS ENDOTHELIAL FUNCTION IN
HEALTHY YOUNG MEN Rationale: Maternal smoking has been considered as an
additional source of oxidant stress in pregnant women and in
H. Kawamura1 *, Y. Ota2, S. Endo2, M. Tani1, M. Ishitani1, newborns exposed in utero, leading to perinatal and postnatal
S. Tanaka2, M. Sakaue1, M. Ito1. 1Graduated school of Human health consequences. Due to overproduction of reactive
Science and Environment, 2School of Human Science and oxygen (ROS) as well as inadequate induce of antioxidant
Environment, University of Hyogo, Himeji, Japan protection newborns are particularly susceptible to oxidative
injury. The aim of the study was to assess the effect of smoking
Rationale: Hyperphosphatemia in chronic kidney disease
on the level of total oxidant capacity (TOC), total antioxidant
patients is a risk factor for cardiovascular disease. High
capacity (TAC), and OSI (oxidative stress index) in matched
phosphorus (P) intake impairs endothelial function, however,
maternal-cord blood pairs.
the difference between inorganic P and organic P remains
Methods: The study included a consecutive series of 45 active
unclear. The purpose of this study was to compare the effect of
smokers who smoked minimum 5 cigarettes per day throughout
inorganic with organic P on endothelial function.
their pregnancy and a series of 45 non-smokers of similar age
Methods: In a double-blinded crossover design, six healthy
and age of gestation, who had never smoked and were not
men, aged 19–22 years, were served two different high P meal
exposed to environmental tobacco smoke during their preg-
(1,200 mg P) for breakfast with more than 1-week wash out.
nancy. Serum TOC and TAC levels were determined by
One of the test meal was organic P meal containing natural P
colorimetric assay. The statistical analyses were performed
sources, the other was inorganic P meal containing natural food
using SPSS software.
and 1,000 mg P additives. We measured flow mediated dilation
Results: Birth weights and body length of the smokers’
(FMD) of the brachial artery at fasting and 30, 60 and 120 min
newborns were found to be lower than those of non-smokers.
after meal ingestion. We collected blood and urine samples for
The smoking pregnant women and their newborns had
the measurement of P, calcium, ionized calcium, intact
significantly higher concentrations of serum TOC, and OSI but
parathyroid hormone (PTH), 1,25-dihydroxyvitamin D (1,25
lower TAC levels compared with non-smoking pairs ( p < 0.001).
(OH)2D) and fibroblast growth factor 23 (FGF-23).
Important association between TOC levels and number of
Results: Serum P levels and urine P levels were significantly
cigarettes daily consumed was found in smokers group of
increased in inorganic P meal compared with organic P meal at
mothers and newborns (r = 0.394; r = 0.298, p < 0.05 respect-
after 30, 60 and 120 min, respectively ( p < 0.05). There were no
ively). In case of pregnant women total oxidant capacity level
significant differences in serum calcium, ionized calcium,
correlated also with serum cotinine concentrations (r = 0.374,
intact PTH, 1,25(OH)2D and FGF-23 levels. FMD decreased after
p < 0.05).
30 min in both meals. However, percent change of FMD from
Conclusion: Our data imply that, maternal smoking enhances
baseline was significantly more impaired in inorganic P meal
oxidative status and depletes antioxidant potential not only in
than organic P meal after 30 min (−20.0 ± 2.8% vs −10.1 ± 2.6%,
pregnant women but also in neonates exposed in utero to
p < 0.05).
tobacco smoke.
Conclusion: In healthy young men, inorganic P intake acutely
increased serum P levels, and impaired endothelial function Disclosure of Interest: None declared.
compared with organic P.
Clinical Nutrition
Poster
SUN-P002
Carbohydrate and lipid metabolism
IS REVERSE CHOLESTEROL TRANSPORT AFFECTED FROM
SUN-P001 HIGH FRUCTOSE INTAKE?
METABOLIC AND MITOCHONDRIAL CHANGES IN AN E. Ugur1 *, R. Nergiz-Unal1. 1Department of Nutrition and
INTERMITTENT FASTING MODEL IN HUMANS Dietetics, Faculty of Health Sciences, Hacettepe University,
A. Pinarbasi1 *, F. B. Aksungar1,2, D. O. Arslan3, M. Kolay1, Ankara, Turkey
M. Pak1, M. Serteser1,2, I. Unsal1,2. 1Department of
Biochemistry, Acibadem University, School of Medicine, Rationale: Reverse cholesterol transport via high density
2
Department of Biochemistry, Acibadem Labmed Clinical lipoprotein-cholesterol (HDL-C) and apolipoprotein-A1 (apo-
Laboratories, 3Department of Biophysics, Acibadem A1) has a protective role for cardiovascular diseases. It is not
University, School Of Medicine, İstanbul, Turkey clear whether dietary lipogenic carbohydrates like fructose
may affect reverse cholesterol transport. Hence, the purpose
Rationale: Dietary composition and calorie intake are the key of the study was to examine the effect of dietary high fructose
factors for healthy aging and disease resistance. Intermittent intake on HDL-C and apo-A1 levels in mice.
fasting (IF) is an alternative model which involves alternating Methods: Male mice (C57BL/6 type, 8-week old, n = 20) were
cycles of fasting and eating in a given time. In the present study divided in to two groups. Following the two weeks wash-out
we have compared the changes in metabolic parameters and period, one group were fed with a standard chow as a control
mitochondrial functions during an IF model in humans. group, and second group were fed with high fructose (35%
Methods: Twenty-two female and 17 male subjects were calories from fructose) ad libitum for 15 weeks. After the
included in the study. Subjects fasted and refrained from dietary manipulation period fasting blood was collected from
any oral intake including drinking and smoking during the each mouse under the anesthesia. HDL-C and apo-A1 levels
daylight hours for 30 days. Fasting duration was 15 hours were analyzed in plasma by ELISA method.
everyday and there were no restriction on the diet. Blood and Results: It was determined that, plasma mean HDL-C level was
urine sampling were performed on the second and the 20th day 87.91 ± 12.19 mg/dL in high fructose containing diet group
of fasting period. Glucose, insulin, glucagon, ketone bodies, while 102.2 ± 9.18 mg/dL in control group. Hence, plasma HDL-
thyroid stimulating hormone (TSH), triglycerides were mea- C was lower in high fructose diet group compared to the control
sured and compared to the basal values of each subject. group significantly ( p < 0.05). Furthermore, the mean plasma
Mitochondrialfunctions from the leucocytes of pheripheral apo-A1 content was 273.4 ± 71.28 ng/mL in high fructose
blood samples were evaluated by flowcytometry. containing diet group whereas 422.18 ± 48.3 ng/mL in the
Results: Significant decrease was detected in fasting glucose control group. Thus, high fructose intake resulted in lower
levels on the 2nd fasting day when compared with that of the plasma apo-A1 levels significantly compared to the control
20th fasting day( p = 0,009). Increased ketone body production ( p = 0.001).
was observed in the 20th fasting day according to the basal Conclusion: In conclusion, this results reveal that dietary high
levels( p = 0,008). TSH, glucagon, insulin, triglyceride levels fructose intake might result in the inhibition of the reverse
were not statistically different. Furthermore, according to the cholesterol transport via HDL-C and apo-A1 in the body by
basal values mitochondrial functions of the subjects improved increasing circulating cholesterol and causing dyslipidemia.
not on the 2nd but on the 20th day. Therefore, decreasing dietary fructose by less intake of
Conclusion: Present study show that our IF model has a positive fructose containing food and beverage consumption may have
impact on the glucose homeostasis, keton body production and a lifelong protective role for cardiovascular disease risk.
mitochondrial functions. Recent studies, imply that physiolo- Acknowledgments: Supported by TUBITAK 1001 – Scientific and
gically produced high ketone levels have beneficial effects on Technological Research Projects Funding Program Project
neurons such as preventing hypoglycemia and epileptic attacks Number:114S726, Ankara, Turkey
which are resistant to medicines. Ketone bodies are a new area Disclosure of Interest: None declared.
for drug discovery, to prevent and treat human cancers.
Furthermore mitochondria are now therapeutic targets for
cancer and aging.
S54 Poster
6
SUN-P003 Department of Internal Medicine, Academic Medical Center,
SATURATED VERSUS MONOUNSARURATED FATTY ACIDS Amsterdam, Netherlands
ELEVATE ACCUMULATION OF CHOLESTEROL IN THE LIVER:
PRELIMINARY DATA Rationale: The postprandial state is an orchestrated interplay
of nutrients and enteroendocrine factors in response to food
E. Ugur1 *, R. Nergiz-Unal1. 1Department of Nutrition and
intake. Plasma glucose levels after standardized meals show
Dietetics, Faculty of Health Sciences, Hacettepe University,
little modest variation in contrast to plasma bile acids (BAs).
Ankara, Turkey
Methods: This study assessed variability and the reproducibility
Rationale: Dietary high saturated fatty acids (SFAs) may affect of the postprandial enteroendocrine response during mixed
cholesterol metabolism a risk factor for the cardiovascular meal testing (MMT) in healthy lean men (N = 8). Moreover, we
diseases. However, effect of dietary fatty acids on cholesterol aim to investigate the interrelationship of all nutrients and
metabolism in the liver has not clarified yet. Hence, the aim of enteroendocrine factors using a metabolomic data analysis
the study was to examine effect of SFAs intake on the liver approach. Subjects consumed a liquid MMT (Nutridrink
cholesterol content in mice. Compact, Nutricia) on 3 separate study days after an overnight
Methods: Male C57BL/6 type 8-week old mice (n = 20) were fast. The meal contained 25% of the calculated daily energy
divided in 2 groups. Following the two weeks wash-out period, expenditure. Blood was sampled until 4 h after the meal. We
one group were fed with high monounsaturated fatty acids and analysed intra- and inter-individual variance of the plasma
second group were fed with high SFAs ad libitum for 15 weeks. glucose and insulin concentrations. Other parameters (e.g.
After dietary manipulation period, the liver and blood were individual BAs, glucagon-like peptide 1, fibroblast growth
collected from each mouse under anesthesia. The livers were factor 19 and 7α-hydroxy-4-cholesten-3-one, inflammatory
perfused with ice-cold saline. Total cholesterol contents in parameters) concentrations are currently analysed.
homogenized liver tissues and plasma low density lipoprotein- Results: A two-way repeated measures ANOVA showed no
cholesterol level (LDL-C) were analyzed by ELISA method. Liver significant effect for the 3 meal days (intra-individual variabil-
protein concentrations were analyzed with BCA method, ity) and a significant effect ( p < 0.001) for subjects (inter-
normalized for tissue amount and stated as mg/g protein. individual variability) for both glucose and insulin concentra-
Results: The liver total cholesterol levels in high MUFA tions. However, the mean coefficient of variance (CV) within
containing diet group were 0.3 ± 0.05 mg/g protein whereas subject of the total postprandial glucose curve was 0.11% (95% CI
in high SFA containing diet group were 0.4 ± 0.09 mg/g protein. 0.09–0.14) and for insulin 0.38% (95% CI 0.29–0.48).
The plasma LDL-C levels were significantly lower in MUFA group Conclusion: This study assesses reproducibility of the mixed
(76.06 ± 2.7 μg/mL) than SFA group (89.51 ± 2.42 μg/mL) ( p < meal test in general and bile acid response specific.
0.001). Although there was no significant difference in feed and Postprandial plasma glucose and insulin concentrations show
energy intake of the animals ( p > 0.05), accumulated choles- inter-individual variability. Repeated testing of postprandial
terol content in liver in SFA group was significantly higher than plasma glucose and insulin levels did not show significant
MUFA group ( p < 0.05). differences between study days even though intra-individual
Conclusion: This results reveal that high SFA intake can variance was substantial especially for insulin.
influence cholesterol metabolism in the liver and may affect Disclosure of Interest: None declared.
cardiovascular health. Therefore, reducing SFA intake and
replacement of SFA with MUFA may be a strategy to prevent SUN-P006
chronic diseases related to the cholesterol metabolism. MODIFIED ACETATE RINGER’s SOLUTIONS VERSUS LACTATE
Acknowledgments: Supported by TUBITAK 1001 – Scientific and RINGER’s SOLUTIONS IN PERIOPERATIVE PATIENTS: A
Technological Research Projects Funding Program Project SYSTEMATIC REVIEW (664 PATIENTS)
Number:114S726, Ankara, Turkey
H. Zhang1 *, Z. Jiang2. 1Cardiology, Guizhou Provincial People’s
Disclosure of Interest: None declared. Hospital, Guiyang, 2General Surgery, Peking Union Medical
College Hospital, Peking Union Medical College, Chinese
SUN-P004 Academy of Medical Sciences, Beijing, China
VARIABILITY AND REPRODUCIBILITY OF THE POSTPRANDIAL
RESPONSE Rationale: A systematic review for published randomized
E. C. Meessen1 *, H. M. Eggink1, K. A. van Galen1, controlled trials to evaluate the impact of perioperative
A. H. van der Spek1, G. J. Bakker2, M. J. Serlie1, administration of Modified Acetate Ringer’s Solutions versus
M. Nieuwdorp2,3, E. Fliers1, A. K. Groen2,4, S. W. Olde Damink5, Lactate Ringer’s solutions on outcomes.
F. G. Schaap5, J. A. Romijn6, M. R. Soeters1. 1Department of Methods: PubMed, EMBASE, Cochrane library, Web of Science,
Endocrinology and Metabolism, 2Department of Vascular CSCD, SinoMed etc databases were searched to identify
Medicine, Academic Medical Center, 3Diabetes Center, randomized controlled trials for this study. Outcomes &
Department of Internal Medicine, VU University Medical parameters were mortality, organ failure, pH, BE, PaCO2,
Center, Amsterdam, 4Department of Pediatrics, Laboratory of lactate concentration, HCO− 3 . Meta-analyses were conducted
Metabolic Diseases, University Medical Center Groningen, for the eligible RCTs
Groningen, 5Department of Surgery, NUTRIM School of Results: A total of 664 patients from 12 published papers were
Nutrition and Translational Research in Metabolism, subjected to systematic review. Modified Acetate Ringer’s
Maastricht University Medical Center, Maastricht, Solutions did significantly decrease the blood lactate concen-
tration than Lactate Ringer’s solutions (SMD-0.89, 95%CI
Carbohydrate and lipid metabolism S55
−1.05 ∼ −0.73, p = 0.000), Modified Acetate Ringer’s Solutions SUN-P008

group patients had higher arterial blood pH than Lactate VALIDITY OF ADDING INTRAVENOUS CARNITINE TO
Ringer’s group (SMD 0.25, 95%CI: 0.8 ∼ 0.42, p = 0.04). Modified PARENTERAL NUTRITION WITH LIPID EMULSION FOR
Acetate Ringer’s Solutions group patients had lower PaCO2 than DECEASING INFLAMMATORY REACTION OF POSTOPERATIVE
Lactate Ringer’s group (SMD −0.26, 95%CI: −0.47 ∼ −0.05, SURGICAL PATIENTS
p = 0.013). There were no significant differences between two Y. Koyama1 *, K. Moro2, K. Miura2, M. Nagahashi2, S.-I. Kosugi3,
groups in BE and HCO− 3. J. Tsuchida2, M. Ikarashi2, M. Nakajima2, H. Ichikawa2,
Conclusion: Modified Acetate Ringer’s Solutions did reduce the Y. Shimada2, J. Sakata2, H. Kameyama2, T. Kobayashi2, T. Wakai2.
blood lactate concentration than Lactate Ringer’s solutions. 1
Niigata University Graduate School of Health Sciences,
2
Disclosure of Interest: None declared. Division of Digestive & General Surgery, Niigata University
Graduate School of Medical Sciences, Niigata, 3Department of
SUN-P007 Digestive and General Surgery, Uonuma Institute of Community
THE EFFECTS OF 25G FAT CONTAINING GLUCOSE TOLERANCE Medicine, Niigata University Medical and Dental Hospital,
TEST ON POSTPRANDIAL TRIGLYCERIDE RESPONSE IN BOTH Urasa, Japan
NORMAL VOLUNTEERS AND TYPE 2 DIABETIC PATIENTS
Rationale: Lipid emulsion including long-chain fatty acids
T. Nakamura1 *, L. M. Sugawara2. 1Endocrinology and (LCFA) should be added parenteral nutrition (PN) for supplying
Metabolism, Omihachiman Community Medical Science, appropriate nutrition. Carnitine is necessary for transporting
Kusatsu, 2Endocrinology and Metabolism, Omihachiman LCFA into mitochondria for beta-oxidation. In the present
Community Medical Science, Otsu, Japan study, we prospectively investigate the validity of carnitine
administration during postoperative PN with lipid emulsion.
Rationale: We have presented that the cookie consisting of 75 g
Methods: Patients who receive surgery for gastric or colorectal
carbohydrate and 25 g fat is more informative than oral glucose
surgery during 2014–2016 were entered. The patients were
tolerance test (OGTT) to study both glucose and triglyceride
randomly divided into 2 groups: Group L (8patients) received
metabolism in type 2 diabetic subjects (Endocrine Journal,
peripherally PN (PPN) solution of 7.5% glucose, 30% amino acid
2006).
and 20% lipid emulsion, and Group LC (8patients) received same
Methods: To examine effects of the postprandial triglyceride
PPN solution plus carnitine intravenously. PPN was performed
levels in normal volunteers (n = 56) and type 2 diabetic subjects
from postoperative day (POD) 1–4 without oral nutrition. Oral
(n = 59), we examined the correlation between the fasting TG
nutrition was stated from POD4. Clinical factors such as amount
levels and postprandial TG ones at 3 hours after loading tests. It
of administered nutrients, pre- to postoperative serum
showed that the positive correlations between fasting TG and
carnitine, albumin (Alb), rapid turnover protein (RTP), total
the post prandial TG levels at 3 hours were observed in both
lymphocyte count (TLC), insulin resistance indicated by HOMA-
groups. It demonstrated a coefficient of correlation was 0.90,
R, C-reactive protein (CRP) and postoperative complication
0.92 respectively and it was statistically significant ( p < 0.001).
were compared. Statistical analyses were performed by
Results: Next, we classified patients with type II diabetes
Kruskal-Wallis test, Mann-Whitney U test and Chi square test.
mellitus in three groups by the area under the curve of TG level
The statistical significance was defined as P < 0.05.
until 3 hours after the test (AUC-TG0–3). AUC-TG0–3 level in each
Results: Serum carnitine concentration was significantly higher
group was from 0 to 500 (Group A), 501–700 (B), 701–1500 (C)
in Group LC at not only POD3 (P < 0.01) but also POD7 (P = 0.01).
mg/dL-hour, respectively. Then, we examined its association
Clinical factors including amount of administered nutrients,
with blood insulin (INS), the ratio of AUC-TG 0–3/AUC-INS 0–3,
pre- to postoperative change of Alb, RTP and TLC, insulin
AUC-TG 0–3 and BMI. The ratio of AUC-TG 0–3/AUC-INS 0–3 was 5.2
resistance and frequency of postoperative infectious compli-
in normal volunteers (N), 8.3, 16.8, 26.3 mg/mU in A, B, C
cation were comparable between 2 groups. Change of CRP from
respectively. Those values were statistically significant
POD 3–7 showed significantly more decrease in Group LC
between N and B ( p < 0.01), N and C ( p < 0.001), A and C
compared with Group L (P = 0.011).
( p < 0.001). Moreover, the positive correlation between AUC-
Conclusion: Our results showed that addition of carnitine to PN
TG 0–3 and BMI was identified in diabetic patients.
with lipid emulsion is safe and valid for recovery from
Conclusion: These results indicated that diabetic patients with
postoperative inflammatory reaction.
elevated fasting triglyceride levels display exaggerated and
prolonged postprandial triglyceride responses and have an Disclosure of Interest: None declared.
effect of high insulin sensitivity, but not insulin amount to
produce triglyceride in both fasting and prandial. SUN-P009
Disclosure of Interest: None declared. ASSOCIATION BETWEEN CARBOHYDRATE INTAKE AND FATTY
ACIDS IN THE DE NOVO LIPOGENIC PATHWAY IN SERUM
PHOSPHOLIPIDS AND ADIPOSE TISSUE AMONG 60-YEAR OLD
MEN
Z. Alsharari1 *, K. Leander2, P. Sjögren1, A. Carlsson2,
T. Cederholm1, U. De Faire2, M.-L. Hellenius2, M. Marklund1,
U. Risérus1. 1Public Health and Caring Sciences, Clinical
Nutrition and Metabolism, Uppsala University, Uppsala, 2Unit
S56 Poster
of Cardiovascular Epidemiology, Institute of Environmental transplantations (60 Tx for CF), were performed between
Medicine, Karolinska Institute, Stockholm, Sweden 2010 and 2015. All medical records of patients operated for
lung Tx for CF between 2013 and 2015, were included.
Rationale: Fatty acid composition in blood and adipose tissue is Results: 22 patients (age: 31 ± 9 years, mean ± SD) were
useful to reflect dietary fat quality, although even-chain included in the study. Preoperative BMI was 18.7 ± 1.2; 8
saturated fatty acids (SFA) and monounsaturated fatty acids patients (36%) had a BMI < 18.5. Median ICU LOS was 29 days.
(MUFA) are weaker biomarkers. Since SFA also can be produced The nutrition support characteristics at the 5th and 10th
via de novo lipogenesis (DNL), and desaturated through SCD-1 postoperative day were: energy intake 25 ± 10 and 25 ± 15 kcal/
to MUFA, we aimed to test the hypothesis that high carbohy- kg/d; protein intake 1.0 ± 0.6 and 1.2 ± 0.7 g/kg/d; NP/NE ratio
drate intake, especially sugars, is related to serum and adipose for energy intake 2.5 and 1.0, respectively. ICU LOS did not
tissue SFA and MUFA, respectively. correlate with preoperative albumin, percent of IBW, nor with
Methods: Samples of 301 men were included (age 60, BMI 25.4) postoperative energy and protein intake, nor with EN and
with available food record data and fatty acid composition in PN route.
both serum phospholipids (PL) and adipose tissue (AT). Conclusion: To our knowledge, our study is first to assess the
Exposure variables were intake of carbohydrate quantity and effect of early nutritional support after lungTx in CF patients. A
quality, including sugar and fiber intake. The major SFA, third of transplanted patients are malnourished. The recom-
palmitic acid, was the primary outcome in serum PL and AT, and mended calorie intake was achieved at day5, but protein intake
the estimated SCD-1 and the SCD product 16:1n-7 was was below recommended one during that period. In this
secondary. RNA expression was conducted in adipose tissue relatively small sample of patients in a fair nutritional status,
biopsies in a subsample of 81 subjects. we failed to demonstrate any effect of preoperative nutritional
Results: There were no positive associations between carbo- status, nor any shortening effect of postoperative nutrition
hydrate intake or sugar-rich foods and serum palmitic acid, support on ICU LOS. Larger scale studies are underway to
total SFA or 16:1n-7. After BMI-adjusted, carbohydrate intake explore this finding.
was inversely associated with 16:0 in PL (P = 0.005) and with
16:1 (P = 0.07) and SCD (P = 0.13) activity in AT. There was a
little evidence of linear associations of disaccharide intake
with FA or SCD activity (BMI-adjusted P ≥ 0.15). However, SUN-P011
disaccharide intake was non-linearly associated with 16:1 and EFFECTS OF GLUTAMINE SUPPLEMENTATION ON CRITICALLY
SCD activity in PL, but not adipose tissue (P for non-linearity ≤ ILL ADULTS: AN UMBRELLA REVIEW OF SYSTEMATIC REVIEWS
0.02). In the subsample, we found no association between AND META-ANALYSES
carbohydrate intake and SCD-1 gene expression. A. Apostolopoulou1 *, A. B. Haidich1, K. Kofina2, M. Chourdakis1.
1
Conclusion: There was no clear evidence to suggest that high Department of Medicine, Aristotle University of Thessaloniki,
carbohydrate intake or sugar-rich foods or beverages is Thessaloniki, 2Medical School, Democritus University of
reflected by higher DNL-derived SFA in serum PL. Thrace, Alexandroupolis, Greece
Rationale: The effect of supplementing immunonutrients in
critical illness has been widely examined but relevant results
offer differential conclusions. The purpose of this study is to
Critical Care 1 evaluate the clinical efficacy of the administration of glutam-
ine to severely ill patients.
SUN-P010
Methods: Four bibliographic databases have been searched
NUTRITIONAL STATUS AND EARLY NUTRITIONAL SUPPORT
(Medline, Scopus, The Cochrane Library, Prospero) til
AFTER LUNG TRANSPLANTATION IN PATIENTS WITH CYSTIC
01.03.2017. Systematic reviews and meta-analyses published
FIBROSIS: A SINGLE CENTER, PRELIMINARY REPORT
in English, including the comparison of immunomodulating
A. Jirka1 *, D. Darmaun2, T. Lepoivre3, A. Haloun4, diets -containing exclusively glutamine- with standard diets for
I. Danner-Boucher4. 1HepatoGastroenterology and Nutrition critically ill adult patients were selected. A descriptive analysis
Support Unit, 2Nutrition Support Team, 3Cardiac Surgery was performed to assess the outcome of glutamine supple-
Intensive Care Unit, Anesthesiology Department, 4Thoracic mentation on mortality, infectious complications, length of
Transplantation Unit, University Hospital Nantes, Nantes, hospital (LOS) and length of ICU stay (LICU) and to synthesize
France the results from the subgroup analyses of primary studies. The
extend of overlapping was also evaluated.
Rationale: The prevalence of malnutrition, defined as Results: Fifteen meta-analyses and one systematic review were
BMI < 18.5, reaches 40% in adult CF patients. Malnutrition is eligible for inclusion, involving 123 studies and 8,194 patients.
known for its negative impact on the postoperative course. Mortality rate was examined as one of the endpoints in 14 of the
Moreover, in ICU patients, the cumulative, postoperative included studies. Five of these (36%) revealed a statistically
energy deficit increases the length of ventilation, ICU length significant survival benefit by the administration of glutamine.
of stay (LOS), and infection risk. The aim of the current study Fifteen of the studies examined the impact of glutamine
was to evaluate the impact of preoperative nutritional status supplementation on infectious complications; a significant
and of early postoperative nutrition support on short-term decrease was found in the majority of the them (12; 80%) 15
post-transplant outcome in CF patients. studies dealing with the effect of glutamine on LOS, with 9
Methods: This was an observational, retrospective study. studies (60%) resulted in the conclusion that glutamine
In a single-center, 120 lung or combined lung/heart
Critical Care 1 S57
administration has shortened LOS. Among 6 studies examinng associated with poor clinical outcomes and function1. So, we
LICU, only 1 showed a beneficial effect (17%). have evaluated low muscle mass with CT and outcomes in
Conclusion: Glutamine may have the ability to play a beneficial critical ill cancer patients
role in critical care patients, in regard to rate of infections and Methods: At the period of 1 year, we included patients who
LOS. Subgroup analysis might reveal in depth which patient performed abdominal CT from the 72 hours of admission in the
could benefit most from such a supplementation. ICU. A ROC curve was applied to defined the groups of patients
Disclosure of Interest: None declared. with sarcopenia and non sarcopenia by CT. A multiple logist
regression was used Cox regression and held the 30 days survival
curve adjusted was used to the check the joint relationship of
SUN-P012
these characteristics with the outcome.
THE ASSOCIATION BETWEEN PHOSPHATASE AND TENSIN
Results: We evaluated 99 the mean age was 61 years, with 56%
HOMOLOGUE (PTEN) EXPRESSION, GLUCOSE CONTROL AND
male. 43.% of the patients were classified as malnourished
CALORIES SUPPLEMENTED IN CRITICALLY ILL PATIENTS
according to weight loss criteria and 19.4% according to BMI.
A. Molfino1 *, F. Alessandri2, A. Farcomeni3, D. Dell’utri2, The BMI values showed no correlation with a sarcopenia
P. Mosillo4, M. I. Amabile1, M. Muscaritoli1, A. Laviano1. R2 = 0.39, P < 0.001. The cutoff point for determination of
1
Department of Clinical Medicine, 2Department of sarcopenia by CTwas 41.2 cm2/m2. Therefore, the diagnosis of
Cardiovascular, Respiratory, Nephrology, Anesthesiology and sarcopenia by CTwith the parameters of nutritional evaluation
Geriatric Sciences, 3Department of Public Health and were correlated with 64.2% by weight loss criteria and only
Infectious Diseases, 4Department of Physiology and 19.4% by BMI. The patients considered sarcopenic by this
Pharmacology “Vittorio Erspamer”, Sapienza University of method presented had higher 30 days mortality by age and SAPS
Rome, Rome, Italy 3 (P < 0.01), hospital mortality (P = 0.006) and ICU complication
( p = 0,016) when compared to nonsarcopenic.
Rationale: PTEN reduces insulin sensitivity and its expression
Conclusion: The sarcopenia assessed by CT demonstrated low
increases during sepsis. Considering that critically ill patients
correlation with malnutrition by BMI and was a risk factor for
present insulin resistance, we investigated the role of PTEN
increased hospital mortality, complications, as well as lower
expression on glucose control and clinical outcome(s) in
survival among 30 days for cancer patients.
patients hospitalized in an intensive care unit (ICU) receiving
artificial nutrition. Reference
Methods: This was an observational, single-center study 1. Paris M, Mourtatizaks M. Assesment skeletal muscle mass in
enrolling adult patients hospitalized for trauma. Plasma critically ill patients: considerations for the utility computed
glucose levels and its variability were recorded in patients tomography imaging and ultrasonography. Curr Opin Clin Nutr
receiving artificial nutrition. PTEN expression via western Metab Care 2016, 19:125–130.
blotting analysis was measured and the associations between Disclosure of Interest: None declared.
PTEN, plasma glucose levels and its variability, and calories
administered were investigated. Parametric and non-paramet- SUN-P014
ric tests were used, as appropriate. P value <0.05 was IRON CONTAMINATION IN PEDIATRIC AND ADULT PARENTERAL
considered statistically significant. NUTRITION MIXTURES
Results: Twenty patients (13 men and 7 women, mean age of
A. M. Menéndez1 *, S. S. Farías2, I. Cortez3, H. J. Montemerlo4,
37.3 ± 12.7 years) were enrolled. No correlation between
M. L. Pita Martín5. 1Clinical Pharmacy, Belgrano University,
plasma glucose and PTEN was documented (r = −0.15,
Ciudad Autónoma de Buenos Aires, 2Analytical Chemistry,
P = 0.55), neither between glycemic variability and PTEN
Atomic Energy National Agency, San Martín, Prov. Buenos Aires,
expression (r = −0.00, P = 0.99). However, total kcal/day 3
Analytical Chemistry Laboratory, Benito Roggio Ambiental &
administered and PTEN expression significantly correlated
Belgrano University, 4Nutrition Research, Argentine Institute
(r = 0.56, P= 0.01). Patients with PTEN levels below the
for Education, 5Nutrition, Buenos Aires University, School of
median value received less kcal/day than those with PTEN
Pharmacy and Biochemistry, Ciudad Autónoma de Buenos
above the median (P = 0.048). This association was more
Aires, Argentina
pronounced when adjusted for body weight (P = 0.03) and for
the average of insulin daily administered (P = 0.02). Rationale: Iron (Fe) is an essential trace element, and could be
Conclusion: PTEN expression might contribute to glucose present as a contaminant in the individual components used to
homeostasis and disposal in critically ill patients receiving prepare TPN. This contamination must be taken into account by
artificial nutrition. the compatibility limitations regarding lipids destabilization.
Disclosure of Interest: None declared. The objectives were to determine Fe contamination levels in
commercial individual components available in Argentina to
SUN-P013 prepare TPN mixtures, to calculate the Fe contamination
ASSESSMENT OF SKELETAL MUSCLE MASS IN CRITICALLY ILL amount present in TPN mixtures prepared with individual
CANCER PATIENTS BY COMPUTED TOMOGRAPHY components and its relation regarding the Fe requirements
Methods: Fe was determined in 40 individual solutions, from
D. O. Toledo1, A. M. Carvalho2, J. Toloi2 *, A. R. Oliveira2. 1ICU,
different labs and lots, belonging to 11 commercial products
Hospita São Luiz Itaim, São Paulo, 2ICU, Hospital do Cancer de
available in Argentina, by Argon Inductively Coupled-Plasma-
Barretos, Barretos, Brazil
Optical Emission Spectrometry. Samples containing organic
Rationale: Recent findings, shown that computed tomography substances were digested in a laboratory microwave oven.
CT have been used to identify critical ill patients with low SM
S58 Poster
Results: Fe levels for each individual solution were (μg/mL): parameters of protein-energy metabolism, manifestations of
mean value ± SD: Dextrose 50%: 1.12 ± 0.03; Dextrose 70%: multiple organ failure, however, it requires strict control over
1.32 ± 0.52; Amino acids 10%: 0.25 ± 0,11; Lipids 20%: the patient due to the remaining risk as to the development of
4.58 ± 0.80; Potassium chloride: 0.11 ± 0.03; Sodium chloride hyperglycemia.
20%: 0.11 ± 0,03; Magnesium sulfate: 0.11 ± 0,00; Sodium Disclosure of Interest: None declared.
glicerophosphate: 2.76 ± 0.48; Sodium phosphate: 4.51 ± 0.13;
Calcium gluconate: 2,01 ± 0,27; Zinc sulfate: 0.12 ± 0,04;
SUN-P016
Sterile water: non detectable. According to the obtained
EVALUATION OF IMPLEMENTATION OF FASTING GUIDELINES
values, the calculated Fe total amount (mg) provided by the
FOR ENTERALLY FED CRITICAL CARE PATIENTS
individual components contamination would be for a typical TPN
mixture: adult 2.352; neonatology: 0.073; pediatric: 0.524. B. Jenkins1 *, L. Marino1, P. Calder2. 1Nutrition and Dietetics,
Conclusion: Fe found as contaminant in the studied compo- University Southampton Hospitals NHS Trust, 2Human
nents was not declared in the label. The Fe contamination Development & Health Academic Unit, Faculty of Medicine
levels in adult TPN were 1.2 mg/L amount which would affect University of Southampton Institute of Developmental
the TPN stability. Regarding the iron daily requirements, Fe Sciences, Southampton, United Kingdom
contamination in TPN mixtures for adults would be very high.
Rationale: Critically ill patients are often fasted prior to
Therefore, it would be advisable that manufacturers declare
procedures leading to the accumulation of nutritional deficits.
the Fe contaminant content in the label products.
Therefore following guidelines on fasting is important to help
Disclosure of Interest: None declared. reduce such deficits. The aim of this work was to determine the
impact of implementation of local fasting guidelines on
SUN-P015 nutrition support delivery and staff knowledge of the guidelines
THE IMPACT OF EARLY ENTERAL NUTRITION IN LOW-VOLUME with a General, Cardiac and Neurosurgical intensive care unit.
REGIMEN ON CLINICAL EFFICIENCY OF THE METHOD OF Methods: Enteral nutrition (EN) intake was audited in 74
INSULIN THERAPY critically ill adults (32 pre- and 42 post-guideline implemen-
A. Nikolenko1 *, I. Prelous2, I. Leiderman3. 1Head of the tation) over 4–14 days at Southampton General Hospital.
Department of Anesthesiology and Reanimatology, Questionnaires were administered to staff assessing knowledge
2
Department of Anesthesiology and Reanimatology, Perm State and barriers to guideline use.
Medical University, Perm, 3MD, Professor of the Department of Results: There were significant differences in % EN received
Anesthesiology, Reanimatology and Transfusiology, Ural State 76.4 ± 11.8 vs. 84.1 ± 10.8 ( p = 0.0009) and the number of hours
Medical University, Ekterinburg, Russian Federation feeds were withheld 42 ± 26.6 vs. 28 ± 20.8 hours pre- and
post-guideline implementation ( p = 0.02). Although not sig-
Rationale: Correction of stress hyperglycemia is a pressing nificant there were improvements pre- and post-implementa-
problem in modern intensive care. The purpose of the study: To tion in the % of energy and protein delivered 80.7 ± 16.4 vs.
evaluate the efficiency of various methods for stress hypergly- 86 ± 17.3; 74 ± 18.3 vs. 79 ± 18.5 respectively.
cemia correction in patients with acute surgical pathology of 77% of staff were familiar with the guidelines, whilst 42%
abdominal organs. requested further education. The main barriers to compliance
Methods: A two-centered randomized open controlled study were delays and unpredictable timing of procedures, and
was performed using a conversion method. In Group 1 nutrition differing guidance from senior staff and non-ICU teams.
was performed in the regimen of low-volume support method, Conclusion: Failure to meet nutritional goals during ICU
enteral component was Nutrison Advanced Diason feed admission has been shown to negatively impact on nutritional
combined with administration of short-acting insulin, and in status, patient morbidity and length of stay. We have been able
Group 2, short-acting insulin was administered in combination to demonstrate that implementation of fasting guidelines
with enteral nutrition (Nutrison). Evaluation was performed resulted in significant improvements in the amount of nutrition
based on laboratory values, circadian dynamics of blood support delivered and reduced duration of feed breaks. The use
glucose level, total insulin consumption, dynamics of systemic of fasting guidelines is a positive step towards increasing
inflammatory response, the period of stay in intensive care nutrition delivery in the ICU. Further staff education and better
unit, assessment of nutritional status. The study was performed planning around procedures is required to promote further
in 5 stages (Day 1, 3, 5, 7, 10). 60 patients with stress adherence to the fasting guidelines.
hyperglycemia were included in the study. Disclosure of Interest: None declared.
Results: In Group 1, rapid correction of mean daily (P = 0.005)
fasted glycemia (P = 0.003) was observed, glycemia’s variabil-
SUN-P017
ity was reduced, total and mean daily consumption of insulin
ASSESSMENT OF GLUTAMINE-SUPPLEMENTED ENTERAL
per person was reduced, (P = 0.006) as compared to Group
FORMULA AND PLASMA AMMONIA LEVELS IN PATIENTS IN
2. Alsoin Group 1, veracious reduction of multiple organ failure
INTENSIVE CARE UNIT
manifestations (P = 0.001), white blood cell count (P = 0.005),
immature granulocytes (P = 0.04) and free-radicals’ activity D. Ebiloğlu1, Ç. Kaymak1 *, A. Özcan1, H. Başar1, N. Özcan1.
1
(P = 0.007) was revealed on Day 3. Periods of artificial Anaesthesiology and Reanimation, Intensive Care Unit,
pulmonary ventilation were reduced (P1–2 = 0.002). Ankara Training and Research Hospital, Health Science
Conclusion: The method of early “low-volume” nutritional University, Ankara, Turkey
support with the inclusion of Nutrison Diason feed in
Rationale: Glutamine is a nonessential amino acid that
combination with intensive insulin therapy stabilizes the
contains free ammonia and it is the most important substrate
Critical Care 1 S59
released to the bloodstream after renal ammoniagenesis. The 27.7% days of enteral feeding less than the planned. Leading
catabolism of glutamine can be increased without the causes were: shock 43.31%, upper digestive intolerance with
production of excessive amounts of specific metabolites. We GAV >500 mL or vomiting 39.03%, profuse diarrhea 10.7% and
compared the plasma ammonia levels in critically ill patients carrying out diagnostic or therapeutic procedures (CT, bron-
given standart and glutamine-supplemented enteral formula. choscopy, physical therapy, tracheotomy) 6.96%.
Methods: Forty patients were enrolled in the study. The Conclusion: Despite evidence-based definite recommenda-
patients were randomized into two groups as isocaloric tions for the superiority of EN in critically ill patients practical
glutamine-free (Control) and glutamine-supplemented difficulties might lead to unintentional underfeeding. The
(Glutamine) enteral formula groups. In Glutamine group implementation of a specific nutritional management protocol
0.3 g/kg/day enteral L-glutamine was given within 16 hours. can help resolve difficulties and increase the use of EN in ICU
The isocaloric enteral formula was also administered during 16 patients.
hours. Plasma samples were collected at the 24th hour and Disclosure of Interest: None declared.
after 7., 14., 21. and 28 days. Demographics of patients were
recorded.
SUN-P019
Results: Eleven of the patients were males in both groups.
ADEQUACY OF ENTERAL ENERGY INTAKE IS ASSOCIATED WITH
APACHE II and SOFA scores of the Glutamine and Control Groups
MORTALITY IN CHILDREN ON EXTRACORPOREAL MEMBRANE
at admission were also similar. Plasma ammonia levels at first
OXYGENATION
24 hour (80.77 ± 44.95 mcg/dL vs. 66.16 ± 26.48 mcg/dL, p =
0.53), 7th day (68.94 ± 29.32 mcg/dL vs. 58.81 ± 28.45 mcg/ C. Ong1,2 *, C. Y. S. Lim2, Y. H. Mok1, Z. H. Tan3, B. Ang1,
dL, p = 0.17), 14th day (68.53 ± 42.97 mcg/dL vs. 85.88 ± 82.42 T. H. Tan1, Y. J. Loh1, Y. H. Chan1, J. H. Lee1. 1KK Women’s and
mcg/dL, p = 0.81), 21st day (83.51 ± 51.84 mcg/dL vs. 79.16 ± Children’s Hospital, 2National University of Singapore, 3SBCC
70.80 mcg/dL, p = 0.54) and 28th day (71.73 ± 38.60 mcg/dL Baby and Child Clinic, Singapore, Singapore
vs. 77.05 ± 70.40 mcg/dL, p = 0.19) were comparable between
Rationale: Use of extracorporeal membrane oxygenation
groups. Plasma ammonia changes within the groups throughout
(ECMO) in children is increasing. Yet, little is known about
the study were insignificant.
optimal nutritional practices in these children. We aim to
Conclusion: Plasma ammonia levels in patients fed with
describe nutritional practices and their association with out-
glutamine-supplemented enteral nutrition and isocaloric glu-
comes in children supported on ECMO.
tamine-free enteral nutrition were similar. An appropriate plan
Methods: This is a retrospective chart review of all patients 1
for nutritional therapy should be developed and assessed
month – 18 years requiring ECMO from 2010 to 2016. Nutrition
periodically during intensive care unit stay.
intake in the first 7 days of ECMO was collected. Adequacy of
Disclosure of Interest: None declared. nutrition intake was defined as % intake vs. requirements.
Primary outcome was hospital mortality. Secondary outcomes
SUN-P018 were ventilator-free days and paediatic intensive care unit
THE INCIDENCE OF UNINTENTIONAL UNDERFEEDING IN ICU (PICU) length of stay.
PATIENTS DURING ENTERAL NUTRITION Results: 51 patients of median age 3.3 [interquartile range
A. M. Mega1, T. Melissopoulou1, C. Dimosthenopoulos2 *, (IQR) 0.6–10.4)] years were included. 43 (84%) were supported
E. Pappa1, I. Floros1. 1Intensive Care Unit, 2Department of on veno-arterial ECMO. Main indications for ECMO were: post
Clinical Nutrition, Laiko General Hospital of Athens, cardiac surgery (n = 24, 47%) and acute respiratory distress
Athens, Greece syndrome (n = 13, 26%). Median ECMO duration was 8.6 (IQR
6.1–16.2) days. Enteral nutrition (EN) was initiated in 31 (61%)
Rationale: Unintentional underfeeding in ICU patients, under- patients. Parenteral nutrition (PN) provided majority of
stood as a lower actual caloric and protein intake than the calories [median 95 (IQR 69–100)]% and protein [median 98
amount prescribed, is a recurring occurrence in patients (IQR 73–100)%]. Median energy and protein adequacy across 7
receiving nutritional support with EN. The aim of the study days was 46.3 (IQR 28.0–66.4) and 59.5 (IQR 20.0–84.2)%
was to determine the incidence and the most frequent causes respectively.
of the problem. 28 (55%) patients died. Compared to survivors, non-survivors
Methods: An observational retrospective study was conducted were started on EN later [67.9 (IQR 40.9–157.6) vs. 36.0 (IQR
among patients admitted to the ICU over a six-month period. 26.2–45.6) hours, p = 0.001], and had lower adequacy of EN
Consecutive 188 patients were enrolled. One hundred and five energy intake [0.5 (IQR 0–4.4) vs. 11.8 (IQR 0–24.5)%, p =
patients (55,8%) with ≤3 days length of stay in ICU were 0.034]. After correcting for ECMO duration and need for
excluded from the study. The remaining 83 patients’ data were dialysis, EN energy adequacy remained significantly associated
analyzed for nutritional support with TPN (total parenteral with mortality [adjusted odds ratio 0.923 (95%CI 0.855–0.966).
nutrition) or EN (enteral nutrition) by nasogastric tube. The There was no association between PN adequacy and outcomes.
total number of TPN and EN days were recorded as well as the Conclusion: There was an association between early EN and EN
number of days of EN intrerruption. energy adequacy with mortality in children requiring ECMO.
Results: Sixty four patients were supported for a total of 838 Strategies to optimize EN in these children may be warranted.
days while 19 patients (22.9%) did not receive any nutritional Disclosure of Interest: None declared.
support. TPN was administered for 350 days (41,8%) and EN
(alone or with supplementary TPN) for 488 days (58,2%). Out of
the initially prescribed 675 days of EN a total of 187 days of
interruption were recorded resulting in patients receiving
S60 Poster
SUN-P020 in a patient with extensive burns and pneumonia successfully

CORRELATION BETWEEN ORAL INTAKE OF 5- treated with bovine thymus extract.
HYDROXYTRIPTOPHAN AND SEROTONIN LEVEL Methods: A 21-year-old male patient was admitted for severe
C. Cobilinschi1 *, R. C. Tincu1, I. F. Tincu2, Z. Ghiorghiu1, extended burns, including airway implication.
R. A. Macovei1,3. 1Anesthesiology and Intensive Care, Clinical Results: After aggressive and early surgical excision and skin
Emergency Hospital Bucharest, 2Pediatrics, Clinical Emergency grafting for full-thickness burns, together with early manage-
Hospital for Children Grigore Alexandrescu, 3Clinical ment of hemodynamic and respiratory failures, on 32nd day of
Pharmacology, Psychopharmacology and Toxicology, Universty hospitalization he developed skin infection with Providencia
of Medicine and Pharmacy Carol Davila, Bucharest, Romania spp. His regim required imipenem/cilastatin (2,000 mg daily).
After twenty days of treatment he developed severe leuco-
Rationale: Serotonin is a neuroamine implicate din many penia, neutropenia, thrombocytopenia and anemia.
physiological processes. Low level of serotonin is associated Hematologic evaluation was negative for any specific diagnosis
with Post-traumatic Stress Disorder (PSD), chronic headache, and in the absence of an alternative explanation, the
depression, fibromyalgia, insomnia or feeding disorders. leucopenia was thought to be secondary to antibiotic treat-
Central nervous system is highly dependent to intrinsic ment. The patient was put on bovine thymus extract capsules
serotonin synthesis and precursors from nutrition are manda- (520 mg daily for 10 days). This resulted in progressive response
tory for this process. 5-hydroxytriptophan may easily pass the in white cell count, turning to normal levels within the first 6
hemato-encephalic barrier while L-tryptophan has many days of administration. In the meantime, imipenem/cilastatin
biochemical limitations. continued to be administered due to microbial resistance, and
Methods: We conducted a randomized controlled trial on 30 a new episode of pancytopenia developed, requiring another 15
patients. We dosed serotonin levels on admission day and after days of thymus extract treatment, as long as the antibiotic
30 days of treatment. Patients with psychiatric disorders, treatment was necessary; blood count turned to normal values
chronic diseases and malignancies were excluded as those who again.
were in treatment with drugs that interfere with the Conclusion: The drugs most commonly associated with
metabolism of serotonin. Selected patients were randomly neutropenia are antibiotics. Severe neutropenia in burned
assigned either to receive placebo treatment (first group, patients is a factor of negative prognostic. Both neutropenia
N = 15) or to received 300 mg of 5-hydroxytryptophan (5-HTP) episodes responded to thymus extract administration without
(second group, N = 15). any other intervention. This might be a well-accepted
Results: At baseline, no significant differences were recorded treatment for antibiotic associated leukopenia.
regarding serotonin plasma levels (223 ± 48.75 and 234.6 ± Disclosure of Interest: None declared.
39.59 μg/L, P > 0.05) or age (54.1 ± 13.38 and 53.66 ± 12.11,
P > 0.05), in both groups. During the procedures, dietary intake
was similar in both groups. After 30 days of treatment we SUN-P022
observed an increase in serotonin levels in 5-HTP group ENTERAL NUTRITION COMPLICATIONS IN PATIENTS WITH
(249.36 ± 39.35) comparative to placebo group (225.46 ± HEART DISEASE
38.57) and ( p < 0.001, T-value is 3.18). Sleeping quality was I. C. P. Mota1, P. A. D. Oliveira1, L. G. D. Borba2, A. Moura2,
improved for 82% of subjects in treatment group. M. J. D. Santos2, A. G. D. M. R. Sousa2, D. Magnoni2 *. 1Nutrition
Conclusion: Serotonin acts as a neurotransmitter capable to and Nutrology, Instituto Dante Pazzanese De Cardiologia, São
influence a variety of psychological functions. Low levels of Caetano do Sul, 2Nutrition and Nutrology, Instituto Dante
serotonin can affect the cardiovascular, endocrine, neurologic Pazzanese De Cardiologia, São Paulo, Brazil
system. Oral intake of tryptophan from food represents the
main source of serotonin synthesis, but many biochemical Rationale: Enteral nutritional therapy is an important tool to
limitations are known. 5 HTP is an immediate precursor capable reach nutritional needs, but intercurrences hamper the
to maintain the normal level of serotonin in healthy population. achievement of caloric and protein goals, requiring attention
of the multiprofessional team. The objective of this study was
Disclosure of Interest: None declared. to observe and compare the prevalence of gastroesophageal
diarrhea and reflux among patients with cardiovascular disease
SUN-P021 in nutritional therapy.
ALTERNATIVE TREATMENT WITH BOVINE THYMUS EXTRACT Methods: We analyzed the sequential record of 102 patients in
FOR ANTIBIOTIC INDUCED LEUKOPENIA – A CASE REPORT enteral nutritional therapy with cardiovascular disease and
C. Cobilinschi1 *, R. C. Tincu1, I. F. Tincu2, Z. Ghiorghiu1, observed the prevalence of diarrhea and gastroesophageal
R. A. Macovei1. 1Anesthesiology and Intensive Care, Clinical reflux (GR) in this group for a period of 2 months.
Emergency Hospital Bucharest, 2Pediatrics, Clinical Emergency
Hospital for Children Grigore Alexandrescu, Bucharest,
ILL Patients Critical ILL Patients Total
Romania
n % n % n
Rationale: Imipenem/cilastatin is largely used in Intensive
Without DT 20 19,61 35 34,3 55
Care Units for various serious infections produced of a wide complications
bacterial spectrum. Most common adverse effects include Diarrhea 9 8,824 14 13,7 23
allergies or seizures, however hematological changes are rare. GR 2 1,961 20 19,6 22
Diarrhea + GR 1 0,98 1 0,98 2
This is case report of imipenem/cilastatin-induced leucopenia
Total 32 31,37 70 68,6 102
Critical Care 1 S61
Results: Digestive tract complications in patients with cardio- SUN-P024

vascular disease in nutrition therapy EARLY PARENTERAL NUTRITION IN CRITICALLY ILL ADULT
Conclusion: Not only diarrhea, but GR is an important PATIENTS: AN OBSERVATIONAL STUDY
complication and must be a clinical concern in critical ill D. Berlana1 *, L. Santulario1, M. Farre2, L. Betriu1, C. Puiggros3,
patients with cardiovascular disease receiving enteral tube R. Burgos3. 1Pharmacy, 2Intensive Care Unit, 3Nutrition
feeding. Aspiration can result in pneumonia leading to Support Unit, Vall Hebron University Hospital, Barcelona,
increases in the use of antibiotics, length of hospital stay, and Spain
the risk of mortality. As with diarrhea, GR prevents nutritional
goals from being attained, generating a greater risk of in- Rationale: Although the relationship between early parenteral
hospital malnutrition. nutrition (PN) and critically-ill patients has been studied a
Disclosure of Interest: None declared. consensus has not been reached.
Methods: An observational study was carried out to assess
morbi-mortality related to early PN. Critically-ill patients who
SUN-P023
received PN from July 2015-December 2016 were included.
ENTERAL NUTRITION IN PATIENTS ON MECHANICAL
Patients were classified as early-PN if PN started within first
VENTILATION AND PRONE POSITION
72 h after intensive care unit (ICU) admission, and late-PN after
M. Ramirez1, K. Papapietro1, D. Adjemian1 *, S. Wigodski1, 72 h. Univariate and multivariate analysis were performed to
C. Romero2. 1Surgery, 2ICU, Hospital Clinico Universidad Chile, assess relationship between early PN and hospital mortality and
Santiago, Chile lenght of stay (LOS) hospital and ICU stay. Patient’s demo-
graphic, admission category, severity-ill score; and routine
Rationale: Prone position in some patients on mechanical blood samples were taken following our Hospital protocol.
ventilation has shown to improve oxygenation. The tolerance Results: A total of 240 patients were included; 117 (48.8%)
and efficiency of enteral nutrition (EN) is variable. early-PN group vs. 123 (51.3%) late-PN. Mean amount of
The objective of this study was to evaluate the tolerance and protein/kg was greater in the late-PN group 1.0 (SD 0.4) vs 0.9
efficacy of EN in mechanically ventilated (MV) patients in prone (0.24). Baseline characteristics were similar between groups:
position age (mean 56.5 y), BMI (29.4), days with hyperglycemia,
Methods: This was a retrospective, observational study in 8 MV severity score, and NUTRIC score (4.2); as well as the use of
patients in prone position that received EN and were admitted PN as complementary nutrition (23.1% early vs 21.1 late).
to the Hospital Clínico Universidad de Chile’s intensive care Overall mortality was 36.7%; 37.6% early-PN vs 35.8% late-PN
unit (ICU) during the last four years. We evaluated days of EN ( p = 0.79). Early PN was related to shorter hospital-LOS and
during prone position, daily volume received, maximum ICU stay (beta coefficient −11.49 [CI95–19.73−3.25] and −8.77
volume reached per hour, percentage of prescribed volume, [CI95 −14.0−3.53] respectively). Mortality was related to
gastric residual volume and presence of diahrrea. We used NUTRIC score and lower energy intake (mean kcal/kg) (OR
average and SD, median and range to express results. 1.23[CI95 1.06 −1.43] and 0.87 [CI95 0.77–0.98])
Results: Conclusion: This study did not find differences between early
and late PN regarding mortality in adult patients at nutritional
Patient Days Average Administered Gastric Stool risk. However this observational single-center study found
of EN volume per volume/ residual (cc) differences in LOS related to lower amount of calories in
day (mL/day) prescribed volume (cc)
volume (%) agreement with optimal amount recommended. Delay in
delivering nutritional support as PN was also related to longer
1 2.4 989 78.1 58 0
2 2 597 76.5 205 0
hospital and ICU stay in patients at nutritional risk.
3 5 230 65.3 327 0 Disclosure of Interest: None declared.
4 4.7 495 78.1 180 0
5 6 930 100.4 147 193
6 4.5 795 102.4 280 0 SUN-P025
7 12 896 87.4 205 154 ENTERAL NUTRITION: IMPACT ON OXYGEN DELIVERY FOR
8 1.4 344 53.2 273 0
CHILDREN IN THE INTENSIVE CARE UNIT?
D. Tretyakov1 *, N. Shen2, D. Suchkov3, E. Tretyakova4. 1ICU,
There were 5 women and 3 men of 59 years old (range 44–69). Pegional City hospital №1, 2Professor, Head of the Department
Prone position was maintained for 5.4 ± 3.4 days on average and of Anesthesiology and Reanimatology, Tyumen State Medical
patients received EN during 4.8 ± 3.3 days. The average volume Academy, Tyumen, 3ICU, Regional City hospital №1, Tuymen,
received was 659 ± 286 mL/day and the maximum volume 4
ICU, Regional City hospital №1, Tuymen, Russian Federation
reached per hour was 49 ± 18 mL/h. Patients received
80 ± 17% of the volume prescribed. Mean residual gastric Rationale: The development of intra-abdominal hypertension
volume was 209 ± 85 mL/day. Only one patient had one (IAH) decreases the survivability of critically ill patients. The
episode of diarrhea following the administration of a para- choice of the enteral nutrition product may play an important
sympathomimetic drug. role in IAH prevention
Conclusion: It is feasible and well tolerated the prescription of Methods: During the first 7 days of intensive care, 63 children
EN in MV patients in prone position admitted to ICU. The underwent the dynamic monitoring of IAH parameters and
volume received in this population was adequate considering hemodynamics. IAH level was studied using the method of
prone position. intra-bladder pressure measurement. Group 1 received only
glucose-electrolyte mixture (GEM) in the course of parenteral
S62 Poster
nutrition. Group 2 was administered a semi-element Neocate patients with delirium and nutritional deficiency may be
mixture. Group 3 received a standard age-adapted enteral described as a more rational method
diet. The criterion for IAH was the increase of intra-abdominal Disclosure of Interest: None declared.
pressure (IAP) above 12 cm Н2О.
Results: iDO2 decrease was observed along with IAP increase
SUN-P027
amid children with unstable hemodynamics and shock ( p-0.05);
THE ENERGY EXPENDITURE OF PATIENTS ON ECMO IS NOT
it was caused by a lower cardiac stroke index (SI), p-0.006. Risk
ELEVATED: BEWARE WHEN YOU FEED THEM!
of IAH development was higher among children receiving only
enteral GEM, OR 3.3 (1.2–10.0; 0.95 CI). The earliest IAH E. De Waele1 *, K. Staessens2, J. Demol1, M. La Meir2,
development was detected in the GEM and standard diet groups H. D. Sapen1. 1Intensive Care, 2Cardiac Surgery, UZ Brussel,
(Me-1.0 for Group 1, Me-3.0 for Group 3). In the Neocate group, Brussel, Belgium
IAH development occurred later (Me-5.0 for Group 2), which
Rationale: Severely ill patients on Extra Corporeal Membrane
proved better nutrition tolerability and enabled to stabilize
Oxygenation (ECMO) have a survival chance of 50%. Optimal
hemodynamic parameters by that time. Group differences
nutrition therapy should be implemented to provide maximal
were statistically significant ( p-0.003).
quality of care. Energy expenditure is mandatory to set caloric
Conclusion: (1) IAH development may impact SI and iDO2
targets. Indirect calorimetry (IC) was made feasible recently.
among unstable patients. (2) Absence of enteral nutrition or its
The aim is to know the mean energy expenditure (EE) of
intolerability may be associated with IAH development. (3)
patients on ECMO to use in settings where IC is not available.
Semi -element enteral diet may be recommended for unstable
Methods: In 6 patients indirect calorimetry was performed at a
patients with the high risk of IAH syndrome development.
stable period in the ECMO run. Ventilator and ECMO gas
Disclosure of Interest: None declared. exchange was analysed and the modified Weir Formula was
used to calculate Resting Energy Expenditure.
SUN-P026 Results: We studied 2 female and 4 male patients, mean age
EXPERIENCE WITH ORAL ALIMENTATION (SIPPING) IN 69, height 1.73 m and weight 77 kg. Total mean VO2 was
PATIENTS WITH ALCOHOLIC DELIRIUM 211 mL/min and total mean VCO2 145 mL/min. The mean EE
D. Kostin1 *. 1ICU, SFHI “Municipal Clinical Hospital n.a. S.S. was 1,430 kcal/24 h. Overall, the Energy Expenditure of ECMO
Yudin of Moscow Health Department”, Moscow, Russian patients was 19 kcal/kg/day.
Federation Conclusion: In absence of indirect calorimetry, a mean EE of
19 kcal/kg/day can be used when prescribing nutrition to ECMO
Rationale: Chronic alcoholism is often lead to nutritional status patients.
deficiency, and the emergence of delirium in this patients is Disclosure of Interest: None declared.
accompanied by a more severe disease, extension lengts of
treatment, deterioration of prognosis and constitutes a serious
SUN-P028
problem. The choice of optimal combination therapy, including
A NEW PROGNOSTIC MARKER IN THE INTENSIVE CARE UNIT
the correction of nutritional deficiency is a crucial task for
(ICU): THE PSOAS MUSCLE AREA INDEX MEASURED BY
specialists in ICU
ABDOMINAL COMPUTED TOMOGRAPHY (CT) TARGETED ON
Methods: 10 patients with alcoholism and the development of
THE THIRD LUMBAR VERTEBRA (L3)
delirium were treated in ICU. Delirium was diagnosed using
CAM-ICU Questionnaire. Nutritional deficiency was evaluated E. Lascouts1 *, A. Mulliez2, G. d’Assignies3, N. Rotovnik Kozjek4,
with the NRS 2002 screening protocol and NRI (Nutritional A.-M. Makhlouf5, I. Ceniceros Rozalen6, J.-C. Preiser7,
Risk Index) within the first 24 h and on discharge from the Z. Krznaric8, K. Kupczyk9, N. Cano10, C. Pichard5,
hospital. Patients’ alimentation was based on standard diets; 6 R. Thibault1,11, on behalf of Phase angle project Investigators.
patients (60%) were getting special medical food, including the
1
Unité de Nutrition, CHU De Rennes – Université De Rennes 1,
use of ready-made balanced products for oral alimentation Rennes, 2DRCI, CHU Clermont Ferrand, Clermont-Ferrand,
(Nutridrink-200 mL) throughout the entire course of in-patient
3
Service de Radiologie, CHU De Rennes – Université De
treatment Rennes 1, Rennes, France, 4Clinical Nutrition Unit, Institute of
Results: In a group where sippings and Nutridrink were used, Oncology, Ljubljana, Slovenia, 5Unité de Nutrition, Hôpitaux
delirium duration (the length of a patient’s stay in ICU) was 1.2 Universitaires de Genève, Geneva, Switzerland, 6Department
days fewer; the length of in-treatment was also 4 days fewer. In of Intensive Care, Clinic USP Palmaplanas, Palma de Majorque,
a group of people getting Nutridrink sipping, no infectious Spain, 7Department of Intensive Care, Hôpital Universitaire
complications were observed, while in the second group Erasme, Brussels, Belgium, 8Departement of Internal
incidence of pneumonia was observed in 2 patients, as well as Medicine, University Hospital Center Zagreb, Zagreb, Croatia,
9
inflammation of paranasal sinuses in 1 person. No significant Department of Anesthesiology and Intensive Care, University
changes in nutritional status were observed in the course of Hospital no 1 CM NCU, Bydgoszcz, Poland, 10CRNH, CHU
treatment. Clermont Ferrand, Clermont-Ferrand, 11Institut NuMeCan
Conclusion: Nutritional deficiency during delirium leads to INRA-INSERM-UR1, Rennes, France
deterioration of treatment results and is associated with a
Rationale: Critical illness leads to fat-free mass loss that
higher risk of infectious complications. Well-timed and
worsens prognosis (1). Main aim: to assess whether the easy-
adequate nutritional treatment helps to shorten the period of
to-measure psoas muscle area is related to day (D) 28 mortality
stay in an intensive care unit and in-patient department, as
in the ICU patients.
well as reducing treatment costs. The use of Nutridrink in
Critical Care 1 S63
Methods: Ancillary study of the international PHASE ANGLE (IQR:25.5–38.1)] and 73.4% (IQR:27.3–99.6) of the protein
(PhA) PROJECT (1). Inclusion criteria: adult medical/surgical [1.7 g/kg (IQR: 1.4–2.2)] respectively prescribed. Median Glu
ICU, length of stay >48 h, no pacemaker or defibrillator, routine was 137.1 mg/dL (IQR:118.1–161.2) and in a total of 3,085
abdominal CT within 9 days postadmission. Transversal (TDPM) patient-days, reported hypoglycemic days were 17 (0.6%).
and axial right psoas diameters measured on a single L3 CT Mortality (60-daycensored) was 19.1%(54 events). We found no
image by a non-expert operator blinded of mortality. Psoas area significant association between neither AUC (OR = 1.00, 95%
index (PAI) = TDPM*ADPM*1/height(m)2. PhA measured by CI:1.00–1.00) nor “Days at 80–140” (OR = 0.94, 95%CI:0.82–
bioimpedance analysis (BIA) at admission. Statistics: area 1.08, p = 0.395) 60-day mortality (after adjusting for calorie
under the Receiver Operating Characteristic (ROC) curve adequacy, APACHE score, Abbreviated Burn Severity Risk Index,
(AUC) evaluating D28 mortality by PAI. Factors associated BMI and insulin administration).
with D28 mortality: multivariable logistic regression (adjusted Conclusion: Glucose control among burn patients seems to be
odd ratio (aOR) [95% confidence interval]). adequate and only limited hypoglycemia is observed. On the
Results: n = 931 patients analysed in PhA PROJECT, n = 193 with other hand, calorie and protein goals were not achieved in a
abdominal CT; n = 154 included: Ljubljana (n = 49), Geneva significant proportion of the patients studied. Overall, Glu in
(n = 43), Palma de Majorque (n = 31), Brussels (n = 15), Zagreb the first 12 days after admission did not seem to be a significant
(n = 13), Bydgoszcz (n = 3); 64 ± 14 yrs, men 54%, body mass predictor of outcome.
index 26.1 ± 5.1, APACHE II 19 ± 9. TDPM (10 ± 4 vs 14 ± 4 mm/m, Disclosure of Interest: None declared.
p = 0.004) and PAI (245 ± 102 vs 363 ± 158 mm/m², p = 0.007)
were lower in non-survivors than in survivors in men (non-
SUN-P030
significant in women). AUC ROC men: 0.75 [0.61–0.88];
THE EFFECT OF THE PRESENCE OF A CLINICAL PHARMACIST
women: 0.56 [0.32–0.81]. PAI thresholds associated with D28
ON THE NUTRITIONAL POLICY IN AN INTENSIVE CARE UNIT OF
mortality: <337.3 (men); <170.1 (women) mm/m2. Were
A GENERAL HOSPITAL
associated with D28 mortality: admission for pneumonia (aOR
14.84 [1.19–185.25], p = 0.04), low PAI (5.87 [1.97–17.51], E. Van Laer1 *, S. Desmet1, K. Verhelle1. 1Pharmacy, AZ
p = 0.001), age (1.05 [1.01–1.10], p = 0.01), and admission PhA Groeninge, Kortrijk, Belgium
(0.52 [0.31–0.87], p = 0.01).
Rationale: Development of a standard of care for nutrition in
Conclusion: Muscle mass loss defined by psoas area index on
ICU patients based on the ESPEN guidelines with a multidiscip-
L3-targeted CT scan is associated with D28 mortality in the ICU
linary approach involving a clinical pharmacist, intensivist,
patients.
dietician and nurse.
Reference Methods: For a period of 2 months, a clinical pharmacist was
1. Thibault R. et al. Intensive Care Med 2016;42:1445–53. present in the ICU of a general hospital in Flanders, Belgium.
Disclosure of Interest: None declared. Patients were screened for their nutritional status. The
pharmacist checked and evaluated a number of criteria and
transferred recommendations to the intensivist during a
SUN-P029
moment of consultation.
MORNING GLUCOSE LEVELS AND OUTCOME AMONG BURN
Results: During 2 months 64 patients were screened for their
PATIENTS. RESULTS FROM THE INTERNATIONAL NUTRITION
nutritional status. 35 patients were included in this research as
SURVEY 2014–5
their LOS was longer than 5 days. A first administration of
E. Bouras1, M. Chourdakis1 *, I. Doundoulakis1, D. K. Heyland2. nutrition was initiated after 5 days for 74% of the population.
1
Department of Medicine, Aristotle University of Thessaloniki, Oral feeding was initiated in 21% of the patients, TPN was
Thessaloniki, Greece, 2Queen’s University, Kingston, Ontario, administered in 31% and enteral tube feeding in 31%. 17% of the
Canada patients received a combination of TPN and tube feeding. The
caloric and protein goals were estimated and compared with
Rationale: Our aim was to evaluate morning glucose(Glu)
the actual administered nutrition for all patients receiving
variability, energy and protein intake in the first 12 ICU days
artificial nutrition. 75% of the compared patients received at
and investigate whether Glu is related to 60 day mortality in
least 75% of the calculated caloric needs and 61% reached at
burn patients included in the 2014–2015 International Nutrition
least 75% of the calculated protein goals. More protein rich
Survey (INS).
formulae were introduced, leading to a bigger proportion of
Methods: 14 centers from USA, Canada, Australia and South
patients reaching their protein goals. 89% of the patients
Africa participated in the INS. “Morning Glucose Areas Under
receiving a protein rich formula reached at least 75% of their
the Curve (AUC)” (as produced from all patient-days in the
protein goal, in comparison to only 38% of the patients
range 80–140 mg/dL) and “Days at range 80–140 mg/dL (Days at
receiving the classic formula.
80–140)’ were used as indicators of glucose control. We used
Conclusion: A multidisciplinary nutrition team with a clinical
logistic regression to examine whether AUC or “Days at 80–140”
pharmacist is a successful method, tracking the nutritional
were related to outcome after adjusting for disease severity,
status of patients and leading to a better understanding of
insulin administration and calorie/protein adequacy.
the importance of correct and adequate nutritional care. In the
Results: In 283 patients (67,1% males) median age was 48ys
following months, this research will be continued and the
(IQR:31–60) and median BMI 26.9 (IQR:23.6–31.1). Patients
results will be compared to the period prior to this project.
had on admission a median burn% of Total Body Surface Area
27.3% (IQR:10–45). Throughout the 12-d period, patients Disclosure of Interest: None declared.
received 74.8% (IQR:28.6–96.9) of the energy [30.9 kcal/kg
S64 Poster
SUN-P031 variability of plasma GLN levels in elderly septic patients is

BEDSIDE ULTRASOUND OF MUSCLE LAYER THICKNESS OF THE linked to degree of immunoactivation and outcome.
QUADRICEPS IN THE CRITICALLY ILL PATIENT Methods: We recruited 507 consecutive patients (51% man,
D. O. Toledo1, B. J. Freitas1, D. Carneiro1, D. M. Santos1, age: 83, 76–88 yr, APACHE II score: 13, 10–16, median and
E. J. Figueiredo1 *, S. F. Piovacari1, J. M. Silva Junior1. 1ICU, interquartile range) with sepsis or septic shock, according to
Hospital Israelita Albert Einstein, São Paulo, Brazil the new SEPSIS 3.0 criteria, admitted to 5 acute medical wards
in Italy. Plasma GLN and clinical parameters were assessed
Rationale: Survivors of critical illness experience significant within 24 hour from admission to emergency department.
skeletal muscle wasting that may predict outcome. The Patient mortality rates at 7 (t7) and 30 (t30) days were
objective of this study was to evaluate the measuring recorded. Plasma GLN was also determined in 196 free-living
quadriceps muscle layer thickness using bedside ultrasound in older adult volunteers (51% men, age: 65, 62–69 yr).
critically ill patient Results: Plasma GLN levels (μmol/L) were lower ( p < 0.01) in
Methods: Twenty patients were included in the ICU required patients (414, 325–515) than in controls (483, 437–539). Septic
mechanical ventilation. Demographic data, anthropometric patients were divided into 3 groups according to tertiles of
data, SAPS 3, NRS and image of US QMLT were collected for plasma GLN: lower (LG, <353), intermediate (IG, 353–472) and
analysis. The thickness of the quadriceps musculature was higher (HG, >472) GLN. Mortality rates significantly increased
quantified with a portable B-mode ultrasound device. With the from LG to IG and HG (t7: 9, 20, 26, p = 0.01; t30: 25, 39, 56,
patient lying supine, 2 landmarks on each quadriceps were p = 0.001; respectively). C-reactive protein (CRP, ng/mL),
identified. The underlying tissues were then maximally leucocytes (WBC, 109/L) and body temperature (T, °C)
compressed by the ultrasound probe. Each landmark was significantly ( p < 0.001) decreased from LG to IG and HG
imaged and averaged across each leg and then between legs. (CRP: 135, 112, 57; WBC: 13.3, 13.8, 11.4; T: 38.0, 37.6, 36.9;
Measurements of the first (D1), third (D3) and seventh (D7) days respectively). In a multiple linear regression model, lactate (β:
were performed and the percentage of QMLT was compared by +0.34), CRP (β: −0.23), T (β: −0.19) and glycemia (β: −0.17)
comparing the left and right legs. significantly ( p < 0.001) predicted (r2: 0.22) glutamine vari-
Results: The mean age was 57.0 ± 20.2 years, 75% male, BMI ability in all patients.
24.6 ± 3.0 kg/m2, SAPS 3 was 51.3 ± 17.4 and NRS 3.2 ± 1.0. Conclusion: In elderly non-ICU patients with sepsis, lower
Overall, 8.4% of muscle wasting in the right leg and 5.2% in the plasma GLN was associated with lower mortality and higher
left leg assessed by the US occurred from the first to the inflammatory response, while normal-to-higher GLN was
seventh day. In the right leg the median values evaluated by the associated with increased mortality and blunted immune
US were 1.16 (0.92–1.75) D1, 1.13 (0.92–1.60) D3, 1.02 (0.81– response (i.e., lower CRP, WBC and T).
1.41) D7; P = 0.005. In the left leg, the median values evaluated Disclosure of Interest: None declared.
by the US were 1.23 (0.93–1.43) D1, 1.16 (0.92–1.34) D3, 1.13
(0.89–1.31) D7; P = 0.017.
SUN-P033
Conclusion: The measuring quadriceps muscle layer thickness
NUTRIC SCORE AND PROTEIN INTAKE ARE INVERSELY RELATED
using ultrasound demonstrated that critical ill patients present
TO MORTALITY IN CRITIC TRAUMA PATIENTS
muscle wasting daily, and this procedure can be a great
differential to identify patients most likely to benefit from G. D. Ceniccola1 *, F. C. Lima1, S. S. M. Dos Santos1,
enhanced nutritional and rehabilitation support. A. R. D. C. Arruda1, D. O. D. Leão1, N. D. C. Dos Santos1,
P. F. S. Dos Santos1, A. B. Okamura1, L. P. S. Paz2. 1Hospital De
Reference Base Do D.F, Brasília, 2University of Brasília, Ceilândia, Brazil
1. Tillquist et al. Bedside Ultrasound Is a Practical and Reliable
Measurement Tool for Assessing Quadriceps Muscle Layer Thickness. Rationale: It is not clear if higher protein intake could improve
JPEN J Parenter Enteral Nutr. 2014; 38:886–890. mortality considering nutritional risk (NR) with NUTRIC score1
Disclosure of Interest: None declared. after a major trauma. Therefore, we aim to compare the effect
of nutritional risk and protein intake in the first 14 ICU days on
SUN-P032 hospital mortality in a multivariate model.
HIGHER CIRCULATING GLUTAMINE IS ASSOCIATED WITH Methods: This is a prospective cohort with adult trauma victims
INCREASED MORTALITY AND BLUNTED IMMUNE RESPONSE IN in enteral nutrition admitted consecutively in one ICU from 4/
ELDERLY NON-ICU PATIENTS WITH SEPSIS: A MULTICENTER 2015 to 4/2016. Patients underwent nutritional screening until
STUDY 48h after admission, daily nutrition data was collected on the
amount of calories and protein intake during the first 14 ICU
G. Biolo1, F. G. Di Girolamo1 *, N. Fiotti1, M. Zanetti1, days unless death/discharge occurred sooner. Outcomes were
L. M. Castello2, C. Casarsa1, E. Lupia3, M. L. Muiesan4, determined at 60 days, patients were followed while in hospital
C. Ronco5, S. Di Somma6, G. C. Avanzi2, F. Mearelli1, and after discharge. We excluded patients who remained in
on behalf of The NEED Speed study group. 1University of ICU < 48 h, pregnant and with suspected cerebral death. Three
Trieste, Trieste, 2University of Eastern Piedmont, Novara, logistic models were made, M1- crude OR, M2- protein intake and
3
University of Turin, Turin, 4University of Brescia, Brescia, high/low NUTRIC, M3 - M2 + BMI, sex, head injure, mechanical
5
San Bortolo Hospital, Vicenza, 6Sapienza University of Rome, ventilation days.
Rome, Italy Results: From 480 patients admitted, adopted criteria
excluded 236. High NR was present in 67 patients (26%). The
Rationale: Glutamine (GLN) is actively taken up and utilized by
first 14 ICU days registered average intake of 15.85 kcal/kg (CI
immune cells in critical illness. We have hypothesized that
95%; 15.0–16.6) and 1.08 g PTN/kg (CI 95% 1.0–1.1). Table 1
Critical Care 1 S65
shows Odds ratios and 95% confidence intervals for the models increase in Apache II, mortality risk is 14% higher (95%CI 1.09–
proposed. 1.19, Z = 6.14, p = 0.001).
Conclusion: This study showed the applicability of the AND-
Table 1:
ASPEN tool in the ICU setting as a predictor of mortality, despite
M1 M2 M3 (R2 0.2; p- limitations due to subjectiveness of the tool and patient
0.0001; lroc 0.78)
anamnesis. Important covariables as BMI, hospital stay and
Average Protein intake* 0.08; 0.03–0.18 0.06; 0.02–0.17 0.07; 0.02–0.19 disease severity were included and could be important
Receive ≥1.2 g PTN/Kg* 0.18; 0.09–0.39 0.17; 0.08–0.38 0.20; 0.09–0.46
High nutritional risk* 5.72; 3.04–10.75 6.12; 3.10–12.07 6.94; 3.4–14.04
subgroups of interest in following studies.
Reference
*p-value <0.0001.
1. White JV, et al. JPEN; 2012.
Conclusion: Protein intake in the first 2 ICU weeks may reduce Disclosure of Interest: None declared.
mortality for trauma patients requiring ICU meanwhile high
NUTRIC score indicates severity more precisely. Larger samples
SUN-P035
are needed to explore subgroups of interests such as extreme
COMPARISON OF CONTINUOUS AND INTERMITTENT ENTERAL
BMI range, age, renal failure and septic’s.
NUTRITION IN PATIENTS WITH SEVERE TRAUMA
Reference H. Slavuta1 *, S. Dubrov1, K. Dubrova2, I. Domin1.
1. Rahman A, et al. Clin Nutr. 2016. 1
Anesthesiology and Intensive Care, Bogomolets National
Disclosure of Interest: None declared. Medical University, 2Kyiv City Municipal Hospital #17, Kyiv,
Ukraine
SUN-P034
Rationale: Early beginning of enteral nutritive support is an
THE IMPACT OF MALNUTRITION USING AND-ASPEN CRITERIA
important measure within the intensive care of patients with
IN THE OUTCOME OF ADULT CRITICAL CARE PATIENTS
severe trauma. There are clear guidelines regarding timing,
G. D. Ceniccola1,2 *, R. S. F. Pequeno3, A. B. M. De Oliveira2, dosing and composition of nutrition, but there is lack of high-
T. P. Holanda3, V. S. Mendonça3, L. S. F. Carvalho4, quality evidence regarding choice between continuous or
I. D. Brito-Ashurst5, W. M. C. Araújo6. 1Núcleo de Nutrição e intermittent (bolus-based) nutrition regimes in patients with
Dietetica, 2Residência Multiprofissional em Terapia Intensiva, severe trauma.
3
Residência em Nutrição Clínica, Hospital de Base do Distrito Methods: A prospective randomized single-center clinical trial
Federal, Brasília, 4Universidade de Campinas (Unicamp), had been conducted from August till December 2016 in Kyiv city
Campinas, Brazil, 5Rehabilitation & Therapies Department, trauma center ICU. Inclusion criteria: age 18–60, trauma
Royal Brompton and Harefield NHS Foundation Trust, London, severity ≥ 15 points (ISS score) and informed consent of
United Kingdom, 6Universidade de Brasília (UnB), participation. Patients were randomized into either bolus
Brasília, Brazil feeding group (BFG) or continuous feeding group (CFG). In
total, 30 patients were included. BFG group (n = 14) received
Rationale: Malnutrition is prevalent in the intensive care unit,
prescribed dose of enteral feeding formula in 200–300 mL
yet, there is a paucity of validated tools. Consequently, this
boluses repeated each 3 hours. CFG (n = 16) group received
study aims to evaluate the validity of the malnutrition AND-
prescribed daily dose of enteral feeding formula as continuous
ASPEN criteria1 as a predictor of mortality in a general ICU
infusion with enteral feeding pump over 24 hours. Both groups
population.
were fed through nasogastric tube, start within 24 hours after
Methods: A one-day cross sectional study every semester for
trauma with isocaloric default enteral formula with caloric
the period of 2014–2016 in a large mixed ICU (72 beds) following
goal ≥20–25 kkals/kg per day and protein goal ≥1.2 g/kg per
all recruited subjects for their admission duration. Routine ICU
day to Day 5.
data were collected in the electronic health record (EHR) on
Results: Patients of both groups did not vary significantly in
sex, age, APACHE II and baseline nutrition assessment at ICU
demographic criteria, trauma severity (ISS), conscious impair-
admission. The AND-ASPEN criteria is the tool of choice to
ment (GCS) and overall severity (APACHE II). Within first day
recognize malnutrition in this hospital. Patients with short ICU
of ICU stay BFG patients daily tolerable volume was 813,4 ±
stay (<48 h) and with missing key data were excluded. Online
162,7 mL of formulae, while CFG patients tolerated 1382,6 ±
forms were elaborated to register data with a secure web-based
97,9 mL( p < 0,01). Within third day of ICU stay, BFG patient
platform. The main hypothesis was assessed with a logistic
tolerated 1274,1 ± 218,5 mL and CFG patients tolerated
regression model.
2486,3 ± 154,0 mL of formulae. ( p < 0,01).
Results: A total of 306 patties were eligible, we excluded 16%
Conclusion: During the early post-traumatic period, continu-
(49 subjects) by the adopted criteria. AND-ASPEN assessment
ous enteral feeding have significant benefit over bolus-based
was found in 93.8% of the EHR, malnutrition at ICU admission
enteral feeding and provides much better tolerance of enteral
was present in 28.1%. Binary logistic regression (n = 257, p-
feeding, leading to earlier meeting of caloric and protein goal.
value = 0.0001, r2 = 0.226, Roc(AUC) = 0.80) suggested that
mortality risk was 2.6x higher (95%CI, 1.3–5.1, Z = 2.72, Disclosure of Interest: None declared.
p = 0.006) in patients malnourished compared with non-
malnourished (controlled by sex, BMI, Apache II, days in
hospital, admission type, and nutritional therapy type),
crude OR was 3.2 (95% CI, 1.8–5.6). For every one (1) point
S66 Poster
Geriatrics 1 Methods: General practitioners and health care workers in the

community and nursing homes across Belgium were invited to
SUN-P036 screen their patients for malnutrition and complete an online
ASSOCIATION OF ORAL STATUS WITH SARCOPENIA AND questionnaire. Malnutrition was screened by MNA-SF; Mobility
MALNUTRITION IN POST-ACUTE STROKE PATIENTS: problems were assessed and Katz-ADL index was determined.
IMPLICATIONS FOR ORAL SARCOPENIA Differences in the prevalence of mobility problems and Katz
A. Shiraishi1 *, Y. Tsuji1, S. Shimazu2, Y. Yoshimura3. ADL by nutritional status were analyzed (Chi-square).
1
Department of Dental Surgery, 2Nutritional Management, Results: 3,299 people of ≥70 y were screened (85.4 y ± 6.4, 76%
3
Rehabiritation Medicine, Kumamoto Rehabilitation Hospital, women). Forty-four per cent of the people were at risk of
Kumamoto-City, Japan malnutrition (MNA-SF score 8–11) and 12% were malnourished
(MNA < 8). Independence in ADL (Katz ADL 0) was more
Rationale: This study investigated the prevalence of stroke- prevalent in well-nourished people (14.9%) than in those at
related sarcopenia and malnutrition its association with poor risk of malnutrition (3.2%) and those with malnutrition (1.5%)
oral status in post-acute stroke patients. ( p < 0.001). Ninety-five per cent of those with malnutrition and
Methods: This cross-sectional study included 202 consecutive 88% of those at risk of malnutrition could not climb 15-stairs,
stroke patients who were admitted to convalescent rehabilita- versus 68% of the people with a normal nutritional status
tion wards in Japan. The Revised Oral Assessment Guide (ROAG) ( p < 0.001). Eighty six per cent of those with malnutrition and
was used to assess oral status. Sarcopenia was defined as a loss 72% of those at risk of malnutrition could not walk for 5-min,
of skeletal muscle mass index (SMI) with bioelectrical versus 44% of the people with a normal nutritional status
impedance and decreased muscle strength as measured by ( p < 0.001).
handgrip strength (HG); cut-off values were adopted from the Conclusion: Malnutrition is associated with mobility problems
Asian Working Group for Sarcopenia. Univariate and multivari- and dependence in ADL in Belgian older people. Its existence
ate analyses were applied to examine the associations between may accelerate the transformation of frailty into disability.
oral status, SMI, and HG. Reference
Results: Study participants included 107 males and 95 females
1. Arvanitakis et al. ESPEN journal, 2013.
with a mean age of 72 ± 12 years. According to the ROAG, 82.2%
of participants had slight to severe oral problems (median The following parties were involved in NutriAction II: Nutricia
score: 11 [9–14]). The prevalence of stroke-related sarcopenia Advanced Medical Nutrition, Vlaamse Vereniging voor Klinische
was 53.5%. Both SMI (mean: 6.1 ± 1.3) and HG (median: 15 [7– Voeding en Metabolisme (VVKVM), Société Belge de Nutrition
25]) were significantly lower in the group with oral problems Clinique (SBNC), Domus Medica, Société Scientifique de
(SMI = 5.8 ± 1.2, HG = 12 [6–20]) compared to individuals Médecine Générale (SSMG), Wit-Gele Kruis, Mobilab
without oral problems (SMI = 7.4 ± 0.8, HG = 27 [23–34]) ( p <
0.001). The ROAG score was independently associated with SMI,
after adjusting for sex, age, stroke severity, activities of daily
living, cognitive level, nutritional status, comorbidities, and SUN-P038
time from stroke onset. MALNUTRITION IS UNDERESTIMATED BY HEALTH CARE
Conclusion: Poor oral status was associated with sarcopenia, PROFESSIONALS IN OLDER ADULTS
reduced muscle mass and strength in post-acute stroke J. Van Wijngaarden1, A. Van Gossum2 *, T. Rudka3, Y. C. Luiking1,
patients. Poor oral status and stroke-related sarcopenia and M. Vandewoude4. 1Nutricia Research, Nutricia Advanced
malnutrition were very common among the patients in this Medical Nutrition, Utrecht, Netherlands, 2Clinic of Intestinal
study, suggesting that healthcare providers should monitor for Diseases and Nutritional Support, Erasme Hospital, 3Nutricia
oral sarcopenia in post-acute stroke patients. Advanced Medical Nutrition, Brussels, 4Department of
Disclosure of Interest: None declared. Geriatrics (ZNA), University of Antwerp, Antwerp, Belgium
Rationale: Prevalence of (risk of ) malnutrition is high in

SUN-P037
Belgian older people (≥70 years), especially those living in
MALNUTRITION IS ASSOCIATED WITH MOBILITY PROBLEMS IN
nursing homes1. To study the awareness of malnutrition among
BELGIAN NURSING HOME RESIDENTS AND COMMUNITY
health care professionals (HCPs) and patients, we compared
DWELLING OLDER ADULTS
their subjective malnutrition estimate with a standardized
A. Van Gossum1 *, J. P. Van Wijngaarden2, D. Van Aarle3, malnutrition screening tool (MNA-SF).
Y. C. Luiking2, M. Vandewoude4. 1Clinic of Intestinal Diseases Methods: General practitioners and health care workers in the
and Nutritional Support, Erasme Hospital, Brussels, Belgium, community and nursing homes were invited to screen their
2
Nutricia Research, Nutricia Advanced Medical Nutrition, patients (aged ≥70 y) and complete an online questionnaire.
Utrecht, 3Nutricia Advanced Medical Nutrition, Zoetermeer, Malnutrition was screened by a validated instrument (MNA-SF),
Netherlands, 4Department of Geriatrics, University of while the HCP was asked: “Do you consider this patient as
Antwerp, Antwerp, Belgium malnourished?” and the patient: “Do you think you are
malnourished?” The use of oral nutritional supplements (ONS)
Rationale: The prevalence of malnutrition in Belgian older
was assessed. Differences in the recognition of malnutrition by
people is high1. Nutritional deficiencies could accelerate the
living situation were analyzed with a Chi-square test.
frailty process. Therefore, the occurrence of malnutrition,
Results: 3,299 people were screened: 2,480 (75%; 86.3 ± 6.2
mobility problems and dependence in activities of daily living
years) lived in a nursing home (NH) and 819 (25%; 82.7 ± 6.1
(ADL) were studied.
years) were community dwelling (CD). Prevalence of
Geriatrics 1 S67
malnutrition (MNA-SF score < 8) was 14% in NH, and 7% in CD nursing homes or with co-morbidities such as depression and
population. The HCP only recognized 49% of the malnourished dementia.
patients as being malnourished, whereas only 13% of the Reference
malnourished patients classified themselves as being malnour-
1. Arvanitakis et al. ESPEN journal, 2013.
ished; this percentage was higher in community dwelling
older people than in nursing homes (30% and 10%, respectively, The following parties were involved in NutriAction II: Nutricia
p < 0.001). Twenty per cent of the malnourished people Advanced Medical Nutrition, Vlaamse Vereniging voor Klinische
used ONS. Voeding en Metabolisme (VVKVM), Société Belge de Nutrition
Conclusion: Health care professionals and patients themselves Clinique (SBNC), Domus Medica, Société Scientifique de
greatly underestimate malnutrition in older people, both in Médecine Générale (SSMG), Wit-Gele Kruis, Mobilab
the community and in nursing homes. Disclosure of Interest: None declared.
Reference
1. Arvanitakis et al. ESPEN journal, 2013. SUN-P040
The following parties were involved in NutriAction II: Nutricia EFFECTS OF AN INTERDISCIPLINARY GUIDELINE ON
Advanced Medical Nutrition, Vlaamse Vereniging voor Klinische NUTRITION PARAMETERS IN HIP FRACTURE PATIENTS
Voeding en Metabolisme (VVKVM), Société Belge de Nutrition A. Kopp Lugli1 *, C. Kiss2, E. Kungler1,3, W. Ruppen1,
Clinique (SBNC), Domus Medica, Société Scientifique de R. Bingisser4, N. Suhm3, R. Kressig5. 1Department of
Médecine Générale (SSMG), Wit-Gele Kruis, Mobilab Anaesthesia, Surgical Intensive Care, Prehospital Emergency
Medicine and Pain Therapy, 2Dietetic Service, Department
of Endocrinology, 3Department of Orthopaedics and
Traumatology, 4Department of Emergency Medicine,
SUN-P039
University Hospital of Basel, 5University Center for Medicine
MALNUTRITION IS HIGHLY PREVALENT IN BELGIAN NURSING
of Aging, Felix Platter Hospital, Basel, Switzerland
HOME RESIDENTS AND COMMUNITY DWELLING OLDER
ADULTS, ESPECIALLY IN THOSE WITH DEPRESSION AND Rationale: Hip fracture is a serious consequence of trauma in
DEMENTIA the growing geriatric population. The interdisciplinary POMME
A. Van Gossum1 *, J. P. Van Wijngaarden2, J. Hofstede3, (PeriOperative Medicine & Metabolism Expertise) guideline was
Y. C. Luiking2, M. Vandewoude4. 1Clinic of Intestinal Diseases designed to improve perioperative outcome and nutritional
and Nutritional Support, Erasme Hospital, Brussels, Belgium, parameters focusing on the management of dietary intake,
2
Nutricia Research, Nutricia Advanced Medical Nutrition, pain control, delirium and planning of discharge.
Utrecht, 3Nutricia Advanced Medical Nutrition, Zoetermeer, Methods: The POMME guideline was developed by a multidis-
Netherlands, 4Department of Geriatrics (ZNA), University of ciplinary team of caregivers (emergency room, traumatology,
Antwerp, Antwerp, Belgium anaesthesia, geriatrics, dietetic and nursing service) to
combine current standards of care. Patients admitted for hip
Rationale: NutriAction (2008)1, showed that among Belgian fracture surgery were enrolled for a quality control assessment
older people living in the community or in a nursing home, the pre (CONTROL, n = 77, Dec 15-Apr 16) and post implementation
risk of malnutrition is highly prevalent (57%) and that 16% of the of the POMME guideline (POMME, n = 67, Aug–Dec 16). The
total population was classified as malnourished (BMI < 20 kg/ POMME management for nutrition involved malnutrition
m2). In 2013, this study was repeated to re-evaluate the risk screening, fortified meals, protein drinks, vitamin D supple-
and the prevalence of malnutrition among Belgian older mentation and preoperative carboloading. Baseline character-
people. istics and nutritional parameters were assessed during
Methods: General practitioners and health care workers in hospitalisation and 1 mth after surgery.
the community and in nursing homes across Belgium were Results: Baseline characteristics were comparable for both
invited to screen their patients and complete an online groups (Table 1). POMME had lower Nutritional Risk Screening
questionnaire. Malnutrition was screened by MNA-SF; presence (NRS) scores 1 mth after surgery compared to CONTROL and
of pre-specified co-morbidities was reviewed. Differences in when adjusted for in-hospital scores (−0.55 (95% CI: −0.11;
the prevalence of malnutrition by living situation were −0.99, p = 0.016)), whereas hand grip measurements showed
analyzed (Chi-square). no difference for both groups (+2.47 kg (95% CI:5.26;−0.33,
Results: 3,299 people aged ≥70 y were screened: 2,480 (75%; p = 0.087). Mean vitamin D levels 1 mth after surgery were
86.3 ± 6.2 years) lived in a nursing home (NH), and 819 (25%; comparable for both groups (POMME 75.3 ± 34.2 nmol/L;
82.7 ± 6.1 years) were community dwelling (CD); 76% were CONTROL 81.3 ± 42.8 nmol/L) but with a higher percentage of
women. The risk of malnutrition (MNA-SF score 8–11) was 49% severe to moderate deficiency for CONTROL (27.3% vs. 22.2%).
(NH) and 29% (CD) ( p < 0.001); 14% (NH) and 7% (CD) were
Table 1:
malnourished (MNA < 8) ( p < 0.001). Dementia was present in
36% (n = 1187) and depression in 13% (n = 414) of the popula- POMME (n = 67) Control (n = 77)
tion. The highest prevalence of malnutrition and risk of Age (yrs) 78 ± 15 79 ± 12
malnutrition was observed in patients with dementia (19% Male/female 18/49 18/59
and 60%, resp) and depression (21% and 52%, resp). Penrode
1 23 18
Conclusion: The prevalence of malnutrition has remained 2a/3a 25 32
stable among Belgian older people over the period 2008–2013. 2b/3b 4 11
Malnutrition remains a major problem, especially for those in 3c/3d 15 16
S68 Poster
5
Conclusion: The preliminary results of this quality control Research, Nurse Council, 6Quality, Mario Negri, 7Nutrition-
assessment revealed positive effects of the interdisciplinary Audit, Health Agency, 8Medical Direction, Korian Group, Milan,
POMME guideline on nutritional outcome parameters in the Italy, 9Istituto oncologico della Svizzera italiana, Ente
vulnerable population of hip fracture patients. Ospedaliero Cantonale Canton Ticino, Bellinzona, Switzerland
Rationale: Nutritional status in nursing homes(NHs) is a
relevant health and quality of life indicator. Few studies have
SUN-P041 explored elderly perspective on the meaning of nutrition,
CORRELATION BETWEEN VASTUS LATERALIS MUSCLE factors that promote it and nutritional care (Donini et al.,
ULTRASOUND PARAMETERS AND APPENDICULAR LEAN MASS 2013). The aim of this study was to explore the nutritional care
IN OLDER PATIENTS WITH PHYSICAL FRAILTY in NHs, with specific focus on residents’ perception.
A. Ticinesi1 *, M. Narici2, F. Lauretani1, A. Nouvenne1, Methods: Participants were selected through purposeful
E. Colizzi1, M. Mantovani1, M. Pedrazzoni1, T. Meschi1, sampling. We interviewed residents, with moderate cognitive
M. Maggio1. 1Department of Medicine and Surgery, University ability, that lived in 29 NHs in Northern Italy. Interviews were
of Parma, Parma, Italy; 2MRC-ARUK Centre of Excellence for audio recorded, transcribed verbatim and analyzed using
Musculoskeletal Aging Research, University of Nottingham, content analysis.
Nottingham, United Kingdom Results: Interviews were carried out in November 2016. Overall
there were 61 participants, of which 82% women (83 ± 9 years).
Rationale: Muscle ultrasound (MUS) is an easy and affordable We identified 6 main categories, that include specific themes:
technique for estimation of muscle mass, not yet studied in the Meaning of nutrition (importance of eating, the meals mark the
physical frailty assessment of older patients. The aim of this time of day); Possibility to choose and variety of food
cross-sectional study was to verify the correlation between (sometimes poor); Quality and quantity of foods (sensory
right vastus lateralis MUS measures and dual-energy X-ray properties of food, unmet cultural food and preferences, food
absorptiometry (DXA)-derived appendicular lean mass (ALM) in temperature and presentation, adequate time to eat);
a group of older patients. Nutritional care (staff levels, staff time to provide care,
Methods: We enrolled 45 older (age 79 ± 5) community-dwell- attitude and skills in assistance with eating); Comfort and
ers (28 F) with physical frailty, defined as Short Physical environment (characteristics of dining area, noise, table
Performance Battery (SPPB) score ≥3 and ≤9. DXA scans were arrangements, meal times); Interactions during mealtime
performed using a Hologic™ QDR4500 A densitometer (Hologic, with other residents (communication and hearing difficulties),
US). We also performed right vastus lateralis MUS using a MyLab staff and relatives (little or no chance to eat with their families
Gamma™ system (Esaote, Italy) equipped with a 5 MHz linear or friends in or out of NH).
probe, acquiring longitudinal and transversal scans with real- Conclusion: This study showed the complexity and multidi-
time and extended-field-of-view (EFOV) techniques at the 65% mensionality of eating and that healthier elderly have good
point of muscle length with the patient resting toes to the knowledge of nutrition. Eating is important and meals can be a
ceiling. Muscle thickness (MT), fascicle length (FL), pennation pleasant experience throughout the day for residents.
angle (PA) and EFOV-derived cross-sectional area (CSA) were Interventions shoud be implement for improving the quality
measured using the NIH ImageJ software. The age-adjusted and experience of mealtime for residents.
Pearson correlation coefficients between crude ALM and MUS
parameters were calculated after stratification by sex. Reference
Results: Mean values of ALM, MT, FL, PA and CSA were Donini LM, et al. Nutritional care in a nursing home in Italy. PLoS One.
16.1 ± 2.6 kg, 1.7 ± 0.4 cm, 10.6 ± 2.6 cm, 9.3 ± 5.0° and 10.9 ± Public Library of Science; 2013 Jan 6;8(2)
4.8 cm2 in females, and 21.7 ± 3.2 kg, 1.8 ± 0.4 cm, 12.9 ± Disclosure of Interest: None declared.
3.1 cm, 9.1 ± 3.0° and 12.8 ± 3.1 cm2 in males, respectively.
ALM was significantly correlated with CSA in both genders SUN-P043
(r = 0.70, p < 0.001 in females; r = 0.46, p = 0.04 in males) and NUTRITION RISK FACTORS ASSOCIATED WITH MALNUTRITION
with MT only in females (r = 0.58, p = 0.001), but not with FL IN COMMUNITY-DWELLING OLDER ADULTS
and PA.
A. van Amerongen1 *, I. Zwinkels1, S. van den Berghe1,
Conclusion: In older patients with physical frailty, vastus
M. H. de Groot1, J. A. E. Langius1. 1Nutrition and Dietetics, The
lateralis MUS-derived CSA exhibited a good correlation with
Hague University of Applied Sciences, The Hague, Netherlands
crude ALM, particularly in females, supporting the implemen-
tation of this technique in clinical practice. Rationale: Malnutrition is a common health problem in
community-dwelling older adults. Several indirect medical,
SUN-P042 physiological and social determinants are found to be associated
NUTRITIONAL CARE: PERCEPTIONS OF RESIDENTS IN with malnutrition in this group. However, a complete overview
NURSING HOMES. A QUALITATIVE STUDY of the predictive value of nutritional determinants directly
A. Castaldo1 *, M. C. Gugiari1, E. Zanetti2, M. Zani3, related to malnutrition is lacking. Therefore, this study
M. Lusignani4, M. Magri5, A. Nobili6, A. Verardi7, A. Ianes8, investigated the nutrition risk factors associated with malnu-
M. Gussoni7, L. Bonetti9. 1Education, Provincia Religiosa Di trition in community-dwelling older adults.
S. Marziano Di Don Orione – Piccolo Cottolengo, Milan, Methods: Community-dwelling adults of at least 65 years of age
2
Research, Gruppo di Ricerca Geriatrica, 3Nursing Home, were screened for malnutrition by the SNAQ65+. Excluded were
Le Rondini, Brescia, 4Nursing Bachelor, University of Milan, people receiving home care and being cognitive impaired.
Nutrition risk factors were selected based on a thorough
Geriatrics 1 S69
literature study and investigated by a questionnaire. Uni- and swAPP mice we studied the effect of a 14-month Cit
multivariate logistic regression analyses were used to identify supplementation on behavioural tests: nest-making and Y-
risk factors associated with malnutrition, with adjustment for maze. Statistics: t-Test.
age. Results: Cit leads to a significant decrease in Aβ ( p < 0.02) and
Results: Of the 548 screened participants, 400 people met the sAPPα ( p < 0.005) in swAPP and WT cells. A decrease in AGE
inclusion criteria (59% female, aged 73.7 ± 6.9 year). According levels ( p < 0.005) and a protective effect against GA fragmen-
to the SNAQ 65+, 52 elderly (13%) were undernourished and 5 tation is observed in swAPP cells. Last, Cit improves the results
persons (1%) were at risk of undernutrition. In multivariate of the two behavioural tests in swAPP mice.
analyses, older adults who eat less than usual (OR = 2.76; 95% Conclusion: Our results show a protective action of Cit on APP
CI = 1.46–5.22; p = 0.002), have lower tasting ability (OR = 3.81; metabolism probably due its effect on GA fragmentation. It
95%CI = 1.22–11.95, p = 0.021), skip meals on a weekly basis could be linked to a modulating effect of Cit on °NO
(OR = 3.44; 95%CI = 1.56–7.60; p = 0.002), experience chewing metabolism. This is further confirmed by the improvement of
difficulties (OR = 2.31; 95%CI = 0.93–5.76; p = 0.042), and never behavioural tests in swAPP mice.
exercise for ≥30 minutes without interruption (OR = 3.13; 95% References
CI = 1.21–8.13 p = 0.019) were at greater risk of being
1. Joshi G, et al., Front Neurosci. 2015;9:340
malnourished.
2. Lee et al., Am J Physiol Heart Circ Physiol. 2011;300:H1141–58
Conclusion: Malnutrition was determined in 13% of the 3. Marquet-de Rougé P, et al., Age. 2013;35:1589–606
community-dwelling older adults. Factors associated with
malnutrition were chewing difficulties, loss of taste, little to Disclosure of Interest: A. Ginguay: None declared, J. Vincent: None
declared, P. Marquet-de Rougé Shareholder of: CITRAGE company,
no exercise, skipping meals and eating less than usual. These
C. Clamagirand Shareholder of: CITRAGE company, J.-P. De-Bandt
factors should be taken into consideration regarding the Shareholder of: CITRAGE company, L. Cynober Shareholder of: CITRAGE
prevention and treatment of malnutrition in older adults. company, Y. Cho: None declared, B. Allinquant Shareholder of: CITRAGE
Disclosure of Interest: None declared. company.
SUN-P044 SUN-P045
PROTECTIVE EFFECT OF CITRULLINE AGAINST BETA AMYLOID NUTRITIONAL STATUS AND BODY COMPOSITION IS ALTERED IN
PRECURSOR PROTEIN (APP) CLEAVAGE PATIENTS WITH ALZHEIMER’s DISEASE AND MILD COGNITIVE
A. Ginguay1,2,3 *, J. Vincent4, P. Marquet-de Rougé5, IMPAIRMENT
C. Clamagirand3, J.-P. De-Bandt1,2, L. Cynober1,2, Y. Cho6, A. Doorduijn1,2 *, O. Van de Rest3, S. Boesveldt3,
B. Allinquant7. 1Laboratory of Biological Nutrition, EA4466 W. Van der Flier2, M. Visser1,4, M. De van der Schueren1,5.
1
PRETRAM, Faculté de Pharmacie, Université Paris Descartes, Nutrition and Dietetics, 2Alzheimer Center, Vu University
2
Clinical Chemistry, Cochin Hospital, GH HUPC, AP-HP, 3Centre Medical Center, Amsterdam, 3Division of Human Nutrition,
de Psychiatrie et Neurosciences, LABORATOIRE INSERM, U894, Wageningen University & Research, Wageningen, 4Department
4
Institut de Neurosciences Cognitives et Intégratives of Health Sciences, Vrije Universiteit, Amsterdam,
5
d’Aquitaine, Université Bordeaux 1, CNRS UMR 5287, Talence, Department of Nutrition and Health, HAN University of
5
Laboratory of Biological Nutrition, EA 4466 PRETRAM, Faculté Applied Sciences, Nijmegen, Netherlands
de Pharmacie, Université Paris Descartes, Paris, 6Institut de
Neurosciences Cognitives et Intégratives d’Aquitaine, Rationale: A poor nutritional status is frequently reported in
Université Bordeaux 1, CNRS UMR 5287, Talence, 7Centre de patients with Alzheimer’s disease (AD) and is thought to
Psychiatrie et Neurosciences, LABORATOIRE INSERM, U 894, develop even before the disease manifests. Our aim was to
Paris, France evaluate and compare the nutritional status of patients with
AD, patients with Mild Cognitive Impairment (MCI), and
Rationale: Amyloid deposits, one of the two pathological controls with Subjective Cognitive Decline.
hallmarks of Alzheimer disease (AD), can result from an Methods: At the VUmc Alzheimer Center we included 424
increased β amyloid-cleavage of APP or a decreased clearance patients: 171 controls with SCD (age 60.1 ± 7.5, 46%F, MMSE
of Aβ peptide. Oxidative stress and Golgi apparatus (GA) 28.0 ± 1.7), 109 MCI (age 66.0 ± 7.3, 40%F, MMSE 26.0 ± 2.5), 144
fragmentation, by promoting β amyloid-cleavage of APP, may AD (age 66.8 ± 7.5, 51%F, MMSE 23.5 ± 3.0). We assessed
enhance the pathological process (1). GA fragmentation can be nutritional status using Mini Nutritional Assessment (MNA)
due to impaired nitric oxide (°NO) metabolism (2). Citrulline and body composition using body mass index (BMI), fat free-
(Cit) supplementation, an antioxidant amino acid and °NO mass index (FFMI) and arm, calf and waist circumferences. We
precursor, could be an interesting nutritional approach to compared groups using age adjusted ANOVA’s with diagnosis and
prevent AD. In 23-months old rats, Cit leads to a decrease in C99 gender as independent variables.
peptide levels (first step of β amyloid-cleavage) suggesting that Results: Groups differed in nutritional status, as observed by a
it could protect against Aβ peptide formation (3). Cit effects in main effect of diagnosis for MNA. We also found main effects of
vitro in human neuroblastoma cells (SH-SY5Y) overexpressing diagnosis for BMI and FFMI ( p < 0.05), but not for calf or waist
swedish APP (swAPP) or not (WT) and in vivo in swAPP circumference. For arm circumference we found an interaction
transgenic mice were studied. between diagnosis and gender ( p = 0.055), indicating that
Methods: In WT and swAPP cells incubated for 48 hours with or group differences were largely attributable to males.
without Cit 5 mM, we measured extracellular Aβ peptide,
sAPPα (non amyloid pathway), advanced glycation end-pro-
ducts (AGE) (antioxidative effect) and GA fragmentation. In
S70 Poster
phenylalanine, isoleucine, leucine and valine) calculated as

Controls MCI AD p-
value marker of TRP uptake into the brain. Mood was assessed by the
Hospital Anxiety and Depression Score, and cognition by a test
MNA (0–30)¶ 26.3 ± 2.0 25.1 ± 2.7a 23.5 ± 3.0a,b 0.000
BMI (kg/m2)¶ 27.0 ± 4.7 25.8 ± 3.8 24.9 ± 3.8a 0.021
battery consisting of the Auditory Verbal Learning, Verbal
FFMI (kg/m2)¶ 17.7 ± 2.6 17.3 ± 2.1 16.9 ± 2.2a 0.038 Fluency, Trail Making, and Stroop tests. Plasma amino acid
Arm (cm) 29.6 ± 3.4 28.5 ± 3.2 28.1 ± 3.0 0.274* levels and isotope enrichments were measured by LC-MS/MS.
Calf (cm) 36.8 ± 3.4 35.5 ± 3.0 35.7 ± 3.5 0.323
Statistics were done by unpaired t-tests and Pearson’s
Waist (cm) 92.3 ± 13.2 92.4 ± 11.9 88.8 ± 11.6 0.128
correlation.
All data in mean ± SD Results: Depression scores were higher in C (5.0 vs 2.6,
¶
Main effect for diagnosis P < 0.05), but cognitive outcomes were comparable between
a
different from controls; bdifferent from MCI p < 0.05 *Interaction diagnosis*
gender p = 0.055
the groups. In C, the depression scores correlated negatively
with plasma TRP (r = −0.69, P < 0.01) and positively with TRP
Conclusion: Patients with MCI and AD have a lower MNA score, clearance rate (r = 0.60, P < 0.05). Additionally, we found that
and BMI and FFMI compared to controls. We are currently only in C, TRP Ra was associated with word fluency (r = 0.70,
studying how nutritional status and body composition contrib- P < 0.01), processing speed (TMT completion time; r < −0.54,
ute to progression of cognitive decline. P < 0.05), and verbal learning capacity and memory (immediate
Disclosure of Interest: A. Doorduijn Grant/Research Support from: and delayed recall, learning rate and recognition; r ≥ 0.63,
This project is funded by the “Food, Brain and Cognition” program of P ≤ 0.01). No relationship was found between plasma TRP/
NWO (057-14-004) and industry (Nutricia Research, Friesland Campina LNAA ratio and mood or cognition.
and DSM), O. Van de Rest Grant/Research Support from: This project is Conclusion: These findings suggest that an imbalance in TRP
funded by the “Food, Brain and Cognition” program of NWO (057-14-
metabolism plays a role in the depressive symptoms in patients
004) and industry (Nutricia Research, Friesland Campina and DSM),
with cancer and may increase their risk of developing cognitive
S. Boesveldt Grant/Research Support from: This project is funded by
the “Food, Brain and Cognition” program of NWO (057-14-004) and deficits.
industry (Nutricia Research, Friesland Campina and DSM), W. Van der Disclosure of Interest: B. Van Der Meij Grant/Research Support from:
Flier Grant/Research Support from: This project is funded by the ESPEN Research Fellowship, C. Lieben: None declared, N. Deutz: None
“Food, Brain and Cognition” program of NWO (057-14-004) and industry declared, R. Rodriguez: None declared, F. Koeman: None declared,
(Nutricia Research, Friesland Campina and DSM), M. Visser Grant/ T. Smit: None declared, M. Engelen: None declared.
Research Support from: This project is funded by the “Food, Brain and
Cognition” program of NWO (057-14-004) and industry (Nutricia
SUN-P047
Research, Friesland Campina and DSM), M. De van der Schueren
THE ACUTE EFFECTS OF TRYPTOPHAN ENRICHED WHEY
Grant/Research Support from: This project is funded by the “Food,
Brain and Cognition” program of NWO (057-14-004) and industry PROTEIN ON COGNITIVE FUNCTIONS IN OLDER ADULTS WITH
(Nutricia Research, Friesland Campina and DSM). MILD COGNITIVE IMPAIRMENT
C. K. Lieben1 *, N. E. Deutz1, A. Salentijn1,2, M. P. Engelen1.
1
SUN-P046 Health and Kinesiology, Texas A&M University, College
DEPRESSED MOOD AND COGNITIVE FUNCTIONS IN PATIENTS Station, United States, 2Neuropsychology &
WITH CANCER ARE ASSOCIATED WITH ALTERATIONS IN Psychopharmacology, Maastricht University, Maastricht,
TRYPTOPHAN METABOLISM Netherlands
B. S. Van Der Meij1,2,3 *, C. K. Lieben1, N. E. Deutz1, Rationale: The essential amino acid tryptophan (TRP, precursor
R. E. Rodriguez4, F. Koeman1, T. C. Smit1, M. P. Engelen5. of serotonin and kynurenine) regulates mood and memory.
1
Center for Translational Research in Aging and Longevity, Since aging modifies the serotonergic metabolism and TRP
Texas A&M University, College Station, United States, 2Faculty enriched protein meals have mood and memory enhancing
of Health Sciences and Medicine, Bond University, God Coast, properties, our hypothesis is that optimizing TRP availability
3
Nutrition and Dietetics, Mater Group, Brisbane, Australia, via intake of α-lactalbumin (ALAC) diminishes cognitive deficits
4
Division of Hematology/Oncology, Scott and White Memorial in older adults with mild cognitive impairment (MCI).
Hospital, College Station, United States, 5Center for Methods: This randomized placebo controlled crossover study
Translational Research in Aging and Longevity, Texas A&M examines the acute effects of ALAC on cognitive functions in
University, College Station, Australia healthy older adults with and without MCI. Participants, older
than 55 years were stratified by cognitive complaints and a
Rationale: Depression and cognitive deficits have been Montreal Cognitive Assessment (MoCA) score of less than 26 in a
observed in patients with cancer. Although degradation of MCI group (n = 19) and an age and gender matched control
tryptophan (TRP; precursor of serotonin) has been detected in group (CON; n = 18). Plasma amino acid levels were measured
cancer, the exact association between whole body TRP prior to and 3h after intake of the protein mixtures (Davisco)
metabolism and neuropsychological functions in advanced containing ALAC or Whey protein as placebo (4.8 vs 2.7 g TRP/
cancer remains unclear. 100 g product, respectively) to determine changes in TRP and
Methods: In 16 patients with solid tumours (C) and 16 age and TRP/large neutral amino acids (LNAA) ratio. Subsequently,
gender matched healthy controls, the rates of appearance (Ra) attention, executive and memory functions (using AVLT, VFT,
and clearance of TRP were assessed by primed continuous TMT, STROOP, and PASAT assessments) were evaluated in both
infusion of L-[indole-2H5]TRP. Plasma amino acid profile was groups. Statistics were done by two-way analysis of variance.
analyzed to measure plasma TRP level, and ratio plasma TRP to
Large neutral amino acids (LNAA = sum of tyrosine,
Geriatrics 1 S71
Results: Baseline characteristics, plasma TRP levels and TRP/ SUN-P049

LNAA ratio were similar between the groups. Independent of NORDIC HEALTHY DIET AND MORTALITY IN A COHORT OF 70
the group, each protein affected TRP levels and TRP/LNAA ratio YEAR-OLD SWEDES: WHAT IS THE CONTRIBUTION OF DAIRY
differently ( p < 0.01) as ALAC increased TRP/LNAA ratio by 92% INTAKE?
and 100%, while Whey induced an increase of 7% and 18% in E. Rothenberg1 *, G. Tognon2, L. Lissner2, M. Petrolo2, V. Sundh2.
both CON and MCI group, respectively. Although the MCI group 1
Food and Meal Science, Kristianstad University, 2Section for
performed worse on all cognitive tests relative to the CON Epidemiology and Social Medicine (EPSO), Department of
group ( p < 0.05), cognitive outcomes after ALAC intake did not Public Health and Community Medicine, Sahlgrenska Academy,
differ from Whey. Gothenburg, Sweden
Conclusion: These findings indicate that a TRP enriched
dietary intake has no acute beneficial effects on cognitive Rationale: Several definitions of the Nordic Healthy Diet have
performance in older adults with MCI. been proposed, but there is no consensus on the role of dairy
Disclosure of Interest: None declared. products. We aim to study the impact of the Nordic diet on all-
cause mortality in a population of 70 year-olds, exploring
SUN-P048 different versions of a Nordic Healthy Diet Score (NHDS) with
WHAT DO NURSES LEARN ABOUT MALNUTRITION IN OLDER focus on the specific role of key dairy products.
ADULTS? Methods: Cox proportional hazard models, adjusted for
potential confounders, were used to assess the prediction of
D. Eglseer1 *, S. Schüssler1, I. Kravanja1, C. Lohrmann1. all-cause mortality using two NHDS definitions (calculated
1
Institute of Nursing Science, Medical University Graz, Graz, either including low-fat or without dairy products). In separate
Austria Cox models, cheese intake and the combined intakes of milk,
soured milk and unsweetened yoghurt were tested as well as
Rationale: Evidence-based interventions for malnourished
intake of fat from these two sources.
older adults are rarely implemented in daily clinical practice.
Results: Neither of the standard versions of NHDS was
One main reason may be the lack of sufficient nutritional
associated with mortality. However, cheese intake was pro-
knowledge of nurses. Therefore, this study aimed at determin-
tective of total mortality, whereas milk products (including
ing the provision and content of malnutrition education in basic
soured milk and unsweetened yoghurt) predicted increased risk
nursing education across European countries.
of mortality. Cheese fat intake was also inversely associated
Methods: This cross-sectional study is part of the European
with mortality, whereas fat from the other dairy products
project Malnutrition in the Elderly Knowledge Hub (MaNuEL).
positively predicted the outcome only when the model was
Based on an existing questionnaire, an online-survey question-
adjusted by energy intake.
naire was developed by experts in the field of malnutrition. In
Conclusion: The NHDS, as previously defined, was not
January 2017, the online-survey link was emailed to 926 nursing
associated with all-cause mortality in this population of
education institutions in 31 European countries. The software
elderly[GT1] Swedes. Intake of milk, soured milk and/or
tool “SurveyMonkey” was used for the survey and SPSS for
unsweetened yoghurt was positively associated with all-cause
descriptive data analysis.
mortality whereas cheese intake was inversely associated with
Results: 86.3% of the institutions stated offering general
this outcome.
nutrition education. In 73%, malnutrition education in older
adults is part of the education. The most frequently mentioned Disclosure of Interest: None declared.
topics were malnutrition screening (70.8%), causes (67.2%) and
consequences (68.7%) of malnutrition. Rarely reported con- SUN-P050
tents were the responsibilities of various professions in INDIVIDUAL VARIANCE IN RESTING METABOLIC RATE AND
nutritional support (35.1%) as well as the cooperation in ENERGY BALANCE IN GERIATRIC OUTPATIENTS WITH
multidisciplinary nutrition support teams (28.2%). In more than MOBILITY PROBLEMS
half of the institutions, malnutrition is taught by nurses and not E. M. Reijnierse1 *, S. Verlaan2, M. C. Trappenburg2,3,
by nutrition professionals. C. G. Meskers4,5, M. A. de van der Schueren6,7, A. B. Maier1,5.
Conclusion: Malnutrition in older adults is, for the most part, 1
Department of Medicine and Aged Care, University of
integrated in basic nursing education. However, the multidis- Melbourne, Melbourne, Australia, 2Department of Internal
ciplinary approach is hardly covered in the respective courses. Medicine, Section of Gerontology and Geriatrics, VU University
Furthermore, (mal)nutrition education is often in non-nutri- Medical Center, Amsterdam, 3Department of Internal
tion-professional’s hands. This might be a reason why adequate Medicine, Amstelland Hospital, Amstelveen, 4Department of
nutritional support is not applied in clinical practice to a Rehabilitation Medicine, VU University Medical Center,
satisfying degree. Adaptations of existing (mal)nutrition 5
Department of Human Movement Sciences, MOVE Research
education courses for nurses in European countries seem to Institute, Vrije Universiteit, 6Department of Internal
be necessary. Medicine, Section of Nutrition and Dietetics, VU University
Disclosure of Interest: None declared. Medical Center, Amsterdam, 7Department of Nutrition and
Health, Faculty of Health and Social Studies, HAN University of
Applied Sciences, Nijmegen, Netherlands
Rationale: In clinical practice, optimization of physical and

nutritional intervention (“tailored therapy”) requires patient
specific data on energy expenditure and nutritional intake
S72 Poster
tailored to the individual requirements; these data are influence of the number of attempts on maximal HGS is not
generally lacking. This study aimed to explore the nutritional yet known and may differ depending on age and health status.
needs of geriatric outpatients regarding energy expenditure This study aimed to assess how many attempts of HGS are
and energy balance. required to obtain maximal HGS.
Methods: This inception cohort of older adults referred to Methods: Three cohorts (939 individuals) differing in age and
the geriatric outpatient clinic of the Center of Geriatric health status were included. HGS was assessed three times and
Medicine Amsterdam, VU University Medical Center included explored as continuous and dichotomous variable. Paired t-
26 outpatients. Geriatric outpatients underwent standardized test, intraclass correlation coefficients (ICC) and Bland-Altman
phenotyping based on regular care and additional nutritional analysis were used to test reproducibility of HGS. The number
(indirect calorimetry to measure resting metabolic rate (RMR), of individuals with misclassified dynapenia at attempts 1 and 2
three day food diary) and physical activity assessments with respect to attempt 3 were assessed.
(accelerometry). Next to indirect calorimetry, RMR was Results: Results showed the same pattern in all three cohorts.
estimated using the equation by the World Health Maximal HGS at attempts 1 and 2 was higher than at attempt 3
Organization based on age, sex, body weight and height. on population level (P < 0.001 for all three cohorts). ICC values
Total energy expenditure (TEE) was calculated by RMR times between all attempts were above 0.8, indicating moderate to
the physical activity level. Energy balance was defined as TEE high reproducibility. Bland-Altman analysis showed that 41.0–
versus the energy intake. 58.9% of individuals had the highest HGS at attempt 2 and 12.4–
Results: A high individual variance was found in both RMR and 37.2% at attempt 3. The percentage of individuals with a
energy balance. Mean difference between the actual measured maximal HGS above the gender-specific cut-off value at
RMR and the estimated RMR was 234 kcal/day on a population attempt 3 compared with attempts 1 and 2 ranged from 0% to
level. On the individual level, estimated RMR underestimated 50.0%, with a higher percentage of misclassification in middle-
the actual measured RMR by more than 10% in more than half of aged and older populations.
the outpatients. Mean difference between TEE and energy Conclusion: Maximal HGS is dependent on the number of
intake was 429 kcal/day. Half of the outpatients had an energy attempts, independent of age and health status. To assess
consumption lower than their needs by more than 10%. maximal HGS, at least three attempts are needed if HGS is
Conclusion: RMR should be measured objectively due to the considered to be a continuous variable. If HGS is considered as a
high underestimation of estimating RMR. In geriatric out- discrete variable to assess dynapenia, two attempts are
patients, it is important to individually quantify the nutritional sufficient to assess dynapenia in younger populations.
needs. Misclassification should be taken into account in middle-aged
Disclosure of Interest: None declared. and older populations.
SUN-P051
ASSESSMENT OF MAXIMAL HANDGRIP STRENGTH: HOW MANY SUN-P052
ATTEMPTS ARE NEEDED? LACK OF KNOWLEDGE AND AVAILABILITY OF DIAGNOSTIC
E. M. Reijnierse1 *, N. de Jong2, M. C. Trappenburg2,3, EQUIPMENT HINDER THE DIAGNOSIS OF SARCOPENIA AND ITS
G. J. Blauw4,5, G. Butler-Browne6, H. Gapeyeva7, J.-Y. Hogrel6, MANAGEMENT
M. V. Narici8, S. Sipilä9, L. Stenroth10, R. C. van Lummel11,12, E. M. Reijnierse1 *, M. A. de van der Schueren2,3,
M. Pijnappels12, C. G. Meskers12,13, A. B. Maier1,12. M. C. Trappenburg4,5, M. Doves6, C. G. Meskers7,8, A. B. Maier1,8.
1 1
Department of Medicine and Aged Care, University of Department of Medicine and Aged Care, University of
Melbourne, Melbourne, Australia, 2Department of Internal Melbourne, Melbourne, Australia, 2Department of Internal
Medicine, Section of Gerontology and Geriatrics, VU University Medicine, Section of Nutrition and Dietetics, VU University
Medical Center, Amsterdam, 3Department of Internal Medical Center, Amsterdam, 3Department of Nutrition and
Medicine, Amstelland Hospital, Amstelveen, 4Department of Health, Faculty of Health and Social Studies, HAN University of
Gerontology and Geriatrics, Leiden University Medical Center, Applied Sciences, Nijmegen, 4Department of Internal Medicine,
Leiden, 5Department of Geriatrics, Bronovo Hospital, The Section of Gerontology and Geriatrics, VU University Medical
Hague, Netherlands, 6UPMC UM 76, INSERM U 974, CNRS 7215, Center, Amsterdam, 5Department of Internal Medicine,
Institute de Myologie, Paris, France, 7Institute of Sport Amstelland Hospital, Amstelveen, 6Institute of Human
Sciences and Physiotherapy, University of Tartu, Tartu, Estonia, Movement Studies, Faculty of Health Care, University of
8
Division of Medical Sciences and Graduate Entry Medicine, Applied Sciences Utrecht, Utrecht, 7Department of
MRC-ARUk Centre of Excellence for Musculoskeletal Ageing Rehabilitation Medicine, VU University Medical Center,
8
Research, University of Nottingham, Royal Derby Hospital Department of Human Movement Sciences, MOVE Research
Centre, Derby, United Kingdom, 9Gerontology Research Centre Institute, Vrije Universiteit, Amsterdam, Netherlands
and Department of Health Sciences, 10Department of Biology
of Physical Activity, University of Jyväskylä, Jyväskylä, Rationale: Sarcopenia is an emerging clinical challenge in an
Finland, 11McRoberts BV, The Hague, 12Department of Human ageing population and is associated with serious negative
Movement Sciences, MOVE Research Institute, Vrije health outcomes. This study aimed to assess the current state
Universiteit, 13Department of Rehabilitation Medicine, VU of knowledge about the concept of sarcopenia, diagnostic
University Medical Center, Amsterdam, Netherlands strategy and management in a cohort of Dutch healthcare
professionals ( physicians, physiotherapists, dietitians and
Rationale: Handgrip strength (HGS) is used to identify others) attending a lecture cycle on sarcopenia.
individuals with low muscle strength (dynapenia). The
Geriatrics 1 S73
Methods: Healthcare professionals (n = 223) were asked to associations were found for education level (B(eta)0.417, P
complete a questionnaire before, directly after and five (-value)0.027), having children (B-1.220, P0.02), number of
months after attending a lecture cycle on the pathophysiology diets adhered to (B0.518, P0.048), polypharmacy (B1.143,
of sarcopenia, diagnostic strategy and management of sarco- P0.025), calf circumference (B0.171, P0.063) and MUAC (B-
penia, i.e. interventions and collaboration. 0.267, P0.007). No significant effects were observed for
Results: Before attendance, 69.7% of healthcare professionals diagnosis, gender or age.
stated to know the concept of sarcopenia and 21.4% indicated Conclusion: Approximately half of patients with SCD, MCI and
to know how to diagnose sarcopenia. Handgrip strength was the AD reported dietary supplement use, with no differences
most frequently used objective diagnostic measure (33.9%). between diagnoses. The here reported associations with
Five months after attendance, reported use of diagnostic tests supplement use provide novel insights, which should be
was increased, i.e. handgrip strength up to 67.4%, gait speed up further related to nutritional intake, nutritional status and
to 72.1% and muscle mass up to 20.9%. Bottlenecks during disease progression.
implementation of the diagnostic strategy were experienced by Disclosure of Interest: E. Hartman: None declared, A. Doorduijn
67.1%; lack of awareness, acquisition of equipment and time Grant/Research Support from: This project is funded by the “Food,
constraints to perform the diagnostic measures were reported Brain and Cognition” program of NWO (057-14-004) and industry
most often. Before attendance, 36.4% stated not to consult a (Nutricia Research, Friesland Campina and DSM), M. Visser Grant/
physiotherapists or exercise therapists (PT/ET) or dietitian for Research Support from: This project is funded by the “Food, Brain and
sarcopenia interventions, 10.5% consulted a PT/ET, 32.7% a Cognition” program of NWO (057-14-004) and industry (Nutricia
dietitian and 20.5% both a PT/ET and dietitian. Five months Research, Friesland Campina and DSM), W. van der Flier Grant/
after attendance, these percentages were 28.3%, 21.7%, 30.0% Research Support from: This project is funded by the “Food, Brain and
Cognition” program of NWO (057-14-004) and industry (Nutricia
and 20.0% respectively. A lack of collaboration was experienced
Research, Friesland Campina and DSM), M. De van der Schueren
by 36.8%. Grant/Research Support from: This project is funded by the “Food,
Conclusion: The concept of sarcopenia is familiar to most Brain and Cognition” program of NWO (057-14-004) and industry
healthcare professionals but application in practice is ham- (Nutricia Research, Friesland Campina and DSM).
pered, mostly by lack of knowledge, availability of equipment,
time constraints and lack of collaboration. SUN-P054
Disclosure of Interest: None declared. MALNUTRITION AND RELATED RISK PROFILES IN OLDER
ADULTS FROM DIFFERENT SETTINGS: AN ENABLE-STUDY
SUN-P053 E. Kiesswetter1 *, M. G. Colombo2,3, D. Volkert1, A. Peters2,
FACTORS ASSOCIATED WITH DIETARY SUPPLEMENT USE IN B. Thorand2, R. Holle4, K.-H. Ladwig2, H. Schulz5, E. Grill6,
PATIENTS WITH ALZHEIMER’s DISEASE AND MILD COGNITIVE R. Diekmann7, E. Schrader1, P. Stehle8, C. C. Sieber1,
IMPAIRMENT C. Meisinger2,9. 1Institute for Biomedicine of Aging, Friedrich-
E. Hartman1 *, A. Doorduijn1,2, M. Visser1,3, W. Van der Flier2, Alexander Universität Erlangen-Nürnberg, Nuremberg,
2
M. De van der Schueren1,4. 1Department of Nutrition and Institute for Epidemiology II, Helmholtz Zentrum München,
Dietetics, 2Alzheimer Center, VU University Medical Center, German Research Center for Environmental Health, Munich,
3 3
Department of Health Sciences, Vrije Universiteit, MONICA/KORA Myocardial Infarction Registry, Central
Amsterdam, 4Department of Nutrition and Health, HAN Hospital of Augsburg, Augsburg, 4Institute of Health Economics
University of Applied Sciences, Nijmegen, Netherlands and Health Care Management, 5Institute for Epidemiology I,
Helmholtz Zentrum München, German Research Center for
Rationale: Patients with different stages of cognitive decline Environmental Health, 6Institute for Medical Information
often report dietary supplement use. This study investigates Processing, Biometrics and Epidemiology (IBE), and German
factors associated with the number of dietary supplements in Center for Vertigo and Balance Disorders, Ludwig-Maximilians-
controls with subjective cognitive decline (SCD), and in University Munich, Munich, 7Department of Health Services
patients with mild cognitive impairment (MCI) or Alzheimer’s Research, Carl von Ossietzky Universität Oldenburg,
disease (AD). Oldenburg, 8IEL-Nutritional Physiology, Universität Bonn,
Methods: Dietary supplement use of 140 subjects of the VUmc Bonn, 9Institute for Epidemiology, Ludwig-Maximilians-
Alzheimer center (63 SCD, 34 MCI, 43 AD), was inquired with the University Munich, UNIKA-T Augsburg, Augsburg, Germany
validated HELIUS Food Frequency Questionnaire. After uni-
variate selection (determinants with p < 0.1), a multivariable Rationale: The origin of malnutrition in older age is multifac-
general linear model was constructed to study the association torial and risk factors may vary according to the health and
between patient and disease characteristics and number of living situation of older adults. The aim of this secondary data
supplements. All analyses were adjusted for diagnosis. analysis was (a) to compare the prevalence of malnutrition in
Results: 66 out of 140 subjects (47%) reported dietary older adults from different health care settings and (b) to
supplement use. Univariate analyses revealed significant identify setting-specific risk profiles of malnutrition.
associations between the number of dietary supplements Methods: Cross-sectional data of 1,073 community-dwelling
used and education level (Verhage scale), having children, older adults from the Kora-Age study (CD), 187 patients of a
number of diets adhered to, needing assistance during the geriatric day hospital (GDH), 335 older adults receiving home
questionnaire, polypharmacy (>3), alcohol consumption care (HC, ErnSiPP study), and 197 nursing home residents (NH)
(units/day), protein intake, BMI, calf circumference (continu- were harmonized. Malnutrition was defined as body mass index
ous), mid-upper arm circumference (MUAC, continuous) and fat <20 kg/m² and/or weight loss >3 kg in the previous 3–6 months.
free mass. In the multivariable model, independent For each data set odds ratios of 27 potential risk factors from 5
S74 Poster
domains (demographics, nutrition related problems, dietary Conclusion: The suitability of the DXI appeared restricted. In
behavior, health, functioning) were calculated. Variables this study, only the item “My mouth feels dry” was best
significantly associated with malnutrition in at least one data correlated with hyposalivation. In nursing homes, the preva-
set were entered into multivariable logistic regression models. lence of hyposalivation and xerostomia is high. Women and
Results: The prevalence of malnutrition was 11% in CD older residents ages over age of 70 years need special attention with
adults, 19% in GDH-patients, 16% in HC-receivers, and 17% in respect to oral health.
NH-residents ( p = 0.002). Twelve potential risk factors were Disclosure of Interest: None declared.
included in the multivariable models. Reduced appetite,
difficulties with eating, respiratory and gastrointestinal dis-
SUN-P056
eases were identified as risk factors of malnutrition in CD older
POOR NUTRITIONAL STATUS BUT NOT COGNITIVE OR
adults. In GDH-patients the same risk profile except gastro-
FUNCTIONAL IMPAIRMENT PER SE INDEPENDENTLY PREDICT
intestinal diseases was found. In HC-receivers only reduced
3- AND 6-MONTH MORTALITY N ELDERLY HIP-FRACTURE
appetite and in NH-residents only mobility limitations
PATIENTS
increased the odds of malnutrition.
Conclusion: CD older adults showed the lowest prevalence of G. Gortan Cappellari1 *, P. De Colle2, E. Concollato3, V. Bonato1,
malnutrition. Reduced appetite was a risk factor of malnutri- C. Ratti4, M. Zanetti1, L. Murena4, G. Toigo3, R. Barazzoni1.
1
tion in 3 of 4 settings. While in CD older adults and GDH- Medical, Surgical and Health Sciences, University of Trieste,
2
patients several factors were related to malnutrition, in HC- Geriatrics Division, Azienda Sanitaria Universitaria Integrata
receivers and NH-residents one single factor was dominant. Trieste, 3Post-Graduate School of Geriatrics, University of
Trieste, 4Orthopaedic Surgery, Azienda Sanitaria Universitaria
Integrata Trieste, Trieste, Italy
SUN-P055 Rationale: Hip fractures are a major health problem and are
EXPLORATION OF THE ASSOCIATION BETWEEN XEROSTOMIA, strongly associated with mortality in elderly individuals.
HYPOSALIVATION AND MEDICATION USE IN NURSING HOME Recent evidence suggested a potential negative impact of
RESIDENTS poor nutritional, cognitive and functional status on hip fracture
G.-J. Van Der Putten1,2 *, H. Brand3, J. Schols4, C. De Baat1. patient survival, but their independent prognostic impact as
1
Department of Oral Function and Prosthetic Dentistry, well as their potential interactions in modulating survival
Radboud Univeristy Medical Centre, Nijmegen, 2Amaris remain undefined.
Gooizicht, Hilversum, 3Department of Dental Basic Sciences, Methods: In 1,259 consecutive elderly patients admitted to a
Academic Centre for Dentistry Amsterdam, Amsterdam, orthopaedic surgery unit for hip fracture treatment [age 85
4
Department General Practice/Caphri, Maastricht University, years (65–109); male gender: 22%], we assessed associations
Maastricht, Netherlands between 3- and 6-month mortality (M) and malnutrition (Mini
Nutritional Assessment - MNA < 23.5), cognitive and functional
Rationale: To maintain good oral health, an adequate amount status (Short Portable Mental Status Questionnaire or Activities
of saliva should be secreted. The first objective was to examine of Daily Living scores).
the diagnostic suitability of a Dutch translation of the Results: Malnutrition and increasing cognitive and functional
Xerostomia Inventory (DXI) for determining the severity of impairment were all associated with M ( p < 0.001). Both
xerostomia. The second objective was to assess to investigate cognitive and functional impairment were associated with
the associations of saliva secretion rate and acidity with malnutrition (P < 0.001). Associations between malnutrition
gender, age, and some medical characteristics in a convience and M were independent of age, gender, pre-fracture disease
sample of nursing home residents. conditions, type of surgery and post-surgical complications as
Methods: A cross-sectional study was carried out in 50 nursing well as cognitive and functional impairment. Malnourished
home residents. The DXI was completed for all residents. patients accordingly presented worse mortality in Kaplan
Unstimulated saliva (UWS), parafilm-stimulated saliva (A-SWS) survival analyses. On the other hand, associations between M
and citric acid stimulated saliva (CH-SWS) flow rates were and cognitive and functional impairment were independent of
determined. Current used (hyposalivation-related) medica- age, gender, disease conditions, surgery and its complications
tions of the residents were collected from residents’ medical but not of malnutrition.
records and analyzed. Conclusion: In hip fracture elderly patients, malnutrition is a
Results: The average age of the residents was 78.1 ± 9.7 years. strong independent risk factor for 3-and 6-month mortality.
The suitability of the DXI appeared restricted. The prevalence Routine assessment and potentially treatment of malnutrition
of xerostomia was 52%. The prevalence of hyposalivation was could improve clinical risk assessment and prognosis of elderly
24% for UWS, 60% for CH-SWS and 18% for A-SWS. In 48% of the hip fracture patients. The negative prognostic impact of
residents, the UWS was less than 0.2 mL/min. The CH-SWS and cognitive and functional impairment appears to be mediated
A-SWS were less than 0.5 mL/min in 60% and 18% of the at least partly by their association with poor nutritional status.
residents respectively. All whole saliva secretion rates were Disclosure of Interest: None declared.
significantly lower in women than in men, even after correction
for age, smoking and the number of prescribed medications.
The number of prescribed medication was significant higher in
residents over the age of 70 and also in women. In residents
aged >70 years, the acidity of U-SWS was positively associated
with age.
Liver and gastrointestinal tract 1 S75
SUN-P057 SUN-P059
IMPROVING ENERGY INTAKE AND MALNUTRITION IN LONG “ARE YOU EATING PROPERLY?”: INCREASE AWARENESS OF
TERM CARE: USING A CONCEPTUAL MODEL TO IDENTIFY MALNUTRITION IN ELDERLY PEOPLE IN JAPAN THROUGH
DETERMINANTS AND POTENTIAL SOLUTIONS SOCIAL ENTERPRISE
H. Keller1 *, S. Slaughter2, C. Lengyel3, N. Carrier4, K. Akiyama1 *, T. Higashiguchi2. 1Surgery, Tokastu Clinic
J. Morrison5, V. Vucea1, C. Steele6, L. Duizer7. 1Applied Health Hospital, Matsudo, 2Surgery & Palliative Medicine, Fujita
Sciences, University of Waterloo, Waterloo, 2Faculty of Health University School of Medicine, Toyoake, Japan
Nursing, University of Alberta, Edmonton, 3Faculty of
Agriculture & Food Sciences, University of Manitoba, Rationale: “WAVES” is an abbreviation for “We Are Very
Winnipeg, 4Ecole des sciences des aliments, de nutrition et Educators for Society”. Prof. T. Higashiguchi created and
d’etudes familiales, Universite de Moncton, Moncton, proposed this organization. He is Chairman of the Board of
5
Applied Health Sciences, Unviersity of Waterlo, Waterloo, Trustees of the Japanese Society for Parenteral and Enteral
6
Toronto Rehab, University Health Network, Toronto, 7Food Nutrition (JSPEN). This organization is defined as a social
Science, University of Guelph, Guelph, Canada enterprise with the goal of creating a better super-aged
society, which includes a “People Education Program” aimed at
Rationale: Poor food intake is the primary cause of malnutri- preventing sarcopenia.
tion in long term care (LTC). The Making the Most of Mealtimes Methods: “Are you eating properly?” are the words we used to
(M3) concept identifies diverse determinants and influences on greet elderly people. This is the first step of WAVES. As part of a
food intake (e.g. meal access, meal quality, and mealtime sarcopenia awareness and prevention campaign we have held
experience). This study describes the predictors of energy events 4 times in 2015 and 2016. After these events, we
intake and malnutrition in residents. analyzed the results of questionnaire surveys from elderly
Methods: Food intake was assessed with 3-day weighed and people who participated in these events.
estimated food records in 628 residents of 32 LTC homes in four Results: Of the 1,307 elderly people were replied, 391 were
Canadian provinces. Average energy intake and malnutrition men, 908 were women. The respondents were in the following
risk as determined by the Mini-Nutritional Assessment-Short age groups: 604 (46%) aged under 65 years old, 309 (24%) aged
Form (MNA-SF) were outcome variables. Risk factors related to 65–74 years old, 290 (22%) aged 75–84 years old and 94 (7%)
meal access, meal quality, and mealtime experience were aged 85 or older. 187 respondents (14%) only eat twice a day and
assessed with valid and reliable standardized measures. 11 (1%) eat only one meal a day. 833 (64%) eat meat or fish every
Hierarchical, clustered regression modeling identified deter- day, but 208 (16%) eat this less than 3 times a week. We also
minants of energy intake and MNA-SF. found that 588 (71%) have never heard the term “sarcopenia”.
Results: Mean age of participants was 86.8 ± 7.83 years; 69% Conclusion: It was found that the nourishment level of
were female. Mean energy intake was 1571.9 ± 411.93 kilo- participants in these events was better than expected, but
calories/day. M3 concepts amenable to change and positively these kinds of events will be important in our society. They
associated ( p < 0.05) with energy intake were: MNA-SF, target people who will be at risk of malnutrition in the near
residing on a dementia care unit, receiving more person- future as they become older and less healthy, many of whom
centred care at meals, and total eating assistance. Energy don’t recognize the concept of sarcopenia. These events are
intake was negatively associated with eating challenges, only the first steps. Next, we plan to establish a nutritional
including sometimes requiring eating assistance, and the education program and, after that, an intervention system for
homelikeness of the dining room. The average MNA-SF score elderly people. I believe that this social enterprise through
was 10.6 ± 2.53 and was negatively associated with prescrip- nutrition will build social capital and lead us to a better society.
tion of a pureed or minced/moist texture diet (vs. regular Disclosure of Interest: None declared.
texture), use of oral nutritional supplements, cognitive
impairment, and eating challenges.
Conclusion: Poor food intake and malnutrition are common in
LTC. Modifiable determinants suggest that interventions
Liver and gastrointestinal tract 1
targeting meal quality (modified texture food), meal access SUN-P060
(eating challenges) and mealtime experience (environment) ASCITES VOLUME ASSESSED BY COMPUTER TOMOGRAPHY
are necessary to prevent malnutrition.
I. Krijger1, A. Droop2 *, D. Bot2, J. Langius1,
Disclosure of Interest: H. Keller Speaker Bureau of: Abbott Nutrition, S. Shahbazi Feshtali3, B. Van Hoek4. 1Nutrition and Dietetics,
Nestle Health Sciences, S. Slaughter: None declared, C. Lengyel: None The Hague University of Applied Sciences, The Hague,
declared, N. Carrier: None declared, J. Morrison: None declared, 2
Dietetics, 3Radiology, 4Gatroenterology and Hepatology,
V. Vucea: None declared, C. Steele Grant/Research Support from:
Nestle Health Sciences, Speaker Bureau of: Nestle Health Sciences,
Leiden University Medical Center, Leiden, Netherlands
L. Duizer: None declared.
Rationale: Nutritional assessment in patients with end stage
liver disease is difficult due to the presence of ascites.
Abdominal CT scans, performed for diagnostic purposes,
might be suitable for measuring the amount of ascites. We
compared two new methods for determining the amount of
ascites using CT-scans with the current ascites estimation.
Methods: In 49 patients with end stage liver disease, ascites
was assessed with three methods. A hepatologist estimated the
S76 Poster
amount of ascites by physical examination (HEP) and graded it (TBW), and Lean Body Mass (LBM) was done by bioelectric
as none (0 kg), moderate (2–6 kg) or severe (>6 kg). Abdominal impedance analysis.
CT scans were used to calculate the amount of ascites with a Results: Significant decrease of weight, WC (Waist
five-point method (CT-5P) and by determining volume through Circumference), BMI and fat mass (kg) were found within
measuring ascites area (−10 to +10 HU) on 19 single slices control, placebo and L-carnitine groups. After adjusting for
from T5 to femoral head with interpolation between the slices covariates, L-carnitine supplement decreased weight
(CT-VM). This method was adapted from a validated method to (P = 0.03), BMI (P = 0.02) and fat mass (kg) (P = 0.018) compared
measure ventricular boundaries. With all 3 methods the to placebo group.
amount of ascites was graded. Cohen’s Kappa was used to Conclusion: L-carnitine supplement for 12 week along with a
analyse the degree of agreement between the ascites grade calorie restricted diet decreased body weight, BMI and weight
ranking. A paired t-test and Pearson correlation coefficient of body fat (kg) but does not affect WC, total body water, lean
were used for analysing difference and correlation between the body mass and percent of body fat.
two CT scan methods Disclosure of Interest: None declared.
Results: The agreement between CT-VM and HEP was moderate
(κ = 0.230) and between CT-5P and HEP reasonable (κ = 0.361).
SUN-P062
The amount of ascites measured by CT-5P was significantly
IMPACT OF SARCOPENIC OBESITY ON OUTCOMES IN PATIENTS
lower than calculated with CT-VM (939 ± 1,275 vs. 2,152 ±
UNDERGOING HEPATECTOMY FOR HEPATOCELLULAR
1,481 mL, p < 0.001). There was a high correlation between the
CARCINOMA
CT methods (R = 0.934).
Conclusion: Estimating ascites volume by physical examination A. Kobayashi1 *, T. Kaido1, Y. Hamaguchi1, S. Okumura1,
by the hepatologist and the five-point method lead to a lower H. Shirai1, S. Yao1, N. Kamo1, S. Yagi1, K. Taura1, H. Okajima1,
amount of ascites than the CT volume measurement. S. Uemoto1. 1Hepato-Biliary-Pancreatic and Transplant
Classification of ascites estimated by hepatologist had a Surgery, Kyoto University, Kyoto City, Japan
reasonable agreement with the CT five-point scale but not
Rationale: Recent studies have indicated that sarcopenia is
with the CT volume measurement. The two new methods
associated with morbidity and mortality in various pathologies,
provide an extra possibility for ascites measurement when an
including cancer, and that obesity or visceral adiposity
exact volume of ascites is necessary for medical decisions.
represents a significant risk factor for several cancers.
Disclosure of Interest: None declared. However, the impact of sarcopenic obesity on outcomes after
hepatectomy for hepatocellular carcinoma (HCC) has not been
SUN-P061 fully investigated.
EFFECTS OF L-CARNITINE SUPPLEMENTATION ON BODY Methods: We retrospectively analyzed 465 patients who
COMPOSITION IN PATIENTS WITH NONALCOHOLIC underwent primary hepatectomy for HCC between April 2005
STEATOHEPATITIS and March 2015. Skeletal muscle mass and visceral adipose
S. Amiri-Moghadam1, M. Nematy2, S. Eghtesadi11, M. Khalili3, tissue were evaluated by preoperative computed tomography
M. Mojarrad4, S. Jazayeri1, H. Vosooghinia5, A. Khosravi5, to define sarcopenia and obesity. Patients were classified into
M. Salehi6, A. Beheshti-Namdar5, A. Mehdizadeh Hakkak7 *. one of four body composition groups according to the presence
1
Nutrition, School of Public Health, Iran University of Medical or absence of sarcopenia and obesity.
Sciences, Tehran, 2Nutrition, School of Medicine, Mashhad Results: Body composition was classified as non-sarcopenic
University of Medical Sciences, Mashhad, 3Neuroscience non-obesity in 184 patients (39%), non-sarcopenic obesity in
Research Center, Tabriz University of Medical Sciences, Tabriz, 219 (47%), sarcopenic non-obesity in 21 (7%), and sarcopenic
4
Medical Genetics, Mashhad University of Medicl Sciences, obesity in 21 (7%). Compared with patients with non-
5
Internal Medicine, Ghaem Hospital, Mashhad University of sarcopenic non-obesity, patients with sarcopenic obesity
Medical Sciences, 6Community Medicine, 7Nutrition, displayed worse median survival (84.7 vs. 39.1 months,
Mashhad University of Medicl Sciences, Mashhad, Iran, Islamic P = 0.002) and worse median recurrence-free survival (21.4
Republic Of vs. 8.4 months, P = 0.003). Multivariate analysis identified
sarcopenic obesity as a significant risk factor for death (hazard
Rationale: Fat deposition and obesity are the primary events in ratio [HR] = 2.446, P = 0.005) and HCC recurrence (HR = 2.031,
nonalcoholic steatohepatitis (NASH). L-carnitine with function P = 0.006) after hepatectomy for HCC.
of fatty acid transporting to mitochondria and fat degradation Conclusion: Preoperative sarcopenic obesity was an independ-
may influence body composition in NASH. This study conducted ent risk factor for death and HCC recurrence after hepatectomy
to investigate the beneficial effect of L-carnitine supplement for HCC.
on body composition in NASH patients following calorie- Disclosure of Interest: None declared.
restriction (CR) program.
Methods: This randomized double-blind placebo-controlled
SUN-P063
clinical trial was performed among 67 patients with NASH and
PLENTY OF INTESTINAL FAILURE TO GO AROUND. REFERRALS
34 control subjects. Subjects were randomly divided into three
TO A NEWLY FORMED NUTRITION SUPPORT TEAM
groups: L-carnitine group (receive 2,000 mg L-carnitine sup-
plements daily plus CR) (n = 36), placebo group (receive B. Rye1 *, A. Culkin1. 1Nutrition & Dietetics, St Mark’s Hospital,
placebo plus CR) (n = 31) and control group (under calorie London, United Kingdom
restricted regimen) (n = 34) for 12 weeks. Body composition
Rationale: Parenteral nutrition (PN) is lifesaving but has
analysis including Body Fat Mass (BFM), Total Body Water
complications. Our hospital has an intestinal failure unit (IFU)
which has a dedicated nutrition support team (NST) as per impedance manometry, blood tests and anthropometric mea-
recommendations1. The demand for PN outside the IFU surements were taken at baseline and after SFED. All
increased by 22% over 3 years so funding for an additional participants answered the EEsAI at baseline and after SFED.
Gastroenterologist and Dietitian was approved in 2015 to Self-reported compliance with the diet was assessed, after 3
provide a new service. The aim of this audit was to assess this and 6 weeks. Oral supplements (Elemental 028 and Provide
new service. Xtra) were prescribed and recommended to all patients.
Methods: All referrals to the newly established NST from June Results: 10 patients were included by April 2017, and four (75%
2015 for a year were recorded. Demographics, route of male, mean age 28 y) had completed the SFED (3 excluded
nutrition, days nil by mouth, type of IF2, days on PN, refeeding after baseline measurements, 3 are undergoing SFED). After
risk, weight and BMI. Central venous catheter (CVC) infections SFED, EEsAI scores decreased in three patients, and increased
were recorded as determined from a positive blood culture. in one. All four had a decrease in eosinophilic cell count, food
Descriptive statistics were used. triggers were identified in two. Weight loss, 1–5 kg, happened
Results: Over 12 months 218 patients were referred. Of these in all patients, but least in those using oral supplements.
69% (n = 151) were surgical and 31% (n = 67) medical. PN was Conclusion: A 6week SFED improved dysphagia and reintro-
recommended in 88% (n = 191), enteral nutrition in 3% (n = 6) duction identified food triggers in a subset of adult Norwegian
and oral nutrition in 10% (n = 21). The Dietitian completed the patients with EoE. Still, a SFED is very restricted and led to
nutritional assessment and calculated requirements in 100% of weight loss in all patients. The role of a dietician is important to
referrals. Mean days nil by mouth was 4 ± 6 (0–30). The Dietitian achieve adequate nutritional intake.
assessed patients to be at risk of refeeding in 45% of cases Disclosure of Interest: None declared.
(n = 86). Mean weight was 58.3 ± 25.6 kg (31–139) and mean BMI
20.3 ± 8.8 kg/m2 (11.8–48). According to ESPEN classification of
SUN-P065
IF 50% had type 1 (n = 95), 35% type 2 (n = 67) and 15% type 3
FAT-FREE MASS IS A STRONG PREDICTOR OF ORAL ENERGY
(n = 29). Existing home parenteral nutrition (HPN) patients
INTAKE IN SHORT BOWEL PATIENTS
accounted for 24% of referrals and 16% of referrals were
initiated on HPN. Mean days on PN was 28 ± 41 (1–368). CVC C. Bétry1, M. Lauverjat2, T. Mouillot3, C. Bergoin2, D. Barnoud2,
infections were found in 17% of patients. S. Ait2, C. Chambrier2 *. 1University of Nottingham,
Conclusion: There is a high demand for PN in our hospital with Nottingham, United Kingdom, 2Hospices Civils de Lyon, Pierre
the majority of referrals being appropriate. A significant Bénite, 3CHU de Dijon, Dijon, France
proportion were type 2 & 3 IF reflecting the presence of a
Rationale: The oral energy intake (OEI) is associated with
national IFU. CVC infection is an issue supporting the need for a
intestinal adaptation and reduced dependence of parenteral
nutrition nurse on the NST.
nutrition in short bowel (SB) patients. Besides, it could be one
References of the key factors for the glucagon-like peptide-2 analogue
1. Parenteral Nutrition: A mixed bag (2010) NCEPOD. efficacy. The purpose of this study was to determine the main
2. Pironi et al. (2016) Clin Nutr,35:247 factors modulating the OEI in SB patients.
Disclosure of Interest: None declared. Methods: Data were retrospectively collected from patient
records. SB patients on parenteral nutrition were included if
they had received from a nutritional assessment including
SUN-P064
indirect calorimetry, DEXA, dietary records, anthropometric
SIX FOOD ELIMINATION DIET IN ADULT EOSINOPHILIC
measurements, blood and stool tests. We excluded patients
ESOPHAGITIS, PRELIMINARY EXPERIENCES FROM A DIETITIAN
with paediatric SB syndrome. Univariate and multivariate
PERSPECTIVE
analyses were performed to determine the associations
C. K. Jacobsen1 *, B.-E. G. Emken2, G. E. Kahrs3,4, between OEI and the parameters collected during the
J. G. Hatlebakk1,2. 1University of Bergen, 2Department of nutritional assessment.
Medicine, 3Department of Clinical Nutrition, 4Department of Results: The patients (24 males and 14 females) had a median
Occupational Medicine, Haukeland University Hospital, age of 63 years [IC95%: 37–77]. The major cause of SB syndrome
Bergen, Norway was mesenteric ischemia (63%). The median period between
the bowel resection and the nutritional assessment was 52
Rationale: Eosinophilic esophagitis (EoE) is a chronic inflam-
months [IC95%: 16–214]. OEI was positively correlated with
matory, allergy-mediated esophageal disease, characterized
weight, fat-free mass (FFM), hand-strength, resting energy
histologically by an excess of eosinophilic cells in the
expenditure and negatively correlated with triiodothyronine
esophageal mucosa and clinically by dysphagia. Studies show
(T3). None of the parameters related to the parenteral
a Six Food Elimination Diet (SFED) as effective in both children
nutrition and the gastrointestinal function was correlated
and adults with EoE, but is not implemented in diagnostic and
with the OEI. When all significant variables were entered into
treatment algorithms. EEsAI is a validated questionnaire
the regression model, only FFM remained correlated with OEI
assessing dysphagia severity.
independently of all other parameters (P = 0.011).
We assessed the feasibility of a SFED for adult patients with EoE
Conclusion: FFM is a strong predictor of OEI in SB patients. Even
in the Norwegian population, based on histology, EEsAI score
if one limitation of this retrospective study is the lack of
and body weight of the first included patients.
information on physical activity, our results suggest that
Methods: Patients 18–60 years with diagnosed EoE (esophageal
improving the FFM with physical activity programs could be a
biopsies showing ≥15 eosinophils/hpf and with EoE-symptoms)
way to stimulate the OEI in SB patients.
underwent a SFED for 6 weeks. Upper endoscopies with biopsies
of the proximal, middle and distal part of the esophagus, Disclosure of Interest: None declared.
S78 Poster
SUN-P066 muscle mass (MM) and provides the possibility to analyse the
LIVER FIBROSIS IN WOMEN WITH NONALCOHOLIC FATTY quality of muscle mass by measuring the fat infiltration
LIVER DISEASE USING BIOELECTRICAL IMPEDANCE ANALYSIS: (myosteatosis). This study aimed to identify the relationship
A CROSS-SECTIONAL STUDY between low muscle attenuation (MA) and postoperative length
D. Uehara1 *, A. Naganuma1, T. Hatanaka1, T. Hoshino1, of hospital stay, duration of ICU stay and two-year survival rate
H. Funakoshi2, Y. Ogawa2, M. Inagawa2, T. Tanaka2, T. Ogawa2, after liver transplantation.
K. Sato3, S. Kakizaki4. 1Department of Gastroenterology, Methods: 27 patients receiving liver transplantation were
2
Nutrition Support Team, Takasaki General Medical Center, included in this retrospective cohort study. MA was assessed by
National Hospital Organization, Takasaki, Gunma, a trained researcher on pre-operative CT scans at the level of
3
Department of Medicine and Molecular Science, 4Department L3 using SliceOmatic (Tomovision, Canada). Cut-off values for
of Medicine and Molecular Science, Gunma University, low MA were defined as a mean Hounsfield Unit (HU) of MM <41
Maebashi, Gunma, Japan (BMI < 24.9 kg/m2) or <33 (BMI ≥ 25.0 kg/m2). The difference in
postoperative length of (ICU) stay and survival between
Rationale: The information obtained through body compos- patients with and without low MA before liver transplant was
ition analysis (BIA) has been utilized for evaluating the severity analysed by respectively Mann-Whitney test and log rank test.
of liver cirrhosis. The phase angle (PA) is a strong survival Results: CT scans of 21 patients (86% male, mean age 52 ± 12
predictor of hepatocellular carcinoma than traditional nutri- year) were eligible for analysis. Mean MAwas 43.0 ± 7.5 HU. Low
tional indicators such as body measurement and blood tests. We MA was prevalent in 4 patients In this small group, low MA did
measured female patients with nonalcoholic fatty liver disease not lead to statistically significant prolonged length of hospital
(NAFLD) using the BIA method. A cross-sectional study was stay ( p = 0.47) or a higher number of days in ICU ( p = 0.33),
performed to clarify whether each data obtained is useful for although mean stay in ICU was higher in the low MA group. Two-
evaluating liver fibrosis. year survival rates were significant higher in the group without
Methods: The subjects were 21 women diagnosed with NAFLD low MA compared to the group with low MA ( p < 0.03).
from September 2014 to December 2016 at our hospital. Conclusion: Low MA before liver transplantation might be a
Height, weight, and grip strength were measured. The PA, body negative prognostic factor for survival in patients after
cell mass (BCM), extracellular water/total body water (ECW/ transplantation. To confirm this finding a study with a large
TBW) ratio, skeletal muscle mass index (SMI), percent body fat sample size is needed.
(PBF), and lower limb muscle mass/upper limb muscle mass Disclosure of Interest: None declared.
ratio (L/U LMM ratio) were obtained by InBody S10TM (InBody
Co. Ltd., Seoul). Fibrosis-4 (FIB4) was the marker for evaluating
SUN-P068
liver fibrosis. We examined whether each data obtained with
IONIZATION OF MAGNESIUM OCCURS IN SMALL INTESTINAL
the BIA method, grip strength, and age correlated with FIB4
LUMEN WITHOUT GASTRIC ACID INFLOW IN MICE
using the Spearman correlation coefficient.
Results: The average age, BMI, PA, PBF, grip strength, and FIB4 E. Tominaga1,2 *, K. Fukatsu1, Y. Nishihara2, S. Murakoshi1,
were 60.5 ± 11.5 years, 26.0 ± 3.8 kg/m2, 5.25 ± 0.47, and M. Ri3, T. Watanabe1, M. Noguchi1, N. Yamada2, M. Ohnawa2,
38.4 ± 6.7%, 23.1 ± 4.5 kg, and 2.31 ± 2.30, respectively. The H. Yasuhara1. 1Surgical Center, The University of Tokyo
correlations between FIB4 and each item were as follows; PA Hospital, 2Yoshida Pharmaceutical Co., Ltd., 3Gastrointestinal
(r = −0.758, P < 0.0001), BCM (r = −0.452, P = 0.04), ECW/TBW Surgery, The University of Tokyo hospital, Tokyo, Japan
ratio (r = 0.544, P = 0.011), SMI (r = −0.234, P = 0.308), PBF
Rationale: Ionization of Mg by gastric acid is believed to be
(r = 0.401, P = 0.072), L/U LMM ratio (r = 0.579, P = 0.006), grip
essential for Magnesium Oxide (MgO) to exert its laxative
strength (r = −0.777, P < 0.0001), and age (r = 0.657, P = 0.001).
effect. However, our previous study demonstrated that
Conclusion: In women with NAFLD, the PA and grip strength
administration of gastric acid secretion inhibitors such as a
were very strongly correlated with FIB4. We plan to investigate
Proton Pump Inhibitor or H2 Blocker together with MgO does not
whether the PA and grip strength are related to long-term
reduce Mg2+ levels in the small intestinal and colonic lumen,
prognosis of NAFLD in women in the future.
thereby maintaining the laxative effect. In the present study,
Disclosure of Interest: None declared. we measured Mg2+ levels in the small intestines of mice to
which MgO had been directly administered into the small
SUN-P067 intestinal lumen.
LOW MUSCLE ATTENUATION BEFORE LIVER Methods: Male ICR mice (6 weeks old, n = 29) were randomized
TRANSPLANTATION, LENGTH OF HOSPITAL AND ICU STAY AND to the MgO375 (375 mg/kg of MgO, n = 8), MgO750 (750 mg/kg,
SURVIVAL IN PATIENTS AFTER LIVER TRANSPLANTATION n = 7), MgO1,125 (1,125 mg/kg, n = 7) and control groups
D. Bot1 *, A. Droop1, M. Lelieveld2, A. Donker1, (n = 7), respectively. To avoid the influence of gastric acid and
S. Shahbazi Feshtali3, J. Langius2, B. V. Hoek4. 1Dietetics, the outflow of small intestinal contents into the colon, gastric
Leiden University Medical Center, Leiden, 2Dietetics, The pylorus and distal colon were ligated. MgO solution or distilled
Hague University of Applied Sciences, Den Haag, 3Radiology, water (control) was injected into the small intestinal pouch. At
4
Hepatology and Gastroenterology, Leiden University Medical 1 hour after injection, the small intestine was harvested, and
Center, Leiden, Netherlands Mg2+ levels in the small intestinal washings were measured.
Results: Mg2+ levels in the washings were significantly higher in
Rationale: Malnutrition, characterised by loss of muscle mass, all of the MgO groups than in the control group. Although the
is highly prevalent in patients receiving a liver transplant. MgO750 group showed significantly higher Mg2+ levels than the
Computed Tomography (CT) is a reference method for analysing MgO375 group, the MgO1,125 group had no additive effect as
compared with the MgO375 group. Mg2+ levels in small Conclusion: GGT increase is only associated with days of PN and
intestinal washings obtained 1 hour after MgO injection surgery, being the LFT recommended for the detection of
patients with LFT alterations associated with PN.
MgO dose 0 (Control, MgO375 MgO750 MgO1,125 Disclosure of Interest: None declared.
(mg/kg) n = 7) (n = 8) (n = 7) (n = 7)
Mg2+ levels 0.88 ± 0.08 3.55 ± 0.37* 6.12 ± 1.02*,† 4.61 ± 0.63*
(mmol/L) SUN-P070
THE EFFICACY OF A THREE-DIMENSIONAL PRINTED TRAINING
Means ± S.E.
*: p < 0.01 vs. Control
SIMULATOR FOR PERCUTANEOUS ENDOSCOPIC
†
: p < 0.01 vs. MgO375 GASTROSTOMY OF THE STOMACH
H. K. Na1 *, G. H. Lee1, J. Y. Ahn1, J. H. Lee1, D. H. Kim1,
Conclusion: Ionization of Mg is observed in the small intestinal K. W. Jung1, K. D. Choi1, H. J. Song1, H.-Y. Jung1.
1
lumen even when influx of gastric acid into the small intestine Gastroenterology, Asan Medical Center, Seoul, Korea,
is blocked. Lack of a dose-dependent Mg2+ increase may suggest Republic Of
that a moderate dosage of MgO is optimal for achieving Mg
ionization in the small intestine. Rationale: We developed a novel training simulator for
percutaneous endoscopic gastrostomy (PEG) and determined
Disclosure of Interest: E. Tominaga Other: Yoshida Pharmaceutical Co.,
its efficacy for improving the skills in PEG beginners.
Ltd, K. Fukatsu Grant/Research Support from: Yoshida Pharmaceutical
Co., Ltd, Y. Nishihara Other: Yoshida Pharmaceutical Co., Ltd,
Methods: This gastrostomy simulator was made using three-
S. Murakoshi: None declared, M. Ri: None declared, T. Watanabe: dimensional (3D) printing technology with readily obtainable
None declared, M. Noguchi: None declared, N. Yamada: None declared, materials. Gastrostomy simulator consists of 2 type of method,
M. Ohnawa: None declared, H. Yasuhara: None declared. pull and introducer type. We enrolled 20 participants consisting
of 10 beginners who had no experienced with PEG insertion and
10 experienced endoscopists with PEG insertion. We recorded
SUN-P069
the simulation time, self-evaluation and difficulty score for
INDICATORS OF PARENTERAL NUTRITION ASSOCIATED LIVER
PEG insertion in the participants using 5 score scale and,
FUNCTION TEST ALTERATION IN HOSPITALIZED ADULT
subsequently, simulator performance was assessed with a
PATIENTS
questionnaire using 7-point Likert scale.
E. Leiva-Badosa1 *, J. Llop-Talaveron1, C. Esteban-Sánchez1, Results: The mean times to completion of PEG simulation
M. Colls-González1, T. Lozano-Andreu1, A. Suárez-Lledó1, decreased from 11.9 ± 5.2 to 9.0 ± 4.0 minutes for pull type
M. Badía-Tahull1. 1Pharmacy Department, Hospital De simulator and 13.8 ± 7.0 to 12.0 ± 5.8 minutes, respectively in
Bellvitge-Idibell, Hospitalet de Llobregat, Barcelona, Spain beginner group. The mean self-evaluation scores of beginners
were increased from 2.2 ± 1.1 to 3.1 ± 0.7 ( pull type) and from
Rationale: In order to prevent or treat parenteral nutrition
2.2 ± 1.2 to 3.3 ± 0.8 (introducer type), respectively. The mean
(PN) associated liver disease in adult hospitalized patients
procedure difficulty scores of beginners were decreased from
treated with PN, we studied which liver function test (LFT)
3.4 ± 1.1 to 2.7 ± 0.9 ( pull type) and from 4.4 ± 0.5 to 3.0 ± 0.8
increase was more associated with PN.
(introducer type), respectively. Improvement of skill score was
Methods: Patients with >7 days of PN containing 0.8 g/kg/day
6.3 ± 1.2 by the beginner group. The general realism score of
of olive/soybean lipid emulsion treated between 2015 and
the simulator for endoscopic handling was judged to be
2017, without liver disease, normal LFT values at the beginning
6.0 ± 0.9 by the experienced group.
of NP were included. Patients were followed until the beginning
Conclusion: This new easy-to-manufacture PEG insertion
of oral/enteral feeding, triglycerides ≥3 mmol/L, or patient
simulators can be useful for training in beginners and shows
transferred to ICU. Data were: demographics (sex, age);
good efficacy and realism.
clinical (diagnostic, infection, surgery, mortality); nutritional
(indication, days of PN); and analytical (C-reactive protein Disclosure of Interest: None declared.
[CRP], glucose, creatinine, triglycerides, prealbumin and LFT:
gamma-glutamyl transferase [GGT], alkaline phosphatase SUN-P071
[AP], alanine aminotransferase [ALT] and total bilirubin THE ROLE OF GLUCOSE, INSULIN, AND GLUCAGON DURING
[BIL]). 4 multiple linear regressions were developed to study LIVER REGENERATION AFTER PARTIAL HEPATECTOMY
the association of each LFT with clinical variables. SPSS v.22 H.-S. Lai1 *, S.-L. Lai1, S.-C. Wu1, W.-J. Chen1. 1Department of
was the software used. Surgery, National Taiwan University Hospital, Taipei, Taiwan,
Results: 177 patients (27.1% woman, 66.8 ± 12.9 years) treated Province of China
with PN and followed for 8.5 ± 6.7 days. Final follow-up was due
to oral/enteral nutrition initiation in 67.8%. 48% had increases Rationale: Engergy substrate either creatine phosphate (CP) or
of ≥2-fold the upper limit of normality (ULN) of GGT and 10.7% adenosine triphosphate (ATP) decreased markedly during liver
of AP. regeneration (LR) after partial hepatectomy (PH). This study
In the multivariate analysis, increases in GGT were associated evaluated the role of glucose, insulin, and glucagon during LR
with days with PN (0.07, CI 95% 0.02–0.12) and surgery (1.11, CI after PH.
95% 0.36–0.18), and AP with days with PN (0.14, CI 95% 0.11– Methods: Male Wistar rats weighing 200g with 67% PH was
0.16), infection (0.35, CI 95% 0.05–0.66), PCR increase (−0.000, performed. They were randomizedly assigned into Gr HG: high
CI 95% −0.004–0.001) and surgery (0.48, CI 95% 0.13–0.82), BIL glucose iv infusion; Gr I: insulin; Gr G: glucagon; Gr I + G:
only was associated with surgery (1.73, CI 95% 0.16–3.31). ALT insulin + glucagon injection; Gr C: control; and Gr S: sham
did not have any association. operation. All rats were sacrificed at 6, 24, 48, 72 h after PH.
S80 Poster
Transmission electron microscope (TEM), high energy phos- differ between patients with and without sarcopenia, a
phate (HEP) including CP, ATP in remnant liver, serum glucose, significant difference was found when these costs were added
insulin, glucagon level were measured. Remnant liver weight/ to the waiting list costs (€98,703 [IQR 75,909–121,071] versus
body weight (RLW/BW) ratio, DNA content, DNA synthetic rate, €81,982 [IQR 58,999–111,497], p = 0.037).
in remnant liver were used as LR indicators. Conclusion: Sarcopenia is independently associated with
Results: HEP (ATP and CP) in remnant liver decreased sharply increased health-related costs for patients on the waiting list
after PH. TEM revealed that glycogen in the cytoplasm of for liver transplantation. Optimizing skeletal muscle mass may
hepatocyte disappeared at 6 h after PH. Serum glucose, insulin therefore lead to a decrease in hospital expenditure, in
decreased markedly with no change of glucagon at 6, 24 h after addition to greater health benefit for the transplant candidate.
PH. Increased LR including RLW/BW ratio, DNA content, DNA Disclosure of Interest: None declared.
synthetic rate was noted in HG, I + G groups rats (Table 1).
Table 1: DNA Synthetic Rate with [3H]-Thymidine Incorporation (DPM/mg DNA). SUN-P073
Group Before 6h 24 h 48 h 72 h SARCOPENIA IS ASSOCIATED WITH INCREASED HOSPITAL
EXPENDITURE IN PATIENTS UNDERGOING CANCER SURGERY
HG 582 ± 78 1732 ± 200 80123 ± 8111* 18322 ± 1723* 4022 ± 683
Insulin 569 ± 75 886 ± 202# 50882 ± 6871# 11224 ± 1802 3362 ± 508
OF THE ALIMENTARY TRACT
Glucagon 602 ± 68 1611 ± 296 67212 ± 7789 12321 ± 1738 3726 ± 495 J. Van Vugt1 *, S. Buettner1, S. Levolger1,
I+G 547 ± 59 2547 ± 442* 82117 ± 11767* 16471 ± 2112* 3907 ± 606
R. Coebergh van den Braak1, M. Suker1, M. Gaspersz1,
Control 512 ± 67 1502 ± 301 64099 ± 6428 12583 ± 2041 3187 ± 412
Sham 592 ± 64 562 ± 72 571 ± 89 508 ± 77 614 ± 65 R. de Bruin1, C. Verhoef2, C. van Eijck1, N. Bossche3,
B. Groot Koerkamp1, J. Ijzermans1. 1Surgery, Erasmus MC
Mean ± SD; *p < 0.01 more than Control; #p < 0.01 less than Control University Medical Center, 2Surgical Oncology, Erasmus MC
Cancer Institute, 3Compliance and Control, Erasmus MC
Conclusion: A marked consumed HEP with disappeared University Medical Center, Rotterdam, Netherlands
glycogen in remnant liver occurred at early stage after PH.
HG and I + G rats have a better LR. It might indicate that glucose Rationale: Sarcopenia is associated with poor postoperative
is the predominant energy substrate during LR after PH. Insulin outcomes in cancer patients. Furthermore, it is associated with
plus glucagon can also play an important role for LR. increased healthcare costs in the United States. We investi-
Disclosure of Interest: None declared. gated its effect on hospital expenditure in a Western-European
healthcare system, with universal access.
Methods: Skeletal muscle mass (assessed by computed
SUN-P072
tomography), patient characteristics, and costs were obtained
LOW SKELETAL MUSCLE MASS IS ASSOCIATED WITH
for patients who underwent major curative-intent abdominal
INCREASED HOSPITAL COSTS IN PATIENTS WITH CIRRHOSIS
cancer surgery from 2005 to 2015. Sarcopenia was defined
LISTED FOR LIVER TRANSPLANTATION
based on pre-established cut-offs. The relationship between
J. Van Vugt1 *, S. Buettner1, L. Alferink2, N. Bossche3, sarcopenia and hospital costs was assessed using linear
R. de Bruin1, S. Darwish Murad2, W. Polak1, H. Metselaar2, regression analysis and Mann-Whitney U-tests.
J. Ijzermans1. 1Surgery, 2Hepatology, 3Compliance and Control, Results: 501 patients were included (median age 64 (inter-
Erasmus MC University Medical Center, Rotterdam, quartile range 58–72), 60.5% males). The majority of patients
Netherlands had an ASA-classification of 1–2 (79.2%). Most patients
underwent a resection for colorectal cancer (36.3%, N = 182),
Rationale: Low skeletal muscle mass (sarcopenia), a feature of
while 137 (27.3%) underwent surgery for colorectal liver
malnutrition, is associated with increased morbidity and
metastases, 126 (25.1%) for primary liver tumours, and 56
mortality in liver transplant candidates. Our aim was to
(11.2%) for pancreatic or periampullary cancer. In total, 45.3%
investigate the association between sarcopenia and hospital
of patients had sarcopenia. Total hospital costs per patient in
costs in patients listed for liver transplantation (LT).
the sarcopenia group were €2,813 higher compared with the
Methods: All patients with cirrhosis listed for LT between 2007
non-sarcopenia group (€17,953 versus €15,140; P < 0.001).
and 2014 were identified. Patients listed with high urgency or
Total costs increased with lower sex-specific quartiles of
for acute liver failure or re-transplantation were excluded.
skeletal muscle mass (P = 0.003). Sarcopenia was associated
Skeletal muscle mass was measured on computed tomography
with higher costs in patients without postoperative complica-
(skeletal muscle index [SMI], cm2/m2) performed <90 days from
tions, prolonged hospital stay, and in patients undergoing
list placement. Sex-specific quartiles were created. The lowest
major surgery. After adjustment for confounders, sarcopenia
quartile represented patients with sarcopenia.
was associated with a cost increase of €4,688 (P = 0.004).
Results: In total, 363 patients were listed during the study
Conclusion: Sarcopenia was independently associated with
period, of which 225 were included. Median time on the waiting
increased hospital costs of about €5,000 per patient. Strategies
list was 169 (IQR 46–306) days and median MELD-score was 16
to reduce sarcopenia could reduce hospital costs in an era of
(IQR 11–20). The median total hospital costs in patients with
incremental healthcare costs and an increasingly ageing
sarcopenia were €11,294 (IQR 3,570–46,469) compared with
population.
€6,878 (IQR 1,305–20,683) in patients without sarcopenia
( p = 0.008). In multivariable regression analysis, an incremen- Disclosure of Interest: None declared.
tal increase in SMI was significantly associated with a decrease
in total costs (€458 per incremental SMI, 95%CI 14–902,
p = 0.043), independent of the total time on the waiting list.
Although costs of hospitalization for LT did not significantly
Nutrition and cancer 1 S81
SUN-P074 remnant bowel anatomy. Recently, the idea that grading

HANDGRIP STRENGTH AND ADDUCTOR POLLICIS MUSCLE severity of SBS−IF is based on magnitude of PS volume needs
THICKNESS IN MALES IN PALLIATIVE CARE FOR led to this clinical trial data post hoc analysis of pts with SBS−IF
HEPATOCELLULAR CARCINOMA: PRELIMINARY DATA based on their baseline PS volume.
J. M. F. Sicchieri1 *, A. P. Paganno1, C. Passos1, M. Pereira1, Methods: STEPS (NCT00798967; EudraCT2008-006193-15): a
C. Manca1, A. Teixeira2, P. Chiarello1. 1Division of Nutrition and 24-week, placebo (PBO)–controlled study of teduglutide (TED)
Metabolism, Department of Internal Medicine, 2Division of 0.05 mg/kg/day in pts with SBS−IF. Three baseline PS volume
Hepatology, Department of Internal Medicine, University groups were evaluated: GrpI, ≤9 L/wk; GrpII, >9 to ≤18 L/wk;
Hospital, Faculty of Medicine of Ribeirão Preto, University of and GrpIII, >18 L/wk.
São Paulo, Brazil, Ribeirao Preto, Brazil Results: The predominant diagnosis leading to SBS−IF in GrpI
(12/28; 43%) and GrpII (15/41; 37%) was vascular gut
Rationale: Hepatocelular carcinoma (HCC) is a tumor predom- complications; in GrpIII (8/16; 50%), Crohn’s disease. Baseline
inant in males, of rapid evolution. Patients diagnosed with HCC PS volume and TED-induced volume reduction (% change) at
usually present ascites and loss of muscle mass. Furthermore,is Wk24 was highest in GrpIII (Table). Evaluation of individual pt
necessary to follow these variations to decide more specific response showed a close, linear, significant correlation
nutritional strategies. The objective of this study is to between absolute PS volume reduction at Wk24 in relation to
characterize the nutritional status of patients diagnosed with TED treatment and daily volume at baseline (y = −0.387x +
HCC in palliative care at Hospital das Clínicas, Medical School of 90.03, R2 = 0.61; P < 0.0001); no significant correlation was
Ribeirão Preto-USP (HCFMRP-USP). observed in the PBO group (y = −0.06x−220.15, R2 = 0.02;
Methods: A review of the medical records for the of nutritional P = 0.36). Adverse events were reported by 93% (GrpI), 80%
assessment to obtain data in the first consultation such as (GrpII), and 71% (GrpIII) of TED pts.
dynamometry and adductor pollicis muscle thicknes (APMT).
All variables were compared using non-parametric tests
Baseline PS Volume
(Wilcoxon and Mann Whitney). The associations between
variables were analyzed by Pearson’s nonparametric correl- ≤9 L/wk >9–≤18 L/wk >18 L/wk
ation test, with p > 0.05. Mean (SD) TED, PBO, TED, PBO, TED, PBO,
Results: 22 males were attended from August 2016 to January PS Volume, n = 15 n = 13 n = 20 n = 21 n=7 n=9
2017. The avarage of body mass index (BMI) in the first Actual Based
assessment was 25,5 kg/m², for dynamometry 23,3 kg and Baseline, 806.9 856.1 1791.8 1870.2 3826.1 3527.4
APTM 11,6 mm. A positive correlation between the APTM and mL/day (328.11) (310.24) (338.33) (408.27) (715.49) (749.04)
dynamometry ( p value = 0.0019; R = 0,6) Change at −28.5 −29.2 −33.5 −19.1 −36.7 −14.9
Wk24, % (18.45)* (35.49)† (20.97)‡ (20.40)‡ (13.97) (17.07)§
Conclusion: Although the sample size limits some inferences,
predictors of lean mass (dynamometry and APTM) have already *n = 13; †n = 12; ‡n = 19, §n = 8.
been depleted since the beginning of treatment, including in
patients with normal BMI, suggesting attention among these
nutritional parameters in the follow-up. Conclusion: Higher baseline PS volume in pts with SBS−IF
correlates with greater absolute reduction in PS volume with
References
TED treatment.
White JV, Guenter P, Jensen G, Malone A, Schofield M. Academy
Malnutrition Work Group; A.S.P.E.N. Malnutrition Task Force; A.S.P.E. Disclosure of Interest: P. Jeppesen Consultant for: Shire, Speaker
N. Board of Directors. Consensus statement: Academy of Nutrition Bureau of: Shire, S. Gabe Consultant for: Shire, D. Seidner Consultant
and Dietetics and American Society for Parenteral and Enteral for: Shire, H.-M. Lee Other: Employee for Shire, C. Olivier Other:
Nutrition: characteristics recommended for the identification and Employee for Shire.
documentation of adult malnutrition (undernutrition). Journal of
Parenteral & Enteral Nutrition; 2012 May;36(3):275–83.
Disclosure of Interest: None declared. Nutrition and cancer 1
SUN-P076
SUN-P075
EFFECTS OF ORAL NUTRITION SUPPORT ON QUALITY OF LIFE
PATIENTS WITH SHORT BOWEL SYNDROME STRATIFIED BY
IN CACHECTIC PANCREATIC CANCER PATIENTS
BASELINE PARENTERAL SUPPORT VOLUME: POST HOC
ANALYSIS OF THE CLINICAL EFFECT OF TEDUGLUTIDE A. Coker1 *, D. B. Hopanci2, N. Oruc3, A. Aydin3, R. Uslu2,
E. Goker2. 1General Surgery HPB Unit, 2Medical Oncology,
P. B. Jeppesen1 *, S. M. Gabe2, D. L. Seidner3, H.-M. Lee4, 3
Gastroenterology, EGE University, Izmir, Turkey
C. Olivier5. 1RIGSHOSPITALET, Copenhagen, Denmark, 2St
Mark’s Hospital, Northwick Park, United Kingdom, 3Vanderbilt Rationale: Pancreatic cancer is one of the most leading factor
University Medical Center, Nashville, 4Shire Human Genetic of cachexia, severe weight loss and muscle wasting. There is
Therapies, Inc., Lexington, United States, 5Shire International limited evidence into the use of Home Enteral Nutrition (HEN)
GmbH, Zug, Switzerland in ERAS era.
Methods: One hundred and fifty two pancreatic cancer(PanCa)
Rationale: Parenteral support (PS) volume needs vary depend-
patients with severe weight loss preoperatively more than 10%
ing on disease severity in patients ( pts) with intestinal failure
and 73 patients with ampullary tumor as a control patients
associated with short bowel syndrome (SBS−IF). Pt classifica-
evaluated retrospectively. Following discharge from a hospital,
tion has focused on the diagnosis that led to resection and the
oral feeding and oral nutrition support (specialized formula for
S82 Poster
cancer patients) has been started. At the end of 2nd month, global survival analysis revealed a low A/L ratio was associated
weight, quality of life (QLQ-C30 data) and ability to start with an increased survival compared to patients with high A/L
adjuvant therapy have been evaluated. ratio (Cox F test = 2.260, P < 0.05).
Results: QLQ-C30 improvement values were higher in cachectic Conclusion: This study suggests that the combined measure-
pancreatic cancer patients compared with the ampullary ment of adiponectin and leptin (A/L ratio) might provide better
tumors. Baseline QoL was measured as median of 61 ± 2.61 in prognostic information in predicting cancer cachexia and
PanCa. Overall Quality of Life was 74 ± 3.05 after ONS ( p < survival than individual parameters.
0.05), in pancreas cancer. Fatigue symptom score was 47 ± 3.81 Disclosure of Interest: None declared.
after operation and 31 ± 4.69 and 24 ± 7.85 after ONS for 2
months and before starting adjuvant therapy respectively
SUN-P078
( p < 0,05).
USING PARENTERAL NUTRITION WITH AN IMMUNE-
Conclusion: ONS after primary treatment of pancreas cancer
ENHANCING FORMULA IN TREATMENT OF METABOLIC
had positive impact on patients’ overall QoL and its compo-
DISORDERS IN SURGICAL PATIENTS
nents or on main symptoms.
N. Arikan1, A. Shestopalov2 *, A. Mitichkin3,
References on behalf of O. Varnavin, V. Stets. 1Anesthesiology and ICU
1. Wesseltoft-Rao N, Hjermstad MJ, Ikdahl T, Dajani O, Ulven SM, Department, Inozemtsev City Clinical Hospital, 2Russian
Iversen PO, Bye A. Comparing two classifications of cancer cachexia Medical Academy of Postgraduate Education, 3Нospital
and their association withsurvival in patients with unresected Administrator, Inozemtsev City Clinical Hospital, Moscow,
pancreatic cancer. Nutr Cancer. 2015;67(3):472–80.
Russian Federation
2. Moningi S, Walker AJ, Hsu CC, Reese JB, Wang JY, Fan KY, Rosati
LM, Laheru DA, Weiss MJ, Wolfgang CL, Pawlik TM, Herman JM.
Rationale: Using nutrition support program with an immune-
Correlation of clinical stage andperformance status with quality of
enhancing formula has impact on postoperative course [1,2].
life in patients seen in a pancreasmultidisciplinary clinic. J Oncol
Pract. 2015 Mar;11(2):e216–21. The aim of the study:to determine efficiency of the post-
operative parenteral nutrition (PN) with use of the 3 in 1 system
(including Ω-3 Fatty Acids + high doses vitamin E + taurine) in
early metabolic disoders correction in the patients with
SUN-P077 esophageal cancer.
ADIPOSE-TISSUE DERIVED FACTORS AS POTENTIAL Methods: Patients (43 men at the age of 67,9 ± 10,5 years) were
BIOMARKERS OF CANCER CACHEXIA divided into two groups depending on the program of
A. Saray1 *, V. Papovic2, S. Glavas2, I. Rasic3. 1Gastroenterology postoperative PN(1st n = 21,2nd n = 22): in the first group
and Hepatology, 2Clinical Center University of Sarajevo, patients received PN without pharmaconutrients, and in the
Sarajevo, Bosnia and Herzegovina, 3Abdominal Surgery, second – PN including an immune-enhancing formula.
Clinical Center University of Sarajevo, Sarajevo, Bosnia and Postoperative enteral nutrition programs were identical.
Herzegovina Indicators of protein, lipid and carbohydrate metabolism
were determined for the 1st,3rd,5th,10th day after operation.
Rationale: Due to the role of adipose tissue in mediating human Parameters were analysed by SSPS.
metabolism, identification of prognostic biomarkers of fat loss Results: Both groups showed positive changes in the same
in cancer cachexia are crucial to achieve better outcomes for direction for the metabolic parameters during the period of full
cancer patients. The aim of the study was to analyze the role of PN and the subsequent period of combined parenteral/enteral
adipose-tissue derived adipokines in predicting cachexia in nutrition. However, in Group 2 these changes occurred more
cancer patients. rapidly: energy intake management 4,9 ± 0,1 day (2nd group) vs
Methods: We evaluated 67 male patients with newly diagnosed 7,0 ± 0,2 day(1st group)( p < 0,05),nitrogen balance 5,2 ± 0,3
GI cancer Serum adiponectin (ADP), leptin (L), ghrelin, tumor day (2nd group) vs 8,1 ± 0,7 day(1st group)(p < 0,05),carbohy-
necrosis factor-alfa (TNF-alfa), and interleukin 6 (IL 6) were drate metabolism-7,4 ± 0,2 day (2nd group) vs 10,2 ± 0,3 day
tested at baseline and after a follow-up period of 6 months. Our (1st group)( p < 0,05). Suppurative complications:3 cases-1st
primary endpoint was 10% weight loss within 6 months. group, 2-cases 2nd group. Mortality: no significant difference.
Receiver operating characteristics (ROC) analysis was employed Conclusion: PN with an immune-enhancing formula can be
to calculate the area under the curve (AUC). Survival analysis used as component of an effective treatment of metabolic
used the Kaplan-Meier curve and the Cox proportional hazards disorders in the early postoperative period.
model.
References
Results: 41 of 67 patients met the primary endpoint. ADP levels
were inversely correlated with leptin levels (rho = −0.431, 1. Klek S, et al. The immunomodulating enteral nutrition in malnour-
ished surgical patients//Clin. Nutr. 2011. Vol. 30. № 3. Р. 282–288.
P < 0.01) in patients showing weight loss (WL). Thus, ADP
2. Sultan J, et al. Randomized clinical trial of omega-3 fatty acid-
concentration were corrected by leptin values (A/L ratio).
supplemented enteral nutrition//Br. J. Surg. 2012. Vol. 99. № 3. Р.
Ghrelin, TNF-alfa and IL-6 levels showed an overall increase in 346–355.
the WL group, but the difference was statistically not
significant. High A/L ratio was the only independent predictor
of cachexia (beta = 0.655, P < 0.001). At ROC analysis the
diagnostic profile of A/L (AUC 0.962;sensitivity 83%;specificity
98%) in detecting cachexia was superior to that of leptin alone
(AUC 0.798;sensitivity 72%;specificity 81%). Kaplan-Meier
SUN-P079 defined as normal vs. reduced (a bit less, half or less than a
NUTRITIONAL STATUS AND CHEMOTHERAPY-INDUCED quarter) in the past week. Using a multiple mediator model we
NEUTROPENIA assessed whether associations were mediated by having pain,
A. T. D. C. F. Barata1, C. Santos1 *, G. Nunes1, H. Mansinho1, feeling weak, feeling tired and/or depressed.
J. Fonseca1. 1Hospital Garcia de Orta, Almada, Portugal Results: A total of 1,131 hospitalised CRC patients were
included in the analyses (65 years, 56% men, 41% stage IV).
Rationale: Neutropenia is the most frequent complication Reduced dietary intake was associated with hospital stay of 4–7
associated with myelosuppression induced by chemotherapy (OR:1.91,95% CI:1.34–2.73), 8–21 (OR:1.97,95% CI:1.42–2.73)
drugs. The frequency and severity of neutropenia may reduce or >21 days (OR:1.92,95% CI:1.28–2.88) vs. <4 days, being
the therapeutic options for cancer patients. Recent studies female (OR:1.38,95% CI:1.06–1.78), cancer stage III
identify malnutrition as a predictive factor, both for the (OR:1.52,95% CI:1.00–2.30) or IV (OR:1.70,95% CI:1.20–2.40)
development of neutropenia and for its severity. The aim of this vs. I, ECOG performance status 2 (OR:1.56,95% CI:1.04–2.32), 3
study was to evaluate the nutritional status prior to chemo- (OR:2.37,95% CI:1.50–3.72) or 4 (OR:4.15,95% CI:2.51–6.86) vs.
therapy and its association with chemotherapy-induced 0 and unintentional weight loss (OR:2.56,95% CI:1.94–3.37).
neutropenia. These predictive relationships were significantly mediated by
Methods: Nutritional status was assessed by using Body Mass feeling weak and having pain.
Index (BMI), Patient Generated Subjective Global Assessment Conclusion: A reduced dietary intake is associated with
(PG-SGA), Calf Circumference (CC) and Mid-upper arm circum- duration since admission, sex, cancer stage, performance
ference (MUAC). Muscle function was evaluated by Hand Grip status and unintentional weight loss and these associations are
Dynamometry (HGS). Patients were evaluated on the first day partly explained by feeling weak and having pain. These factors
of chemotherapy and the presence of neutropenia was can be used to identify patients at risk of malnutrition. Future
observed up to eight weeks after the first cycle. To establish studies should determine efficient methods for correcting
the association between the nutritional status and the them to prevent malnutrition related intercurrences.
presence of neutropenia we used the chi-square test. Disclosure of Interest: None declared.
Results: Forty five patients were enrolled. According to PG-
SGA, 27 patients (60%) were undernourished prior to chemo- SUN-P081
therapy. Seventeen (45%) Patients developed neutropenia
INDICATORS FOR PROPHYLACTIC PERCUTANEOUS
within 8 weeks after the first cycle, in this patients the PG-
ENDOSCOPIC GASTROSTOMY PLACEMENT IN PATIENTS WITH
SGA score and the mean BMI was lower at the beginning of
HEAD AND NECK CANCER UNDERGOING
treatment. We found a significant association between
CHEMORADIOTHERAPY OR CETUXIMAB-RADIOTHERAPY: A
nutritional status according to low MUAC and the presence of
CONSENSUS PROTOCOL
neutropenia ( p > 0,001).
Conclusion: Patients who developed neutropenia present more A. Kok1 *, M. J. Leermakers-Vermeer1, L. A. Devriese2,
frequent and severe malnutrition before starting chemother- N. Kasperts3, R. de Bree4, C. H. Terhaard3. 1Dietetics, 2Medical
apy. It is mandatory to support these patients since the moment Oncology, 3Radiotherapy, 4Head and Neck Surgical Oncology,
of the malnutrition diagnosis in order to reverse or minimize University Medical Center Utrecht, Utrecht, Netherlands
the negative impact of malnutrition and prevent chemother-
Rationale: There is (inter)nationally no consensus on how to
apy-induced neutropenia.
identify head neck cancer (HNC) patients for prophylactic
Disclosure of Interest: None declared. percutaneous endoscopic gastrostomy (PEG) placement. The
Utrecht Head and Neck Cancer Working Group developed a
SUN-P080 protocol for prophylactic PEG placement in HNC patients
THE DETERMINANTS OF REDUCED DIETARY INTAKE IN scheduled for chemoradiotherapy or cetuximab-radiotherapy
HOSPITALISED COLORECTAL CANCER PATIENTS (CRT).
K. Arthey1, A. van der Werf1 *, J. Langius1, I. Sulz2, Methods: A concept protocol for prophylactic PEG placement
K. Schindler2, A. Laviano3, P. Bauer2, M. De van der Schueren1. was developed based on our published data1 of a retrospective
1
VU University Medical Center, Amsterdam, Netherlands, chart review combined with literature research aiming at
2
Medical University Vienna, Vienna, Austria, 3University of identifying indicators for PEG placement. Expert opinions were
Rome, Rome, Italy used to specify suggested indicators. Consensus was reached
within the Utrecht Head and Neck Cancer Working Group.
Rationale: Patients with colorectal cancer (CRC) often Results: According to our protocol prophylactic PEG for HNC
experience malnutrition and weight loss, which are associated patients scheduled for CRT is indicated when at least one of the
with worse clinical outcomes. We aimed to identify the following criteria applies;
determinants of reduced dietary intake, facilitating early • Advanced tumour (T3/T4) of the oral cavity, oropharynx or
recognition and treatment, in order to optimise nutritional hypopharynx
intake and prevent malnutrition. • Nasopharyngeal tumour
Methods: This study is based on data from nutritionDay, an • Bilateral neck node radiation field (with CRT as primary
international, 1 day cross-sectional survey investigating treatment)
patient, treatment and food intake profiles of hospitalised • Weight loss >5% in 1 month or >10% in 3 months
patients. Data were analysed using multivariate backward • Low Body Mass Index (BMI); aged <65 year: BMI < 18,5 kg/m2
logistic regression to identify predictors of dietary intake, or aged ≥65 year: BMI < 20 kg/m2
S84 Poster
• Pre-existing swallowing disorder with inadequate nutri- insulin resistance; (4) includes a less conservative recommen-
tional intake (determined by a specialized oncology dation on increasing energy intake for prevention of refeeding
dietitian), despite nutritional interventions (counselling, syndrome; and (5) supports a longer period of corticosteroid
oral nutritional support) use to increase appetite (4–8 weeks vs ESPEN 1–3 weeks).
Additionally, the DDOG does not include a specific advice for
Conclusion: The hereby presented prophylactic PEG protocol parenteral nutrition composition during intensive chemother-
helps to improve clinical decision making and nutritional care apy, and includes the advice to avoid fatty fish/fish oil 24 hours
for HNC patients receiving CRT. Further research will focus on before and after specific chemotherapy treatment.
examination of sensitivity and specificity of the proposed PEG Both guidelines recommend nutritional care to be accompan-
placement indicators. ied by exercise training.
References Conclusion: The DDOG and ESPEN recommendations are
1. van der Linden NC, Kok A, Leermakers-Vermeer MJ, et al. Nutr Clin
generally in line with each other, but the DDOG recommenda-
Pract. 2017 Apr;32(2):225–232. tions are more specific and practical. DDOG and ESPEN are
complementary to each other.
Disclosure of Interest: A. Kok: None declared, N. Doornink Other:
editoral member of the Hanboek Nutrition in Cancer, M. Ariëns: None
SUN-P082 declared, S. Beijer Other: editoral member of the Hanboek Nutrition in
COMPARISON OF THE “ESPEN GUIDELINES ON NUTRITION IN Cancer, M. van den Berg: None declared, H. Jager-Wittenaar Other: co-
CANCER PATIENTS 2016” WITH THE RECOMMENDATIONS OF developer of the PG-SGA based Pt-Global app, R. van Lieshout Other:
THE DUTCH DIETITIANS IN ONCOLOGY GROUP editoral member of the Hanboek Nutrition in Cancer, B. Sytema: None
declared, M. van Veen: None declared, J. Breedveld-Peters: None
A. Kok1 *, N. Doornink2, M. P. Ariëns3, S. Beijer4,
declared.
M. G. A. van den Berg5, H. Jager-Wittenaar6,7, R. van Lieshout8,
B. Sytema9, M. R. van Veen4,10, J. J. L. Breedveld-Peters11.
1
Division of Internal Medicine and Dermatology, Department of SUN-P083
Dietetics, University Medical Center Utrecht, Utrecht, IMPACT OF CHEMOTHERAPY ON NUTRITIONAL STATUS AND
2
Department of Dietetics, Academic Medical Center, ORAL HEALTH IN SENIOR PATIENTS WITH BREAST CANCER
3
Department of Dietetics, Netherlands Cancer Institute Antoni N. El Osta1, R. Saad1, N. Naaman1, J. Fakhoury1, A. Aoun2 *,
van Leeuwenhoek, Amsterdam, 4Department of Research, M. Hennequin3, L. El Osta1. 1Saint Joseph University, Beirut,
2
Netherlands Comprehensive Cancer Organisation (IKNL), Notre Dame University - Louaize, Zouk Mosbeh, Lebanon,
3
Utrecht, 5Dept. of Gastro-enterology and Hepatology, University of Auvergne, Clermont-Ferrand, France
Dietetics and Intestinal Failure, Radboud University Nijmegen
Medical Center, Nijmegen, 6Research group Healthy Ageing, Rationale: In the medical management of breast cancer, oral
Allied Health Care and Nursing, Hanze University of Applied lesions may affect nutritional status and quality of life. This
Sciences, 7Dept. of Oral and Maxillofacial Surgery, University study assessed the relationship between oral health and
of Groningen, University Medical Center Groningen, nutritional status in senior breast cancer sufferers.
Groningen, 8Máxima Medical Center, Veldhoven, 9Department Methods: This was an observational cross-sectional study. A
of Dietetics, UMCG Comprehensive Cancer Center, Groningen, consecutive sample of non-institutionalised elderly aged 65
10
Division of Human Nutrition, Wageningen University, years or more was recruited from oncologic and primary care
Wageningen, 11Department of Epidemiology, GROW – School for outpatient units in Beirut. Data were collected from a
Oncology and Developmental Biology, Maastricht University, questionnaire including the mini-nutritional assessment
Maastricht, Netherlands index, the geriatric oral health assessment index (GOHAI) and
questions about perception of xerostomia. Oral examination
Rationale: In 2016, a completely revised second version of the recorded the presence of oral lesions.
“Handbook Nutrition in Cancer” (HNC, in Dutch) by the Dutch Results: A total of 117 women were included. The sample
Dietitians Oncology Group (DDOG) was published. In this comprised 21 breast cancer patients receiving chemotherapy,
project, the DDOG evaluated similarities and potential 35 receiving non-chemotherapy regimen, 31 in complete
discrepancies between DDOG recommendations and the remission without treatment and 30 non-cancer patients. 42%
ESPEN guidelines for the identification, prevention and of participants undergoing chemotherapy were malnourished
treatment of reversible elements of malnutrition during and or at risk of malnutrition. Oral health perceptions was worst in
after cancer treatment. chemotherapy patients, followed by patients receiving non
Methods: The recommendations of the DDOG, as published in chemo-treatment regimen and was better in participants in
the HCN, were systematically compared with the ESPEN complete remission and non-cancer patients ( p-value < 0.001).
guidelines on nutrition in cancer patients. The presence of oral lesions was significantly more frequent in
Results: Overall, the DDOG recommendations are in line with patients taking chemotherapy ( p-value < 0.001). Nutritional
the ESPEN guidelines. However, DDOG recommendations are status was linked to the breast cancer treatment regimen
more detailed, comprehensive, and practical. ( p-value < 0.001), presence of oral lesions ( p-value = 0.040),
The DDOG and the ESPEN guidelines differ in that the DDOG (1) perception of xerostomia ( p-value = 0.010), and GOHAI score
recommends the comprehensive PG-SGA and PG-SGA Short ( p-value < 0.001).
Form for screening and nutritional assessment; (2) recom- Conclusion: The presence of oral lesions and chemotherapy
mends to start artificial nutrition at an earlier stage; (3) does were highly associated with nutritional status in older patients
not recommend increasing the ratio of energy from fat/energy with breast cancer. Dental professionals should interfere
from carbohydrates in weight-losing cancer patients with
preventively and per-therapy to optimize oral health status in National Defense Medical College, Saitama, 4Gastrointestinal
elderly breast cancer patients. Surgery, Graduate School of Medicine, The University of Tokyo,
Disclosure of Interest: None declared. Tokyo, Japan
Rationale: Low carbohydrate-high fat diets (LCHFD) are

SUN-P084 thought to be beneficial in nutritional therapy of cancer
INFLUENCE OF BOTH SKELETAL MUSCLE DEPLETION AND patients due to the preservation of normal fat metabolism even
LOW MUSCLE QUALITY ON PROGNOSIS OF LOCALLY in advanced cancers. However, whether LCHFD would improve
ADVANCED PANCREATIC CANCER TREATED WITH survival or not remains unclear. We examined influences of ad
CHEMORADIOTHERAPY: A RETROSPECTIVE STUDY libitum LCHFD on survival, peritoneal inflammation, and
A. Naganuma1 *, T. Hoshino1, H. Yasuoka1, T. Hatanaka1, systemic immunity in murine carcinomatous peritonitis (CP)
D. Uehara1, T. Kudo1, Y. Ogawa2, M. Inagawa2, T. Tanaka2, model.
T. Ogawa2, Y. Kitamoto3, M. Mizuide4, K. Sato4, S. Kakizaki4. Methods: Exp1: Male C57BL/6J mice (8 weeks old, n = 38) were
1
Department of Gastroenterology, 2Nutrition Support Team, fed normal diets (ND)(Protein 15.0%, Fat 9.0%, Carbohydrate
3
Department of Radiation Therapy, Takasaki General Medical 76.0%/kcal) or LCHFD (18.2%, 62.2%, 19.6%) for 52 days. On day
Center, National Hospital Organization, Takasaki, Gunma, 8, Panc02 cancer cells (1 × 106/body) were inoculated i.p.
4
Department of Medicine and Molecular Science, Gunma Survival after inoculation, body weight (BW) changes were
University, Maebashi, Gunma, Japan recorded during this period. Exp2: Mice (n = 14) subject to the
same protocol as and in Exp.1 were killed on day 35. All
Rationale: Skeletal muscle depletion and low muscle quality peritoneal cancer nodules were harvested and weighed.
are poor prognostic factors for pancreatic cancer. However, the Cytokine levels (TNF-α, MCP-1, IL-6 and IL10) of peritoneal
association between skeletal muscle quality and chemora- washings were measured using the beads array method. Spleen
diotherapy (CRT) in locally advanced pancreatic cancer (LAPC) was harvested of counting total NK(NK1.1+) and activated NK
has not yet been reported. In this study, we measured the (NK1.1+&CD107a+) cell numbers.
skeletal muscle mass and muscle quality of patients with LAPC Results: LCHFD mice gained more weight than ND from day 9 to
treated with CRT, and retrospectively examined the association 20 (t-test). All mice showed feature of cachexia.
between the treatment and prognosis.
Methods: Twelve LAPC patients were treated with CRT from
LCHFD ND
August 2010 to December 2015. Radiotherapy was delivered
through 4 fields at a dose of 50.4 Gy in 28 fractions. S-1 was Survival times (day)1 34.5 ± 1.0* 38.9 ± 1.0
Peritoneal cancer nodule weight (g)2 2.4 ± 0.3* 1.6 ± 0.2
administered twice, orally, at a dose of 80 mg/m2, on the day of NK cell number (×102)2 132.9 ± 14.3* 178.9 ± 14.3
irradiation. Medical records were retrospectively reviewed for CD107a+NK cell number (×102)2 3.2 ± 1.3‡ 4.9 ± 1.3
laboratory results and computed tomography (CT) images. The TNFα(pg/mL)3 10.6 ± 2.1* 5.0 ± 2.0
MCP-1(pg/mL)3 379.3 ± 64.9 309.9 ± 60.1
L3 skeletal muscle index (L3-SMI) and intramuscular adipose
IL-6(pg/mL)3 1299.1 ± 265.2† 523.5 ± 245.6
tissue content (IMAC), which indicate muscle quality, were IL-10 (pg/mL)3 8.5 ± 1.4* 4.1 ± 1.3
calculated from CT images. Data were analysed using a paired t-
test, the Kaplan-Meier method, and the Cox proportional Mean ± SE *p < 0.05, †p = 0.06, ‡p = 0.09 vs. ND (1log-rank test 2t-test, 3Mann-
Whitney U–test)
hazards regression model.
Results: Eight patients (66.7%) were men; the median age was
Conclusion: Ad libitum LCHFD feeding worsens survival of CP
72 years. The tumour locations were the pancreatic head (6
mice together with increased peritoneal tumor mass and
cases), and body (6 cases). The mean L3-SMI level was
cytokine levels. Impaired splenic immunity may play a role in
38.3 cm2/m2 (2 months after CRT, 36.9 cm2/m2, p = 0.068).
accelerating accelerate tumor progression by LCHFD feeding.
The mean IMAC level was −0.347 (2 months after CRT, −0.416,
p = 0.104). The median survival time and 2-year survival rate Disclosure of Interest: None declared.
were 7 months and 12.5%, respectively. In the univariate Cox
regression analysis, only the C-reactive protein level at 2 SUN-P086
months post-CRT (hazard ratio, 1.77; 95% confidence interval, MALNUTRITION PREDICTS LONG-TERM MORTALITY IN
1.05–2.98; p = 0.03) was associated with mortality, while L3-SMI HOSPITALIZED GASTROENTEROLOGICAL CANCER PATIENTS
and IMAC were not. B. Knappe-Drzikova1 *, S. Maasberg1, D. Vonderbeck1,
Conclusion: Low muscle quality did not contribute to poorer A. Sturm1, A. Pascher2, S. Knüppel3, U.-F. Pape1.
survival in LAPC patients. 1
Gastroenterology and Hepatology, 2General, Visceral and
Disclosure of Interest: None declared. Transplantation Surgery, CHARITÉ, University Medicine Berlin,
Berlin, 3Department of Epidemiology, German Institute of
SUN-P085 Human Nutrition, Potsdam-Rehbrücke, Germany
EFFECTS OF AD LIBITUM FEEDING OF A LOW CARBOHYDRATE-
HIGH FAT DIET ON SURVIVAL AND INTRAPERITONEAL TUMOR Rationale: Malnutrition (MT) is a common problem in onco-
IMMUNITY OF MICE WITH CARCINOMATOUS PERITONITIS logical diseases, influencing treatment outcomes, and overall
survival. The present study aimed to assess the predictive
A. Watkins1 *, K. Fukatsu2, S. Murakoshi2, T. Watanabe3, potential of nutritional status (NT) parameters as character-
K. Higashizono4, M. Noguchi2, H. Yasuhara2. 1Surgical Sciences, ized by Subjective Global Assessment (SGA), Nutritional Risk
Graduate School of Medicine, University of Tokyo, 2Surgical Screening (NRS), anthropometry, serum surrogate parameters
Center, The University of Tokyo Hospital, Tokyo, 3Surgery,
S86 Poster
(SP), and BIA, resp. for overall long-term mortality in Results: Of 292 patients with available CT assessment of L3
gastroenterological (GI) cancer patients ( pts). vertebral level, 170 (58.2%) were male. Mean age at surgery
Methods: NT was assessed in 332 pts with GI-malignancies in a was 61.6 years. Follow up was available on all participants with
cross-sectional study by SGA and NRS scores. Body mass index a mean of 26 months. 116 (39.7%) were defined as osteopenia
(BMI), serum albumin (sALB), and serum transferrin (sTRANS) and 95 (32.5%) as sarcopenia. Sarcopenia and osteopenia had
were determined and BIA was performed. Mid-upper arm no influence on overall survival. Osteopenia was associated
circumference (MUAC) and triceps skinfold thickness (TST) with higher risk of postoperative recurrence. With risk
were measured. Pts were followed for a mean period of 38 adjustment, osteopenia demonstrated to be the independent
months (range:1–108 months). risk factors of postoperative recurrence (Adjusted OR = 2.44,
Results: 231 pts were diagnosed as well-nourished by SGA and p = 0.011).
238 pts by NRS, resp. By screening score results an increased Conclusion: Osteopenia assessed by CT scan appeared to be a
risk of or manifest MT (NRS >3, SGA B or C) was found in 101 pts strong prognostic factor of postoperative recurrence in this
(SGA) and 94 pts (NRS). Pts with MT had highly significant lower cohort. Total psoas area and psoas density as a proxy measure of
BMI, sALB level, sTRANS level, TST, MUAC, and PhA as compared sarcopenia did not generate prognostic impact on survival or
with the well-nourish group ( p < 0.001 for all groups; TST recurrence. Future study is strongly warranted for evaluating
p = 0.001). As relevant clinical endpoint overall survival was whether opportunistic screening of osteopenia in a selected
analyzed. Overall 1- and 5-year survival rates (YSR) were population have prognostic utility.
significantly shorter in malnourished pts: SGA: 5-YSR 51.7% vs. Disclosure of Interest: None declared.
11%; NRS: 5-YSR 51.8% vs. 7.0%, resp. An increased relative risk
of death was associated with PhA <4.8° (5-YSR 49.3% vs. 5%),
SUN-P088
sALB <35 mg/dL (5-YRS 53.8% vs. 1%), and sTRANS <150 mg/dL
COMBINATION OF ARGININE, GLUTAMINE AND OMEGA-3
(5-YRS 55.6% vs. 11.1%). By multivariate analysis SGA (HR
FATTY ACIDS SUPPLEMENT TO PERIOPERATIVE ENTERAL
2.924, p < 0.001), NRS (HR 3.14, p < 0.001), PhA cut off 4.8° (HR
NUTRITION IN SURGICAL PATIENTS WITH GASTRIC
2.032, p < 0.004) were found to be independent risk factors of
ADENOCARCINOMA OR GASTROINTESTINAL STROMAL TUMOR
long-term mortality.
(GIST): A PROSPECTIVELY, RANDOMIZED AND DOUBLE-
Conclusion: In the present study we demonstrated that MT
BLINDED STUDY
characterized by SGA, NRS, SP and BIA not only predicts short-
term but also long-term survival in GI-pts. C.-J. Ma1 *, J.-Y. Wang2. 1General Surgery, 2Colorectal Surgery,
Kaoshing Medical University Hospital, Kaohsiung, Taiwan,
Province of China
SUN-P087 Rationale: Enteral nutrition (EN) is preferable with immune-

THE PROGNOSTIC IMPACT OF RADIOLOGIC ASSESSMENT OF modulating substrates perioperatively for patients undergoing
SACROPENIA AND OSTEOPENIA IN STAGE III COLON CANCER major abdominal cancer surgery. Perioperative immune-modu-
C. W. Chen1,2 *, J. Y. Wang3,4, Y. T. Lou5, Y. S. Yeh2, H. L. Tsai3,4, lating nutrients enriched EN containing arginine, glutamine
C. W. Huang3,4. 1Department of Emergency Medicine, College and omega-3 fatty acids was evaluated for anti-inflammatory
of Medicine, Kaohsiung Medical University, 2Trauma and efficacy in patients with gastric adenocarcinoma and gastro-
Surgical Critical Care Service, Kaohsiung Medical University intestinal stromal tumor (GIST) receiving curative surgery.
Hospital, 3Department of Surgery, College of Medicine, Methods: In a prospectively, randomized, double-blinded
Kaohsiung Medical University, 4Division of Colorectal Surgery, study, 34 patients with gastric adenocarcinoma and gastric
Department of Surgery, Kaohsiung Medical University Hospital, GIST undergoing elective curative surgery were recruited and
5
School of Medicine, I-Shou University, Kaohsiung, Taiwan, randomly assigned to either the study group, receiving
Province of China immune-modulating nutrients enriched EN, or the control
group, receiving standard EN from 3 days before surgery (day -3)
Rationale: Sarcopenia and osteopenia have been proposed as up to post-operative day 14 or to discharge. Laboratory and
prognostic factors in some surgical cohorts. Regarding the inflammatory parameters were assessed on day -3 and post-
colon cancer patients, we hypothesized that sarcopenia and operative visits on day 14 or at discharge. Adverse events (AEs)
osteopenia measured by abdominal computerized tomography and clinical outcomes were documented daily and compared
(CT) could generate influence on oncological prognostication. between the groups.
Methods: Between 2008 and 2012, all UICC stage III colon Results: Chosen laboratory and inflammatory parameters
cancer patients following surgery and adjuvant chemotherapy before, after treatment, and net change had no significant
were enrolled for this study. Preoperative abdominal CT scans differences between the 2 groups. AEs and clinical outcomes,
from the patients were analyzed to identify patients with including infectious complications, overall complications, time
sarcopenia and/or osteopenia. Sarcopenia and osteopenia were to first bowel action and length of hospital stays after surgery,
assessed via total cross-sectional muscle area and coronal- were comparable in the treatment groups (all P > 0.05).
sectional bone density at the L3 vertebral level. Clinical Conclusion: Imumme-modulating nutrients enriched EN had no
information and postoperative outcomes including overall prominent immune-modulation effect compared to standard
survival, postoperative recurrence and disease-free survival EN. Curative surgery for gastric adenocarcinoma and GIST may
were recorded by trained abstractors. Univariate, multivariate induce hypercatabolism and need more caloric supplement.
and survival analyses were conducted for recognizing prognos- Disclosure of Interest: None declared.
tic factors of oncological outcome.
SUN-P089 (3 × 1) were given in 22 patients, the others received Glt

EXPERIENCE OF HOME PARENTERAL NUTRITION IN PATIENTS (30 mg/day) starting one week before radiotherapy and
WITH GASTROINTESTINAL TRACT CANCER continuing for two weeks after the completion of radiotherapy.
C.-W. Huang1 *, L.-C. Sun2, J.-Y. Wang1. 1Surgery, 2Nursing, We assessed the baseline and weekly BMI of each patient via
Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, TANITA® body composition analyzer and blood count/chemistry
Province of China were requested weekly. Factors in each group were compared
with independent samples-t test.
Rationale: Malnutrition is common in patients with gastro- Results: All patients completed the treatment without
intestinal (GI) tract cancers (up to 80%), especially in advanced interruption. There was no grade ≥3 ARIE in Glt group, while
stage. We analyze the incidence and characteristics of grade 3 ARIE was observed in one patient in HypNS group.
complications associated with home enteral nutrition (HPN) Diagnosis of grade 2 ARIE was delayed by one week with the use
in patients with GI tract cancers. of Glt compared to other group. Comparisons between two
Methods: From January 2012 to December 2015, 159 patients groups revealed no significant difference in weight, BMI, fat
with GI tract cancers on HPN at least 7 days were analyzed. The and muscle mass change. Median albumin, transferrin, uric
demographic characteristics and complications were retro- acid, leukocyte levels were decreased in both groups as
spectively investigated. C-reactive protein level was increased in HypNS group.
Results: Of 149 patients, the median age was 62 (range, 24–92) Conclusion: Supplementation with Glt or HypNS during
years of age. There were 93 males (62.4%) and 56 females radiotherapy prevents treatment interruptions. Although diag-
(37.6%). The most common two cancers were colorectal cancer nosis of grade 2 ARIE was delayed in Glt group, we couldn’t
and gastric cancer, 57.0% (85/149) and 35.6% (53/149), show significant difference between two groups, with respect
respectively. The majority of patients had stage IV disease to the incidence of ARIE and prevention of weight loss, change
(58.4%, 87/149). The median duration of HPN was 45 (7–368) in BMI and blood count/chemistry.
days. The caregivers were educated adequately for aseptic Disclosure of Interest: None declared.
care of catheters. The median estimated necessary calories
were 1,510 (1,081–2,642) kilocalorie per day and the median SUN-P091
provided calories were 1,404 (732–2,320) kilocalorie per day. A NOVEL ORAL NUTRITIONAL SUPPORT IN HCC AND LIVER
The median body mass index (BMI) was 19.82 (12.80–38.87).
DISEASE MANAGEMENT: PRELIMINARY RESULTS
Ports with central venous catheters were used in 93.3% of
patients and peripherally inserted central venous catheters E. Rinninella1 *, M. Cintoni1, L. Basso1, S. Leone1,
were used in 6.7% of patients. Catheter-related complications G. A. D. Miggiano1, A. Gasbarrini1, M. C. Mele1. 1Clinical
included line infection (8.7%, 13/149), line obstruction (4%, 6/ Nutrition, Gastroenterology Area, Fondazione Policlinico
149) and line fracture (0.7%, 1/149). Catheter-associated Agostino Gemelli, Rome, Italy
bacteremia was noted in 8 patients (5.4%, 8/149). HPN-
Rationale: HCC and liver diseases are associated to malnutri-
related complications included hyperbilirubinemia (6.0%, 9/
tion. BIA Phase angle (PhA) is an independent prognostic factor
149), hyperglycemia (1.3%, 2/149), electrolyte unbalance
in patients with HCC (1,2).
(4.7%, 7/149) and dehydration (1.3%, 2/149).
Methods: From November 2016 to February 2017 HCC cirrhotic
Conclusion: HPN is feasible and safe with low incidence of
patients of our outpatient clinic, were enrolled. Patients with a
complications in patients with GI tract cancers. An adequate
PhA < 4.8 (2) received an oral nutritional support (Fresubin®
educational program for caregivers is very important in
Hepa Drink 200 mL), at the dose of 2 bottle/day per os.
decreasing rate of catheter-related complications.
Anthropometric measures, BMI, lab tests and BIA were
Disclosure of Interest: None declared. performed at baseline and at 1-month control visit. Etiology,
Child Pugh, BCLC classification were also collected. Data are
SUN-P090 summarized in median, 25th and 75th percentile or numbers.
COMPARISON OF THE IMPACT OF ORAL GLUTAMINE AND Wilcoxon signed rank test was used to compare numerical
HYPERCALORIC ORAL NUTRITIONAL SUPPLEMENTATION IN variables at baseline and 1-month later. A p < 0.05 was
LUNG CANCER PATIENTS TREATED WITH RADIOTHERAPY +/− considered statistically significant.
CHEMOTHERAPY Results: 10/32 patients seen received Fresubin Hepa drink: 7
S. A. Ergen1, D. Çolpan Öksüz1 *, M. Şahin1, N. Kaydıhan1, were in Child A, 2 in B, 1 in C; according to BCLC, 2 were in A
E. Sedef1, F. Ö. Dinçbaş1. 1Radiation Oncology, I.U. Cerrahpasa stage; 6 in B, 1 and 1 in C and D. Five patients had a HCV-related
Medical Faculty, Istanbul, Turkey cirrhosis, 2 had an alcoholic cirrhosis, 2 metabolic and 1 HBV
related cirrhosis. At 1-month visit, reactance and PhA were
Rationale: Acute radiation induced esophagitis (ARIE) may significantly higher, respectively from 33.5 Ohm (27.7–37.2) to
cause morbidity, weight loss and unplanned treatment delays. 43 (38–44) ( p = 0.03) and from 3.6 (3.2–4) to 4.6 (4.1–4.7)
We investigated and compared the effects of oral glutamine ( p = 0.02). No difference were seen in other anthropometric
(Glt) and hypercaloric oral nutritional supplement (HypNS) on and lab tests. No serious adverse events were registered. Only 1
ARIE and body mass index (BMI) in patients who were treated patient referred nausea and 2 referred satiety after the drink.
with radical radiotherapy ± chemotherapy. All patient referred to like the taste.
Methods: Forty-four patients were included and the median Conclusion: Fresubin® Hepa drink is safe and effective in
age was 59 years (31–80). Thirty-two patients received malnourished cirrhotic patient affected by HCC in improving
concurrent chemoradiotherapy. All patients were treated PhA and is a valid oral support in ambulatory patients affected
with IMRT with a median dose of 61.2 Gy (50.4–66). HypNS
S88 Poster
by liver diseases. Further studies are required to confirm these and nutrition therapy is an important cornerstone in the
preliminary data. treatment of cancer patients. Nevertheless, it has been
References reported that malnutrition is often neglected, screening
techniques are not sufficient, and there is insufficient
1. Purnak T, Yilmaz Y, Liver disease and malnutrition. Best Pract Res
consensus on malnutrition evaluation criteria. This study
Clin Gastroenterol. 2013 Aug; 27:619–29.
2. Schütte K, et al. P.Malnutrition is a prognostic factor in patients with aimed to determine the awareness and knowledge of medical
hepatocellular carcinoma (HCC). Clin Nutr. 2015 Dec;34:1122–7. oncologists in Turkey about nutrition therapy, to evaluate their
approaches to defining malnutrition and the importance of
Disclosure of Interest: E. Rinninella Grant/Research Support from:
malnutrition in the treatment, to determine their educational
Fresenius, M. Cintoni: None declared, L. Basso: None declared, S. Leone:
None declared, G. A. D. Miggiano: None declared, A. Gasbarrini: None status regarding clinical nutrition, and to investigate their
declared, M. C. Mele Grant/Research Support from: Fresenius. educational expectations.
Methods: A questionnaire form was used to obtain demo-
graphic and occupational information of the physicians as well
SUN-P092
as their knowledge, attitudes, and behaviors about clinical
ARE SERUM VITAMIN D LEVELS RELATED WITH COLORECTAL
nutrition education through two scenario cases.
CANCER RISK?
Results: Among the physicians who answered the questionnaire
E. Yassıbaş1 *, G. Samur2, O. Toka3. 1Department of Nutrition (n = 109), 43.1% reported that they had clinical nutrition
and Dietetics, Gazi University, 2Department of Nutrition and education and 33.9% followed the oncology sections in the
Dietetics, 3Department of Statistics, Hacettepe University, ESPEN guidelines. A scoring system was established according
Ankara, Turkey to the answers given to the knowledge questions by the
physicians. There were 31 (28.4%) physicians with a knowledge
Rationale: Colorectal cancer is the third most common cancer
score of <3 and 78 (71.6%) physicians with a knowledge score
in Turkey. Understanding the role of nutrition which is a
of ≥3 (higher level of knowledge). The rate of physicians having
modifiable risk factor in colorectal carcinogenesis is one of the
clinical nutrition education and the rate of physicians following
primary prevention strategies and the most of studies has
the oncology sections in the ESPEN guidelines were significantly
addressed the relationship between vitamin D and colorectal
higher among those with a score of ≥3 as compared with those
cancer risk. This research was planned and conducted to
with a score of <3.
evaluate the relationship between serum vitamin D levels,
Conclusion: Our findings emphasized the importance of
nutrition, some lifestyle factors and colorectal cancer risk.
education and suggested that routine use of clinical nutrition
Methods: Fifty one colorectal cancer patients who were
would be more frequent as the knowledge and awareness of
diagnosed in last three months and 51 age and sex matched
physicians increases.
control who were not diagnosed cancer or colon diseases and
have no family colorectal cancer history participated to this Disclosure of Interest: F. Kirbiyik Other: Employee of Nutricia Medical
study. A questionnaire which include information about general Nutrition, Turkey, E. Ozkan Other: Employee of Nutricia Medical
Nutrition, Turkey, M. Ertugrul Other: Employee of Nutricia Medical
characteristics, dietary habits and food consumption frequency
Nutrition, Turkey.
was applied to all participants. Serum vitamin D levels were
analysed from were obtained blood samples. Logistic regression
analyse was made for the serum vitamin D levels. SUN-P094
Results: As a result, mean serum vitamin D levels was PLASMA PROTEOMIC ANALYSIS OF INTRAVENOUS OMEGA-3
21.41 ± 12.90 ng/mL in colorectal cancer patients and 31.22 ± FATTY ACID AND GEMCITABINE IN ADVANCED PANCREATIC
19.05 ng/mL in controls. 10 ng/mL decrease in serum vitamin D ADENOCARCINOMA
levels increased colorectal cancer risk by 0.45 fold (OR:1.046, F. Runau1 *, A. Arshad1, J. Isherwood1, D. Jones2, A. Dennison1.
1
95%CI:1.013–1.086). It was determined that serum vitamin D Department of Hepatobiliary and Pancreatic Surgery,
deficiency (<20 ng/mL) increase the colorectal cancer risk University Hospitals of Leicester, 2Department of Cancer
approximately 5.5 times (OR:5.452, 95%CI:1.909–15.568). It Studies, University of Leicester, Leicester, United Kingdom
was not found significant association between body mass index,
body fat percentage, dietary vitamin D intake and serum Rationale: Intravenous omega-3 fatty acid (n-3FA) for advanced
vitamin D levels in both groups. pancreatic adenocarcinoma patients receiving gemcitabine
Conclusion: Developing strategies for achieve normal serum chemotherapy shows disease stabilisation and improved pro-
vitamin D levels and raising awareness of healthy nutrition of gression free survival. Utilising high definition plasma proteo-
individuals are important to decrease colorectal cancer mics we aimed to elucidate the underlying biological
prevalence. mechanism.
Methods: Plasma from 13 patients with histologically con-
firmed un-resectable pancreatic adenocarcinoma, collected
pre-treatment (baseline, n = 3), after one month treatment
SUN-P093 with intravenous gemcitabine and n-3FA (treatment, n = 5) and
APPROACHES AND KNOWLEDGE OF MEDICAL ONCOLOGISTS intravenous gemcitabine only (control, n = 5). Plasma was 99%
TO NUTRITION THERAPY: A QUESTIONNAIRE STUDY immuno-depleted, reduced, alkylated and tryptically
F. Kirbiyik1 *, E. Ozkan1, M. Ertugrul1. 1Nutricia Medical digested. A 2 × 2 (baseline vs treatment, treatment vs control
Nutrition, Istanbul, Turkey group) experimental design where each individual sample was
labelled with TMT-6plex, then combined for high-pH reversed-
Rationale: Undernutiriton and cachexia, which are the phase fractionation. Fractions were injected into a QExactive-
indicators of poor prognosis, are common in oncology patients
Orbitrap LC-MS/MS and analysed on Proteome Discoverer 2.1 Conclusion: There is an association between SGA and FFMI. The
and Scaffold 4.7. Bioinformatic analysis was performed on prevalence of malnutrition according to FFMI is associated with
Protein Centre for Gene Ontology Biological Process (GO-BP: prolongation of length of stay and mortality.
p < 0.05, Bonferroni corrected), Cytoscape for visualisation and Disclosure of Interest: F. Sanchez-Torralvo: None declared,
KEGG pathway analysis. V. Contreras-Bolivar Grant/Research Support from: ABBOTT-SANCYD,
Results: 3,476 proteins were identified with 125 significant G. Olveira Grant/Research Support from: ABBOTT-SANCYD, M. Ruiz-
pancreatic cancer markers. Anti-inflammatory markers (CRP, Vico: None declared, J. Abuin-Fernandez: None declared, I. Lopez-
Haptoglobin and Serum amyloid A1) were reduced in the Martinez: None declared, M. Gonzalo: None declared.
treatment group. GO-BP showed a reduction in angiogenesis,
upregulation of complement immune systems and epigenetic SUN-P096
modifications on histones. KEGG pathway analysis identified NUTRITIONAL ASSESSMENT IN HOSPITALISED ONCOLOGIC
direct action via the Pi3K-AKT pathway, with decreased HSP90 PATIENTS
and increased inhibitory protein 14-3-3. Serum amyloid A1 was V. Contreras-Bolivar1, F. Sanchez-Torralvo1,
significantly reduced ( p < 0.01) as a potential biomarker of J. Abuin-Fernandez1, M. Ruiz-Vico2, I. Lopez-Martinez2,
efficacy for n-3FA. V. Doulatram-Gamgaram1, G. Olveira1 *. 1Endocrinologia y
Conclusion: Administration of n-3FA has anti-inflammatory, Nutricion, 2Oncologia Medica, Hospital Regional Universitario
anti-angiogenic and pro-apoptotic effect via direct mechanism De Malaga, Málaga, Spain
on cancer signalling pathways in patients with advanced
pancreatic adenocarcinoma. Rationale: To determine the prevalence of malnutrition in
Disclosure of Interest: None declared. hospitalised oncologic patients in our environment. Assess the
use of quadriceps dynamometer as an alternative to handgrip.
SUN-P095 Relate FFMI, BMI and dynamometry with cut-off points
MALNUTRITION AND FAT FREE MASS INDEX IN ONCOLOGIC established by ESPEN.
PATIENTS AND ITS ASSOCIATION WITH LENGTH OF HOSPITAL Methods: Cross-sectional study, in hospitalised patients in
STAY AND MORTALITY Oncology and Hematology between August and February of
2017. Subjective Global Assessment test (SGA), anthropomet-
F. J. Sanchez-Torralvo1, V. Contreras-Bolivar1, G. Olveira1 *,
ric data and muscular strength with handgrip (Jamar) and
M. Ruiz-Vico2, J. Abuin-Fernandez1, I. Lopez-Martinez2,
quadriceps dynamometer (Commander) were determined. FFM
M. Gonzalo1. 1Endocrinología y Nutrición, 2Oncología Médica,
was calculated with Durnin and Siri formulae.
Hospital Regional Universitario de Malaga, Malaga, Spain
Results: 153 patients, 79.7% admitted in Oncology (122) and
Rationale: Malnutrition and cancer cachexia occur up to in 50% 20.3% in Hematology (31). 51.6% men and 48.4% women, aged
of oncologic patients. Latest ESPEN guidelines have established 60.6 ± 12.5 years. BMI was 24.52 ± 4.5 kg/m2, with LBMI of
cut-off points according to fat free mass index (FFMI) as a 16.23 ± 2.38 g/m2 (16.8 ± 2.13 kg/m2 for men and 15.63 ± 2.49
criteria of malnutrition: 17 kg/m2 for men and 15 kg/m2 for kg/m2 for women).
women. We found positive correlation between quadriceps dynamo-
Methods: Objective: To study the association between FFMI metry of both legs (r = 0.928; p < 0.001), as well as between
and Subjective Global Assessment test (SGA) in admitted handgrip and quadriceps dynamometry (r = 0.546 and 0.549;
patients with solid and hematologic neoplasms and to associate left and right respectively; p < 0.001). Positive correlation was
nutritional status with length of hospital stay and mortality. found between handgrip dynamometry and LBMI (r = 0.279,
Prospective study, in hospitalised patients in Oncology and p = 0.005).
Hematology between August 2016 and February 2017. A Malnourished patients according to BMI obtained lesser
complete nutritional assessment was carried out and anthropo- dynamometry values than normo-nourished in handgrip
metric data was gathered. (22.9 ± 9.2 kg vs 18.8 ± 7.7 kg; p = 0.02) and in quadriceps
Results: 153 patients, 51.6% men and 48.4% women, aged (13.2 ± 5.1 kg vs 10.5 ± 5.4 kg; p = 0.009). No statistical differ-
60.6 ± 12.5 years. BMI was 24.42 ± 4.5 kg/m2, with FFMI of ences were found out stratifying nutritional status according
16.23 ± 2.38 kg/m2 (16.8 ± 2.13 kg/m2 for men y 15.63 ± 2.49 to LBMI.
kg/m2 for women). Conclusion: Malnutrition prevalence amongst our series
SGA found 19.5% of normo-nourished, 24.8% of moderately was high.
malnourished and 55.7% of severely malnourished. There is correlation between handgrip and quadriceps strength
Stratifying according to SGA, mean FFMI in men was 18.69 kg/ measured by dynamometry. Quadriceps dynamometry can be
m2 in normo-nourished, 16.63 kg/m2 in moderately malnour- considered as an alternative to handgrip.
ished and 16.21 kg/m2 in severely malnourished ( p = 0.001); Patients with malnutrition criteria according to BMI presented
whilst in women was 17.83 kg/m2 in normo-nourished, less muscular strength.
15.92 kg/m2 in moderately malnourished and 14.75 kg/m2 in Disclosure of Interest: V. Contreras-Bolivar Grant/Research Support
severely malnourished ( p = 0.001). from: Abbot-SANCYD, F. Sanchez-Torralvo: None declared, J. Abuin-
Length of stay in patients with malnutrition criteria according Fernandez: None declared, M. Ruiz-Vico: None declared, I. Lopez-
to FFMI was 11.8 ± 6.3 days vs 8.3 ± 3 days in normo-nourished Martinez: None declared, V. Doulatram-Gamgaram: None declared,
G. Olveira Grant/Research Support from: Abbot-SANCYD.
patients ( p = 0.008).
A total of 28 deaths were registered: 22 in malnourished and 6
in normo-nourished ( p < 0.001).
S90 Poster
SUN-P097 Methods: This was a cross-sectional case-control study on a

HIGH-RADIODENSITY SKELETAL MUSCLE INDEX IS THE BEST group of patients with non-small cell lung cancer aged 75 y or
PREDICTOR OF MAJOR SURGICAL COMPLICATIONS IN over, and a group of patients younger than 75 y. REE was
GYNECOLOGIC CANCER measured by indirect calorimetry. Body composition was
N. S. de Paula1, K. A. Bruno1, M. A. Aredes1, G. V. Chaves1 *. determined by extrapolation from a single-slice CT-scan
1
Nutrition and Dietetics, Brazilian National Cancer Institute, imaging at L3 level. Endocrine, inflammatory, nutritional and
Rio de Janeiro, Brazil metabolic blood testing was done. Statistics: parametric
(Student, Pearson) or not (Mann-Whitney, Spearman) depend-
Rationale: This study aimed to evaluate the influence of ing on data distribution.
sarcopenia and other indicators of skeletal muscle mass quality Results: We included 20 patients below 75 y and 7 patients 75 y
on surgical complications in women with ovarian and endo- or over. Though not significant, REE was higher in the younger
metrial cancer who underwent oncologic surgery. patients (1,564 kcal/d vs. 1,367 kcal/d, p > 0.1) but this trend
Methods: Endometrial and ovarian cancer patients admitted disappeared after correction for fat-free mass (FFM) (39 kcal/
between 2008 and 2015 and who had computerized tomog- kg/d in both groups). Linear correlations indicated that below
raphy (CT) images available within 45 days before treatment 75 y, the main determinant of REE was FFM (r = 0.649, p < 0.01)
were enrolled in a retrospective cohort (n = 250). Skeletal whereas after 75 y slight changes in endocrine (TSH, r = 0.929,
muscle index (SMI) was calculated in the range −29 + 150 HU; p < 0.01), metabolic (tryptophane plasma levels, r = −0.736,
reduced muscle attenuation (range −29 + 29HU) was classified p = 0.09) or inflammatory (IL-6, r = 0.900, p < 0.05) parameters
as low-radiodensity skeletal muscle index (LRSMI), represent- could influence REE/FFM.
ing SM area with increased intramyocellular triglycerides. By Conclusion: Our pilot study suggests that the variations in REE
subtracting the LRSMI area from total SMI, we created the high- with aging in our cancer patients are mainly related to that in
radiodensity skeletal muscle index (HRSMI), representing the body composition. However, it also seems that after 75 y REE
area with low fat infiltration. Sarcopenia was defined when SMI becomes more sensitive to variations in endocrine, inflamma-
was ≤ 38.9 cm2/m2. Multiple logistic regression evaluated tory and metabolic parameters.
predictors of surgical complications. The variables were References
considered statistically significant when p < 0.05.
1. Resting energy expenditure in the risk assessment of anticancer
Results: Patients in lower HRSMI quartiles as well as those in the
treatments. Clin Nutr (2017).
highest quartiles of LRSMI had more severe surgical complica-
tions and remained more time hospitalized. Both sarcopenia as Disclosure of Interest: None declared.
the quality indicators of skeletal muscle were predictors of
increased risk of severe postoperative surgical complication, SUN-P099
being the HRSMI the strongest predictor. In a combined THE ROLE OF HOME PARENTERAL NUTRITION IN ADVANCED
adjustment for HRSMI and sarcopenia, only HRSMI remained AND MALNOURISHED GASTROINTESTINAL CANCER PATIENTS
in the model as an independent predictor for surgical UNDERGOING NEOADJUVANT CHEMOTHERAPY
complication. Moreover, HRSMI was the only one associated H.-L. Tsai1 *, J.-Y. Wang1. 1Surgery, Kaohsiung Medical
with early mortality (≤30 days). University Hospital, Kaohsiung, Taiwan, Province of China
Conclusion: The indicators of skeletal muscle quality were the
most significant predictors of surgical complications. Rationale: The tolerance of chemotherapy for advanced and
Classifying muscle quality in terms of low- or high-radiodensity malnourished GI cancer patients was worse. This study aims to
area is a promissing strategy to understand the impact of clarify the role of HPN in patients with incurable and
muscle mass quality on unfavourable outcomes in oncology. malnourished GI cancer patients undergoing neoadjuvant
Disclosure of Interest: None declared. chemotherapy.
Methods: There were thirty advanced colorectal cancer (CRC)
patients and seventeen advanced gastric cancer (GC) patients
SUN-P098
undergoing neoadjuvant chemotherapy to be enrolled. Among
HYPERMETABOLISM IN THE ELDERLY CANCER PATIENT: A
them, 27 patients were malnourished and administrated with
PILOT STUDY
HPN. We compared the nutritional status before the adminis-
G. Ulmann1,2 *, A. Jouinot3, C. Tlemsani3, N. Neveux1,2, tration of HPN and after HPN of the malnourished patients. The
J.-P. Durand3, F. Goldwasser3, J.-P. De Bandt1,2, L. Cynober1,2. average cycles of chemotherapy were compared between the
1
Clinical Chemistry, Hôpital Cochin-APHP, 2EA 4466 - Faculty of malnourished group and nourished group. The overall survival
Pharmacy, Paris Descartes University, 3Oncology dpt, Hôpital rates between these two groups were calculated by Kaplan-
Cochin-APHP, Paris, France Meier.
Results: The value of albumin of malnourished group and
Rationale: Cancer and aging are both frequently associated
nourished group before administration of HPN was 2.91 ± 0.45
with malnutrition, a factor of poor prognosis, and this may be
and 3.73 ± 0.69, respectively (P < 0.001). The value of albumin
related in part to alterations of energy metabolism. We
of malnourished group and nourished group after administra-
previously showed that about 50% of the patients of our
tion of HPN was 3.39 ± 0.43 and 3.27 ± 0.65, respectively
oncology department had higher than predicted resting energy
(P = 0.475). The average cycles of neoadjuvant chemotherapy
expenditure (REE)1. Our aim was to study the influence of age
between the malnourished group and nourished group were
on the hypermetabolic response to cancer and the underlying
8.59 ± 3.57 and 8.85 ± 4.09, respectively (P = 0.819). There was
potential determinants.
not significant difference of cumulative overall survival rates
between advanced/malnourished GI cancer patients and
advanced/nourished GI cancer patients (19.16 ± 2.78 vs.19.79 ± SUN-P101

3.12; HR, 1.017; 95% CI, 0.522–1.980; P = 0.959). NUTRITIONAL ASSESSMENT IN PANCREATIC CANCER PATIENTS
Conclusion: HPN for advanced malnourished gastrointestinal TREATED IN AN ONCOLOGICAL MONOGRAPHIC HOSPITAL
cancer patients with neoadjuvant chemotherapy was feasible I. Peiró1 *, R. González-Tampán1, L. Hurtós1, E. Fort1,
and demonstrated that it could markedly improve in the R. López-Urdiales2, G. Creus2, L. Arribas1,3, C. Sánchez4,
nutrition status. The totally average cycles of neoadjuvant B. Laquente4. 1Clinical Nutrition Unit, Catalan Institute of
chemotherapy was similar. The cumulative overall survival Oncology (ICO-L’H)-IDIBELL, 2Endocrinology and Nutrition
rates was also not significantly difference. Department, Hospital Universitari de Bellvitge, Hospitalet de
Disclosure of Interest: None declared. Llobregat, 3University of Barcelona, Barcelona, 4Medical
Oncology Department, Catalan Institute of Oncology (ICO-L’H)-
SUN-P100 IDIBELL, Hospitalet de Llobregat, Spain
TOMATO INTAKE, GLEASON SCORE, AND PROSTATE SPECIFIC
ANTIGEN IN PROSTATE CANCER PATIENTS Rationale: Pancreatic cancer (PC) has a high rate of malnutri-
tion. A multimodal intervention through multidisciplinary
I. Paur1,2 *, M. H. Carlsen2, W. Lilleby3, N. Bolstad3, T. Bjøro3, teams improves oncoespecific outcomes. In our center, PC
S. Smeland3, A. S. Karlsen2, R. Blomhoff4. 1Norwegian National patients ( pts) are visited by the medical oncologist and the
Advisory Unit on Disease-related Malnutrition, Oslo University endocrinologist within the pancreatic unit.
Hospital, 2Dept. of Nutrition, University of Oslo, 3Oslo The purpose of this study is to evaluate the nutritional status of
University Hospital, 4Dept. of Nutrition, Oslo University all PC patients visited at the Clinical Nutrition Unit (CNU).
Hospital and University of Oslo, Oslo, Norway Methods: From January to December 2016 all consecutive PC
patients newly visited at the CNU were included. Demographic,
Rationale: A chemopreventive effect of tomato or lycopene
oncological and nutritional parameters: % weight (wt) loss in
intake on prostate cancer has been suggested, however the
the last 3–6 months (m), serum albumin level, pancreatic
evidence remain inconclusive. Previously, we reported that
insufficiency and nutritional intervention were recorded.
nutritional interventions (3 weeks) with tomato-products
Results: 63 of 102 (61.8%) PC patients evaluated by the medical
affects the prostate cancer biomarker Prostate specific
oncologist were referred to the CNU for a nutritional
antigen (PSA) in patients with non-metastatic prostate
assessment. Mean age: 63.5 y (39–80), 52.4% men. 57.1% had
cancer. In the current project, we therefore investigate the
unresectable or metastatic disease, 15.9% resectable disease.
relations between prior tomato intake, and PSA and Gleason
59 pts received oncological treatment: 19% neoadjuvant
score which are both used in prostate cancer staging.
chemotherapy (CT), 21.5% adjuvant treatment (CTor concomi-
Methods: Prior to curative treatment, 79 prostate cancer
tant CT/radiotherapy), 50.8% palliative CT and 4 pts with
patients completed a food frequency questionnaire reflecting
symptomatic care. Mean body mass index: 23.8 kg/m2.
the diet the previous year. Intake of tomato and tomato
Exocrine pancreatic insufficiency (EPI) was present in 71.4%
products was calculated. Gleason score was routinely deter-
of pts and 46% had hyperglycemia. Patients with EPI were
mined in diagnostic biopsies (range: 2–10). PSA was measured
significatly more malnourished: 86.7% vs 13.3% ( p = 0.045). 81%
with a DELFIA PSA immunoassay kit. For statistical analyses
were moderate or severely malnourished (>5% wt loss in the last
Kruskal Wallis, Mann–WhitneyU tests and Spearman’s correl-
3 m) with ≥ 10% wt loss the last 6 m in 76.2% of them. All
ation were used.
patients with serum albumin <35 mg/dL (15.9%) were mal-
Results: Median tomato intake the year prior to diagnosis was
nourished. All patients received nutritional counselling and 80%
64 g/day (range 11–494 g/day). Gleason score distribution: 49%
needed oral nutritional supplementation.
Gleason score 6% and 46% Gleason score 7. Patients with
Conclusion: A high prevalence of severe malnutrition and
Gleason score 6 had a median intake of tomato and tomato
pancreatic insufficiency was observed in our patients. EPI may
products of 87 g/day (range 11–494 g/day) which was signifi-
contribute to deteriorate nutritional status. To detect and
cantly higher ( p = 0.007) than patients with Gleason score 7
treat early stages of malnutrition and EPI is mandatory, in order
(56 g/day; range 12–139 g/day) in the year prior to diagnosis.
to improve their outcomes.
PSA levels at time of diagnosis did not correlate with prior
tomato intake. Disclosure of Interest: None declared.
Conclusion: In patients with non-metastatic prostate cancer,
those with the most differentiated tumors (Gleason 6) had SUN-P102
significantly higher intake of tomatoes and tomato products COMPLICATIONS OF NUTRITIONAL THERAPY IN HOME
during the year prior to diagnosis. We believe that further ENTERALLY FED PATIENTS WITH CANCER
testing of the “tomato/lycopene hypothesis” in prostate E. Zakrzewska1, K. Majewska2, J. Sobocki3 *. 1Department of
cancer patients should be based on tomato products and not Surgery and Clinical Nutrition, 2Department of General
lycopene. A possible target group is patients in active Surgery and Clinical Nutrition, Medical University of Warsaw,
surveillance programs to explore whether tomato-based 3
Department of General Surgery and Clinical Nutrition,
intervention extends radical treatment-free survival. Medical Universty of Warsaw, Warsaw, Poland
Rationale: Enteral nutrition is widely used in cancer patients in
perioperative and postoperative time, during radiotherapy,
chemotherapy and palliative care. Appropriate qualification
and training of patients are necessary to ensure safe enteral
nutrition at home. Treatment monitoring should prevent
S92 Poster
complications which could be dangerous for those patients. Table 1: Evaluation of nutrition screening tools compared to nutrition assessment
The aim of the study was to analyze the incidence of mechanic, SGNA.
septic and gastrointestinal complications of nutritional therapy SCAN mSTAMP mSCAN mSCAN
in patients with cancer enterally fed at home. (Cutoff ≥3) (≥4) (≥3) (≥2)
Methods: The study included 105 patients with cancer Specificity (%) 66.7 61.1 66.7 61.1
diagnosis aged 35–89 years old fed enterally at home, Sensitivity (%) 92.3 84.6 69.2 92.3
between January 2013 and October 2015. We performed Positive predictive 66.7 61.1 60 63.2
value (%)
retrospective analysis of medical records, patient medical Negative predictive 92.3 84.6 75 91.7
history, blood test results and reports of follow up visits. value (%)
Results: Septic complications were observed in 62,1% of K value (p) 0.56 0.43 0.35 0.50
patients. Mechanical and gastrointestinal complications were (0.001) (0.011) (0.048) (0.03)
Area under curve 0.85 0.80 0.78
observed in 31,8% and 6,1% respectively. There was no
significant correlation between the time of feeding and the
incidence, severity and number of complications. The analysis Conclusion: SCAN had the highest correlation with SGNA;
showed that women had significantly more complications than mSCAN, with cut-off ≥2, was comparable. mSCAN may be
men. The most common complications were septic complica- considered an acceptable tool at our unit.
tions such as inflammation and infection with discharge of pus Disclosure of Interest: None declared.
at the side of enteral access. There were minor hygienic
problems easy to eliminate by improvement in aseptic
preparation and administration of the diet. Gastrointestinal SUN-P104
complications such as diarrhea or constipation occurred rarely, HOME PARENTERAL NUTRITION FOR MALNOURISHED
and were easily managed with change of diet type or UNRESECTABLE/METASTATIC GASTRIC CANCER WITH SALVAGE
administration regimen. CHEMOTHERAPY
Conclusion: Providing proper training and instruction of the J. Y. Wang1,2,3 *, L.-C. Sun1,4, Y.-L. Shih1,4, H.-L. Tsai1,2,3.
1
patients, supervision by hospital and holding regular control Nutrition Support Team, 2Division of Colorectal Surgery,
visits allow fast diagnosis and prevention of HEN complications. Departments of Surgery, 3Department of Surgery, Faculty of
HEN is a safe method with few and mainly mild complications. Medicine, College of Medicine, 4Division of Nursing, Kaohsiung
Disclosure of Interest: E. Zakrzewska: None declared, K. Majewska: Medical University Hospital, Kaohsiung, Medical University,
None declared, J. Sobocki Paid Instructor at: Fresenius, BBraun, Baxter, Kaohsiung, Taiwan, Province of China
Nutricia.
Rationale: Although significant advances have been made in
the surgical techniques and the treatment, salvage chemo-
SUN-P103
therapy remains a major treatment strategy for unresectable/
VALIDATION OF MODIFIED NUTRITION SCREENING TOOLS FOR
metastatic gastric cancer (GC) patients. Practical and technical
CHILDHOOD CANCER IN A TERTIARY HOSPITAL IN SINGAPORE
advances have simplified safe and convenient use of home
J. Koo1 *, C. Ong1, W. M. Han1. 1Nutrition and Dietetics, KK parenteral nutrition (HPN). This study aims to clarify the role of
Women’s and Children’s Hospital, Singapore, Singapore HPN in patients with incurable GC undergoing salvage
chemotherapy.
Rationale: Early identification of undernutrition is essential for
Methods: Sixteen GC patients administrated with HPN were
timely intervention in children receiving anti-cancer therapy.
enrolled. A total caloric supplement of 910 kcal/day parenteral
However, existing screening tools are operationally challenging
nutrition, including 33 g amino acid/day, 120 g glucose/day,
to implement in our local hospital. Our aim was to explore the
30 g lipid/day and electrolyte, micro-element and vitamin
validity of modified nutrition screening tools at our unit.
according to the nutritional status of subjects, of which was
Methods: Three nutrition screening tools were examined in a infused continuously daily in an infusion time ranged between
convenient sample of 31 pediatric oncology patients admitted 18–24 hours. The nutritional status and laboratory data before
over a 3 week period in KK Women’s and Children’s Hospital, the administration of HPN and after HPN at 0.5, 1, 2, 3 months
Singapore. The tools were: (1) Nutrition Screening Tool were analyzed.
Childhood Cancer (SCAN), (2) Modified Screening Tool for Results: There were 10 (62.5%) males and 6 (37.5%) females,
Assessment of Malnutrition in Pediatrics (mSTAMP) tool, (3) with a mean age of 67.56 ± 11.52 years. Median HPN adminis-
SCAN tool without physical signs and 2-step scoring of intake tration period was 98 (range, 16–282) days. Nine patients and 6
(mSCAN). Criterion validity was assessed against nutrition patients were categorized to ECOG status 1 and 2, respectively.
assessment using the Pediatric Subjective Global Nutrition There was a significant improvement of serum prealbulmin
Assessment (SGNA). Results were analyzed using Cohen’s Kappa level (P < 0.001) after 0.5 month of HPN administration, while
and receiver-operator characteristic curve. The screening and inflammation-related cytokines were not significantly altered
assessment were performed by a single, trained dietitian. (all P > 0.05). The incidence of venous port-associated blood-
Results: Mean age of children was 8.5 ± 5.5 years. Using the stream infection was 1.3‰/person-days.
SGNA, 18 (58%) were well nourished, 12 (39%) were moderately Conclusion: HPN for malnourished unresectable/metastatic
malnourished and 1 (3%) was severely malnourished. GC patients with salvage chemotherapy was feasible and
SCAN was found to be the best tool to identify risk of revealed the markedly improvement in nutritional status after
malnutrition (Table 1). Adjusting the cutoff score from 3 to 2
0.5 month of administration without significant alterations of
increased the sensitivity, negative predictive value and
inflammatory cytokines.
agreement of mSCAN.
SUN-P105 SUN-P106
NORMAL ENTEROCYTE FUNCTION IN PATIENTS WITH LOCALLY PARENTERAL OMEGA 3 SIGNIFICANTLY INCREASES
ADVANCED PANCREATIC CANCER ENDOTHELIAL PROGENITOR CELLS IN PALLIATIVE PANCREATIC
J. Witvliet-Van Nierop1 *, H. Scheffer2, L. Vroomen2, PATIENTS RECEIVING GEMCITABINE AND INTRAVENOUS
M. Meijerink2, A. van Bodegraven3, M. De van der Schueren1, OMEGA 3 COMPARED TO PATIENTS RECEIVING GEMCITABINE
N. Wierdsma1. 1Department of Nutrition and Dietetics, ONLY
2
Department of Radiology and Nuclear Medicine, VU University J. Isherwood1 *, A. Arshad1, W. Chung1, F. Runau1, J. Cooke1,
Medical Center, Amsterdam, 3Department of Gastoenterology, C. Pollard1, J. Thompson2, M. Metcalfe1, A. Dennison1.
1
Geriatrics, Intensive care and Internal Medicine (Co-MIK), Department of Hepatobiliary and Pancreatic Surgery,
Zuyderland Medical Center, Heerlen-Sittard-Geleen, Leicester General Hospital, 2Department of Health Sciences,
Netherlands College of Medicine, Biological Sciences and Psychology,
University of Leicester, Leicester, United Kingdom
Rationale: This study was designed to investigate whether the
reactively inflamed duodenal wall, observed as a side effect of Rationale: Vasculogenesis describes new blood vessel forma-
Irreversible Electroporation (IRE) in patients with Locally tion and Endothelial Progenitor Cells (EPCs) are important
Advanced Pancreatic Cancer (LAPC)1, affects enterocyte regulators of this process. Advanced pancreatic cancer (APC) is
function (EF). characterised by a hypoxic environment known to promote
Methods: EF was assessed in 13 LAPC patients before and in 9 mobilisation of EPCs.
patients 3 months after IRE. EF was studied by Citrulline Methods: Trial patients were treated with weekly gemcitabine
Generation Test (CGT). This test measures plasma glutamine plus intravenous omega -3 rich lipid infusion (Lipidem® BBraun,
[GLU], a precursor of citrulline [CIT], and [CIT] levels after an Melsungen 200 mg/mL, up to 100 g/500 mLs) in patients with
overnight fast and [CIT] levels 15, 75 and 90 minutes after an APC. Control patients were treated with gemcitabine only.
oral bolus of 20g of dipeptide alanine-glutamine2. Results: 27 patients were included in the analysis (18 trial and 9
Results: control). 103 times points were analysed. Three EPC signatures
were analysed. CD45−, CD31+ and CD133+EPCs. There was a
Before IRE 3 months after Reference healthy significant increase in trial EPCs (P = 0.04), but not control EPCs
(n = 13) IRE (n = 9) subjects2 (n = 19) over treatment. There was no significant difference between
Mean ± SD Mean ± SD Mean ± SD
trial and control patients over time. There was a significant
Baseline [CIT] 24 ± 9 21 ± 9 38 ± 8 (range 20–60) difference in progression free survival (P = 0.002) & overall
(μmol/L) survival (P = 0.01) in patients with a high change in EPCs; trial
Baseline [GLU] 61 ± 36 50 ± 26 561 ± 77
(μmol/L) versus control patients. CD45−, CD31+ and CD34+ EPCs. There
Peak [CIT] (μmol/L) 37 ± 16 31 ± 13 55 ± 10 was a significant increase in trial EPCs (P = 0.0001), but not
Increment (%) 59 ± 40 65 ± 44 44 ± 13 control over treatment. There was a significant difference
Slope (μmol/L/min) 0.19 ± 0.13 0.15 ± 0.09 0.22 ± 0.08
between trial and control patients over time (P = 0.0001).
Progression free survival was significantly improved in trial
Low fasting [CIT] levels (<20 μmol/L) were found in 5/13 (38%) patients with a high change in EPCs compared to control patients
LAPC patients before and 6/9 (67%) patients after IRE. Fasting (P = 0.01). CD45−, CD31+, CD133+ and CD34+ EPCs. There was an
[GLU] levels were far below reference levels of healthy increase in trial EPCs (P = 0.007), but not control EPCs over
subjects (HS) in all patients, both before and after IRE. treatment. There was a significant difference between trial and
Altough at a lower level, a normal CGT curve is presented control patients over treatment (P = 0.0001). Progression free
with normal slope and increment of [CIT] levels after the survival was significantly improved in trial patients with a high
alanine-glutamine dose, indicating a normal enterocyte change in EPCs compared to control patients (P = 0.01).
function. Conclusion: Intravenous omega- 3FAs in combination with
Conclusion: Patients with LAPC had low fasting [CIT] levels and gemcitabine significantly increase EPCs in patients with APC.
very low fasting [GLU] levels, both before and after IRE
procedure, likely representing a cancer induced catabolic
state. Fasting plasma [CIT] levels are inappropriate markers for
EF since low values can be explained by low [GLU] levels. The SUN-P107
normal slope and increment of [CIT] levels after CGT indicated PARENTERAL OMEGA 3 SIGNIFICANTLY REDUCES MYELOID-
normal EF, also post-IRE when duodenitis has been reported. DERIVED SUPPRESSOR CELLS IN PALLIATIVE PANCREATIC
PATIENTS RECEIVING GEMCITABINE AND INTRAVENOUS
References
OMEGA 3 COMPARED TO PATIENTS RECEIVING GEMCITABINE
1. Scheffer HJ, et al. Radiology 2017; 282(2):585–7 (doi: 10.1148/ ONLY TREATMENT
radiol.2016152835)
2. Peters JH, et al. APT 2008; 27(12):1300–10 (doi: 10.1111/j.1365- J. Isherwood1 *, A. Arshad1, W. Chung1, F. Runau1, J. Cooke1,
2036.2008.03678.x) C. Pollard1, J. Thompson2, M. Metcalfe1, A. Dennison1.
1
Department of Hepatobiliary and Pancreatic Surgery,
Leicester General Hospital, 2Department of Health Sciences,
College of Medicine, Biological Sciences and Psychology,
University of Leicester, Leicester, United Kingdom
Rationale: Advanced pancreatic cancer (APC) is characterised

by a complex immune microenvironment involving a plethora of
S94 Poster
immune mediators. Myeloid-Derived Suppressor Cells (MDSCs) survival less than 6 months at treatment end point compared to
have primarily been implicated in facilitating tumour growth by baseline (P = 0.03, 95% CI = −6.309 – −0.266). Overall there was
suppressing anti-tumour immunity. an increasing trend in trial Tregs over treatment but this was
Methods: As part of a phase II trial investigating weekly not significant (P = 0.23, 95% CI = −0.003–0.014). There was a
gemcitabine (1000 mg/m3 weekly for 3 weeks followed by a significant increase in control Tregs over treatment (P = 0.005,
rest week, up to 6 months) plus intravenous ω-3FA rich lipid 95% CI = 0.007–0.041). There was no significant difference
infusion (Lipidem® BBraun, Melsungen 200 mg/mL, up to 100 g/ between the trial and control patients over time (P = 0.586).
500mLs over 4 hours) in patients with APC. Control patients Conclusion: Tregs are significantly increased in patients
were treated with gemcitabine only. MDSCs with two antibody treated with gemcitabine alone compared to patents treated
signatures were analysed. (1) Lin1−, HLA-DR−, CD33+ & CD11b+ with omega-3 and gemcitabine. Omega -3 fatty acids may
& (2) Lin1−, HLA-DR− & CD11b+. Cells were analysed with flow prevent an increase in Tregs in APC. More studies are required
cytometry using the FACSAria II (BD Biocsiences). to investigate this.
Results: 27 patients were included in the analysis (18 trial and Disclosure of Interest: None declared.
9 control). 134 times points were analysed. Four-antibody stain
MDSCs were analysed. There was a significant decrease of
SUN-P109
MDSCs in trial patients during trial treatment (P = 0.0001).
NUTRITIONAL INTERVENTION IN PATIENTS UNDERGOING
There was no change in the control patients (P = 0.9). Overall
HAEMATOPETIC STEM CELL TRANSPLANTATION IN THE
there was no significant difference between the trial and
CATALAN INSTITUTE OF ONCOLOGY - BADALONA
control patients over time (P = 0.3). There was a significant
difference in progression free survival in patients with a high J. M. Sánchez-Migallón Montull1,2 *, M. J. Sendros Madroño1,2,
change in MDSCs in trial versus control patients (P = 0.08). R. Puig Piña1, M. Martion Giol1, M. Cachero Triadú1,
Three-antibody stain MDSCs were analysed. There was a E. Martínez López1, J. Julià Torras3, M. Sospedra Martínez1,
significant decrease of MDSCs in trial patients during treatment C. Joaquín Ortiz1. 1Dietetics and Nutrition Department,
(P = 0.0001). There was no change in MDSCs in the control Germans Trias i Pujol Hospital, 2Dietetics and Nutrition
patients (P = 0.3). Overall there was a significant difference Department, 3Comprehensive Support Services and Palliative
between the trial and control patients over time (P = 0.01). Care Department, Catalan Institut of Oncology, Badalona,
Conclusion: Intravenous ω-3FAs in combination with gemcita- Spain
bine significantly reduces MDSC cells in patients with APC
Rationale: To analyze the nutritional status of the patients
compared to those treated with gemcitabine alone.
undergoing haematopoetic stem cell transplantation (HSCT)
Disclosure of Interest: None declared. and the nutritional support used during hospitalization.
Methods: All the patients undergoing HSCT during the years
SUN-P108 2015 and 2016 were studied. Nutritional status was assessed by
T REGULATOR CELLS ARE SIGNIFICANTLY INCREASED IN Patient-Generated Subjective Global Assessment (PG-SGA) at
PALLIATIVE PANCREATIC PATIENTS TREATED WITH three different stages: admission, discharge from the hospital
GEMCITABINE ALONE COMPARED TO PATIENTS RECEIVING and one month later. The nutritional supports were classified
GEMCITABINE AND INTRAVENOUS OMEGA 3 into: Low Bacteria Diet (LBD) adapted to the preferences of the
J. Isherwood1 *, A. Arshad1, W. Chung1, F. Runau1, J. Cooke1, patient, LBD combined with Oral Nutritional Supplementation
C. Pollard1, J. Thompson2, M. Metcalfe1, A. Dennison1. (ONS) or Parenteral Nutrition (PN). Statistical analysis was
1
Department of Hepatobiliary and Pancreatic Surgery, performed using SPSS 15.0.
Leicester General Hospital, 2Department of Health Sciences, Results: 105 patients; Average age 52.4 (+/−12.7 years) of
College of Medicine, Biological Sciences and Psychology, whom 43.8% were women. 51.4% of the patients underwent
University of Leicester, Leicester, United Kingdom allogenic HSTC. 17% of the patients presented with malnutri-
tion at admission, 91.6% at discharge from the hospital and 40%
Rationale: Advanced pancreatic cancer (APC) is characterised one month after the discharge. The nutritional supports
by a complex immune microenvironment involving a plethora of employed were LBD (11.4%), ONS (57.1%) and PN (31.4%).
immune mediators. T regulator cells (Tregs) are significantly Patients undergoing allogenic HSCT required PN more fre-
increased in APC and their levels have been shown to correlate quently than the patients undergoing autogenic HSCT (38.8% vs
with survival 23.5%). No significant statistical differences we found in the
Methods: As part of a phase II trial investigating weekly nutritional status at the time of discharge between the two
gemcitabine (1,000 mg/m3 weekly for 3 weeks followed by a types of HSCT.
rest week, up to 6 months) plus intravenous ω-3FA rich lipid Conclusion: Monitoring the nutritional status during the
infusion (Lipidem® BBraun, Melsungen 200 mg/mL, up to different phases of the HSCT is justified by the high percentage
100 g/500 mLs over 4 hours) in patients with APC. Control of malnutrition. The majority of the patients didn’t present
patients were treated with gemcitabine only. Peripheral blood with malnutrition at admission, but almost all presented with it
mononuclear cells (PBMC) were stained with CD4, CD25 and at discharge from the hospital. The most frequently employed
FOXP3 antibodies for Tregs. Cells were analysed with flow nutritional support was ONS followed by PN. The high
cytometry using the FACSAria II (BD Biocsiences, San Jose, prevalence of malnutrition one month after discharge from
USA). the hospital is a justification for the follow-up of these patients
Results: Twenty-seven patients were included in the analysis until the recovery of an adequate nutritional status is achieved.
(18 trial and 9 control). 136 times points were analysed. There Disclosure of Interest: None declared.
was a significant increase in Tregs in trial patients with a
SUN-P110 yet. This study aimed to identify how patients experience diet
ASSOCIATION BETWEEN EARLY NUTRITIONAL STATUS AND and to assess the relationship between food behavior,
SURVIVAL TIME AMONG KOREAN ADULT PATIENTS WITH preference and intake of sweet foods and weight gain.
PANCREATIC CANCER: A RETROSPECTIVE STUDY Methods: It was assessed 31 breast cancer patients with
J. S. Park1 *, H. M. Kim1, H. C. Jeung2. 1Clinical Nutrition, indication for chemotherapy at two moments: prior to
2
Internal Medicine, Gangnam Severance Hospital, Yonsei initiating (T0) and after the fourth chemotherapy session
University College of Medicine, Seoul, Korea, Republic Of (T1). They were evaluated for weight, height, sweet food
intake (split into two categories: “healthy sweets” for fruits
Rationale: We investigated the associations between baseline and natural juices and “non-healthy sweets” for cakes,
nutritional status and survival time among Korean patients with cookies, candies, ice creams, soft drinks, industrialized
pancreatic cancer. juices, homemade sweets, and chocolate) and preferred
Methods: A retrospective study was conducted on 412 sucrose concentration in cashew juice (3%, 6%, 12%, 24%, and
inpatients with pancreatic cancer between January 2007 and 36% w/v). An interview based on a semi-structured script was
February 2015 at the department of Oncology of the Gangnam applied at T1.
Severance Hospital in Korea. Anthropometric and biochemical Results: The patients’ weight and BMI increased, as did the
data was collected from electronic medical records and likely “healthy sweets” intake ( p = 0.00), with positive correlation
survival time was estimated. Screening for risk of under- between the variation of “healthy sweets” intake and weight
nutrition was performed using a tool, the “Nutritional Risk (r = 0.38; p = 0.04). The preferred sucrose concentration
Screening 2002 (NRS 2002)”. Patients who received a NRS 2002 remained stable. The interviews analysis shows that fear,
score less than three were classified as “no-risk”, those who anxiety, and stress, as well as the coping attitude emerged in
received a score of three as “moderate-risk”, and those who face of the treatment and reflected in opposite food behaviors.
received a score of four or higher as “high-risk”. At times, the food behavior is driven by self-care intention,
Results: Following nutritional screening at baseline, 194 conducting to a massive intake of fruits and vegetables and, at
patients (47.1%, mean age 61.8 ± 9.9 years) were placed in other times, it is driven by the emotional vulnerability that
the “no-risk” group. A further, 81 patients (19.7%, mean age leads to an excessive and unorganized food intake.
65.4 ± 10.8 years) were placed in the “moderate-risk” group, Conclusion: The results found indicate opposed, thought
and 137 patients (33.2%, mean age 67.8 ± 12.0 years) were concomitant, food behavior patterns that may contribute to
placed in the “high-risk” group. Stepwise multiple linear the weight gain observed.
regression analysis was used to determine independent Disclosure of Interest: None declared.
predictive factors for survival time. Lymphocyte Percentage
was found to be the strongest predictor of survival among
SUN-P112
patients with pancreatic cancer ( p < 0.001). NRS 2002 score
EVALUATION OF BODY COMPOSITION AND PROGNOSTIC
( p < 0.001) and age ( p < 0.05) were also significant predictors.
INDEXES IN HEMATOLOGIC MALIGNANCIES
The estimated survival time showed that there were significant
differences in median survival time among groups according to J. M. F. Sicchieri1 *, M. V. Geraldi1, G. Marques1, B. Simões2,
NRS 2002 score. Those in the “no-risk” group were predicted to R. W. Diez-Garcia1. 1Division of Nutrition and Metabolism,
live 1.89 times longer than those in the “moderate-risk” group, Department of Internal Medicine, 2Division of Hematology,
and 2.24 times longer than those in the “high-risk” group Department of Internal Medicine, University Hospital, Faculty
( p < 0.001). of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao
Conclusion: Improved early nutritional status was associated Preto, Brazil
with increased estimated survival time among Korean patients
Rationale: Hematopoietic cel transplantation has become
with pancreatic cancer.
standart treatment for many hematologic malignancies.
Disclosure of Interest: None declared. Moreover, malnutrition with lean body mass losses, affecting
both the functional capacity and the metabolic health of
SUN-P111 cancer survivors. The objective of this study was to describe
FOOD BEHAVIOR AND WEIGHT GAIN IN CHEMOTHERAPY FOR the body composition, the fat free mass index (FFMI) and fat
BREAST CANCER mass index (FMI) and to relate nutritional prognostic indicators
J. M. F. Sicchieri1 *, C. Palazzo2, C. C. Japur3, L. B. Araújo4, in patients hospitalized for treatment of hematologic malig-
R. W. Diez-Garcia5. 1Division of Nutrition and Metabolism, nancies in Bone Marrow Transplantation Unit and the
Department of Internal Medicine, University Hospital, Faculty Hematology of the Hospital of Clinics of the Medical School of
of Medicine of Ribeirão Preto, University of São Paulo, Brazil, Ribeirão Preto (HCFMRP-USP)
2
Nutrition and Metabolism, Ribeirão Preto Medicine School, Methods: A cross-sectional study was conducted between
University of São Paulo, Ribeirao Preto, 3Nutrition Course, August and December 2016 with hospitalized patients in
Medicine School, University of Uberlândia, 4Mathematics treatment to hematological malignancies who have been
School, University of Uberlândia, Uberlândia, 5Division of agreed to participate this study. Percentage of body fat (%
Nutrition and Metabolism, Department of Internal Medicine, BF), lean body mass and were determined by Impedance
University Hospital, Faculty of Medicine of Ribeirão Preto, Bioelectrical (BIA), wich was realized in the morning, with
University of São Paulo, Brazil, Ribeirao Preto, Brazil fasting. Exclusion criteria: patients who present cognitive
problem or disagreeded to participate. The study protocol was
Rationale: Weight gain is a common issue during chemotherapy approved by the Research Ethics Committee of the HCFMRP-
for breast cancer, though its causes have not been explained USP (number 1,887,320).
S96 Poster
Results: 21 patients (9 females and 12 males) were evaluated, SUN-P114

presenting FFMI avarage 19.3 kg/m² in male and 17.1 kg/m² in HOME PARENTERAL NUTRITION IN PATIENTS WITH ADVANCED
female. FMI avarage was 5.4 kg/m² and 8.4 kg/m² in male and CANCER: A SYSTEMATIC REVIEW
female respectively. According with this classification: 38.0% K. C. Fragkos1 *, L. Fini2, N. Keane3, H. Kwok1, E. Paulon1,
(n = 8), obese, 42.9% (n = 9) eutrophic and 19.0% (n = 4) J. Barragry1, S. Mehta1, F. Rahman1, S. Di Caro1. 1GI Services,
sarcopenic patients which differs off BMI in 3 patients (14%). University College London Hospitals NHS Foundation Trust,
Conclusion: The evaluation of body composition by BIA, London, United Kingdom, 2Busto Arstizio Hospital, Busto
associated to analysis of fat free mass index, fat mass index, Arstizio, Varese, Italy, 3Dietetics, University College London
can contribute to the identification of nutritional status and Hospitals NHS Foundation TRUST, London, United Kingdom
prognosis more accurately.
Rationale: The use of Home Parenteral Nutrition (HPN) in
References patients ( pts) with advanced cancer who cannot meet their
Kyle U, Pirlich M, Loch H. Increased length of hospital stay in nutritional requirements by oral or enteral routes, remains
underweight and overweight patients at hospital admission: a controversial with significant variation worldwide. Our aim was
controlled population study. Clinical Nutrition (2005) 24, 133–142 to review data from literature and identify the potential
Disclosure of Interest: None declared. benefit of HPN in pts with advanced cancer.
Methods: Articles on HPN in advanced cancer from 2002 to
SUN-P113 2016 were scrutined in PubMED. Primary end point was survival,
ORAL ADMINISTRATION OF AMINO ACIDS CYSTINE AND secondary end points were quality of life (QoL) and nutritional/
THEANINE ATTENUATES 5-FLUOROURACIL-INDUCED performance (Karnofsky score, KPS) status.
INTESTINAL INFLAMMATION BY SUPPRESSING THE Results: Eighteen studies met the quality inclusion criteria (11
RECRUITMENT OF INFLAMMATORY MONOCYTE retrospective, 7 prospective and 2 randomized). Studies were
mainly conducted in Western countries (30% in Italy, 15% in USA,
J. Yoneda1 *, S. Iwayama1,1, M. Shiozaki1,1. 1Institute for
10% in Canada and Germany), including overall 3,066 patients.
Innovation, Kawasaki, Japan
Mean age was 57,2 ± 6,4 years. Most common cancer site were
Rationale: Cystine/theanine (CT) is a supplement containing GI tract, ovary, breast, head and neck. Main indication for HPN
700 mg of cystine and 280 mg of theanine. A recent clinical was bowel obstruction or cachexia. Mean duration of HPN was
study demonstrated that oral administration of CT reduced 3,8 ± 1,4 months. Median overall survival was 4,6 ± 2,4 months
adverse events and improved completion rate of an adjuvant (1,5 month in a selected cohort with peritoneal carcinoma-
chemotherapy. CTattenuated intestinal mucositis and diarrhea tosis, 8 months in a study including only advanced ovarian
in 5-FU-induced mouse mucositis model, however mechanism is cancer). At baseline, mean weight was Kg 57,6 ± 5,1, mean BMI
unclear. The objective of this study is to verify mechanisms of 20,7 ± 0,8 and mean KPS 55 ± 5. After 1–5 months of HPN, mean
the suppressive effects of CTon the intestinal tissue using 5-FU- weight and mean BMI increased to 61,9 ± 5.3 and 21,2 ± 0,5
induced mouse mucositis model. respectively. KPS increased in 2 studies, stable in 2 studies. QoL
Methods: Intestinal mucositis was induced in male BALB/c was analyzed through validated scales in 5 studies and resulted
mice by a single intraperitoneal injection of 5-FU (450 mg/kg). significantly increased after HPN. On average, HPN related
Saline or CT (280 mg/kg) were orally administered once daily complications were reported in 13 ± 6% of the pts.
starting 3 days before 5-FU administration until the end of the Conclusion: Indications for HPN and overall survival (3,8 ± 1,4
experiment. FITC-conjugated microbeads-labeled bone months) in advanced cancer was in accordance with prognostic
marrow derived Ly6Chi monocytes were i.v. inoculated into parameters specified in International guidelines. Variation in
BALB/c mice on day 1 and on day 2 after 5-FU i.p. injection. clinical practice is evident in different countries. A cultural
One day following 2nd adoptive transfer (day 3 after 5-FU change and education of healthcare professionals is required to
injection), small intestine were collected and frozen sections ensure early access to HPN for appropriate patients.
were examined by fluorescent microscopy. Disclosure of Interest: None declared.
Results: To determine the protective effects of the CT on the
inflammatory damage of small intestine, mice, that received
adoptive transfer of FITC-labeled Ly6Chi monocyte, were Nutrition and chronic diseases 1
sacrificed. While recruitment of Ly6Chi monocyte were
observed in the lamina propria region in the villi of 5-FU SUN-P115
administrated mice, CT reduced the number of monocytes OLDER ADULTS WITH REDUCED RENAL FUNCTION:
( p < 0.05). We also found increased MCP-1 levels in the plasma EVALUATION OF THE EFFECTS OF UNDERLYING RENAL
in 5-FU treated mice, which were partially decreased by CT DISEASE ON NUTRITIONAL AND METABOLIC PROFILE
administration ( p < 0.05). A. Molfino1 *, M. I. Amabile1, S. Altieri2, D. Mastroluca3, C. Lai4,
Conclusion: CT treatment decreased the 5-FU induced P. Aceto5, M. Crudo6, F. Rossi Fanelli1, M. Muscaritoli1, S. Lai1.
increase of MCP-1 in plasma and recruitment of inflammatory 1
Department of Clinical Medicine, 2Department of Clinical and
Ly6Chi monocytes in intestinal tissue, which may results in Molecular Medicine, 3Department of Internal Medicine and
suppression of inflammatory response and promotion of Medical Specialties, 4Department of Dynamic and Clinic
mucosal recovery. Psychology, Sapienza University of Rome, 5Department of
Nutrition and chronic diseases 1 S97
Anesthesiology and Intensive Care, Catholic University of group), the expression of ubiquitinated proteins was assessed
Sacred Heart, 6Software House, INTECS S.p.A, Rome, Italy by using macroarrays.
Results: In mice, 50 proteins were differentially and signifi-
Rationale: Chronic kidney disease is highly prevalent among
cantly expressed between the 4 groups ( p < 0.05, ANOVA). 20
older adults. Metabolic and nutritional derangements are
proteins were downregulated in wt WAS mice ( p < 0.05 vs wt
associated with renal impairment, and increased risk of
control), suggesting altered energy and mitochondrial metab-
cardiovascular disease is frequent in this condition. We
olism. Interestingly, 3 (PSMA3, PSAM5, UCHL3) and 4 (PSMA4,
compared the metabolic, nutritional, and cardiovascular
ENO1, HSP60, GLUD1) proteins were significantly up- or down-
impact of reduced renal function between patients with and
regulated in β2i−/− WAS mice ( p < 0.05 vs wt WAS), respectively.
without known renal disease.
UCHL3 and PSMA3/4/5 are involved in the ubiquitin prote-
Methods: We enrolled consecutive outpatients aged ≥65 years
asome pathway and GLUD1 is glutamate dehydrogenase 1. In
with reduced renal function divided into two groups: Group A
IBS-D patients, the colonic expression of 7 ubiquitinated
including patients with history of renal disease, and Group B
proteins (TRAF6, A20, Nrf2, HSP70, HSP90, IRF3, COX-2) was
patients with unknown renal disease. Nutritional and meta-
significantly reduced.
bolic parameters, including involuntary body weight loss (BWL)
Conclusion: Our results show specific alterations of colonic
in the previous 6 months, inflammatory indices, mineral
protein metabolism in WAS mice. Immunoproteasome invali-
metabolism, and left ventricular mass index (LVMI), were
dation modified colonic proteome. Interestingly, IBS-D patients
evaluated. Parametric and non-parametric tests were per-
exhibited alterations of ubiquitome, and particularly of
formed as appropriate, and p value < 0.05 was considered
proteins involved in inflammatory signalling pathways.
statistically significant.
Results: A total of 76 patients were enrolled. Group A (n = 39, Disclosure of Interest: None declared.
M: 24, F: 15) showed greater BWL with a significant reduction of
25-hydroxyvitamin D, transferrin, cholinesterase, albumin, and SUN-P117
greater LVMI with respect to Group B ( p < 0.01). In addition, ENERGY- AND PROTEIN INTAKE IN HOSPITALIZED PATIENTS
Group A showed significantly increased intact parathyroid WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)
hormone, total cholesterol, low-density lipoprotein, triglycer- AND ASSOCIATIONS WITH BODY COMPOSITION, LUNG
ides, and C-reactive protein when compared to Group B FUNCTION AND HEALTH RELATED OUTCOMES
( p < 0.05). A. Ingadottir1,2 *, A. M. Beck3,4, C. Baldwin5, C. E. Weekes5,
Conclusion: The positive history of renal disease may nega- O. G. Geirsdottir1,6, A. Ramel1, T. Gislason7,8,
tively impact on several nutritional and metabolic parameters I. Gunnarsdottir1,2. 1Unit for Nutrition Research, Landspitali
related to increased cardiovascular risk among older adults. University Hospital & Faculty of Food Science and Nutrition,
Disclosure of Interest: None declared. University of Iceland, 2Department of Clinical Nutrition,
Landspitali University Hospital, Reykjavik, Iceland,
3
SUN-P116 Department of Nutrition and Health, Faculty of Health and
IMMUNOPROTEASOME SUBUNIT BETA2I DEFICIENCY MODIFIES Technology, Metropolitan University College, Copenhagen,
4
COLONIC PROTEOME IN STRESSED MICE: PUTATIVE ROLE FOR Research Unit for Nutrition, Herlev and Gentofte Hospital,
IRRITABLE BOWEL SYNDROME Gentofte, Denmark, 5Division of Diabetes and Nutritional
Sciences, King’s College London, London, United Kingdom,
A. Goichon1,2, I. Ghouzali1,2, W. Bahlouli1,2, P. Chan2,3, 6
The Icelandic Gerontological Research Center, Landspitali
D. Vaudry2,3,4, P. Déchelotte1,2,5 *, P. Ducrotté1,2,6,
University Hospital & University of Iceland, 7Faculty of
M. Coëffier1,2,5. 1Normandie Univ., URN, INSERM Unit 1073,
2 Medicine, University of Iceland, 8Department of Respiratory
Institute for Research and Innovation in Biomedicine (IRIB),
Medicine and Sleep, Landspitali University Hospital,
University of Rouen Normandy, Rouen, 3Platform in Proteomics
Reykjavik, Iceland
PISSARO, University of Rouen Normandy, 4Normandie Univ.,
URN, INSERM Unit 1239, Mont-Saint-Aignan, 5Rouen University Rationale: Low energy and protein intake has been associated
Hospital, Nutrition Department, 6Rouen University Hospital, with increased risk of malnutrition in outpatiens with chronic
Gastroenterology Department, Rouen, France obstructive pulmonary disease (COPD). The aim was to assess
energy-/protein intake of hospitalized COPD patients and to
Rationale: A role for immunoproteasome in the regulation of
examine whether it predicts COPD severity, length of stay,
intestinal permeability has been previously suggested both in
readmissions within 30 days and mortality.
mice during water avoidance stress (WAS) and in patients with
Methods: Subjects were COPD patients (n = 99) admitted to
irritable bowel syndrome (IBS). We thus aimed (i) to evaluate
Landspitali University Hospital during one year (March 2015-
the colonic proteome in wild-type (wt) and β2i immunoprotea-
March 2016). Patients were screened for nutritional risk using
some subunit knock-out (β2i−/−) mice during WAS and (ii) to
validated screening tool. Energy- and protein intake was
investigate the colonic expression of 49 ubiquitinated-proteins
estimated using a validated plate diagram sheet. Body
in diarrhea-predominant IBS patients (IBS-D).
composition was measured with a bioelectrical impedance
Methods: Wt and β2i−/− C57BL/6 male mice (n = 5/group) were
analyser. Lung function was measured with spirometry.
subjected to WAS (1 h/day for 10 days) or not (control). Then, a
Results: The energy-/protein intake from the hospital meals
2D-PAGE-based comparative proteomic analysis was performed
provided was lower in subjects defined at nutritional risk than
and differentially expressed colonic proteins (at least ± 1.4 fold
those not at risk (1,173 ± 358 vs. 1,360 ± 360 kcal; p = 0.013 and
change; two-way ANOVA, p < 0.05) were identified by LC-MS/
49.0 ± 16.3 vs. 57.2 ± 16.7 g; p = 0.019). However, patients at
MS. From colonic biopsies of IBS-D and control patients (n = 8/
nutritional risk were provided with greater amount of oral
S98 Poster
nutritional supplements or food brought from home (194 ± 151 patients. Early diagnosis and therapeutic interventions are the
vs. 85 ± 89 kcal; p < 0.001 and 7.8 ± 6.1 vs. 3.3 ± 4.7 g; p < best way to improve prognosis of those patients and to delay
0.001), resulting in no difference in total energy-/protein frailty syndrome.
intake. Energy-/protein intake was positively associated with Methods: Body mass composition together with bioimpedance
measures of body composition (fat free mass index and body body analysis are useful, noninvasive option for diagnosis of
mass index), but no association was seen with outcomes. malnutrition, sarcopenia and hypervolemia in dialysis patients.
Conclusion: Although energy-/protein intake was lower than In one single center study 183 dialysis patients were evaluated.
recommended during hospitalization we found no association Over-hydration index (OH), fat tissue index (FTI), lean tissue
with outcomes. Long term studies, assessing energy-/protein index (LTI) and Phase angle (Phi50) were evaluated and
intake both during hospitalization and after discharge are compared to routine classical biochemical blood analysis data
needed. (hemogram, creatinine, serum electrolyte, lipidogram, I-PTH.)
Disclosure of Interest: None declared. Results: Phi50 shows positive correlation with triglyceride
( p = 0.02), serum albumine ( p = 0.009), BMI ( p = 0.06), LTI
( p = 0.06), FTI( p = 0.06) and I-PTH(0.07) and negative correl-
SUN-P118
ation with overhidration ( p = 0.0001) and age ( p = 0.0001).
THE RELATIONSHIP BETWEEN HEALTHY EATING INDEX SCORE
Patients with severe hyperparathyrodism (cinacalcet therapy)
AND SERUM LIPID PROFILE IN PATIENTS WITH CORONARY
unexpectedly show increasing values of LTI ( p = 0,05) and lower
ARTERY DISEASE
values of FTI ( p = 0.05).
A. Aktaş1 *, E. B. Kaya2, G. Samur1. 1Nutrition and Dietetics, Conclusion: Low values od I-PTH are more dangerous for
2
Medicine, Hacettepe University, Ankara, Turkey malnutrition and sarcopenia in dialysis patients than patients
wirh higher values of I-PTH. Bioimpedance body mass markers
Rationale: The aim of this study is to evaluate the dietary
show interesting data about functional reserve of dialysis
quality and determine serum cholesterol levels in patients with
patients and with more experience this methods could be
coronary artery disease.
indicate dangerous of frailty syndrome in dialysis patients and
Methods: This study was conducted with 99 adults aged 40–80
possibility to its prevention.
years. Patients with coronary artery disease had more than 50%
stenosis in heart arteries who undergoing balloon angioplasty Disclosure of Interest: None declared.
or stent placement. They were taking cholesterol-lowering
drugs regularly. Food Frequency Questionnaire (FFQ) and 24- SUN-P120
hour dietary recall were used to assess dietary intake. Healthy DYSLIPIDEMIA AMONG CLIMACTERIC WOMEN IN SOUTHERN
Eating Index (HEI-2005) scores were calculated. Biochemical BRAZIL
findings were taken from hospital database. Total diet quality C. W. Gallon1 *, K. G. Mendes1, H. Theodoro1, J. G. D. Vargas1,
was classified into three categories: good diet quality (over 80 R. Miecinikovsski1, D. R. S. De Lorenzi1, M. T. A. Olinto2.
points), needs impovement (51–80 points), and poor diet 1
Universidade De Caxias Do Sul, Caxias do Sul, 2Unisinos, São
quality (50 and under) but there wasn’t found patients who Leopoldo, Brazil
good diet quality was found. For that reason the subjects were
divided into two groups (needs improvement and poor) with Rationale: The climacteric phase implies metabolic and
regard to HEI-2005 scores (³50 and <50, respectively). hormonal changes that might lead to adverse effects, such as
Results: The average HEI score was 62,9 ± 8,3. When lipid dyslipidemia and cardiovascular risks. Determine factors
profile of patients with coronary artery disease evaluated, associated with the prevalence of dyslipidemia among climac-
serum concentrations of TC were 173,6 ± 44,9 mg/dL, high teric women treated in a reference clinic in southern Brazil.
density lipoprotein cholesterol (HDL) were 42,2 ± 9,7 mg/dL, Methods: Cross-sectional study with 550 women aged 40–65
TC/HDL ratio were 4,2 ± 1,13, low density lipoprotein choles- years treated in a clinic specialized in climacteric therapies and
terol (LDL) were 118,1 ± 34,4 and triglyceride were gynecologic surgeries. A precoded and pretested standardized
163,9 ± 101,7. The mean TC levels were slightly higher in poor survey with questions about socioeconomic, demographic,
group than “needs improvement” group (179,5 ± 35,0 and behavioral and reproductive features was applied. Laboratory
173,1 ± 45,9, respectively), but this difference was not tests needed to define lipid profiles were the analysis of HDL
statistically significant( p > 0.05). cholesterol, total cholesterol and triglycerides. This study was
Conclusion: The results indicate that there is no relationship approved by the Research Ethics Committee of the University of
between HEI scores and serum lipid levels in patients with Caxias do Sul (No. 124/08)
coronary artery disease. Results: 550 climacteric women were evaluated. An elevated
Disclosure of Interest: None declared. prevalence of dyslipidemia (83.8%) was found. The group
presenting the largest number of dyslipidemic women was the
group aged 56–65 years (92.5%). There was no significant
SUN-P119
association between occurrence of dyslipidemia and meno-
BIOIMPEDANCE BODY MASS COMPOSITION DATA MIRROR
pausal state. Multivariate analysis revealed that dyslipidemias
FUNCTIONAL RESERVE AND FRAILTY IN DIALYSIS PATIENTS
were 11% more prevalent in women aged 56–65 years (PR 1.11;
B. Knap1 *, Ž. Haler1, K. Knap1, J. Buturovic-́ Ponikvar1. p = 0.03) and 16% more frequent among women with three or
1
Nephrology, University Clinical Centre, Ljubljana, Slovenia more gestational periods ( p = 0.04). The prevalence of dyslipi-
demia was also higher among obese women than among the
Rationale: Malnutrition, sarcopenia and hypervolemia are
eutrophic ones, however, the significance level remained in a
indicators of increased cardiovascular risk, morbidity and
boundary zone (PR 1.12; p = 0.06).
mortality and indicate the loss of quality of life in dialysis
Conclusion: A higher prevalence of dyslipidemia was found SUN-P122

among women with multiple pregnancies, something that may A RARE CASE: EXTENSIVE SUBCUTANEOUS HEMORRHAGE AND
be linked to hormonal and metabolic issues, as well as dietary GASKET DISPLACEMENT TO SUBCUTANEOUS AFTER
issues during pregnancy. Possibly, the aging process and its PERCUTANEOUS ENDOSCOPIC GASTROSTOMY(PEG)
metabolic changes —more than the menopausal state itself— is C. Zhu1 *. 1Department of General Surgery, Peking Union
the main factor associated with dyslipidemia during the Medical College Hospital, Chinese Academy of Medical Science
climacteric years. and Peking Union Medical College, Beijing, China
Rationale: Endoscopic gastrostomy Percutaneous (PEG) has
SUN-P121 many complications. But extensive subcutaneous hematoma
APPLICATION OF ONODERA PROGNOSTIC NUTRITION INDEX caused by muscle hemorrhage in site of paracentesis and gasket
AND NEUTROPHIL TO LYMPHOCYTE RATIO IN EVALUATION OF displacement to subcutaneous after PEG in short-term was
POSTOPERATIVE COMPLICATIONS IN PATIENTS WITH CROHN’S extremely rare. A patient with dysphagia and forced crying has
DISEASE this complication in our hospital. we summarized it to prevent
its recurrence.
C. Zhu1 *. 1Department of General Surgery, Peking Union Methods: Patient Zhang, female, 60 years old. Diagnosis is
Medical College Hospital, Chinese Academy of Medical Science dysphagia and forced crying loudly intermittently beyond self-
and Peking Union Medical College, Beijing, China control. PEG was carried on in May10th, 2016.
Results: On second day after operation, Forced crying was
Rationale: To study the application of Onodera prognostic
significantly worse than before. there existed a purple
nutrition index (OPNI) and neutrophil to lymphocyte ratio(NLR)
ecchymosis, about 5*5 cm, at the left side of puncture point.
in evaluation of postoperative complications in patients with
On third day, Forced crying was significantly worse. Dark red
Crohn’s disease (CD)
liquid outflowed. The area of purple ecchymosis expanded to
Methods: Data of 108 CD patients with bowel resection was
iliolumbar. The decline of hemoglobin was 45 g/L. CT showed
analyzed. OPNI and NLR was calculated within one week before
local muscle was bleeding.
surgery. The distributions of OPNI and NLR in clinical features
From fourth days to seventh days, Forced crying was more
and correlation were analyzed. The cutoff values for OPNI and
frequently. Dark red liquid outflowed from puncture site. The
NLR was calculated by Receiver Operating Characteristic (ROC)
area of purple ecchymosis expanded to labium majus and
curve and Youden index. the independent risk factors for
perineum. Hemoglobin was stable.
complications was investigated by logistic regression model.
On eighth day, Ecchymosis were gradually narrowing, even
Results: OPNI was 38.8 ± 8.2. when OPNI was 39.8, the Youden
disappearing. But the massive clear gastric juice and gastric
index was maximal. CD patients were divided into high (≥39.8)
contents outflowed from puncture site.
and low (<39.8) OPNI groups. OPNI were significantly lower
On twenty-first days, PEG gastric disc shifted from the stomach
(P < 0.05) in patients whose CD were B3 subtype, lymphocytes,
to the subcutaneous tissue. Then PEG was removed. Daily
hemoglobin, prealbumin, albumin were less than normal value,
dressing change until the skin wound healing.
and energy of enteral nutrition was less than 500 kcal/d within
Conclusion: The most fundamental reason is blood pressure
two weeks before surgery; as was the same in two groups
and abdominal pressure increased dramatically for an instant
(P < 0.05).
caused by forced crying over and over again. For the patients
NLR was 5.9 ± 12.1. NLR was 4.1, the Youden index was
who have forced crying beyond self-control and PEG indica-
maximal. CD patients were divided into high (≥4.1) and low
tions, sedation and analgesia should be carried on timely after
(<4.1) NLR groups. NLR were significantly higher(P < 0.05) in
operation to prevent this kind of complication.
patients whose CD were B3 subtype, lymphocytes and
prealbumin were lower and neutrophils was higher than Disclosure of Interest: C. Zhu Grant/Research Support from: The
normal value, energy of enteral nutrition was less than capital health research and development of special fund, Consultant
for: weimingkang.
500 kcal/d within two weeks before surgery. as was the same
in two groups(P < 0.05).
OPNI and NLR had significant negative correlation. SUN-P123
Smoking within 1 year before surgery, OPNI < 39.8 and DEFICITS IN COGNITIVE FLEXIBILITY IN COPD ARE LINKED TO
NLR ≥ 4.1were independent risk factors for postoperative CHANGES IN METABOLISM OF BRANCHED-CHAIN AMINO ACIDS
complications. C. K. Lieben1 *, N. E. Deutz1, R. Jonkers1, E. Veley2,
Conclusion: OPNI and NLR were important reference for R. Harrykissoon3, A. Zachria3, M. P. Engelen1. 1Health and
perioperative complications in CD patients. Smoking within 1 Kinesiology, Texas A&M University, 2Pulmonary and Critical
year before surgery, OPNI < 39.8 and NLR ≥ 4.1were independ- Care, Scott and White Memorial Hospital, 3Pulmonary, Critical
ent risk factors for complications. Care & Sleep Medicine, College Station Medical Center, College
Disclosure of Interest: C. Zhu Grant/Research Support from: The Station, United States
capital health research and development of special fund, Consultant
for: weimingkang. Rationale: There is growing awareness of cognitive dysfunc-
tions (i.e., impairment in visuoperceptual abilities, cognitive
processing speed and flexibility) in chronic obstructive pul-
monary disease (COPD). However to date, no studies have
explored the metabolic changes underlying cognitive
S100 Poster
impairment in COPD. This study evaluates the metabolic biochemical variables, no model of predictors was established
signature of attentional and executive dysfunctions in COPD. in relation to the strength and frequency of both studied hunger
Methods: We enrolled 23 COPD patients (GOLD II-IV) and 17 age due to lack of statistical significance. From the group of
and gender matched healthy control subjects. For the STROOP nutritional variables, predictors of pre-meal hunger were BMI
test, a cut-off interference score (IS) of 60 sec between (Beta −0.313; R2 = 0.08), and the frequency of alcoholic
incongruent and congruent parts was used as high IS (>60 sec) beverage in the week was WHR (Beta −0.343; R2 = 0.11).
reflects less mental flexibility. Plasma amino acid profile was Conclusion: In male alcohol addicts initiating withdrawal
assessed by LC-MS/MS and the sum of branched-chain amino therapy, smoking is a significant contributing factor to pre-
acids (BCAA: valine, isoleucine, leucine) was calculated. As meal hunger (12% of variance), and the frequency of alcohol
markers of central precursor availability for the synthesis of craving is the number of standard drinks (7% variance). The
serotonin and dopamine, we calculated the ratios of trypto- lower the BMI value, the higher the pre-meal hunger
phan (TRP) and sum of tyrosine (TYR) and phenylalanine (PHE) prevalence (8% variance), and the lower the WHRs, the
to other large neutral amino acids (i.e. TRP/LNAA and higher alcohol craving frequency (11% of the variance
(TYR + PHE)/(TRP + BCAA)), respectively. Statistics was done explained).
by t-test. Disclosure of Interest: None declared.
Results: As the tasks became more cognitively demanding, a
high IS was more frequently observed in COPD (59%) compared
SUN-P125
to the control group (23%; p < 0.05). COPD patients with high IS
APPLICATION OF THE FINDRISC QUESTIONNAIRE TO
showed reduced levels of plasma BCAA ( p < 0.01), increased
SCREENING THE RISK OF DIABETES MELLITUS IN PATIENTS
(TYR + PHE)/(TRP + BCAA) ratio ( p < 0.01), and a tendency
WITH CARDIOVASCULAR DISEASE
towards increased TRP/LNAA ratio ( p = 0.06). These effects
did not occur in healthy subjects with high IS. K. G. D. Santos1, A. S. Monteiro1, C. C. J. Paiva1, F. C. Amparo1,
Conclusion: Our findings indicate that impaired attentional P. Moreira1, R. Alves1, C. Kovacs1, D. Magnoni1 *. 1Ambulatory of
control in COPD patients are associated with increased central Nutrition Clinic, Institute Dante Pazzanese of Cardiology, Sao
uptake of TYR to promote dopamine synthesis. Since this effect Paulo, Brazil
seems to be mediated by a metabolic imbalance, nutritional
Rationale: Diabetes mellitus (DM) is associated with increased
intake of BCAAs might enhance attentional processes and
of cardiovascular risk, complications and health costs. Among
response inhibition in COPD with cognitive impairment.
the instruments validated, the Findrisc (Finnish Diabetes Risk
Disclosure of Interest: None declared. Score) is self-administered and estimates the risk of developing
DM in the next 10 years. The objective was to verify the risk of
SUN-P124 developing DM in patients referred for nutritional follow-up
HUNGER BEFORE MEALS AND ALCOHOLIC CRAVINGS AND through the Findrisc.
SELECTED CLINICAL, BIOCHEMICAL, AND NUTRITIONAL Methods: Cross-sectional study at an Institute of Cardiology
VARIABLES IN PATIENTS WHO ARE ADDICTED TO ALCOHOL with patients aged ≥18 years, without diagnosis of DM or
D. Czarnecki1 *, M. Ziółkowski2, K. Antczak3, K. Pawlucha4, hypoglycemic drugs. Data were collected from the medical
W. Cieślak4, E. Holec4,5. 1Department of Psychiatry Nursing, record: age, gender, body mass index (BMI), abdominal
2
Deparment of Psychiatry Nursing, Nicolaus Copernicus circumference (CA), fasting glucose (FG) and glycated hemo-
University in Torun, Collegium Medicum in Bydgoszcz, globin (HbA1c), physical activity, fruit and vegetable consump-
3
University Hospital No. 1, 4Nicolaus Copernicus University in tion, antihypertensive drugs and family history of DM.
Torun, Collegium Medicum in Bydgoszcz, 5University Hospital Descriptive analysis was performed using the Microsoft Excel®
No 1, Bydgoszcz, Poland program.
Results: Among the 95 patients evaluated, there was a
Rationale: It is known from clinical observations that patients predominance of the female gender (64.2%), with a mean age
with alcohol dependence at the initial stage of abstinence of 57.9 ± 13.1 years. According to Findrisc’s classification,
often experience both alcohol craving and severe hunger 57.90% had a high or very high risk of developing DM (47.37%
before meals occurring coincidentally. The purpose of the study and 10.53%, respectively). Among the analyzed variables, the
was to assess whether alcoholism and pre-meal hunger depend most important to the elevation of the score were BMI (32.63%
on similar clinical, biochemical, and nutritional variables in between 25 and 30 kg/m² and 48.42% ≥ 30 kg/m²), CA (16.84%
patients hospitalized for alcohol dependence. equivalent to high risk and 66.32% very high risk), sedentary
Methods: The study was conducted among 67 men hospitalized lifestyle (55,79%), use of antihypertensive drugs (73%) and
for alcohol dependence. In the first week of treatment, each family history of DM (56.84%). The FG was altered in 33.68%,
patient was evaluated for age, clinical dependence (e.g. time with a mean of 95 ± 12.37 mg/dL and the HbA1c with a mean of
and depth of addiction, craving, smoking) and nutritional (e.g. 6.1 ± 3.81%, a value that also corresponds to the high risk for
hunger, body mass, BMI, WHR,% FM) and biochemical (Eg leptin, the development of DM.
ghrelin, GTP or triglycerides) status. IMAGO 3 with linear Conclusion: The Findrisc is a low cost and easy applicability
regression was used for statistical evaluation. tool in clinical practice. Among the variables with a higher
Results: It has been shown that in the group of clinical prevalence of alterations, there are modifiable factors that can
variables, a predictor of pre-meal hunger intensity was tobacco be improved during nutritional follow-up, mainly in individuals
smoking (Beta 0.348; R2 = 0.12). In turn, a predictor of the with a higher risk for the development of DM.
frequency of alcohol craving in the week was the number of Disclosure of Interest: None declared.
standard drinks (Beta 0.292; R2 = 0.07). From the group of
SUN-P126 global assessment (SGA) and laboratory. Nutritional status

BIOELECTRICAL IMPEDANCE ANALYSIS PHASE ANGLE AS A was classified at the beginning and the end of nutritional
PROGNOSTIC MARKER FOR OUTCOME IN PATIENTS ADMITTED program based on the TLC: normal >2,000 mm3, MNT mild
IN HOSPITAL WITH ACUTE EXACERBATION OF CHRONIC 1,500–1,999 mm3, moderate 1,200–1,499 mm3 and severe
OBSTRUCTIVE PULMONARY DISEASE <1,200 mm3. REE was calculated by Harris-Benedict and
S. Kakavas1,2, D. Karayiannis3 *, A. Papanikolaou2, A. Baschali3, protein requirement were 0.6 g/Kg/d in G4 and 0.7 g/Kg/d at
M. Sarantidou3, A. Karachaliou3, A. Karli3, Z. Mastora1, G3 KDIGO stage. Attachment was assessed with a 24-hour
M. Palavra2, G. Boulbasakos2. 1First Department of Critical reminder and weekly dietary diary. Data are presented as
Care Medicine and Pulmonary Services, 2Pulmonary percentages, means ± SD; paired Student’s tests were used; a
Department, 3Nutrition and Dietetics, Evangelismos Hospital, difference was significant for p < 0.05.
Athens, Greece Results: 25 patients (19 women and 6 men) were included.
Mean age was 53.76 ± 10.96 years. According to the SGA were
Rationale: Changes in body composition are important extra- classified 44% as SGA-A, 36% SGA-B and 20% SGA-C. REE
pulmonary manifestations of chronic obstructive pulmonary provided was 1871.8 ± 292.59 cal. BW (68.69 ± 18.16–65.90 ±
disease (COPD) that occur in all stages of disease and are 17.39 kg; p < 0.001), BMI (28.42 ± 7.0–26.90 ± 7.16 Kg/m2; p <
associated with poor outcome. Bioelectrical impedance ana- 0.001) and serum creatinine levels decreased significantly
lysis phase angle (BIAPA) is a strong functional and prognostic (2.4 ± 0.21–1.93 ± 0.12 mg/dL; p < 0.001) (Table).
marker in many disease states, but data in COPD with acute
Table: Effects of nutritional intervention on TLC in patients with CKD.
exacerbation are lacking. Our aim was to determine the
Nutritional status TLC mm3 0 months 4 months
relationship of BIAPA with established markers of function,
disease severity and prognosis. Normal >2,000 44% 64%
Methods: A cross sectional observation study constituting 31 MNT mild 1,500–1,999 12% 20%
MNT moderate 1,200–1,499 28% 8%
COPD patients consecutively hospitalized with acute exacer- MNT severe <1,200 16% 8%
bation. Lung function was measured by routine spirometry.
Nutritional status was assessed by the measurement of
anthropometric indices, handgrip dynamometry and bioelec- Conclusion: MNT is a persistent problem for CKD patients.
trical impedance analysis. Hospital outcome was also assessed. Nutritional intervention was associated with an improvement
Results: Thirty one COPD patients with acute exacerbation of nutritional status and decreased of serum creatinine levels.
(mean age 62.5 ± 7.1 years, mean BMI 26.5 ± 4.1 kg/m2) were References
assessed. Phase angle correlated positively with Fat Free Mass
Leinig C, Morales T, Ribeiro S, Riella M, Olandosky M, Martins C.
(FFM) (r = 0.351, p < 0.001), serum albumin at admission Predictive value of malnutrition markers for mortality in peritoneal
(r = 0.298, p < 0.05) and handgrip strength (r = −0.288, p < dialysis patients. J Ren Nutr. 2011.
0.05). In multivariate adjusted models, participants in the
lowest tertile of BIAPA had significantly higher Length of
Hospital Stay (OR:2.21, 95% CI 1.38–2.84), after adjusting for
age, BMI, sex, Forced Expiratory Volume in one second (FEV1) SUN-P128
and forced vital capacity (FVC), compared to those in the third DIETARY HABITS IN PARKINSON’S DISEASE: ADHERENCE TO
tertile. Lower phase angle values were associated with more MEDITERRANEAN DIET
exacerbations and hospital days in past year ( p < 0.05). M. Barichella1, E. Cereda2 *, E. Cassani1, V. Ferri1, G. Pinelli1,
Conclusion: Bioelectrical impedance analysis phase angle L. Iorio1, C. Bolliri1, S. Caronni1, S. A. Faierman1,
relates to markers of function, disease severity and length of A. Mottolese1, C. Pusani1, F. Monajemi1, M. Pasqua1,
hospital stay in patients with acute exacerbation of COPD and A. Lubisco3, G. Pezzoli1. 1Parkinson Institute, ASST G.Pini-CTO,
demonstrates promising prognostic utility. ex ICP, Milano, 2Nutrition and Dietetics Service, Fondazione
Disclosure of Interest: None declared. IRCCS Policlinico San Matteo, Pavia, 3Department of Statistical
Sciences “P. Fortunati”, University of Bologna, Bologna, Italy
SUN-P127
Rationale: Our objective is to describe the dietary habits, food
EFFECTS OF NUTRITIONAL INTERVENTION ON LYMPHOCYTE
preferences and adherence to Mediterranean diet (MeDi) of a
COUNT IN PATIENTS WITH CHRONIC KIDNEY DISEASE IN G3-4
large sample of Italian Parkinson’s Disease (PD) patients
KDIGO STAGE
compared to a group of healthy controls.
E. Perez-Cruz1 *, A. Pablo-Francisco1, B. R. Pardo-Pacheco1, Methods: Dietary habits of 600 PD patients from throughout
Y. Luna-Camacho1. 1Nutrition Support, Critical Medicine Italy and 600 healthy controls matched by gender, age,
Department, Hospital Juárez De México, CD Mexico, Mexico education, physical activity level and geographical residence,
were collected using the ON-GP Food Frequency Questionnaire.
Rationale: Chronic kidney disease (CKD) patients are at risk of
Then, we compared patients by disease duration and the
malnutrition (MNT). The aim of this study was to describe the
presence of swallowing disturbances.
impact of a nutritional program in total lymphocyte count
Results: Overall, adherence of PD patients (males, 53.8%;
(TLC) of patients with CKD.
mean disease duration, 9.2 ± 7.0 years) to MeDi was similar to
Methods: A prospective, longitudinal study was conducted in
controls (score, 4.8 ± 1.7 vs. 4.9 ± 1.6; P = 0.294). Patients
patients with CKD G3-G4 KDIGO during 4 months. Etiology
consumed less alcohol and fish and drank significantly less
diagnostic and demographic information were obtained. The
water, coffee, and milk (P < 0.05 for all) which resulted also in
protocol included anthropometry measurements, subjective
lower total fluids intake. On the contrary, they ate more fruit,
S102 Poster
cooked vegetables, cereals and baked items, more dressings Conclusion: Severely undernourished AN patients present a
and more sweets in general (P < 0.05 for all). Disease duration global decrease of muscular strength, more important in axial
was associated with increased intake of several food groups but muscles. This impairment is associated with severity of
it was not was not associated with changes in MeDi score undernutrition and hypertransaminasemia. An incomplete
(P = 0.721). Patients with swallowing disturbances (n = 72) recovery was observed after 5 weeks of enteral nutrition.
preferred softer and more viscous food but preferences did Ongoing larger study with electromyogram evaluation will
not result in differences in dietary pattern. However, patients allow a better characterization of this muscular impairment
with dysphagia drank less fluids (P = 0.043). (neurogenic vs myogenic).
Conclusion: PD patients presented different dietary habits and Disclosure of Interest: None declared.
food preferences compared to the general population and
adherence to MeDi was not associated with disease duration.
SUN-P130
Self-reported dysphagia was associated with reduced intake of
CARDIOVASCULAR RISK AND ATPIII GOALS ACHIEVEMENT IN
fluids. These aspects may be amenable to change in order to
ECUADORIAN POPULATION
improve the management of nutritional issues in this patient
population. I. Hernandez1, A. Estrella1, J. L. Salazar2, Y. C. Duarte3,
E. Torres4, C. Lopez5, E. Teran1,6 *. 1Facultad de Enfermeria,
References Pontificia Universidad Catolica del Ecuador, 2Servicio de
Barichella M, Cereda E, et al. Dietary habits and neurological features Endocrinologia, Hospital Especialidades Eugenio Espejo,
of Parkinson’s disease patients: Implications for practice. Clin Nutr. Quito, 3Servicio de Cardiología, Hospital Luis Vernaza,
2016; In Press doi: 10.1016/j.clnu.2016.06.020. Guayaquil, 4Servicio de Medicina Interna, Hospital Carlos
Disclosure of Interest: None declared. Andrade Marín, Quito, 5Servicio de Endocrinología, Hospital
Teodoro Maldonado Carbo, Guayaquil, 6Colegio de Ciencias de
SUN-P129 la Salud, Universidad San Francisco De Quito, Quito, Ecuador
EVALUATION OF MUSCLE-SKELETAL STRENGTH AND IN
SEVERELY MALNOURISHED PATIENTS WITH ANOREXIA Rationale: ATPIII guidelines for dyslipidemia treatment are
NERVOSA (AN) aimed to reduce cardiovascular morbi-mortality and reduced
avoidable health care costs. In Ecuador, 19.9% of people
E. Minano1 *, P. Bemer1, H. Ohanyan1, A. Pleple1, N. Kayser1,
younger than 60 years old shows high LDLc and hypertriglycer-
J.-C. Melchior1,2, M. Hanachi2,3. 1Unité de Nutrition Clinique,
idemia is present in 38.7%. The objective of the present study
Hôpital Raymond Poincaré, Garches, 2Faculté de médecine,
was to investigate the percentage of ATPIII goals achievement
Université de Versailles Saint Quentin en Yvelines INSERM
in Ecuadorian population.
U1179, Montigny-le-Bretonneux, 3Raymond Poincaré Hospital
Methods: 385 subjects older than 30 years, with confirmed
(AP-HP), Garches, Clinical Nutrition Unit, Garches, France
dyslipidemia by laboratory analysis and having received
Rationale: Anorexia nervosa (AN) is a psychiatric pathology medical care and pharmacological treatment for at least
with potential somatic consequences. Loss of autonomy and three months were included from both public and private
functional impotence are not well known in severely malnour- institutions from the two main cities (Quito and Guayaquil) of
ished patients (BMI < 13) with AN. We aimed to study the Ecuador. In an explanatory, observational and retrospective
muscles strength at admission and after 5 weeks of nutritional study, subjects were randomly selected, and patient’s record,
care. age, gender, diagnosis, initial and 12 weeks values of lipids, and
Methods: A prospective cohort study was conducted during 6 treatment provided were collected.
months. Clinical and biological nutritional assessment and Results: Results showed equal distribution by gender. Very high
weekly muscular testing using simplified muscle test* up to 5 cardiovascular risk was present in 77.6% of the subjects, and
weeks of evolution were organized. this was significantly more frequent in women (86.6%, OR 2.97
Results: We included 24 AN female patients (79% AN restrictive 95%IC 1.65–5.3; p = 0.0002). When comparing initial and post
type and 21% AN purging type): BMI 11.7 ± 2.17, age 25.5 ± 6.3 treatment lipid values, the high-risk group showed a decrease
years, duration of disease 9.06 ± 6.51 years. All patients showed in the latter, although it was no significant, but allowed 62% of
a global decrease in muscle strength at admission. This was the patients at this group to reach their goal. However, in very
more marked on axial than peripheral levels (2/5 ± 1/5 vs 3/ high-risk subjects, although there was a significant decrease in
5 ± 1/5, p < 0.0001). Concerning peripheral muscular force, LDLc ( p < 0.0001) and triglycerides ( p = 0.0009), only 19%
there was no significant difference between proximal and distal patients reached their goal. Statins were the treatment of
muscles (Proximal vs Distal (3.2/5 + 0.51/5 vs 3.1/5 + 0.9/5, choice in 91% of the cases, but in most of them, they were
p = 0.45). Global and segmental loss of muscle strength at prescribed at the lowest available doses.
admission was significantly associated with severity of under- Conclusion: In conclusion, in this representative sample of
nutrition (BMI: p < 0.0001, Alb: p = 0.02, Pre Alb: p = 0.02) and Ecuadorian subject with high or very high cardiovascular risk,
severity of hypertransaminasemia (AST: p = 0.02, ALT: p = independent of the treatment used, only 29% of patients
0.005). After follow up under enteral nutrition, the evolution achieved ATP III goals.
of muscle strength was significantly positive (S1 vs S5: Disclosure of Interest: None declared.
p = 0.0012) as well as weight gain (BMI S5:12.7, p = 0.001)
With an average improvement in testing at S5 of more than 50%
of the initial value).
SUN-P131 Results: A total of 30 children (43.3% male) with a median age

FECAL SHORT CHAIN FATTY ACIDS CONCENTRATIONS AND of 27.5 months (11–121 months) were included. Mean duration
DIETARY INTAKE IN FEMALES WITH RESTRICTIVE ANOREXIA of thickener use was 14.3 ± 11.4 months. A xanthan-gum based
NERVOSA thickener was the choice of thickener in 53.3% of children while
E. Speranza1 *, I. Cioffi1, L. Santarpia1, C. De Caprio1, a modified-starch based or locust bean gum based thickener
C. Del Piano1, E. De Filippo1, M. Marra1, F. Pasanisi2, was used in 26.7% and 20.0%, respectively. Most of the children
F. Contaldo2. 1Federico II University, 2Interuniversity Center for (93.4%) were recommended to drink nectar/honey-like con-
Obesity and Eating Disorders, Federico II, Naples, Italy sistencies. The most common problems regarding the prepar-
ation of thickened fluids were lumpiness (53.3%), excessive
Rationale: The composition of the intestinal microbiota could thickening with waiting (33.3%) and inability to obtain same
affect body weight regulation. The role of gut microbiota in consistency in different liquids (23.3%). Families reported
undernourished subjects, including anorexia nervosa (AN), has reduced frequency of pulmonary infections (93.3%), decreased
not been fully investigated. This study aims to analyze fecal feelings of thirst (83.3%) and increased liquid intake after
short chain fatty acids (SCFAs) and bacteria profiles along with treatment (63.3%). Ease of preparation or treatment outcomes
dietary intake in restrictive AN patients (r-AN) versus controls. were not statistically different according to types of thickener
Methods: Fecal SCFA and bacteria concentrations were or consistency level ( p > 0.05). All of the families reported that
evaluated in 11 females with r-AN and 7 healthy females thickened liquids were safe and 90.0% of families were satisfied
controls (age = r-AN: 22.4 ± 3.0 y, controls: 31.0 ± 5.5 y; with the treatment.
BMI = r-AN: 14.9 ± 1.0 kg/m2, controls: 22 ± 2.4 kg/m2). Fecal Conclusion: Although the families experience some difficulties
SCFA were quantified with gas chromatography, while different in preparation of thickened liquids with appropriate thickness
bacteria phyla (Bacteroidetes, Firmicutes, Lactobacillus, and level, they are still found to be safe and efficient by families,
Bifidobacterium) were identified by quantitative Real-Time particularly due to reduced pulmonary infections and
PCR (qRT-PCR). Additionally, the r-AN patients and controls increased fluid intake.
underwent indirect calorimetry for measuring Resting Energy Disclosure of Interest: None declared.
Expenditure (MREE) and dietary intake was assessed by using
7-day food records in both groups. SUN-P133
Results: The concentrations of total fecal SCFA, butyrate,
MALNUTRITION AND PULMONARY FUNCTIONS IN PATIENTS
propionate were reduced in r-AN patients compared to controls
WITH CYSTIC FIBROSIS
( p = 0.013; p = 0.004; p = 0–018; respectively); while no differ-
ence was observed for different bacteria groups. As expected, H. Akbıyık1 *, N. Emiralioğlu2, E. Güneş Yalçın2, D. Doğru Ersöz2,
MREE (r-AN = 915 ± 165 kcal; controls = 1,359 ± 147 Kcal; p = H. U. Özçelik2, N. Kiper2, H. Gökmen Özel1. 1Nutrition and
0.001) as well as reported energy intake was significantly Dietetics, Faculty of Health Sciences, 2Department of Pediatric
lower for r-AN versus controls (r-AN = 1,062 ± 321 kcal; controls = Pulmonary Diseases, Faculty of Medicine, Hacettepe
1,507 ± 395 Kcal; p = 0.02). Fat intake was significantly lower in University, Ankara, Turkey
r-AN patients whereas fiber intake did not differ between
Rationale: Malnutrition is common in patients with cystic
groups.
fibrosis (CF). Lower body mass index Z (BMIZ) score is
Conclusion: The significant reduction in fecal SCFA in r-AN
associated with worse pulmonary function. The aim of this
compared to controls might represent an adaptive mechanism
study was to evaluate malnutrition and pulmonary functions in
of nutrients digestion in r-AN subjects.
CF patients.
Disclosure of Interest: None declared. Methods: Seventy-four patients with CF (37 boys, 37 girls), aged
between 9 and 19 years (mean ± SD = 11.4 ± 3.9 yrs) attending
SUN-P132 Hacettepe University, Faculty of Medicine, Department of
THICKENER USE IN PEDIATRIC DYSPHAGIA: TREATMENT Pediatric Pulmonary Diseases were included. Weight for age
RESULTS AND FAMILY EXPERIENCES (WAZ), height for age (HAZ) and BMIZ scores were calculated
F. Ilgaz1 *, S. Serel Arslan2, H. Gökmen Özel1, N. Demir2, using WHO Anthro and Anthro plus programmes. Forced
A. A. Karaduman2. 1Department of Nutrition and Dietetics, expiratory volume in 1 second (FEV1) was measured according
2
Department of Physical Therapy & Rehabilitation, Hacettepe to standard guidelines in patients over 6 years of age. Patients
University Faculty of Health Sciences, Ankara, Turkey having FEV1 > 80%; ≤80% and ≥61%; ≥41% and ≤60% and ≤40%
were classified as normal, mild obstruction, moderate obstruc-
Rationale: Thickened fluids are widely used in pediatric tion and severe obstruction, respectively.
dysphagia but little is known about the results and family Results: It was found that 11.6% of patients were underweight
experiences regarding the use of commercially fluid thick- (WAZ ≤−2SD) and 7.0% were stunted (HAZ ≤−2SD). The
eners. This study was designed to determine the results and percentage of patients whose BMIZ scores ≤−2SD was 9.9%.
family experiences related to the use of thickeners in children There were no patients who had moderate and severe lung
with liquid aspiration. disease. Mean FEV1 was %91.3 ± 10.1 and WAZ, HAZ and BMIZ
Methods: This cross-sectional study was conducted on children score was −0.84 ± 1.34, −0.86 ± 1.04 and −0.60 ± 1.28, respect-
using thickeners for management of thin liquid aspiration, ively. There was no relationship betweenWAZ, HAZ, BMIZ and
which was determined by videofluoroscopic swallowing study. FEV1%.
Data was obtained from families by a detailed questionnaire. Conclusion: Although it was not shown a relationship between
Statistical analyses were performed by chi-squared test. BMIZ score and pulmonary function in this study, it is important
S104 Poster
to assess nutritional status and pulmonary functions in cystic the effect of dietary treatment by achieving individual dietary
fibrosis population. goals.
Disclosure of Interest: None declared. Methods: Individual treatment goals were set for each patient
and evaluated after 3 and 6 months. Goals were established to
improve or stabilize bodyweight, fat free mass, fat percentage,
SUN-P134
handgrip strength (HGS), level of fatigue, and/or presence and
ENERGY AND MACRONUTRIENT INTAKES IN PATIENTS WITH
nature of intestinal problems. Analysis of individual goals was
CYSTIC FIBROSIS: DO THEY ACHIEVE GUIDELINES?
performed at 3 and 6 months after starting the intervention by
H. Akbıyık1 *, N. Emiralioğlu1, E. Güneş Yalçın1, D. Doğru Ersöz1, scoring the rate of success for each goal.
H. U. Özçelik1, N. Kiper1, H. Gokmen Ozel2. 1Department of Results: 38 adult patients with the m.3243A > G mutation (age:
Pediatric Pulmonary Diseases, Faculty of Medicine, 2Nutrition 47 yr ± 13, mean ± SD, 21% male) were enrolled. The majority of
and Dietetics, Faculty of Health Sciences, Hacettepe these patients (74%) expressed a wish to decrease their level of
University, Ankara, Turkey fatigue. Tailored dietary advice resulted in improvement or
stabilization of body composition (51%), HGS (51%), fatigue
Rationale: Most patients with cystic fibrosis (CF) require a
(34%), and gastro intestinal problems (50%). Eighty-four
higher energy and protein intake than their healthy peer group.
percent of the MD patients reported an improvement of one
There are few data on dietary intakes in our CF patient group.
or more goals related to body composition and/or functioning,
The aim of this study was to evaluate daily energy and
success of stabilization was registered in 95%. A total of 190
macronutrient intakes and compare according to the recom-
dietary goals at initiation decreased to 171 goals after 3 months
mendations of the nutritional guidelines for CF.
of the intervention. Each patient formulated an average of 5
Methods: One-hundred sixty four patients with CF, aged
(2–7) different goals of which 2,3 were achieved, thus resulting
between 2 and 20 years (mean ± SD = 7.4 ± 4.9 yrs) attending
in a success rate of 48%.
Hacettepe University, Faculty of Medicine, Department of
Conclusion: Almost half of the individually set dietary goals
Pediatric Pulmonary Diseases were included. Energy and
were achieved. Individually tailored dietary treatment seems a
macronutrient intakes were calculated using a-24-hour
successful strategy in a substantial subset of adult MD patients
dietary recall method and compared according to ESPEN-
to improve or stabilize body composition, HGS, and/or gastro-
ESPGHAN-ECFS guidelines with CF. Mean percentage (±SD) of
intestinal complaints.
energy from protein, carbohydrate and fat was calculated.
Results: The mean value of carbohydrate intake was Disclosure of Interest: H. Zweers Grant/Research Support from:
46.9 ± 8.8%, with mean values was close to the higher Vitaflo, M. Rutten: None declared, M. Rossum: None declared, S. Leij:
None declared, G. Wanten: None declared, M. Janssen: None declared.
recommended threshold (40–45%). Mean percentage of
energy from carbohydrate was higher than the recommended
threshold in 86 patients. The mean daily protein intake was SUN-P136
14.6 ± 3.6%, not reaching the recommendation of 20%. A total PATIENT SATISFACTION, ENERGY AND PROTEIN INTAKE IN A
149 patients’ mean percentage of energy from protein was GENERAL HOSPITAL POPULATION AFTER SWITCHING TO A
lower than recommendation. The mean fat intake (37.5 ± 8.3%) NEW HOSPITAL ROOM CATERING SERVICE
was in the recommended ranges (35–40%). The recommended I. A. M. De Groot1 *, N. Kampman2, A. G. C. M. van Oort3,
lower (110%) and higher (200%) limit of daily energy intake was H. Jongejan4, I. A. M. Gisbertz5. 1Dietetics, Bernhoven
not reached by 40% and 96% of the patients, respectively. The Hospital, Uden, 2Nutrition and Dietetics, HAN Hogeschool van
mean value of was 236 kcal higher than the lower threshold and Arnhem en Nijmegen, Nijmegen, 3Food Innovation, HAS
−1,864 kcal lower than the higher threshold. Mean fat intake hogeschool Venlo, Venlo, 4Room & Lounge Services,
decreased with age (r = −0.225, p < 0.01), while mean carbo- 5
Gastroenterology, Bernhoven Hospital, Uden, Netherlands
hydrate intake increased (r = 0.182, p < 0.05). Percentage of
protein intake did not change with age. Rationale: Traditional hospital meal service often does not
Conclusion: It was shown that mean carbohydrate and fat improve the nutritional status of hospitalised patients, allready
intakes were close to recommended guidelines, although at risk for malnutrition. After introducing a new, flexible and
energy and protein recommendations were not met. Dietary patient-friendly meal service in our (general) hospital we
assessment is essential to identify the need for earlier aimed to investigate patient satisfaction and to determine the
nutritional intervention. percentage of patient-days in which nutrition goals were
achieved.
Methods: We prospectively collected data from general ward
patients in hospital Bernhoven (Uden, The Netherlands). A
SUN-P135 questionnaire1 (40 questions in 6 domains) was used to
INDIVIDUALLY TAILORED DIETARY TREATMENT IN PATIENTS determine patient satisfaction in 90 patients. Energy and
WITH MITOCHONDRIAL DISORDERS: THE DINAMITE STUDY protein intake was studied by comparing the exact weights of
H. Zweers1, M. Rutten1,2, M. V. Rossum1,2, S. Leij1,2 *, meal components before and after meal consumption on 90
G. Wanten1, M. Janssen3. 1Department of Gastroenterology patient-days. This was compared to calculated energy (Harris
and Hepatology, Radboudumc, 2Dietetics, HAN University of and Benedict) and protein (1,2 g/kg/day) requirements.
Applied Sciences, 3Department of Internal Medicine, Results: Overall patients rated our meal service with a 8,4 on a
Radboudumc, Nijmegen, Netherlands scale from 1 to 10. The calculated energy requirements were
achieved in 28% of the patient-days studied, protein goals were
Rationale: The DINAMITE study is the first explorative study in achieved in 33% of days studied. Measurements in patients with
adult patients with mitochondrial disease (MD) that explored
a high (2 or more) versus a low (0 or 1) SNAQ (Short Nutritional SUN-P138

Assessment Questionnaire) score showed a clear difference: RETROSPECTIVE ANALYSIS OF LABORATORY DATA AFTER USE
measurements in high SNAQ score patients (supplied with OF 2ND AND 3RD GENERATION LIPID-CONTAINING
protein and energy enriched diets) showing sufficient protein PARENTERAL NUTRITION SOLUTIONS
intake in 56% of patient-days studied, versus in 21% of patients- I. G. Telessy1 *. 1Generacio Patika Bt, Gödöllö, Hungary
days in patients with a low SNAQ score (supplied with normal
diets). Rationale: Clinical laboratory (CL) parameters are accepted
Conclusion: Patients reported to be quite satisfied with our indicators of adverse reactions during and after parenteral
meal concept. This study shows again that it is very important to nutrition (PN). According to our hypothesis retrospective
find ways to improve energy and protein intake. One way could analysis of patient data can help in decision about nutrition
be to supply energy and protein enriched diets to all hospitalised therapy of patients today. Data originated from an earlier study
patients, instead of in high SNAQ score patients only. we performed with other goal.
References Methods: 27 routine CL parameters originated from randomly
selected 41 patients of Surgical Department of Debrecen
1. Nutrition-related Quality of Life Questionnaire. Developed by de
Roos ea. Wageningen University, the Netherlands, 2011.
University, Hungary. Patient undervent subacute GI surgical
interventions and due to their nutritional status they were
Disclosure of Interest: None declared. nourished with total PN solutions from the first postoperative
day. PN mixtures were identical except fat emulsion and the
SUN-P137 dosage per 1 kgBW was the same, too. Group-I received MCT-
INHIBITORY EFFECTS OF RESVERATROL ON STERILE LCT mixture and the Group-II received SMOFLipid. Blood was
INFLAMMATION IN HIGH FAT DIET INDUCED OBESITY collected after 12 hours fasting early morning before operation
I. Khodadadi Kohlan1 *, E. Siahpoushi1, H. Tayebinia1, and on the 4th postoperative day. Data were statistically
M. T. Goodarzi1, A. Zamani2. 1Clinical Biochemistry, Faculty of evaluated by Mann-Whitney tests and significant difference
Medicine, 2Immunology, Faculty of Medicine, Hamadan between day 0 and day 4, as well as Group-I and Group-II was
University of Medical Sciences, Hamadan, Iran, Islamic stated if p < 0.05.
Republic Of Results: Out of 27 laboratory parameters in Group-I 14
parameters and in Group-II 12 parameters were out of normal
Rationale: Activation of NLRP3 inflammasome/caspase-1 range on 4th postoperative day. Statistically significant differ-
complex in oxidative stress and production of interleukin-1 ence between day 0 and day 4 data were found in 11 parameters
beta (IL-1β) causes chronic inflammation observed in obesity. (Group-I) and in 12 (Group-II). Intergroup differences were
This study aimed to investigate the antioxidant property of found in 5 parameters (LDH, GGT, TG, CRP and se-Alb).
resveratrol (RSV) on inhibiting the NLRP3 inflammasome and Conclusion: Postoperative periode is full of metabolic changes.
reducing the production of IL-1β. Parenteral nutrition can also influence these parameters,
Methods: Forty male wistar rats (250 ± 14.3 g) were divided therefore evaluation of changes in this periode needs thorough
into 4 groups. Normal control and RSV-treated control groups consideration. The support with PN solutions containing
received chow diet for 6 weeks whereas untreated obese and different lipid components shows that administration of 2nd
RSV-treated obese (Ob + RSV) groups were fed high fat diet generation lipids resulted in significantly higher GGT, CRP and
(HFD) to induce obesity. Rats were then received chow diet or TG levels in comparison to 3rd generation lipid emulsion.
chow diet plus daily i.p. injection of RSV (8 mg/kg) for 4 weeks. Disclosure of Interest: None declared.
Blood neutrophils, lymphocytes, and white blood cell count
(WBC), serum IL-1β level, liver enzymes activities, fasting
SUN-P139
blood sugar (FBS), lipid profile, HbA1c and caspase-1 activity in
“AWARENESS OF NUTRITIONAL SUPPORT IN HOSPICE CARE
adipose tissues were determined. Normal distribution of the
SETTINGS AMONG MEDICAL STAFF – PRELIMINARY STUDY
results was tested using the Kolmogrov-Smirnov test. The one-
FROM POLAND”
way ANOVA with post hoc Tukey test was used for comparison
between groups. Statistical significance was set at p < 0.05. J. Januszczyk1,2,3 * on behalf of POLSPEN’s Palliative Care
Results: Untreated obese rats showed mild liver steatosis with Working Group, M. Stukan4 on behalf of POLSPEN’s Palliative
elevated lipid profile and had significantly higher body weight, Care Working Group, M. Czyzewska3 on behalf of POLSPEN’s
FBS, HbA1c, WBC, neutrophil to lymphocyte ratio, IL-1β level, Palliative Care Working Group, M. Renke2, S. Klek5 on behalf
and caspase-1 activity. Treatment with RSV remarkably reduced of POLSPEN’s Palliative Care Working Group on behalf of
body weight, FBS and HbA1c and favorably corrected lipid POLSPEN’s Palliative Care Working Group. 1Father Dutkiewicz
profile, WBC count and neutrophil to lymphocyte ratio. Hospice, Gdansk, 2Department of Occupational, Metabolic and
Interestingly, resveratrol completely ameliorated the detri- Internal Medicine, Medical University of Gdansk, Gdynia,
3
mental increase in adipose tissue caspase-1 activity and serum Department of Hematology, Nicolaus Copernicus Municipal
IL-1β, and improved steatosis in Ob + RSV group. Specialist Hospital, Torun, 4Gynecologic Oncology
Conclusion: Resveratrol confers some protective roles by Department, Gdynia Oncology Center, Gdynia, 5General and
reducing the activity of caspase-1 and IL-1β level, therefore, Oncology Surgery Unit and Intestinal Failure Center, 5 Stanley
it can be envisioned as a candidate therapeutic agent to reduce Dudrick’s Memorial Hospital, Skawina, Poland
systemic inflammation in obesity and prevent the risk of
chronic inflammatory diseases. Rationale: The aim of the study was to evaluate awareness of a
nutritional status among medical staff and a need for imple-
Disclosure of Interest: None declared. mentation nutritional support in patients under hospice care.
S106 Poster
Methods: An electronic questionnaire was sent to all hospices

Average of 4 days ostomy output
(584) in Poland, using webpage www.hospicja.pl. Doctors and
nurses were asked to express their opinion about nutritional Patient No Water (mL) WHO ORS Water + TP
support. The survey consisted of 14 different questions was 1 1205 875 175
designed at the surveymonkey.com. These are preliminary data. 2 1800 1200 912
Results: We have collected 95 responses –33 from doctors and 3 1050 725 775
4 1450 1100 850
60 from nurses. 92% of responders felt that patients under 5 1200 950 637
hospice care were undernourished. Even though 44% of the staff 6 620 400 800
had nutritional experience >6 years, only in 58% cases they used 7 1300 1065 800
8 1640 1012 625
nutrition assessment as a routine procedure. Weight loss and Average 1283,1 915,6 696,8
anorexia was used in 91% cases along with physical examination
in 68% situations. NRS 2012 or SGA scale were used only in 17%
Conclusion: Consumption of water with thickening powder
and 16% cases respectively. 38% evaluated nutrition status with
significantly reduced ostomy output and feeling thirsty.
subjective patient’s handgrip strenght. Biochemical results (i.
e. albumin, lymphocytes, cholesterol) were used by 32% Disclosure of Interest: J. Sobocki Paid Instructor at: nutricia,
responders for nutrition assessment. Once decided to intro- K. Lachowicz: None declared, P. Jurczak: None declared, P. Groszek:
None declared, K. Majewska: None declared.
duce nutritional intervention a majority (95%) used oral
nutritional supplements and anticachectic drugs (70%).
Nasogastric tube, enteral nutrition, parenteral nutrition was SUN-P141
used in 41, 67% and 35% of cases respectively. Only 35% of IS THERE A NEED FOR ROUTINE BROVIAC CATHETER
patients were reffered to dietician, 31% to rehabilitant and to REPLACEMENT IN HPN PATIENTS AFTER 10 YEARS?
psychologist. Responders claimed nutrition intervention was J. Sobocki1 *, K. Lachowicz1, M. Omidi1, K. Majewska1.
1
needed for hospice patients, 98% of them suggested it could Department of Surgery and Clinical Nutrition, Medical
improve quality of life and 84% of the staff believed it could University of Warsaw, Warsaw, Poland
prolong patients’ lives.
Conclusion: Number of palliative patients increase. Based on Rationale: Incidence of catheter infections in HPN patiens
mediocre awareness of nutritional asessement among medical falled to less that 1 per 1,000 catheter-days. This resulted in
staff from our study, we see need to emphasize value of proper longer lifetime of catheters. Old catheters could be more prone
evaluation followed by an adequate nutrition support in this to rupture and provoke life-thretenning complications. The aim
group of patients. of the study was to evaluate after-effects/history of catheters
kept for longer than 10 years.
Methods: In 2015–2016 years 410 patients were treated with
HPN. 23 patients have had catheters for longer than 10 years. A
SUN-P140 retrospective analysis of catheter-related complications was
THICKENING POWDER REDUCES OSTOMY OUTPUT AND preformed.
THIRST IN PATIENTS WITH END JEJUNOSTOMY SYNDROME – Results: Fifteen of 23 patients have never had their catheters
PRELIMINARY STUDY replaced. Patients have used them uneventfully so far (average
J. Sobocki1 *, K. Lachowicz2, P. Jurczak2, P. Groszek2, maintenance 13,5 yrs). The longest maintainence is 18 years.
K. Majewska2. 1Department of General Surgery and Clinical Eight patients required catheter removal (see table).
Nutrition, Medical Universty of Warsaw, 2Department of
General Surgery and Clinical Nutrition, Medical University of Patients No 1 2 3 4 5 6 7 8
Warsaw, Warsaw, Poland
Cauce of Occlusion Mechanical occlusion Tunel Mechanical occlusion occlusion Tunnel
catheter rupture infection rupture infection
Rationale: Liquids intake increases end jejunostomy output removal
more than solid food. On the other hand solid food is unable to Blood culture – – – – – – – –
reduce thirst. The aim of this study is to estimate effect of Catheter – – – – – – – +
culture
thickening powder (TP) mixed with water on ostomy output and
Maintenance 14 15 10 11 12 11 11 11
feeling thirsty. time
Methods: Eight patients with end jejunostomy syndrome were (years)
included into the study. For the first 4 days they were allowed to
drink 600 mL of water per day, than for 4 day 600 mLWHO ORS Two patients required vascular surgeon intervention (one
and for last 4 days 600 mL water with TP to reach syrup patient due to intravenal attachment of the catheter, which
consistency (1st stage). Ingredients of the powder were as required removal with a part of the vein and the other patient
follows: Dried glucose syrup, xanthan gum, guar gum (Nutrilis, due to intravascular erosion of the catheter). None of the
Nutricia) complications was fatal.
Results: Filling thirsty was reduced after WHO ORS and almost Conclusion: The analysis suggest that routin replacement of
suppressed after water + TP, but not after water. catheter after 10 years is unjustified.
SUN-P142 “Multiple Sclerosis Acute Fulminating” [Title/Abstract]) AND

BIXIN INHIBIT THE EXPRESSION OF TH2 CYTOKINES (“Nutritional Status” [Mesh] OR “Nutritional Status” [Title/
REPRESSING NF-KB TRANSCRIPTION FACTOR Abstract] OR “Nutrition Status” [Title/Abstract]). The quality
J. Marrugo1 *, E. Zarate1, C. Meza2, Y. Ocampo3, L. Franco3, of the selected articles was discussed using the STROBE
B. Martinez1, L. Hernandez1, G. Lopez-Lluch2, questionnaire. The search was completed through experts
J. C. Rodriguez-Aguilera2. 1Immunology, University of inquiry and additional review of the bibliographic references
Cartagena, Cartagena, Colombia, 2Physiology, Anatomy and included in the selected papers. The concordance between
Cell Biology, Universidad Pablo de Olavide, Sevilla, Spain, authors (Kappa Index) had to be higher than 80% for inclusion in
3
Pharmacy, University of Cartagena, Cartagena, Colombia this review.
Results: Of the 160 references recovered, after applying
Rationale: Bixin is a food colorant, with potent antioxidant, inclusion and exclusion criteria, 29 articles were selected for
anti-clastogenic and cytoprotector activities. The role of this review. Concordance between evaluators was 100.00%. The
colorant in the Th2 allergic immune response has not been most studies established vitamin D levels. Others focused their
established. research on finding out which nutrient deficits might be related
Methods: Freshly-isolated PBMC of five atopic patients were to the multiple sclerosis development.
culture in complete RPMI 1,640, pre-treated with Bixin Conclusion: Vitamin D may influence multiple sclerosis
(12.5 mM and 25 mM) for one hour, and stimulated with PHA improvement. Sunlight and physical activity would be import-
(10 ug/mL) for six hours. Total RNA was extracted using Gene ant factors, with nutritional status, in the course of this
Jet RNA purification kit (Thermo Scientific. E.U. Lithuania). disease. It is necessary to produce new specific works that will
cDNA was generated with Transcriptor Universal cDNA Master delve into the subject to find out more about the relationship
(Roche Diagnostics,Germany). Cytokine mRNA expression were between nutritional status and multiple sclerosis.
detected by RT-PCR using specific primers for IL4, IL5, IL13 and Disclosure of Interest: None declared.
GAPDH as a control. NF-kB p65 and pp65 were detected in PMBC
extracts by immunoblotting using specific antibodies (Abcam, SUN-P144
Cambridge, UK). Statistical analysis was performed using one- PATIENT’S DIETARY BELIEFS AND BEHAVIOURS IN
way ANOVA, p < 0.05 were considered significant. INFLAMMATORY BOWEL DISEASE
Results: Our results showed that bixin inhibits the expression of
IL4, IL5 and IL13 mRNA induced by PHA. NF-kB immunoblotting B. Witteman1,2 *, M. Dijkhuizen2, P. Tap3, J. de Vries2.
1
analysis showed that bixin inhibits the PHA-dependent phos- Gastroenterology and Hepatology, Gelderse Vallei hospital,
phorylation of p65 NF-kB subunit. Ede, 2Global Nutrition and Health, Wageningen University,
Conclusion: Bixin inhibits the expression of Th2 cytokines via Wageningen, 3Communication, crohn en colitis ulcerosa
NF-kB transcription factor, suggesting that bixin has an vereniging Nederland, Woerden, Netherlands
immunomodulatory effect on the allergic immune response
Rationale: The aim of this study was to assess the dietary
and may have a therapeutic potential.
beliefs, behaviour and knowledge within a large adult Dutch
References population with IBD, to enable taking into account the patient’s
Antunes LG, et al. Evaluation of the clastogenicity and antic- perspective when giving dietary advice.
lastogenicity of the carotenoid bixin in human lymphocyte cultures. Methods: A self-administered online survey assessing the
Mutation Research - Genetic Toxicology and Environmental general characteristics, dietary beliefs, eating behaviour,
Mutagenesis 2005;585:113–9. source of nutritional knowledge and advice of IBD patients
Mazzaron GR, et al. Bixin and Norbixin Protect Against DNA-Damage was designed. The questionnaire was distributed to members of
and Alterations of Redox Status Induced by Methylmercury Exposure
the Dutch Crohn and Ulcerative Colitis patient association (in
In Vivo. Environmental and Molecular Mutagenesis 2012;53:535–41.
Dutch: Crohn en Colitis Ulcerosa Vereniging Nederland). There
Tao S, et al. Bixin protects mice against ventilation-induced lung injury
in an NRF2-dependent manner. Nature 2016;1–13. were a total of 294 respondents.
Results: Fifty nine per cent of the patients valued nutrition to
be either more or equally important compared to medication
for the treatment of their disease and 64% believed diet to be
SUN-P143 more important in influencing the course of disease. Sixty two
EFFECTS OF NUTRITIONAL STATUS ON THE MULTIPLE per cent reported to be successful in controlling disease
SCLEROSIS DISEASE: SYSTEMATIC REVIEW symptoms through dietary adaptations, of whom almost half
I. Rodenas Esteve1, C. Wanden-Berghe2, J. Sanz-Valero3 *. reported to be always successful. Avoiding certain foods was
1
Universidad Miguel Hernández De Elche, 2General University preferred over eating more beneficial foods and following
Hospital, ISABIAL, 3Universidad Miguel Hernández De Elche, specific diets in order to influence disease symptoms (77% vs
ISABIAL, Alicante, Spain 57%, respectively). Dietary supplements were used by 68% of
the IBD patients. Even though over 71% have had dietary advice
Rationale: To review the available scientific literature about mainly by dieticians, 81% stated that the main source of their
the effects of nutritional status on the multiple sclerosis disease nutritional knowledge related to IBD was their own experience.
Methods: A systematic review of the scientific literature in the Conclusion: A majority of IBD patients consider diet a more
MEDLINE (PubMed), Scopus, Cochrane Library and Web of important and successful managing tool than medication to
Science databases through April 2016. Search equation: relieve of their disease symptoms and claim own experience as
(“Multiple Sclerosis” [Mesh] OR “Multiple Sclerosis” [Title/ the most important source of their nutritional knowledge.
Abstract] OR “Disseminated Sclerosis” [Title/Abstract] OR Disclosure of Interest: None declared.
S108 Poster
SUN-P145 Results: 147 patients and 91 caregivers were included. 28 (19%)

SOCIAL SUPPORTAND EMPLOYMENT STATUS ARE ASSOCIATED patients were male, had been treated with HPN for more than a
WITH NEGATIVE AFFECT IN PATIENTS WITH TYPE 3 year (mean 5 years). The most common underlying disease was
INTESTINAL FAILURE dysmotility (N = 62 (42%)) and the most prevalent indication
J. Ablett1 *, D. Vasant1, M. Taylor1, C. Cawley1, S. Lal1. was short bowel disease (N = 72 (48%)). Patients experienced a
1
Intestinal Failure Team, Salford Royal NHS Foundation Trust, moderate distress of 5 (scale 0–10). Furthermore, findings
Salford, United Kingdom revealed that Qol during the past week was moderate 5, and it
was moderate affected by HPN (0 (scale −5 till +5; high
Rationale: Quality-of-life in patients with type 3 Intestinal score = good Qol)) and not affected by the underlying disease (0
Failure (IF) on Home Parenteral Nutrition (HPN) has been (scale −5 till +5; high score = good Qol)). Similarly to the
reported as poor. However, the influence of social support, patient, the caregiver experienced a moderate distress of 6
employment and levels of anxiety and depression have not (scale 0–12; high score is high strain).
been previously described. Conclusion: This is the first evaluation of Qol and distress in
Methods: Patients requiring HPN managed at a national UK IF patients using HPN and their caregiver in the Netherlands. This
Unit were invited to complete a postal survey. Data were study shows that there is a moderate prevalence of burden
collected on demographics, HPN duration, employment and IF resulting in a moderate Qol for both the patient and their
aetiology. All patients completed the Hospital Anxiety & caregiver, possibly due to the fact that CIF patients and their
Depression Scale (HADS) and the Multi-Dimensional Scale of caregiver have learned to cope with their circumstances to
Perceived Social Support (MSPSS). HADS data, anxiety scores some degree. Insight into distress and Qol can be used to
(HADS-A), depression scores (HADS-D) and negative affect implement measurements improving Qol for patient and
(HADS-NA) were compared using regression and one-way ANOVA caregiver.
analyses, where appropriate. References
Results: 85/256 (33%) patients (median age 59 (range: 25–78),
1. Roskott A.M., et al., Clin Nutr, 2013.
60% Female, median length of time on PN 42 months (range: 2–
2. Baxter JP, Fayers PM, McKinlay AW, JPEN, 2010.
408)), responded. 22/85 (26%) patients were unemployed, 44/ 3. MA & Bos, GAM van den (2004). Clinical Rehabilitation.
85 (52%) retired, 10/85 (12%) employed. Overall, 48/85 (56%)
patients had clinical levels of anxiety and/or depression.
Regression analysis confirmed a significant relationship
between MSPSS and HADS scores (HADS-A: P < 0.0005, SUN-P147
R2 = 0.29, HADS-D: P < 0.0005, R2 = 0.21 and HADS-NA: ORGANIZATION OF THE DIETETIC SERVICE IN A HOSPITAL –
P < 0.0005, R2 = 0.29). Unemployment was associated with LOCAL IN THE DEPARTMENT OR CENTRALIZED?
significantly worse HADS scores (HADS-A: P = 0.004, HADS-D: J. K. B. Clausen1,2 *, L. Martinsen3, B. Wilson3, S. Duncan2,
P = 0.008, HADS-NA: P = 0.003). By contrast, HADS scores were J. R. Andersen1. 1Department of Nutrition, Exercise and
not influenced by age, length of time on HPN or aetiology of IF. Sports, University of Copenhagen, Copenhagen, 2Lung Section
Conclusion: Clinical anxiety and depression is common, 230, Department of Medicine, 3Department of Medicine,
affecting over half of patients with type 3 IF; these data Nykøbing Falster Hospital, Nykøbing Falster, Denmark
suggest that patients requiring HPN should be routinely
screened for affective disorders. Patients with poor social Rationale: In Denmark the dieticians can be organized
networks and those of working age who have ceased employ- centrally and called upon if needed, or locally in larger units,
ment appear to be particularly vulnerable and should be or very locally related to bed-units. The organization form is
prioritised for psychological support. based on tradition not on measurements of quality. We wanted
Disclosure of Interest: None declared. to compare the very local form with the traditional
centralized.
Methods: Randomized, unblindet, parallel design. The inter-
SUN-P146
vention group (IT) was nutritionally handled by the dietician,
EVALUATION OF QUALITY OF LIFE AND DISTRESS IN PATIENTS
and the control group (C) by the nurses as previously with the
USING HOME PARENTERAL NUTRITION AND THEIR
possibility for dietetic help from the centre. All patients were
CAREGIVER: A CROSS SECTIONAL ANALYSIS
screened by NRS-2002 and had their estimated needs calcu-
J. Beurskens Meijerink1 *, G. Huisman de Waal2, G. Wanten1. lated (equations in IT, tables in C). The IT was in addition
1
Department of Gastroenterology and Hepatology, Intestinal assessed for adapted weight-loss, counseled with a plan for
Failure Unit, Radboud University Nijmegen Medical Centre, nutrition and followed-up daily by the dietician if in nutritional
2
Scientific Institute for Quality of Healthcare, IQ Healthcare, risk. All patients were re-screened weekly and had their intake
Nijmegen, Netherlands registered. Hand-grib-strength (HGS) was measured in both
groups at admittance and discharge, and weight three times
Rationale: Home parenteral nutrition (HPN) is indicated in
weekly. After discharge only death and re-admittance was
chronic intestinal failure (CIF) to improve survival and quality
registered.
of life (Qol). The aim of this study was to compare Qol and
Results: We included 16 intervention- and 17 control-patients
distress between CIF patients and their caregiver.
(12 in each group had COPD). The intake was significantly
Methods: 193 patients with CIF and their caregivers were
higher in the intervention group of both energy and protein
invited. Qol and distress were assessed using the “Lastmeter”
(mean 1,5 g/kg/d (SD 0,5) versus 0,8 (0,3)) ( p < 0.0001), also if
[1] and the HPN Qol [2] for the patient with CIF and the Caregiver
calculated as the fulfilment of the estimated needs: protein:
Strain Index (CSI) [3] for the caregiver of the patient with CIF.
mean 98% (SD 16) versus 56% (12) ( p < 0.0001) and energy:
mean 107% (SD 18) versus 73% (34) ( p < 0.0001). HGS did not SUN-P149
change in any of the groups. Four patients died in the EFFECT OF ENTERAL NUTRITION WITH EICOSAPENTAENOIC
intervention group within the two months of observation ACIDS (EPA) FOR PREVENTING PRESSURE ULCERS IN PATIENTS
compared to two in the control group (not significant). Three WITH CEREBRAL INFARCTION
patients (one of those twice) were re-admitted within the two K. Ogawa1 *, Y. Kurokawa2, J. Kuwamura3, M. Watanabe4,
months in the intervention group compared to 10 in the control T. Yamamoto4. 1Clinical Medicine, 2Gerontological Nursing,
group ( p < 0.02). 3
Adult Nursing, Juntendo University Faculty of Health Sciences
Conclusion: We found very clear benefits with the very local and Nursing, Mishima, 4Neurosurgery, Juntendo University
organization form, but did not calculate the costs in the two Shizuoka Hospital, Shizuoka, Japan
groups.
Disclosure of Interest: None declared. Rationale: Enteral diets enriched with EPA contributed to
preventing pressure ulcers in patients with cerebral infarction.
SUN-P148 The beneficial effect of the EPA diets was associated with a
EXPLORING NUTRITIONAL SUPPORT PRACTICES IN RENAL lower occurrence of new pressure ulcers in the clinical nutrition
NURSES IN HEMODIALYSIS UNITS WORLDWIDE – RESULTS OF A management of outcomes.
PILOT STUDY Methods: Patients were randomly allocated into two groups:
one to be given the enteral diet enriched with EPA, and the
K. A. Poulia1 *, M. C. Casal2, M. Chourdakis3. 1Department of other to be fed with an isonitrogenous and isocaloric control
Nutrition and Dietetics, Laiko General Hospital of Athens, diet. All patients were evaluated regarding the incidence
Athens, Greece, 2University Hospital 12 de Octubre, Madrid, frequency of pressure ulcers based on DESIGN-R. Feeding was
Spain, 3Department of Medicine, Aristotle University of continued for a minimum of four days, while monitoring
Thessaloniki, Thessaloniki, Greece continued for 14 days.
Results: In total 12 patients were enrolled in this study,
Rationale: Protein – energy wasting (PEW) is a common problem
including 6 patients placed in the EPA enriched diet group and 6
in patients with chronic kidney disease (CKD) on dialysis.
patients in the control group. Regarding new occurrence of
Provision of adequate individualized nutrition support during
pressure ulcers, only a single lesion was observed on day 7 in the
hemodialysis is an effective way of improving nutritional status
EPA enriched diet group, showing apparently lower incidence of
of the patients and thus minimizing the effect of malnutrition.
pressure ulcer compared to the control group, in which 2 lesions
Methods: The aim of the present study was a preliminary
on day 4, 4 lesions on day 7 and 4 lesions on day 14 were
evaluation of the nutritional support practices applied by renal
observed. Investigation on changes in CRP, an inflammatory
nurses in hemodialysis units worldwide. Questionnaires were
index, showed more significant suppression of inflammation in
distributed to renal nurses working in hemodialysis units in
the EPA enriched diet group when compared to the control
Europe, Asia, Middle East, and Africa. One hundred and
group. Results made it clear that enteral
two questionnaires were analyzed from twenty-three countries
diets enriched with EPA, which can control the inflammation,
(15 European, 2 from the Middle East, 3 from Africa and 1
are more effective than other diets without EPA.
from Asia).
Conclusion: Nutritional management using EPA enriched
Results: Seventy six per cent of the nurses replied that they
enteral diets could be a useful option for pressure ulcer
perform nutritional screening to the patients and 90.2% that
prevention in patients who need long-term immobile bed rest
they provide -any kind of- nutritional support to their patients.
in a supine position, as with cerebral infarction patients.
Related practice was perfromed mainly as a team decision
(45%), secondly per physicians’ decision (38%) and lastly equal References
percentages were reported per nurses’ and dietitians’ decision Matsui Y, et al. Development of the DESIGN-R with an observational
(9%). Common barriers for not providing nutritional support study. Wound Repair Regen 2011; 19: 309–315.
were financial reasons (25%), lack of knowledge (20%), Disclosure of Interest: None declared.
physicians’ (11%) and patients’ disapproval (6%).
Conclusion: Provision of nutrition support seems to be a
SUN-P150
common practice in hemodialysis units. To facilitate its
PREDICTING 3 AND 6- MONTH SURVIVAL FOR ADVANCED
efficient provision there is a need for continuous education
CANCER PATIENTS ON HOME PARENTERAL NUTRITION: A
among health professionals dealing with hemodialysis patients,
NOMOGRAM
which shall be the main step towards the elimination of the
barriers of providing nutritional support in this sensitive K. C. Fragkos1 *, N. Keane2, P. S. Patel2, K. Murray1, S. Obbard1,
population. S. Ajibodu3, S. O’callaghan3, H. Kwok1, E. Paulon1,
J. Barragry1, S. Mehta1, S. Di Caro1, F. Rahman1. 1GI Services,
References 2
Dietetics, 3Pharmacy, University College London Hospitals
1. Fouque D, et al.: Protein–energy wasting in kidney disease. Kidney NHS Foundation Trust, London, United Kingdom
International (2008) 73, 391–398
Disclosure of Interest: None declared. Rationale: We describe the largest cohort of Home Parenteral
Nutrition (HPN) patients with advanced cancer in the UK in
order to identify factors affecting prognosis and develop a
nomogram.
Methods: Data was collected retrospectively for all patients
receiving HPN between 01/01/2006 and 15/10/2016.
Demographic, anthropometric, biochemical and medical
S110 Poster
factors, Karnofsky Performance Status (KPS), Glasgow p = 0.017) and loss of appetite (OR:2.754, KI:1.010–7.512,
Prognostic Score (GPS), and PN requirements were recorded. p = 0.048) were identified as the most powerful predictors of 3
Univariate and multivariate analyses were performed including month readmission in malnourished participants. Age, sex,
Kaplan-Meier curves, Cox Regression and correlation analyses. number of drugs, BMI, loss of weight in last 6 months, frailty and
Results: In total, 107 HPN patients (68 women, 39 men, mean fatigue had no influence.
age 57 years) with advanced cancer were identified. The main Conclusion: Among geriatric persons, sleep deprivation and
indications for HPN were bowel obstruction (74.3%) and high decreased oral nutritional intake increase the risk of readmis-
output ostomies (14.3%). Cancer cachexia was present in 87.1% sion within 3 months.
of patients. The hazard ratio (HR) for upper gastrointestinal References
and “other” cancers vs gynaecological malignancy was 1.75
1. Krumholz HM. NEJM, 2013.
( p = 0.077) and 2.11 ( p = 0.05), respectively. KPS score, GPS,
2. Fried LP, et al. J Gerontol A Biol Sci Med Sci, 2001.
PN volume and PN potassium levels significantly predicted
survival (HRKPS≥50 vs <50 = 0.47; HRGPS=2 vs GPS=0 = 3.19). In multi- Disclosure of Interest: None declared.
variate Cox regression analyses after adjustment for covari-
ates, KPS and GPS remained significant predictors ( p < 0.05), SUN-P152
whilst PN volume reached borderline significance ( p = 0.094). MOBILITY, FUNCTIONAL STATUS AND FATIGUE IN
In general, people who score over 150 in the 3-month and over MALNOURISHED, GERIATRIC PATIENTS AT HOSPITAL
100 in the 12-month survival prediction nomograms, respect- DISCHARGE
ively, had less than 20% survival probability. Internal validation K. Franz1 *, L. Otten1, L. Bahr1, J. Kiselev1, U. Müller-Werdan1,
is also presented. K. Norman1. 1CHARITÉ - University Medicine, Research Group
Conclusion: Performance status, prognostic scoring and PN on Geriatrics, Berlin, Germany
requirements may predict survival in patients with advanced
cancer receiving HPN. PN volume and potassium content might Rationale: The majority of geriatric patients are at high risk for
assist in decision making as predictors of survival. Further malnutrition at hospital discharge, which negatively impacts
research and education of healthcare professionals is needed to post-hospital outcome. In a cross-sectional analysis in mal-
identify which patients would most benefit from HPN and nourished, geriatric patients, we evaluated functional status
ensure timely referral and access to HPN. using objective and subjective methods as well as the
Disclosure of Interest: None declared. prevalence of frailty at discharge.
Methods: Patients with malnutrition according to the Mini
Nutritional Assessment Short Form were included. Frailty was
SUN-P151
evaluated with the Fried-criteria (1). Mobility was measured
POST-HOSPITAL SYNDROME: DETERMINANTS OF
based on the 4 m-walk test (gait speed) and the Timed Up & Go
READMISSION IN MALNOURISHED, GERIATRIC PATIENTS
(TUG) test. Muscle strength was determined using dynamome-
WITHIN 3 MONTHS OF HOSPITAL DISCHARGE
try. Validated questionnaires estimated functional restrictions
K. Franz1 *, L. Otten1, L. Bahr1, J. Kiselev1, U. Müller-Werdan1, (LASA) and fatigue (BFI). Moreover, anorexia (CNAQ), depres-
K. Norman1. 1CHARITÉ - University Medicine, Research Group sive symptoms (CES-D) and fall frequency within the previous
on Geriatrics, Berlin, Germany 12 months was assessed.
Results: 145 patients (77.9 ± 6.8 years, 59% women) were
Rationale: The post-hospital syndrome is an acquired, transi-
analyzed. 50% were classified prefrail, 46.4% frail. While 64.2%
ent period of vulnerability due to e.g. reduced oral nutritional
had reduced gait speed (<0.8 m/sec), reduced TUG time was
intake, sleep deprivation and psychological distress in hospi-
found in 100% of patients (60–69 y: <8.1 sec; 70–79 y: <9.2 sec;
talized patients and correlates with readmission rates (1). In
≥80 y: <11.3 sec). Decreased hand grip strength was observed
this longitudinal study, we analyzed influencing factors on 3
in 36.2% (male:<26 kg; female: <16 kg) and reduced knee grip
month readmissions of malnourished, geriatric patients after
strength in 100% of patients (male: <0.97 kg/kg BW; female:
hospital discharge.
<0.84 kg/kg BW). The majority of patients showed functional
Methods: Mini Nutritional Assessment Short Form was used to
limitations (mild: 59.3%; severe: 38.6%). Fatigue was observed
identify manifest malnutrition or risk of malnutrition. Frailty
in 95.6%; 26.7% even suffered severe fatigue. 73.6% had loss of
was classified according to Fried-criteria (2). Loss of weight in
appetite. While 23.7% had moderate depressive symptoms,
the last 3 and 6 months was recorded. Loss of appetite, sleep
32.4% exhibited a high risk for depression. 64.3% reported falls
deprivation and fatigue were evaluated using the CES-
in the previous 12 months.
depression scale. Determinants of 3 month hospital readmis-
Conclusion: Malnourished, geriatric patients are frequently
sion were analyzed using logistic regression.
frail and suffer from impaired mobility and functional status as
Results: 177 patients (77.9 ± 6.8 years; 59% women) were
well as increased fatigue at discharge. Moreover, they are at
included in the analysis. At discharge, 46.4% were frail; 88.2%
increased risk of anorexia and depression which are known to
had lost weight in the last 3% and 92% in the last 6 months.
increase the risk of further weight loss.
38.8% reported hospital readmissions (mean length of hospital
stay:17.9 ± 15.5 days). While low BMI (r = −0.32, p = 0.041) and References
higher frailty-score (r = 0.35, p = 0.038) correlated significantly 1. Fried LP, et al. J Gerontol A Biol Sci Med Sci. 2001;56.
with increased length of hospital stay during readmission, >5% Disclosure of Interest: None declared.
weight loss within 3 months correlated with an increased risk
of 3 month readmission (r = 0.48, p = 0.02). However, in a
logistic regression sleep deprivation (OR:3.459,CI:1.244–9.619,
Nutritional assessment 1 S111
4
Nutritional assessment 1 Departamento de Nutrição, Universidade Federal Do Paraná,
Curitiba, 5Departamento de Nutrição, Universidade Federal De
SUN-P153 Minas Gerais, Belo Horizonte, Brazil
A CLINICAL AUDIT OF NUTRITIONAL SCREENING AND
SUPPORT OF HOSPITALIZED HEMATOLOGIC PATIENTS Rationale: The objective was to assess the applicability of the
1 1 1
A. Stamou , T. Liaskas , I.-G. Tzanninis , E. Kanioura ,1 “Body Index-adjusted Weight Loss” Grading System in a hospital
D. Politis1, A. Kaoura1, L. Poulia2 *, M. Arapaki3, N.-A. Viniou1, Emergency Service.
P. Diamantopoulos1. 11st Department of Internal Medicine, Methods: A prospective cohort study was carried out in an
Hematology Unit, Laikon General Hospital, National and Emergency Service of tertiary public hospital. Usual body
Kapodistrian University of Athens, 2Clinical Nutrition weight (in kg) and anthropometric measurements (height, in
Department, Laikon General Hospital, 3Hematology cm and actual weight, in kg) were assessed. Body mass index
Department, Laikon General Hospital, National and (BMI) and percentage of weight loss (WL) were calculated.
Kapodistrian University of Athens, Athens, Greece Patients were classified according to BMI-adjusted WL Grading
System (Martin L et al.)1 in five categories: grade 0 was assigned
Rationale: Poor food intake is a common problem in patients to the least risk subgroup (longest survival), and grades 1, 2, 3,
with hematologic diseases. Audits about the nutritional and 4 were assigned to the subgroups according to decreasing
support of hospitalized patients may detect significant failures survival. Outcome were length of hospital stay (LOS), infection
in patient care and help towards the correct application of the and death. LOS was considering very long when >16 days.
international guidelines. Relative risk (RR) and hazard ratio (HR) are presented with
We performed a prospective observational audit on hospita- confidence interval of 95% (95% IC).
lized hematologic patients to investigate their nutritional Results: In total, 752 individuals were included, aged
status, as well as whether they received the appropriate 53.6 ± 15.5 years and 54.5% females. According to the BMI-
nutritional support. adjusted WL Grading System, patients were classified as
Methods: The initial population consisted of 122 consecutive follows: Grade 0: 38.3%; Grade 1: 18.0%; Grade 2: 14.0%;
hematologic patients admitted from March to June 2016 in two Grade 3: 16.2%; and Grade 4: 13.5%. Patients in the five
Hematologic Units of a Tertiary University Hospital in Athens, categories of BMI-adjusted WL Grading System did not differ in
Greece. We designed a questionnaire based on the Malnutrition relation to sex, ethnicity and age. The frequency of infection
Universal Screening Tool (MUST) with additional demographic, also did not differ among inpatients according to the five
somatometric and medical data. The questionnaire was applied categories ( p = 0.226). Only Grade 4 presented significant
by medical students to all patients within 48 hours of association with very long LOS and with mortality (RR: 1.93
admission. Patients were classified as high, intermediate, and [1.30–2.86, p < 0.001] and HR: 5.90 [1.27–27.47, p = 0.024],
low-risk per the MUST score and were reassessed accordingly. respectively).
During reassessment, we examined the quantity of food intake Conclusion: BMI-adjusted WL Grading System may be a useful
and the nutritional interventions applied. tool in effort to predict outcomes in patients admitted at
Results: The final analysis included 95 patients (27 were hospital Emergency Services, and Grade 4 can identify patients
excluded due to short-term hospitalization and for personal with worse prognosis.
reasons). A MUST score ≥2 was found in 41 (38%) patients only References
on was supported ( parenteral nutrition). 1. Martin L, et al. Diagnostic criteria for the classification of cancer-
Conclusion: Our audit revealed a lack of nutritional support of associated weight loss. J Clin Oncol. 2015;33(1):90–9.
the hospitalized patients. A meeting with the involved health
professionals and a presentation of the results and the possible
causes (lack of sensitization, high regimen cost, and shortness
of staff ) was performed. Proposals to change the current SUN-P155
situation were made such as detection of high risk patients by THE IMPACT OF NUTRITIONAL RISK STATUS ON QUALITY OF
medical students and further assessment by a nutritional LIFE AND FUNCTION IN OLDER ADULTS AT THE HOSPITAL-
specialist. A brief MUST-based questionnaire was also proposed COMMUNITY INTERFACE
to be used for all patients upon admission. A re-audit is already A. R. Julian1 *, G. S. Frost1, C. E. Weekes2, M. Hickson3. 1Division
in progress. of Diabetes, Endocrinology and Metabolism, Faculty of
Disclosure of Interest: None declared. Medicine, Imperial College London, 2Diabetes and Nutritional
Sciences Division, King’s College London, London, 3School of
Health Professions, Faculty of Health and Human Sciences,
SUN-P154
Plymouth University, Plymouth, United Kingdom
CAN THE “BODY INDEX-ADJUSTED WEIGHT LOSS GRADING
SYSTEM” BE APPLIED IN A HOSPITAL EMERGENCY SERVICE? Rationale: Older people are at high risk of undernutrition
A. Marcadenti1,2 *, J. S. Fink3, E. I. Rabito4, A. S. do Carmo5, particularly after a hospital admission1. This study aims to
F. M. Silva5. 1Departamento de Nutrição, Universidade Federal explore the impact of undernutrition on the quality of life and
De Ciências Da Saúde De Porto Alegre (UFCSPA), 2PPG Ciências function of older adults at 3 months post-discharge from
da Saúde: Cardiologia, Instituto De Cardiologia/Fundação hospital.
Universitária De Cardiologia (IC/FUC), 3Serviço de Nutrição e Methods: Patients aged 60+ approaching discharge partici-
Dietética, Hospital Nossa Senhora Da Conceição, Porto Alegre, pated in this prospective cohort study. Nutritional status was
assessed by Malnutrition Universal Screening Tool, quality of
S112 Poster
life by EQ5D-5L, and function using modified Townsend Index and 150 Hounsfield Units (HU). Sex specific distributions were
and handgrip dynamometry. obtained and the association between age and SMI and between
Results: The cohort included 171 adults, mean (SD) age = 79 BMI and SMI was analyzed with linear regression analyses. Based
(10) years and 36% male. Participants were grouped by under- on this correlation, age- and BMI specific predicted percentiles
nutrition status; 45% at risk, 55% low risk. Both groups’ function were computed. The 5th percentile was considered as cut-off
worsened according to the Townsend score at 3 months (table). for low SMA, SMI and MRA.
This deterioration was greater in the at risk group; median (IQR) Results: Sex specific cut-offs of SMA, SMI and MRA were
increasing from 36 (19–58) to 50 (27–71) ( p = 0.001). Conversely, 134.0 cm2, 41.6 cm2/m2 and 29.3 HU in men and 89.2 cm2,
EQ5D-5L index score improved over time, particularly in the 32.0 cm2/m2 and 22.0 HU in women, respectively. SMI was
pain domain for the at risk group. Handgrip strength did not negatively correlated with age (b = 0.16 in men, b = 0.13 in
change significantly within or between groups. women, both p < 0.001) and with BMI (b = 1.23 in men, b = 0.47
in women, both p < 0.001) resulting in specific cut-off points for
different age- and BMI categories.
Nutritional risk status
Conclusion: This study provides sex specific percentiles and
Median change (IQR) Low risk Med/high risk P= cut-offs for SMA, SMI and MRA. In addition, age- and BMI
from baseline to 3
months specific percentiles in a healthy Caucasian population have
been established, which may facilitate interpretation of
Modified Townsend −3 (−12, 1) −6 (−16, 0) <0.001*
score
muscle parameters in disease.
EQ5D-5L Index score −0.006 (−0.19, 0.08) −0.06 (−0.2, 0.11) 0.02* Disclosure of Interest: None declared.
EQ5D-VAS score −8 (−20, 9.5) 0 (−10, 10) 0.132
Handgrip strength (kg) 0 (−2, 3) 0 (−1.75, 2) 0.564
SUN-P158
*p < 0.05, derived from Wilcoxon test. CHANGE IN BODY COMPOSITION DURING TRAINING MEASURED
WITH DENSITOMETRY (BODPOD) AND BIO-ELECTRICAL
Conclusion: Irrespective of nutritional status, older adults IMPEDANCE ANALYSIS (BIA), AND CALCULATED WITH THE
recently discharged from hospital exhibited reduced ability to FORMULA OF GALLAGHER
perform activities of daily living at 3 month follow-up. A. V. Dijk1 *, A. Kok1, F. Hollander1, S. Runia1, E. Steenhagen2.
1
Nevertheless, the at risk group showed greatest deterioration, Dietitian, 2UMC UTRECHT, Utrecht, Netherlands
suggesting that worse nutritional status may compound adverse
effects on physical function following hospital admission. Rationale: Patients with hemophilia and other coagulation
Interestingly, quality of life was not affected by nutritional risk. disorders were on training for a cycle tour of 900 km. During
training, patients received nutritional advises by a sport
Reference
dietitian. Body composition was measured by densitometry
1. Liang et al. Nutrition. 2008;24(10):969–76 (BODPOD) and bio-electrical impedance analysis (BIA). An
Disclosure of Interest: None declared. estimation of body composition was made by the formula of
Gallagher (1). The aim of the study was to compare the results
of body composition measured by BODPOD and BIA, and
SUN-P157
calculated with the formula of Gallagher.
NORMATIVE VALUES FOR SKELETAL MUSCLE INDEX, -AREA
Methods: Patients (>/=18 y) with hemophilia and other
AND -RADIATION ATTENUATION BASED ON COMPUTED
coagulation disorders on training for a cycle tour were
TOMOGRAPHY IMAGING IN A HEALTHY CAUCASIAN
included. Length, body weight and body composition
POPULATION
(BODPOD and BIA) were measured. BODPOD uses the formula
A. Van Der Werf1 *, J. Langius1, M. de Van Der Schueren1, of Siri (2) and BIA the formula of Kyle (3) for determining body
S. Nurmohamed2, K. Van Der Pant3, composition. BMI, age, sex and race were used for calculating
S. Blauwhoff-Buskermolen1, N. Wierdsma1. 1Nutrition and body composition with the formula of Gallagher. Measurements
Dietetics, 2Nephrology, VUMC, 3Nephrology, AMC, Amsterdam, were repeated four times: before training(T1), twice during
Netherlands training (T2, T3) and afterwards (T4).
Results: Eight patients were included (5 men, 3 women; age
Rationale: Muscle mass is a key determinant of nutritional
range 21–53Y). Results of FM(%) are presented in the table
status and associated with outcomes in several patient groups.
below. Body composition analysis by BODPOD at T1 are missing.
Computed Tomography (CT) analysis is increasingly used to
Only small differences in body composition were found between
assess skeletal muscle area (SMA), skeletal muscle index (SMI)
the three methods, the formula of Gallagher showed a relative
and muscle radiation attenuation (MRA). However, interpret-
low FM. All three methods show the same tendency, decrease in
ation is difficult since values in a healthy population are
FM at T1,T2,T3 and an increase in FM at T4.
lacking. Therefore we obtained sex specific percentiles and
provide cut-offs for low SMA, SMI and MRA of a healthy
Caucasian population. T1 T2 T3 T4
Methods: In this study 420 CT scans of healthy persons were BIA 28,0 27,0 25,5 27,7
used. All scans were made as part of kidney donor screening BODPOD 27,0 24,4 27,5
Gallagher 23,8 23,1 21,0 24,4
with 120 kV without use of a contrast agent. A single slice at the
level of the 3rd lumbar vertebra was used to assess SMA, SMI and
MRA with SliceOmatic software V5.0 (Tomovision, Magog,
Canada), using a radiation attenuation range between −29
Conclusion: Only small differences in body composition were SUN-P160

found between the BODPOD, BIA and the formula of Gallagher. EATING DISORDERS AND POST-TRAUMATIC STRESS DISORDER
However we had a small study population, results must be AMONG SYRIAN REFUGEES IN NORTH LEBANON: SCREENING
interpreted with caution. AND CORRELATION
References A. Aoun1 *, J. Joundi1, N. El Gerges1, F. El Jabbour2, L. El Osta3.
1
1. Gallagher et al. Am J Clin Nutr 2000;72:694–701. Notre Dame University - Louaize, Zouk Mosbeh, 2Lebanese
2. Siri et al. Natl Acad Sciences/Natl Res Council 1961:223–224. University, Fanar, 3Saint Joseph University, Beirut, Lebanon
3. Kyle et al. Nutr 2001;17:248–253.
Rationale: Post-Traumatic Stress Disorder (PTSD) may be an
important risk factor for the development of eating disorders
(EDs) in refugees. The aim of this study was to assess the
SUN-P159 prevalence of positive SCOFF screens among Syrian refugees in
SEVERE PAIN INTENSITY IS ASSOCIATED WITH INSUFFICIENT North Lebanon, and its correlation with the prevalence of
ENERGY INTAKE IN HOSPITALISED PATIENTS positive test screening for PTSD.
A.-M. Makhlouf1, L. Genton1 *, M. Kossovsky2, F. Gurba3, Methods: This was a cross-sectional study including a repre-
S. Pautex4, M. Chikhi1, C. Pichard1. 1Nutrition Unit, sentative sample of 450 Syrian refugees aged between 14 and
2
Rehabilitation and Geriatrics, University Hospital of Geneva, 45 years, living in North Lebanon. Participants were recruited
3
Nutrition and Dietetic Department, HES-SO, 4Division of by random sampling method during February and March 2016
Primary Care, University Hospital of Geneva, Geneva, from different individual tented settlements, collective
Switzerland shelters, and primary health care centers. Each participant
was interviewed individually using the SCOFF and PC-PTSD
Rationale: The assessment of pain intensity in hospitalised questionnaires. Data on socio-demographic factors and health
patients is part of routine care but the impact of pain on food status were collected. Informed consent form was signed by all
intake has been poorly studied. This cross-sectional study participants prior to contribution.
assessed the influence of pain on coverage of energy needs in Results: The prevalence of positive SCOFF and PC-PTSD screens
hospitalized patients. were respectively 5.6% and 47.3%. The multiple linear
Methods: Dieticians assessed the energy intake on one day in regression showed that subjects screened with PTSD had 3
all patients hospitalized at the Geneva University Hospitals times higher risk of having positive test screening for EDs
who received three meals per day. Insufficient energy intake (OR = 3.14; 95%CI: 1.125–8.778).
was defined as energy intake ≤70% of energy requirements Conclusion: Positive SCOFF and PC-PTSD screens were strongly
determined by the Harris-Benedict formula. Pain intensity was correlated among Syrian refugees included in our study.
scored from 0 (no pain) to 10 (worst pain ever) with a visual
scale and stratified into no pain (0), slight (1–3), moderate (4–6)
or severe pain (>6). We evaluated the association of energy
intake and pain intensity by a multivariate logistic regression SUN-P161
with adjustment for gender, age and body mass index. EATING DISORDERS AMONG UNIVERSITY STUDENTS IN A
Results: This analysis included 776 patients (mean age MIDDLE EASTERN URBAN SETTING: WHO IS AT RISK?
70.1 ± 19 y, BMI 25.4 ± 6 kg/m2, pain score 2.3 ± 2). The R. Chammas1, J. Bou Mosleh1, D. Jaalouk1, C. Bou Mitri1,
multivariate logistic regression shows that severe pain and A. Aoun1 *. 1Notre Dame University - Louaize, Zouk Mosbeh,
age ≥85 years are risk factors for insufficient energy intake: Lebanon
Rationale: The purpose of this study was to estimate the

n b [95% CI]
proportion of Notre Dame University (NDU) students who are at
Gender male vs. female 776 0.43 [−0.01;0.86] high risk of developing EDs, and to examine the association of
Age (yrs) <65 255 1
EDs high risk with socio-demographic, lifestyle, dietary and
65–74 129 0.26 [−0.31;0.83]
75–84 200 −0.06 [−0.59;0.47] health-related factors.
≥85 192 −1.05 [−1.75;−0.34]* Methods: This was a cross-sectional study, conducted among
BMI (kg/m2) 18.5–24.9 348 1 a random sample of 457 NDU undergraduate students who
<18.5 64 0.19 [−0.69;1.07]
>24.9–29.9 222 0.04 [−0.48;0.56] were asked to complete a self-administered survey including
>29.9 142 0.35 [−0.25;0.95] a food frequency questionnaire, a background questionnaire,
Pain intensity No pain 349 1 and the Patient Health Questionnaire-9 (PHQ-9). Risk of
Slight pain 243 −0.24 [−0.78;0.29]
Moderate pain 106 0.57 [−0.04;1.18]
developing EDs was assessed using the SCOFF questionnaire
Severe pain 78 1.00 [0.38;1.63]* (The Sick, Control, One stone, Fat, Food). Anthropometric and
body composition measurements were obtained, using stand-
b, regression coefficient; CI, confidence interval. *P < 0.05 ard protocols and bioelectrical impedance analysis, respect-
ively. Informed consent form was signed by all students prior
Conclusion: Severe pain and an age ≥85 years were associated to participation. The study protocol was approved by NDU
with insufficient coverage of energy needs. This result suggests Research Board.
that pain control is essential to prevent malnutrition. Results: The sample consisted of 457 undergraduate students
Disclosure of Interest: None declared. with a mean age of 21.3 ± 1.9 years (63% males). Using the SCOFF
questionnaire, 146 (32.4%) students were found to be at high risk
of developing EDs with a significantly higher proportion of
S114 Poster
females than males (F (40%) vs. M (28.1%), P < 0.05). Students SUN-P163
who were found to be at high risk of EDs had significantly higher BIOELECTRICAL IMPEDANCE PHASE ANGLE IN CLINICAL
depression score (8.26 vs. 6.20, P = 0.000), waist circumference PRACTICE: THE RELATIONSHIP BETWEEN NUTRITIONAL RISK
(85.4 vs. 82.4cm, P = 0.013), percentage of body fat (26.3 vs. SCREENING, BIOELECTRICAL IMPEDANCE ANALYSIS AND
19.6, P = 0.004), body mass index (25.6 vs. 23.9 Kg/m2, SERUM SURROGATE PARAMETERS
P = 0.000), potassium intake (1437.9 vs. 1325.5 mg, P = 0.003) B. Knappe-Drzikova1 *, S. Maasberg1, D. Vonderbeck1,
and magnesium intake (151.5 vs 143 mg, P = 0.04) adjusted for A. Sturm1, A. Pascher2, U.-F. Pape1. 1Gastroenterology and
energy intake. They had as well lower daily kilocalories intake Hepatology, 2General, Visceral and Transplantation Surgery,
(4172.5 vs. 4860.1, P = 0.004). CHARITÉ, University Medicine Berlin, Berlin, Germany
Conclusion: Early detection and treatment of EDs may be
improved by routinely evaluation of several specific risk factors Rationale: Nutritional risk screening (NRS) is a widely accepted
in adolescence. complex approach to evaluate nutritional status (NT).
Disclosure of Interest: None declared. Bioelectrical impedance analysis (BIA) is a non-invasive, easy-
to-use and reproducible technique to evaluate changes in body
SUN-P162 composition. The present study aimed to evaluate the
NUTRITIONAL HABITS OF AMATEUR AND PROFESSIONAL association between NRS, BIA, phase angle (PhA) and surrogate
FOOTBALL PLAYERS parameters (SP), resp. for a NT assessment in gastroentero-
logical (GI) patients ( pts).
A. Ilhan1 *, A. Tokay2, A. Ilhan3. 1Hacettepe University Faculty Methods: NTwas assessed in 611 GI pts by NRS. In addition, BMI,
of Health Sciences Department of Nutrition and Dietetics, serum albumin, and serum transferrin were determined and BIA
Ankara, 2Ondokuz Mayis University School of Health performed. Receiver Operating Curves (ROC) were estimated to
Department of Nutrition and Dietetics, Samsun, 3Selcuklu determine the optimal cut-off levels of PhA.
Community Health Center, Konya, Turkey Results: An increased risk of malnutrition (score NRS > 3) was
found in 219 pts (35.8%). Well-nourished pts (score NRS 0–2) –
Rationale: The aim of this study is to investigate the dietary
392 (64.2%) - had a statistically higher ( p < 0.001) mean phase
habits of amateur and professional football players and to
angle (5.4° ± 1.03°) as compared with the score NRS > 3 group
examine their differences.
(4.1° ± 1.08°). Malnutrition was significantly associated with
Methods: A total of 125 football players (25 professional,
poorer results for BMI ( p < 0.01), albumin (34.9 ± 7.4 vs. 40.5 ±
100 amateur) in Samsun were participated to this study. The
6.3; p < 0.001), transferrin (186.6 ± 67.7 vs. 253.5 ± 63.2; p <
professional football players were selected from Samsunspor
0.001) and BIA (ECM/BCM-index 1.7 ± 0.8 vs. 1.12 ± 0.3; p <
football club and amateur football players were selected from
0.001). A PhA of 4.85° in men was 74% sensitive and 71% specific
Samsun Kadikoyspor football club. Subjects expected to
and of 4.5° in women was 79% sensitive and 74% specific for
complete a questionnaire about their personal charac-
detecting malnutrition[UP1] [ROC (for men): 0.797 ± 0.027;
teristics, eating habits and using energy drinks and vitamin
95% CI.745-.849, p < 0.001; ROC (for women): 0.808 ± 0.026;
and mineral supplements. The SPSS23 package software was
95% CI.757-.860, p < 0.001)].
used for statistics, evaluating group differences by chi-square
Conclusion: The present study demonstrates that PhA is a good
test.
indicator of risk for malnutrition in GI pts. There is a significant
Results: Mean ages of participants were 25.72 ± 4.79 for
association between NT risk, low PhA and SP, resp. The optimal
professionals and 20.05 ± 2.05 for amateurs. Lifting weight,
cut-off level of PhA is practical to identify pts with malnutrition
using vitamin mineral supplements and energy drinks were
risk with the intent to limit the number of in-depth NT
statistically significant between professional and amateur
assessments and it can easily be included into clinical NT status
players ( p < 0.01). There was not significant difference for
evaluation and management.
using protein supplement ( p > 0.05). In the professional group;
consumption of milk and dairy products, meat and meat Disclosure of Interest: None declared.
products, vegetables and fruits were found significantly higher
than the amateur group ( p < 0.05). Professional football players SUN-P164
were more conscious for the diet under dietitian supervision NUTRITIONAL STATUS ACCORDING TO DIFFERENT
( p < 0.01). NUTRITIONAL ASSESSMENT TOOLS IN ELDERLY NURSING
Conclusion: Football is one of the most popular sports HOME RESIDENTS AND AGREEMENT BETWEEN THEM
branches all over the world. Just like in all sports, many B. Lardiés-Sánchez1 *, A. Sanz-París2, G. Verdes-Sanz3,
factors in football affect the performance of the players. With L. Pérez-Fernández2. 1Endocrinology and Nutrition, H. Royo
the help of healthy nutrition, football players can reach their Villanova, 2Endocrinology and Nutrition, H.U. Miguel Servet,
maximum efficiency in the training sessions and feel more Zaragoza, 3Endocrinology and Nutrition, H. Obispo Polanco,
fresh and fit. In conclusion; in the lights of the nutritional Teruel, Spain
knowledge based on scientific studies, we suggest that athle-
tes and their trainers should be supported by nutritional Rationale: The aim of this study was to assess the nutritional
instruction. status in elderly nursing home residents with different
Disclosure of Interest: None declared. nutritional assessment tools and to check the agreement
between these tools.
Methods: A cross-sectional study with 383 individuals of both fat. 6 months after surgery energy intake was 1257.73(456.85)
sexes was carried out in three public nursing homes in the urban Kcal in DBP, 828.48(187.61) Kcal in SG and 1153.8(390.69) kcal
area of Zaragoza (Spain). For the assessment of nutritional in GB( p = 0.034). One year after surgery no differences were
status in this elderly population, three nutritional tools were found on intake. Carbohydrates intake was statistically signifi-
used: MNA, the new ESPEN consensus definition of malnutrition, cant( p = 0.039) being 216.30(6.22) g in BDP, 88.69(44.05) g in
and “CONtrolling NUTritional Status” (CONUT). Cohen’s kappa SG and 115.4(93.05) g in GB. There was also a tendency to a
(κ) statistic was calculated to determine diagnostic agreement lower protein intake that was 98.7(4.24)g in BDP, 50.49(15.70)g
Results: 383 subjects met inclusion criteria and participated in in SG and 62.90(49.07)g in GB( p = 0.072)
the study. Subjects had a mean age of 84.9 (SD 7.6) years old, Conclusion: BDP and GB appear to help ensure the long-term
being 70.2% (n = 269) females. 20.4% of the participants had energy and carbohydrate intake. The small sample size does
diabetes mellitus, and dementia was documented in 57.4% of not allow to either confirm nor deny the same situation aboyt
this population. Regarding nutritional status according to MNA, protein intaje although there is a clear tendency towards a
21.3% of the elderly were malnourished (MNA < 17 points), and lower protein intake maintained over time in SG
55.9% were at risk of malnutrition. With CONUT, a total of 67.6% Disclosure of Interest: None declared.
had a normal nutritional status, 11.7% had mild malnutrition
and 20.7% had moderate malnutrition. In the nutritional
SUN-P166
assessment according to the new ESPEN definition of malnu-
IS THERE A DIFFERENCE ON HOW BARIATRIC SURGERY
trition, of the 72.5% of people with risk of malnutrition
AFFECTS THE QUALITY OF INTAKE AND FOOD TOLERANCE?
identified with MNA-Short Form, 17.5% were malnourished.
COMPARISON OF SLEEVE GASTRECTOMY VS BILIOPANCREATIC
The agreement between MNA and ESPEN criteria was moderate
DIVERSION VS GASTRIC BYPASS
(κ = 0.483, p = 0.003). The agreement between CONUT vs MNA
criteria and CONUT vs ESPEN criteria was low (κ = 0.19, B. Pintor De La Maza1 *, M. D. Ballesteros-Pomar1,
p = 0.046; and κ: 0.23, p = 0.037, respectively). A. Urioste-Fondo1, L. M. Gajete-Martín1, M. Alejo-Ramos1,
Conclusion: In this population there is a high prevalence of D. Barajas-Galindo1, P. Fernández-Martínez1,
malnutrition and risk of malnutrition assessed with MNA, A. Hernandez-Moreno1, L. González-Herráez1,
CONUT and the new ESPEN criteria of malnutrition. MNA and I. Cano-Rodríguez1. 1High Risk Obesity Unit, Complejo
ESPEN criteria are moderately correlated, but the agreement Asistencial Universitario De León, León, Spain
with CONUT was low.
Rationale: Reduced food tolerance is often associated to
Disclosure of Interest: None declared. bariatric surgery and sometimes it is also related to vomiting.
The aim of this study was to know the food tolerance in patients
SUN-P165 that underwent Sleeve gastrectomy (SG), Biliopancreatic
EVOLUTION OF THE INTAKE AND DIFFERENCES WITH Diversion (BPD) and Gastric Bypass (GB).
DIFFERENT BARIATRIC SURGERY PROCEDURES: SLEEVE Methods: The study was performed between July 2015 and
GASTRECTOMY VS BILIOPANCREATIC DIVERSION VS GASTRIC February 2017. All patients that underwent bariatric surgery
BYPASS were included. The food test tolerance, described by Suter M.,
B. Pintor De La Maza1 *, M. D. Ballesteros-Pomar1, was administered to all patients 6 and 12 months after surgery.
A. Urioste-Fondo1, L. M. Gajete-Martín1, M. Alejo-Ramos1, This test included one question about the self-perception
D. Barajas-Galindo1, P. Fernández-Martínez1, quality of the intake [total score 1 (very poor) to 5 points
A. Hernandez-Moreno1, L. González-Herráez1, (excellent)], food tolerance of 7 food groups [total score 0
I. Cano-Rodríguez1. 1High Risk Obesity Unit, Complejo (food not tolerated) to 16 points (no difficulty with consump-
Asistencial Universitario De León, León, Spain tion)] and the presence or not of vomiting [total score 0 (daily)
to 6 points (never)], giving a global test score of 0–27 points
Rationale: Bariatric surgery(BS) appears to be the most (from worst to superior food tolerance). The statistical analysis
long-lasting technique for obtaining major weight loss. The included ANOVA test.
different used procedures might have a different impact in the Results: 24 patients with a mean age of 44.67 (10.39) were
intake of patients that underwent Sleeve gastrectomy(SG), included. 75% (18 patients) were female. Medium weight
Biliopancreatic diversion(BPD) and Gastric Bypass(GB). before surgery was 121.36 (22.60) kg. 8 patients underwent
Methods: The study was performed between July 2015 and BDP, 12 SG and 4 GB. No differences were found in the three
February 2017. All patients that underwent bariatric surgery questions asked and total score at 6 months. The quality of
were included. All the data were collected before surgery and 6 the intake self-perception was statistically different ( p =
and 12 months after surgery. Intake was collected using a 24-h 0.024) being 4.00 (0.00) in DBP, 4.86 (0.38) in SG and 5.00
intake record and analyzed by a Registered Dietitian using (0.00) in GB.
Dietsource 3.0® software (Novartis Consumer Health- Conclusion: It appears to be no differences in food tole-
Cath Soft). The statistical analysis performed included an rance, although the small sample size might require longer
ANOVA test. studies.
Results: 24 patients with a mean age of 44.67(10.39) years Disclosure of Interest: None declared.
were included. 75% were female. Medium weight before
surgery was 121.36(22.60) kg. 8 patients underwent BDP, 12
SG and 4 GB. After 24-h dietary recall before surgery, medium
energy intake was 1600.82(500.57) kcal, 173.00(60.83) g of
carbohydrates, 73.07(21.32) g of protein and 68.88(35.21) g of
S116 Poster
SUN-P167 participants’ BMI was under <20,5 kg/m2, 25,4% of them lost
DIFFERENCES IN MUSCLE MASS LOSS DEPENDING ON THE weight in last 3 months, 26,3% of them had a reduced dietary
PROTEIN INTAKE AND THE BARIATRIC PROCEDURE intake, and 5,4% of them were severely ill. Of 68 patients who
B. Pintor De La Maza1 *, M. D. Ballesteros-Pomar1, were undertaken the second phase of the tool, 7 patient’s score
A. Urioste-Fondo1, L. M. Gajete-Martín1, M. Alejo-Ramos1, was assessed more than 3. About 35 of (14.6%) patients stayed
D. Barajas-Galindo1, P. Fernández-Martínez1, at least once in hospital, the rest of them (85.4%) stayed more
A. Hernández-Moreno1, L. González-Herráez1, than once. The number of patients whose BMI status were under
I. Cano-Rodríguez1. 1High Risk Obesity Unit, Complejo 20.5 kg/m2 were higher in the subjects who stayed more than
Asistencial Universitario De León, León, Spain once in hospital than who stayed once ( p < 0,05). However
there was no significant correlation between hospitalization
Rationale: Severe obesity is currently increasing worldwide rate and BMI scores. Also, there was a statistically significant
and bariatric surgery appears as an effective intervention difference in education status in terms of weight loss
strategy for weight loss, causing changes in body composition ( p < 0,05).
and protein intake. The aim of this study was to assess the Conclusion: Malnutrition is a common problem among hospi-
evolution of body composition related to protein intake in talized patients. NRS 2002 is recommended as the preferred
patients that underwent Sleeve gastrectomy (SG), screening tool for hospitalized patients. This study showed a
Biliopancreatic Diversion (BPD) and Gastric Bypass (GB). relation between the number of hospitalization and BMI status
Methods: The study was performed between July 2015 and of hospitalized patients. In order to prevent from hospital
February 2017. All patients that underwent bariatric surgery malnutrition, screening tools should be applied and nutritional
were included. All data were collected before and 6 months support should be supplied on time.
after surgery. Muscle mass (MM) was assessed by Bioelectrical Disclosure of Interest: None declared.
Impedance Analyzer (BIA - Tanita MC780). Protein intake was
collected using the 24-h intake record and analyzed by a SUN-P169
Registered Dietitian using Dietsource 3.0® software (Novartis NUTRICIONAL STATUS AND THE ESTIMATE CONSUMPTION OF
Consumer Health-Cath Soft, 1997–2003). The statistical ana- NUTRIENTS IN WOMEN PARTICIPATING IN AN EXTENSION
lysis included a Pearson correlation test. PROGRAM IN THE SOUTH OF BRAZIL
Results: 24 patients with a mean age of 44.67 (10.39) were
included. 75% (18 patients) were female. 8 patients underwent C. W. Gallon1 *, J. Siviero1, S. C. Benincá1, C. P. Gabrielli1,
BDP, 12 SG and 4 GB. MM before surgery was 65.8 (11.50) kg. T. D. Justina1, T. Pedrollo1. 1Universidade De Caxias do Sul,
After 6 months MM was 63.74 (12.12) kg in DBP, 51.28 (6.23) kg Caxias do Sul, Brazil
in SG and 61.60 (9.23) in GB. There was a positive correla-
Rationale: Aging is a process characterized by physiological,
tion between protein intake and MM (r = 0.427; p = 0.037).
psychological and social changes that occur over the years.
Percentage of MM loss was similar among the three techniques
These changes affect the nutritional status (NS) which, in turn,
(13.22 DBP vs 13.18 SG vs 13.12 GB). There was a positive
relate to health. Healthy eating and consequent maintenance
correlation between protein intake and percentage of MM loss
of NS are essential factors for successful aging. The study was to
(r = 0.435; p = 0.034).
evaluate the nutritional status and the consumption of macro
Conclusion: Muscle mass loss appears to be lower after BDP in
and micronutrients in women participating in an extension
patients with a higher protein intake, although the small
program.
sample size requires longer studies.
Methods: Cross-sectional study. Realized with women older
Disclosure of Interest: None declared. than 50 years. The variables analyzed were socio demographic,
anthropometric and food consumption, correlating the NS with
SUN-P168 the food consumption.
IS THERE A RELATION BETWEEN HOSPITALIZATION RATE AND Results: From 176 women, the average age found was 63.2
MALNUTRITION RISK, AN ASSESSMENT STUDY WITH NRS-2002 years old (±7.4). The predominant scholarship level was high
B. Madali1, A. Ozdemir1 *, E. Inan-Eroglu1, D. Dikmen1. school completed or higher (58.5%), overweight (52.3%) and
1
Nutrition and Dietetics, Hacettepe University, Ankara, Turkey high risk due for cardio vascular disease (CVD) to the abdominal
circumference (AC) in 78.4%. The consumption of macronu-
Rationale: Number of hospitalization is one of the important trients is 57.7% carbohydrates, 17.2% protein and 25% lipids.
factors that affect hospital malnutrition. This study was While analyzing the correlation between Body Mass Index (BMI)
planned and conducted to investigate the effects of the with the AC, demographic data and food consumption, there
number of hospitalization on body weight and nutritional was a positive association ( p < 0.001). There was also a negative
status of patients with NRS2002 screening tool. association between BMI with the scholarship level ( p = 0.041),
Methods: This study was carried out with 240 hospitalized with calories in the breakfast ( p = 0.040) and fibers ( p = 0.008).
patients. A questionnaire that consists socio-demographic While analyzing the correlation between AC with demographic
characteristics and hospitalization periods were administered data and food consumption, there was a positive association
and body weight and height were examined. Nutritional Risk with age ( p = 0.039) and proteins, ( p = 0.011). There was also a
Screening (NRS)-2002 was assessed. The questionnaires were negative association between AC with level of scholarship
analyzed with the statistical program SPSS. ( p = 0.005) and fibers ( p = 0.007).
Results: The mean age of patients was 44,9 ± 13,8 and mean Conclusion: A high prevalence of overweight was found, as like
BMI was 26,9 ± 4,9 kg/m2. Of participants, 42,9% were men as AC with an elevated risk for CVD, also finding some
and 57,1% were women. According to NRS2002 tool, 8,3% of correlations between the NS with the food consumption. The
nutritional education is fundamental; this way women can audit was to examine compliance of nursing staff with Sir
readapt their food consumption, and consequently, improve Charles Gairdner Hospital policy #241 - Weighing Patients.
their NS. Methods: Seven high risk wards were selected based on the last
Disclosure of Interest: None declared. hospital malnutrition audit. From these wards a total of 140
patients were audited to identify compliance with the five
items on the hospital weighing policy.
SUN-P170
Results: The combined results showed only 51.5% of 140
BODY COMPOSITION BY BIOELECTRICAL IMPEDANCE VECTOR
patients audited had their weight recorded on admission
ANALYSIS ACCORDING TO SEVERITY OF OROPHARYNGEAL
(range 41.7% > 70.6%), 36.4% of patients had their weight
DYSPHAGIA IN HOSPITALIZED PATIENTS
recorded on the National Medication Chart (range 5.6% >
C. A. Reyes-Torres1 *, A. Ramos-Vázquez2, S. Tapia-Valdés2, 90.9%), 50.0% of patients had their weight recorded on the
L. Castillo-Martínez1, A. E. Serralde-Zúñiga1. 1Clinical Adult Observation Response Chart (13.6% > 100.0%), 57.1% had
Nutrition Service, 2Instituto Nacional De Ciencias Médicas Y their weekly weight recorded if they were admitted >7 days
Nutrición Salvador Zubirán, Mexico City, Mexico (22.2% > 100.0%) and 68.6% had their weight recorded as
monitored in accordance with their special clinical need
Rationale: Oropharyngeal dysphagia (OD) has clinical compli-
(50.0–100.0%).
cations as malnutrition and dehydration which can not always
Conclusion: Despite the implementation of a weighing policy,
be assessed using classical anthropometric parameters.
weighing patients is still not considered an essential part of
Bioelectrical impedance vector analysis (BIVA) offers advan-
the information collected during a patient’s initial nursing
tages in the evaluation of patients with OD, in addition the
assessment. The lowest score was for documentation on the
phase angle is considered a prognostic factor. The aim is to
Medication Chart, which is concerning given the risk of
evaluate the body composition according to severity of OD in
preventable medication errors. Dietitians are often involved
hospitalized patients.
with special clinical needs patients and routinely liaise with
Methods: A cross-sectional study was performed recruiting
nursing staff for patient weights, which may have contributed
patients with diagnosis of OD. Body composition was assessed
to higher compliance. Ongoing education is indicated to ensure
by BIVA and phase angle. We have used the EAT-10 scale to
all staff are familiar with this policy. A follow up survey of
evaluate the risk of OD. If the score was ≥3, the Volume-
nursing staff to determine the barriers to weighing patients/
Viscosity Clinical Test was performed to confirm the diagnosis
documenting and identifying appropriate supports is
and severity of OD (mild, moderate and severe). One-way
recommended.
ANOVA test and Pearson’s χ2 test were used to compare the
three groups. Disclosure of Interest: None declared.
Results: Were recruited 46 patients (48% females) with age of
74 (RIQ 54–81) years, the mean BMI was 22 ± 5 kg/m2. The SUN-P172
diagnoses were: stroke (28%), dementia (20%), Parkinson’s NUTRITIONAL EVOLUTION OF HOSPITALIZED PATIENTS AFTER
disease (13%), amyotrophic lateral sclerosis (13%), multiple ISCHEMIC ENCEPHALIC VASCULAR ACCIDENT WITH OR
sclerosis (8%), neuroinfection (8%), Sjögren’s syndrome (4%) WITHOUT DYSPHAGIA
and others (8%). The 33% of the patients had mild OD, 47% C. Rodrigues1 *, C. Q. Brant1, Y. Juliano1, N. F. Novo1. 1Ciencias
moderate and 20% severe OD. Phase angle was higher between Da Saude, Universidade Santo Amaro, Sao Paulo, Brazil
the mild (4.8 ± 1.2) and moderate (4.9 ± 1.1) compared to the
severe OD group (3.4 ± 0.5) ( p=0.003). The frequency of Rationale: Brain stroke is a disease caused by an alteration
patients with cachexia was higher in the severe group (89%) of the blood flow in the brain. Dysphagia and malnutri-
compared to the mild and moderate OD group (46% and 63%) tion affect 37–78% and 35–67% of brain stroke patients,
respectively ( p=0.04). respectively.
Conclusion: The phase angle was lower in severe OD group. The Methods: Contemporary cohort study of hospitalized patients
frequency of cachexia evaluated by BIVA was higher in patients admitted in intensive care units located in a public hospital in
with severe OD despite having a normal BMI. Clinical trials are southern São Paulo city.
required to perform nutritional interventions to prevent Results: In the dysphagia group, the frequency of nutritional
adverse events in patients with OD. supplementation was significantly bigger ( p = 0,0001) in order
Disclosure of Interest: None declared. to maintain their lean mass, as assessed by calf circumference,
and fat mass ( p = 0,0113), as assessed by triceps skinfold
thickness ( p = 0,0280).
SUN-P171
Conclusion: We conclude that interventions, such as nutri-
AUDIT OF COMPLIANCE WITH HOSPITAL WEIGHING
tional state follow-up through anthropometry and modified
POLICY #241
and offered food acceptance assessment, adequate use of
C. La Spada1 *, J. Van Schalkwyk2, P. Fitzgerald1, M. Sin2. nutritional supplementation and dysphagia diagnose reduced
1
Nutrition and Dietetics, 2Centre for Nursing Research, Sir the eminent risk of malnutrition associated to brain stroke,
Charles Gairdner Hospital, Nedlands, Australia dysphagia and nutritional state triad during hospitalization.
Rationale: Patient weight is a crucial part of nutritional Disclosure of Interest: None declared.
assessment, intervention and evaluation. It is also necessary
for monitoring fluid status, ensuring correct dosage of certain
medication and for patient manual handling. The aim of this
S118 Poster
SUN-P173 (EOE)– and the other 4 subscales reflect behaviors related to

FUNCTIONAL CORRELATES OF DETAILED BODY COMPOSITION “lack of interest in food”– Emotional Undereating (EUE),
IN HEALTHY ELDERLY (65+) Satiety Responsiveness (SR), Slowness in Eating (SE)and Food
C. Geisler1 *, L. Schweitzer1, M. J. Müller1. 1Institute for Human Fussiness (FF).The answers were given using a likert scale of 5
Nutrition, Christian-Albrechts Universität Zu Kiel, Kiel, points, according to the frequency in which their children
Germany presented each behavior.Anthropometric measurements were
collected by nutritionists.The nutritional status of children was
Rationale: Methods of body composition analysis (BCA) are assessed as percentiles by using WHO Child Growth Standards of
widely used to characterize health status, i.e. nutritional weight and height for age standards.
status, metabolic rates and cardio-metabolic risk factors. Results: The mean weight of boys and girls were 25,6 ± 5,9 kg
However, the functional correlates of individual body compo- and 22,9 ± 5,7 kg respectively. The mean height of boys and
nents have not been systematically analyzed. girls were 116,2 ± 7,3 cmand 112,8 ± 5,2 cm respectively.12,8%
Methods: In a healthy population of 40 Caucasians aged 65–81 children (n = 6) was below 50th Percentil in height and 25,5%
years (20 males; BMI: 18.6–37.2 kg/m²) body composition was (n = 12) children was below 50th Percentil in weight. The eating
assessed by (i) air displacement plethysmographie (ADP) and behavior of boys and girls were similar ( p = 0,381). Children
(ii) whole-body magnetic resonance imaging (MRI). Body who were below 50th Percentile in height had lower scores in FR
functions included vital functions, pulmonary function, hand- ( p = 0,015), EF ( p = 0,035), DD ( p = 0,039) and EOE ( p = 0,025).
grip strength (HGS) and mobility tests, resting energy expend- Children who were below 50th Percentile in weight had higher
iture (REE), liver and kidney functions (GFR), while metabolic scores at the subscales that reflect “lack of interest in food”
functions included insulin sensitivity (HOMA), inflammation, ( p = 0,041).
plasma levels of lipids, leptin, hormones and vitamins. Conclusion: The results of the present study suggest that
Results: Individual body compartments were (i) inter-corre- eating behavior is associated with nutritional status in children.
lated e.g. muscle mass (SM) was correlated with visceral Thus, the study findings may help to promote healthy eating
adipose tissue (VAT; r = 0.53) and kidney volumes (r = 0.62); (ii) behaviors in children.
correlated with body functions e.g. SM (r = 0.58) and liver Disclosure of Interest: None declared.
volume (r = 0.63) with REE, SM with HGS (r = 0.57) and kidneys
with GFR (r = 0.57) and (iii) correlated with metabolic functions
SUN-P175
and endocrine characteristics e.g. VAT was related to HOMA
RISK OF SARCOPENIA BY SCREENING TOOL SARC-F AND
(r = 0.59) and subcutaneous adipose tissue (SAT) to leptin
PRESARCOPENIA BY THE CALF CIRCUMFERENCE
(r = 0.84). Moderator analysis showed that inflammation mod-
erated the SAT-leptin relationship (+4.0%). Using linear I. D. A. Vaez1, H. F. Bufato1, J. E. de Aguilar-Nascimento2,
regression analysis detailed BCA improved the explained D. D. Dock1 *. 1UFMT, 2UNIVAG, Cuiaba, Brazil
variance in REE (78.2%), HOMA (41.0%) and leptin (78.0%)
Rationale: This study aimed to determine the frequency of
when compared to a BMI based model (REE 16.0%; HOMA 31.0%;
sarcopenia risk by screening tool SARC-F (Strength; Assistance
leptin 45.0%). By contrast, SM did not improve the explained
with walking; Rise from a chair; Climb stairs Falls) and
variance in HGS (74.0%).
presarcopenia by calf circumference in older people.
Conclusion: BCA reflects health status related to (i) functional
Methods: Cross-sectional study conducted with older people
(REE, GFR, HGS) and (ii) metabolic as well as endocrine (HOMA,
from a community centre in Cuiabá-MT-Brazil. The screening
leptin) characteristics. Body composition needs a narrower
tool SARC-F to determine sarcopenia risk and calf circumfer-
focus on metabolic and endocrine functions.
ence (CC) to evaluate presarcopenia was measured. Body
Disclosure of Interest: C. Geisler Grant/Research Support from: weight, age, and height, body mass index (BMI), nutritional
DANONE Institute- Nutrition for Health, Germany (2013/13), status (mini nutritional assessment short form), adductor
L. Schweitzer: None declared, M. Müller: None declared.
pollicis muscle thickness; handgrip dynamometer and gait
speed was measured on a 4-meter distance. The older people at
SUN-P174 risk, showed SARC-F score ≥4 and presarcopenia CC ≤ 33 cm for
EATING BEHAVIOR IS ASSOCIATED WITH NUTRITIONAL STATUS women and ≤34 cm for males.
IN KINDERGARTEN CHILDREN Results: One hundred and sixteen subjects were recruited for
D. Gumus1 *, M. Tengilimoglu Metin1, S. Sevim1, G. Topal1, this study, 90.5% was female and 28.5% was malnourished. The
M. Kizil1. 1Hacettepe University, Ankara, Turkey prevalence of presarcopenia was 12.9% and the risk of sarcopenia
was 27%. Pre sarcopenic older people had lower weight (53 ± 1.8
Rationale: The aim of this study was to evaluate the relation- vs 71.1 ± 1.2 Kg; p = 0.000), were oldest (74.6 ± 1.9 vs 69.7 ± 0.6
ship between children’s eating behavior and their nutritional years; p = 0.02) showed lower BMI (23.5 ± 0.6 vs 30.0 ± 0.51 Kg/m2;
status. p = 0.000) and lower adductor pollicis muscle thickness
Methods: This study was conducted with 47 kindergarten (15.4 ± 0.9 vs 18.2 ± 0.3 mm; p = 0.005). Older people at sarco-
children aged between 37 and 66 months in Ankara, Turkey. penia risk by SARC-F, had lower handgrip strength (19.1 ± 0.82 vs
Eating behavior of children were assessed through the 23.9 ± 0.75 Kg; p = 0.000) and gait speed (0.82 ± 0.04 vs 1.01 ±
subjective perception of parents by answering the Children’s 0.02 m/s p = 0.000) than those without risk.
Eating Behaviour Questionnaire (CEBQ).This questionnaire is Conclusion: Considering screening tool SARC-F, almost 30% of
divided into 8 subscales.4 subscales investigate behaviors that the sample was at sarcopenia risk and approximately 15% were
reflect “interest in food” –Food Response (FR), Enjoyment of presarcopenic by CC.
Food (EF), Desire to Drink (DD) and Emotional Overeating Disclosure of Interest: None declared.
SUN-P176 method, anthropometrics measurements, body composition

THE EFFECT OF AMINO ACID KETOANALOGS ON THE analysis and biochemical parameters were used for the
NUTRITIONAL STATUS AND MORBIDITY OF MALNOURISHED assessment of nutritional status.
PERITONEAL DIALYSIS PATIENTS Results: Postoperative complications were observed in 51%
P. Borek1, M. Chmielewski1, M. Lichodziejewska–Niemierko1, (n = 57) of patients. The atrial fibrillation (25%), delirium (18%)
E. Wernio2 *, S. Małgorzewicz2. 1Department of Nephrology, were the most common incidents. In comparison with those,
Transplantology and Internal Diseases, 2Department of Clinical who did not develop complications, patients with post-
Nutrition, Medical University of Gdansk, Gdańsk, Poland operative incidents were older [73 (66–82) vs 76 (65–87)
y. p = 0.0009], had poorer nutritional status according to f-
Rationale: One reason for protein malnutrition in patients with MNA (25.3 ± 2.1 vs 23.6 ± 2.7 p = 0.003) and lower level of
peritoneal dialysis is increased protein requirements due to biochemical parameters such as prealbumin mg/dL (34 ± 7.6 vs
high protein loss of dialysate and loss of appetite due to uremic 29.4 ± 8.2 p = 0.045), cholesterol mg/dL [146 (92–231) vs 118
toxemia. Among the possible nutritional interventions in CKD (70–263), p = 0.038), triglycerides mg/dL [79.5 (35–923) vs 133
patients ketoanalogues (KA) of amino acids supplementation (33–417), p = 0.029]. Also, percent of ejection fraction was
deserves particular attention. The purpose of the study was to lower and a number of taken medications was higher.
evaluate the effects of treatment with amino acid ketoanalo- Differences in the Charlson Comorbidity Index were not
gues on the nutritional status and morbidity of peritoneal observed. The occurrence of complications positively corre-
dialysis patients with malnutrition. lated with age and negatively with the results of full-MNA, scale
Methods: The study group was composed of 24 PD patients with and 7-SGA scale and with the level of prealbumin (mg/dL),
diagnosed malnutrition. Patients were randomly assigned to cholesterol (mg/dL), triglycerides (mg/dL).
the intervention and control groups. Conclusion: Poor nutritional status in elderly with AS before
The intervention consisted of administration of KA for 3 months AVR is related to the occurrence of postoperative complica-
at a dose of 9 tablets of Ketosteril® daily. The several laboratory tions. In this group of patients, nutritional support before AVR
parameters and nutritional status were monitored during may be considered, although further studies are needed.
the study. Disclosure of Interest: None declared.
Results: NRS 2002 and SNAQ showed significant improve-
ment of nutritional status and appetite in intervention group
SUN-P178
after observation period. The increased of nPCR was noticed
ORAL SUPPLEMENTATION WITH THE OMEGA-3
in intervention group after 3 months of treatment (0.93 vs
DOCOSAHEXAENOIC ACID (DHA) IN PATIENTS WITH
1.14 g/kg/day), whereas in the control group nPCR was
AMYOTROPHIC LATERAL SCLEROSIS (ALS): A RANDOMIZED,
decreased (1.13 vs. 0.98).
DOUBLE-BLIND, PLACEBO-CONTROLLED PILOT STUDY
During the study lean body mass - LBM (kg) did not change in the
control group(36 vs 37 kg), but in the intervention group E. Romero1,2,3 *, M. Virgili1,2,3, M. Barceló2,3,4, M. Povedano2,3,
increased (38 vs 44 kg). Laboratory markers of inflammation, J. C. Domingo5. 1Clinical Nutrition and Dietetics Unit.
oxidative stress, urea, creatinine and other routine biochem- Endocrinology and Nutrition Department, 2Multidisciplinary
ical parameters, and also the adequacy of dialysis were stable Unit Motor Neurone Disease, Bellvitge Universitary Hospital,
3
in both groups. IDIBELL, Hospitalet de Llobregat (Barcelona), 4Research
Conclusion: Oral treatment with amino acid ketoanalogs in Group on Statistics, Econometrics and Health (GRECS),
malnourished peritoneal dialysis patients is safe. It results in University of Girona, Girona, 5Department of Biochemistry,
improved nutritional status, appetite and improves body University of Barcelona, Barcelona, Spain
composition by increasing lean body mass.
Rationale: Patients with ALS have progressive muscle atrophy
Disclosure of Interest: None declared. with high levels of circulating inflammatory markers and
altered lipidic profile. The anti-inflammatory activity of DHA
SUN-P177 and their contribution to the normal function of the nervous
THE RELATIONSHIP BETWEEN NUTRITIONAL STATUS AND system is expected to have a positive effect on ALS patients.
POSTOPERATIVE COMPLICATIONS AFTER AORTIC VALVE Methods: To evaluate the possible benefits of DHA on ALS
REPLACEMENT DUE TO AORTIC STENOSIS IN ELDERLY patients an oral supplementation of 1 g of DHA (+vit E) was
PATIENTS given to a group of 14 patients, while another similar group
E. W. Wernio1,2 *, S. Małgorzewicz1, D. Jagielak2. 1Department received 1g of olive oil as a placebo. The supplementation was
of Clinical Nutrition, 2Department of Cardiovascular Surgery, for 1 year. Blood samples of two groups were collected every 3
Medical University of Gdańsk, Gdańsk, Poland months to evaluate levels of cholesterol fractions, triglycerides
and inflammatory biomarkers. Besides this, weight loss pre-
Rationale: Longer life expectancy is associated with the diagnosis, ALS Functional Rate Scale (ALSFRS) and Forced Vital
increase incidents of aortic stenosis and rising number of Capacity (FVC) as clinical parameters were recorded.
surgical treatment of this valve lesion. The aim of this study Results: 28 ALS patients were included but only 16 completed
was the identification of factors related to nutritional status the follow up. No significant differences between treatment/
predisposing to the occurrence of postoperative complications placebo group were found on demographic characteristics at
after aortic valve replacement (AVR) surgery. baseline: weight loss pre-diagnosis, diagnostic delay (median
Methods: The nutritional status of 111 patients [74.1 ± 5.3 250/300 days), gender (57/71% male), onset site (86/64% limb)
years, 43% of women, mean AVA (cm2) 0.778 ± 0.21] with AS was and age (53/58 years). Evolution of study variables in 1 year
evaluated the day before AVR surgery. The questionnaire was: no changes for Triglycerides and HDL cholesterol. FVC
S120 Poster
−11/−11, ALSFRS −12.5/−4.5 points, LDL cholesterol −0.260/ SUN-P180

0.035, TNF alfa −0.570/1.59 meaning lower levels in the “LA DESCULTURIZACIÓN”: PERCEPTIONS ON TRADITIONAL
treated group than in placebo group ( p = 0.022) at 1 year. DIET AND NUTRITIONAL TRANSITION AMONG INDIGENOUS
Conclusion: A clinical improvement in the treated group COMMUNITIES OF ECUADOR
cannot be concluded due to the small size of the sample (a V. Chee1, L. Wright2, I. Hernandez3, M. Reina-Ortiz2,
limitation of the study). TNF alfa levels differences are only S. Bejarano2, M. Flores4, E. Teran4 *, R. Izurieta2, J. Baldwin5,
weakly significant. Lack of change in lipidic profile could be D. Martinez-Tyson2. 1College of Public Health, 2College of
disguised as the expected evolution of the disease. Further Public Health, University of South Florida, Tampa, FL, United
studies with an increased number of ALS patients would be States, 3Facultad de Enfermeria, Pontificia Universidad
necessary to confirm this anti-inflammatory activity. Catolica del Ecuador, 4Colegio de Ciencias de la Salud,
Disclosure of Interest: None declared. Universidad San Francisco de Quito, Quito, Ecuador,
5
Department of Health Sciences, Northern Arizona University,
SUN-P179 Arizona, United States
NUTRITIONAL ASSESSMENT IN PATIENTS AFFECTED BY
MITOCHONDRIAL CYTOPATHY (NAMITO STUDY) Rationale: Nutrition transition refers to the global shift from
traditional, nutrient-dense foods to nutrient-poor, high-fat
E. Aubry1 *, C. Aeberhard1, L. Bally1, S. Mühlebach2, Z. Stanga1. foods. Chronic disease risk is further elevated by sedentary
1
Department of Diabetes, Endocrinology, Nutritional Medicine lifestyles. Few studies have examined the nutrition transition
and Metabolism, Bern University Hospital and University of among indigenous communities in Ecuador despite the national
Bern, Bern, 2Department of Clinical Pharmacy and growing rates of overweight (40% men, 50% women) and obesity
Epidemiology, University of Basel, Basel, Switzerland (6% men, 16% women)1. Understanding dietary behavior
-within its cultural context- and its relationship to nutritional
Rationale: Patients suffering mitochondrial cytopathy (MC) are
transition -within its socioeconomic context- is a crucial step
at high risk for malnutrition and often suffer from gastrointes-
for informing evidence-based interventions.
tinal symptoms (e.g. dysphagia, dysmotility). It considerably
Methods: A qualitative study was conducted to explore
influences nutritional intake and therefore deteriorates nutri-
nutritional transition among Indigenous communities in the
tional state. Literature in this regard is very sparse. Aim of this
province of Imbabura, Ecuador. A total of eight focus groups
study was to evaluate a simple screening tool for protein energy
(n = 55) were conducted. Focus group questions explored
malnutrition (PEM) and conduct extended nutritional assess-
perceptions of diet and nutrition. Data was analyzed using
ment to explore potential presence of PEM in patients with MC
grounded theory.
compared to controls.
Results: A central role of diet in cultural identity among these
Methods: Prospective cohort study comparing outpatients
communities was reported. Additionally, changing trends
with MC to matched healthy controls. Nutritional screening
in household dietary behaviors were observed due to diurnal/
(NRS-2002) and full nutritional assessment were conducted,
daily parental absenteeism as a result of employment oppor-
including quantitative and qualitative dietary habits (food
tunities. Grandparents had difficulty feeding children with
recall protocol), body composition (bioimpedance analysis,
healthy foods at home while children were instructed to
anthropometrics), rest energy expenditure (indirect calorim-
consume “mestizo” food in schools. Participants were con-
etry) and quality of life (QoL; SF36v2) measurements. Blood
cerned about “desculturización” – a loss of their traditions and
and 24-hours urine analysis were done in the patients’ group.
identity- in the face of the increased popularity of “mestizo”/
Results: Twenty-six patients were included: 11 in the patients’
fast foods that were replacing traditional staples (quinoa, favas,
group and 15 in the control group. No patient was screened at
amaranth).
high risk for malnutrition according to the NRS-2002.
Conclusion: Economic needs, urban employment and institu-
Nutritional assessment showed that patients had inadequate
tionalized education may have impacted household diets,
energy intake and significantly lower protein intake. Nitrogen
resulting in increased intake of nutrient poor, fatty fast foods.
balance and creatinine height index showed pathologic values.
The implications of nutritional transition and cultural identity
Body composition and function were altered as well as QoL.
and its comparison with other Latin-American indigenous
Conclusion: According to detailed nutritional assessment and
communities will be discussed.
ESPEN guidelines1, all patients were malnourished. Thus, NRS-
2002 appears to be too less sensitive for outclinic chronic ill References:
patients. There is a rational to increase protein intake and 1.
adapt energy supply to improve symptoms and QoL. Further Disclosure of Interest: None declared.
studies should investigate potential positive influence of
dietary management on disease’s course.
SUN-P181
References URINARY SODIUM EXCRETION AMONG ECUADORIAN ADULT
1. Cederholm T, et al. ESPEN Guidelines on definitions and terminology POPULATION: A CROSS-SECTIONAL STUDY
of clinical nutrition. Clinical nutrition 36 (2017), 49–64 I. Sisa1, M. E. Herrera-Fontana1 *, M. M. Bovera2,
Disclosure of Interest: None declared. M. Palomeque3, E. Teran1. 1Colegio de Ciencias de la Salud,
Universidad San Francisco de Quito, 2Servicio de Laboratorio,
3
Hospital de los Valles, Quito, Ecuador
Rationale: It is well known that high dietary sodium intake

is associated with cardiovascular disease (CVD) through a
mediated effect on blood pressure. In this sense, Ecuador is and reactance and impedance increased. Both FFM and FM
currently facing a high prevalence of hypertension and other increased by 0.3 ± 0.9 kg and 0.6 ± 1.0 kg respectively (Table 1).
health problems related with dietary patterns in their
Table 1: Differences in BIA results after ingestion of 1.0 L water in 166 students
population. The aim of this study was to determine the (means ± SD).
sodium intake in Ecuadorian population.
T0 T1 p-value
Methods: It was conducted a cross-sectional study in a
representative sample of people living in Quito, Ecuador Weight (kg) 63.9 ± 10.6 64.8 ± 10.6 <0.001
Resistance 50 kHz 603.3 ± 82.0 602.8 ± 80.6 <0.001
(2,800 m above sea level). Study was reviewed and approved Reactance 50 kHz 66.5 ± 8.1 67.3 ± 8.1 <0.001
by an IRB and sodium was measured in 24-hr urine collection Impedance 50 kHz 606.5 ± 82.7 606.6 ± 80.7 <0.001
using an Ion-Selective Electrode indirect Na-K-Cl (Roche FFM (kg) 49.9 ± 9.2 50.3 ± 9.2 <0.001
Diagnostics, Switzerland). 24-hr sodium excretion was reported FM (kg) 13.9 ± 4.2 14.6 ± 4.2 <0.001
in mmol/d, then transformed to mg sodium/d and finally g T0 = sober and with empty bladder; T1 = after 1.0 L water intake
salt/d. A WHO reference value of 2.0 g/d was used to Conclusion: Our data suggest that water intake has a direct
discriminate consumers. All statistical analyses were per- effect on BIA outcomes. Drinking water increases a person’s
formed using R v 3.3.2. body weight, but as the water is not settled in the intracellular
Results: Study population was 130 subjects. The median age
space yet, it has minimal influence on the resistance and
was 40 years old and the average sodium intake was 2,771 ±
reactance. Since FFM equations rely on age, sex, body weight,
1,771 mg/d (range, 1,736–3,404) equivalent to salt intake of
and BIA raw values, increase in body weight incorrectly results
7.1 g/d (range, 4.4–8.7). Sixty-three percent (82 of 130) of
in an overestimation of FM. It is advised to measure patients
individuals had sodium levels higher than the reference value.
with empty bladder to minimize bias.
Sixty-five percent were overweight (BMI ≥ 25 kg/m2), 77%
considered themselves as proper salt consumers, and had Disclosure of Interest: None declared.
a mean potassium intake of 1226 ± 548 mg/d (range, 858–
1,511). In the univariate analysis individuals with higher SUN-P183
sodium intake were more likely to be service workers, had FATTY LIVER INDEX FOR PREDICTING NON-ALCOHOLIC FATTY
higher BMI values and had no association with salt consumption LIVER DISEASE BASED ON CAP GRADING
perception. F. Razmpour1 *, M. Nematy1, Z. Dehnavi1, on behalf of Dehnavi
Conclusion: Sodium intake in the Ecuadorian population is zahra. 1Department of Clinical Nutrition, Clinical Nutrition,
higher than expected and might be related with the increasing Mashhad, Iran, Islamic Republic Of
cases of hypertension, obesity and other metabolic diseases.
There is then an urgent need to implement health policy to Rationale: Non-alcoholic fatty liver disease (NAFLD) is the most
reduce sodium intake and therefore successfully prevent CVD common chronic liver disease which can contribute to some
at a community and country-level. clinical conditions such as: simple steatosis, non-alcoholic
Steatohepatatis (NASH), hepatic cirrhosis and also hepatocel-
lular carcinoma, so the early diagnosis of NAFLD is important.
The aim of this study is to investigate the ability of FLI (Fatty Liver
SUN-P182 Index) in predicting NAFLD and then determining an optimal
IMPACT OF DRINKING 1L WATER ON BIA MEASUREMENT IN cutoff point for FLI based on Fibro Scan and CAP diagnosis.
HEALTHY STUDENTS Methods: This cross sectional study consisted of 212 subjects.
E. Leistra1 *, H. Kruizenga2,3. 1Health Sciences, Vrije Anthropometric parameters were measured and blood samples
Universiteit, 2Nutrition and Dietetics, VU University Medical were collected from participants, then hepatic steatosis of the
Center, Amsterdam, 3Dutch Dietetic Association, Houten, participants was determined by CAP. We calculated FLI from
Netherlands body mass index, waist circumference (WC), triglyceride, and
gamma glutamyl transferase data. Logistic regression was used
Rationale: Bioelectrical Impedance Analysis (BIA) measure- to determine the relationship between FLI and NAFLD. The
ments are often performed in clinical practice to determine sensitivity and specificity of FLI and also the optimal cutoff
FFM/FM. Controversy exists on the necessity of emptying points of it were determined by receiver operating character-
the bladder before a BIA measurement. To answer this question istic analysis.
we assessed the influence of drinking 1L water on BIA Results: the mean age of participants was 39.26 ± 14.18. FLI was
outcomes. significantly associated with NAFLD (OR = 1.062, 95%CI: 1.042–
Methods: Healthy master students Health Sciences at the 1.082, P < 0.001). The AUC of FLI was 0.84 for diagnosis of NAFLD
VU University Amsterdam participated in this observational and its optimal cutoff point was 26.2 (sensitivity = 0.833,
study between 2011 and 2016. BIA measurements were specificity = 0.696), also the optimal cutoff points of FLI were
performed according to protocol with Bodystat 1,500 MDD 30.4 in men (sensitivity = 0.817, specificity = 0.714) and 20.7 in
sober and with empty bladder (T0) and after intake of 1.0 L women (sensitivity = 0.892, specificity = 0.657). The optimal
water (T1). Time between measurements was max. 3 hours. cutoff points of FLI in different grades of steatosis were
Paired sample t-tests were performed to explore differences in determined which it was 26.2, 38.3 and 49.7, respectively in
weight, FFM, FM, and BIA raw values (resistance, reactance, grade 1, 2 and 3 of NAFLD.
impedance). Conclusion: FLI has a suitable performance in diagnosis of
Results: 166 students were included (88% female, mean age NAFLD, and it can also predicts the grade of Steatosis in NAFLD
24.3 ± 3.8 y, mean BMI 21.7 ± 2.5). After drinking 1.0 L water, patients.
body weight increased by 0.9 ± 0.7 kg. Resistance decreased,
S122 Poster
SUN-P184 in a private hospital in the city of São Paulo, Brazil. Data

THE EVANES STUDY: A PROTOCOL FOR THE NUTRITIONAL collection started on the first day of introduction of the enteral
ASSESSMENT OF SCHOOLCHILDREN IN THE RURAL diet and follow-up was performed until the discontinuation of
HIGHLANDS OF ECUADOR the nutritional therapy, discharge, or death of the patient.
F. Morales1,2 *, M. Guerendiain3. 1Metabolism and Nutrition Monitoring was carried out from July 2016 to February 2017.
Disorders Research Group, Faculty of Health Sciences, Protein requirements were calculated using predictive formu-
National University of Chimborazo, Riobamba, Ecuador, las based on the International Guidelines of American (ASPEN)
2
Department of Organic Chemistry, Faculty of Chemistry, and European (ESPEN) Societies for Parenteral and Enteral
University of Murcia, Murcia, Spain, 3School of Medicine, Nutrition, using the following categories: elderly with acute or
Faculty of Health Sciences, National University of Chimborazo, chronic diseases, critical, obese, cancerous, and surgical
Riobamba, Ecuador patients. It was set a proposed target of 80% of patients
under protein adequacy.
Rationale: Clinical studies have shown a high nutritional Results: The percentage of protein requirement reached using
vulnerability of rural populations, especially those of indigen- the enteral diet according to the established value was: July:
ous origin that inhabit Ecuadorian highlands [1]. Herein, we 86% (1,178 follow-ups); August 92% (1010 follow-ups),
designed the EVANES study as a holistic strategy for the September 88% (793 follow-ups); October 96% (975 follow-
nutritional assessment of schoolchildren living in the rural ups), November 93% (812 follow-ups); December 89% (588
highlands of Ecuador in order to identify nutritional problems follow-ups); January 93% (765 follow-ups) and February 97%
and their effects in these indigenous populations, as well as the (731 follow-ups).
factors that may cause them. Conclusion: It was observed that the targets reached each
Methods: We utilize a multi- and interdisciplinary approach month were superior to those previously established. From the
that will be conducted in five hundred children aged from 5 to outset, an adjustment of the target was suggested according to
12 years old attending eleven different rural schools. In order the historical series. In view of the results, we were able to
to achieve a complete analysis, we will evaluate the: (i) guarantee the protein supply to the patients undergoing
nutritional status, (ii) dietary intake, (iii) intestinal parasitic enteral nutritional therapy. The continuous monitoring of
infections, (iv) hygienic, sanitary and environmental condi- these data by an interdisciplinary team is of extreme
tions, (v) pre and postnatal factors, (vi) haematological and importance to improve the care provided to the patient.
metabolic profiles, and (vii) cognitive development. Reference
Results: The EVANES study is expected to result in a useful data
BRASPEN, 2016. PROT-AGE, 2013. ESPEN, 2016.
set of the nutritional deficiencies, diseases and their risk
factors in Ecuador. Disclosure of Interest: None declared.
Conclusion: This study may be pertinent in establishing health
policies for disease prevention, health promotion and health SUN-P186
education oriented programs in this population. IMPLEMENTATION OF THE TRAINING COURSE OF NURSING
Acknowledgments: We would like to thank the Universidad REFERRAL IN NUTRITIONAL THERAPY
Nacional de Chimborazo for its support, as well as the Ethics F. R. Totti1 *, M. Guimarães2, L. M. Sanches3, V. C. Paraizo4,
Committee of the Universidad San Francisco de Quito for its L. Lins3, R. L. Santos5, F. R. Alves3, D. F. Ferreirea6, C. Cukier2,
approval. F.M. also thanks the Fundación Seneca-CARM for her on behalf of Fernanda Ramires Totti. 1Enfermeira, 2Nutrologia,
3
Saavedra Fajardo contract and funding (Contract No. 20025/ Nutricionista, 4Gerente, 5ICEP, 6Superintendente Medico,
SF/16). Hospital Samaritano de São Paulo, São Paulo, Brazil
Reference
Rationale: To divulge a work carried out with a Group of
1. Freire WB, Silva-Jaramillo KM, Ramírez-Luzuriaga MJ, Belmont P,
Reference-Nurses in Multidisciplinary Team in Nutritional
Waters WF (2014) The double burden of undernutrition and excess
Therapy promoted to encourage and educate nursing profes-
body weight in Ecuador. The American Journal of Clinical Nutrition
100: 1636S–1643S. sionals to improve patient care in Nutrition Therapy.
Methods: Preparatory course accomplished in a private hospital
in the city of São Paulo, Brazil, with 10 monthly meetings, from
March to December 2016, with trained instructors with
SUN-P185 theoretical and practical classes. The topics covered were:
OBSERVATIONAL STUDY: PROTEIN TARGET ADEQUACY AND Peripheral and Manipulated Parenteral Nutrition-care in hand-
NEW CHALLENGES ling and installation, Protein Caloric Support, Nasoenteral Probe
L. T. M. Sanches1 *, F. R. Totti1, F. Alves1, M. P. Guimaraes1, Care and Infusion Pump, Oral Supplementation, Gastrostomy
L. Lins1, A. V. Arrais1, V. M. C. Paraiso1, D. F. Ferreira1. and Probes Fixation, Check Of Diet and Water Balance, Care
1
Nutrition, Hospital Samaritano de São Paulo, São Paulo, Brazil for Avoiding Bronchaspiration, Nasal Probe Medications-
Administration, interaction and obstruction, Final evaluation
Rationale: The adequate protein has been an important point and delivery of certificates. The presence in 80% of the classes
for clinical improvement of the patient. The objective of this was obligatory.
study was to evaluate the protein adequacy of patients Results: 21 employees from different sectors, Critical and Non-
undergoing enteral nutritional therapy. Critical Adult and Infantile Units were enrolled. In the end, we
Methods: An observational, descriptive, and retrospective had 15 members (72%) who finished, 4(19%) failed due to lack
study with patients undergoing exclusive enteral nutritional and 2(9%) due to the institution’s disengagement. The average
therapy, both men and women, aged 18–99 years, hospitalized of the Pre-Course Evaluation was obtained with a grade of 8.0
and Post Course of 9.6, representing 20% of knowledge gain. 4 SUN-P188

participants had 100% presence. PREOPERATIVE NUTRITIONAL RISK ASSESSMENT IN
Conclusion: The course promoted a better interaction NEUROSURGERY PATIENTS
between the multidisciplinary team and the participants. We F. Yüzbaşıoğlu Marangoz1 *, G. Kaner2, N. Seremet Kurklu3.
were able to develop and work on the professionalś skills and 1
Clinic of Neurosurgery, Ege University Faculty of Medicine,
thus disseminate learning and add knowledge to all. Suggestion İzmir, 2Faculty of Health Sciences, Department of Nutrition
for the next course of 2017 will be the multiplication of the and Dietetics, Izmir Katip Celebi University, Izmir,
knowledge acquired to the professionals of the Reference Units 3
Department of Nutrition and Dietetics, Akdeniz University
of each participant. Antalya School of Health, Antalya, Turkey
References
Rationale: Nutritional Risk Screeening (NRS-2002) is a recom-
Education From Conceptualization to Evaluation. New York: National
mended method by ESPEN for the evaluation of preoperative
League for Nursing; 2007.
Sharon D. Simulation: education and ethics. In: PamelaR, editor. nutritional status. This study aimed to evaluate malnutrition
Simulation in Nursing risk of neurosurgery patients by using NRS 2002 and standar-
dized questionnaire
Methods: A total of 60 inpatients (30 males and 30 females)
aged 19–79 years in the neurosurgery service between February-
SUN-P187 March 2016 were included to the study. Anthropometric
RESULTS OF NUTRITIONAL SCREENING (CONUT) measurements, such as body weight and height were measured
IMPLEMENTATION IN NON-CRITICALLY ILL INPATIENTS IN A and BMI was calculated. Obesity classification was made
THIRD LEVEL HOSPITAL according to WHO criteria. Evaluation of the patients nutri-
F. J. Vílchez-López1 *, A. Doncel-Moriano2, J. Tamayo-Serrato1, tional status was made according to the NRS-2002 system.
A. Montero-Galván1, M. Á. Bailén-García3, M. Aguilar-Diosdado1. Patients were considered malnourished when NRS-2002 score
1
Endocrinology and Nutrition Department, Hospital Puerta was ≥3. In addition, standardized questionnaire was used to
Del Mar, 2Medicine, School of Medicine, 3Clinical Analysis determine nutritional status of patients
Department, Hospital Puerta Del Mar, Cádiz, Spain Results: Mean age, body weight and BMI of patients were
52.6 ± 16.40 years, 73.1 ± 13.85 kg, and 25.9 ± 4.15 kg/m2,
Rationale: Analyse the diffusion of nutritional screening system respectively. According to WHO BMI classification, 3.3% of
(CONUT) at Hospital Puerta del Mar (Cádiz) in 2015 in different patients were thin whereas 83.3% overweight. It was detected
departments. Evaluate mortality and hospital stay based on that 26.6% of patients had involuntary weight loss history
nutritional risk at admission. (8.8 ± 4.08 kg) in the past year. Mean length of stay in hospital
Methods: Retrospective cohorts study including patients older was 8.8 ± 15.16 day (median 4.0 day). Only 1.7% of patients
than 18, admitted to hospital for more than 3 days in 2015. A recieved enteral nutrition support. On the other hand, the
systematic analysis of CONUT was undertaken in general blood majority of the patients ate their full meal provided by the
tests analysed during the first 3 days’ admission. Positive risk hospital. More than half of patients (78.3%) had 2 or lower NRS-
was defined by CONUT >4. The relationship between CONUT 2002 scores. On the other hand, 11.7% of patients had 3 NRS-
result and clinical variables was evaluated. 2002 scores and they were considered as malnourished.
Results: Of 674 patients included: 69.8% negative, 30.2% Conclusion: In spite of starving because of invasive diagnostic
positive. 53.1% men, mean age 67.3 (±16.7). 90.9% of screened procedures, changes in food intake because of psychical
patients were admitted from Emergency, 55.9% were multi- alterations and repeated vomiting resulting from elevated
medicated (taking ≥5 drugs) and 34.6% were diabetic. CONUT intracranial pressure, the percentages of malnutrition was very
was more frequently analysed in patients admitted to low in our neurosurgery clinics. This condition may be due to
Gastroenterology (29.7%), Endocrinology (27.3%) and Internal the lack of a long period of hospitalization of patients in our
Medicine (23.7%). None of the patients were admitted to clinic as well as other clinics.
Maxillofacial Surgery, Otorhinolaryngology, Plastic Surgery,
Heart Surgery. Patients with CONUT positive were older. The
percentage of women, urgent admissions and multimedicated
patients was significatively higher in CONUT positive than SUN-P189
CONUT negative. Length of stay (LOS) was longer in CONUT DISEASE-RELATED UNDERNUTRITION, ETHNICITY AND
positive (12.4 vs 10.1 days, p < 0.05). 11.4% of patients studied LENGTH OF HOSPITAL STAY: A PROSPECTIVE COHORT STUDY
died during their admission (24.1% CONUT positive vs 5.9% AT THE DEPARTMENT OF SURGERY OF THE ACADEMIC
negative, p < 0.05). Relative risk for mortality was 4,1 (CI 95%: HOSPITAL PARAMARIBO (AZP)
2,6–6,2) in patients with CONUT positive compared to CONUT G. van der Held-Horinga1 *, M. MaCdonald - Ottevanger2,
negative. A. van Kanten3, L. Nahar-van Venrooij4. 1Dietetics, 2Research
Conclusion: The implementation of CONUT on admission is Center, 3Surgery, Academic Hospital, 4Department of Public
functioning well in medical departments, but greater uptake is Health, Faculty of Medical Sciences, Anton de Kom University,
needed by surgical departments. Positive nutritional screening Paramaribo, Suriname
is related to age, females, urgent admissions and multi-
medication. An increase in mortality and LOS were identified Rationale: To assess prevalence of disease-related under-
in patients with CONUT positive compared to those with a nutrition (DRU) and its association with ethnicity and length of
CONUT negative at admission. stay (LOS) at the department of surgery of the AZP, in Suriname,
a middle-income, multi-ethnic country, in South America.
S124 Poster
Methods: Between February and May 2016 all patients methods. The 95% limits of individual agreement between IC
(≥18 yrs), except pregnant women, admitted at the depart- and HB equation ranged from 316.33 to 363.83 Kcal. The
ment of surgery (>24 h) were asked to participate. Within 48 Pearson correlations between IC with EG and BG were 0.71
hours of admission, weight (history), length, fat-free mas index (CCC = 0.13 and Cb = 0.18) and 0.71 (CCC = 0.23 and Cb = 0.32),
(FFMI) using bio-impedance analysis, and self-reported ethni- respectively.
city were collected. Age, sex and diagnosis were extracted
Table 1:
from medical files. DRU was defined as (1) unintended weight
loss (UWL) of >10%, or >5% over the last 3 months, and/or (2) Methods Resting Energy
Expenditure
low FFMI (<17 kg/m2 in men and 15 kg/m2 in women).
Associations between ethnicity (Hindustan [reference cat- Indirect calorimetry 1612,26 ± 262,97
Harris-Benedict equation 1587,52 ± 222,49
egory], Creole, Javanese, Maroon, Amerindian, Mixed) and ESPEN guidelines 2646,08 ± 488,44
DRU, UWL and low FFMI were adjusted for age, sex, diagnosis, Brazilian guidelines - DITEN 2268,07 ± 418,66
and severity of disease (NRS-2002) using multivariate logistic
regression analysis. For DRU and LOS (>7 days) similar Conclusion: The HB equation showed good correlation with the
multivariate models were used extended with pre-admission reference method (IC), while ESPEN and Brazilian guidelines -
setting (at home without or with help, or institutionalized). DITEN overestimates energy requirements in this sample of
Results: In the total population (N = 351) 46.3% was found to be cirrhotic patients.
undernourished; 31.3% had UWL and 27.4% had low FFMI. 10.7%
Reference
of Maroons had a low FFMI compared to 32.5% of Hindustani,
p = 0.02; (adj. OR 0.24, 95% CI 0.06–0.91). Both DRU and low 1. Riggio O, Angeloni S, Ciuffa L, Nicolini G, Attili AF, Albanese C,
FFMI were associated with LOS >7 days (Adj OR 2.52, 95% CI Merli M. Malnutrition is not related to alterations in energy balance
in patients with stable liver cirrhosis. Clin Nutr. 2003;22:553–9.
1.49–4.26 and OR 3.26, 95% CI 1.90–5.57, respectively).
Conclusion: Almost half of patients had DRU on admission. Disclosure of Interest: None declared.
Prevalence of low FFMI differed between ethnic groups, and
was, as DRU, associated with increased LOS. Future research SUN-P191
has to reveal if ethnicity should be part of risk assessment for DOES ADHERENCE TO MEDITERRANEAN DIET AFFECT
DRU as it is for obesity and cardiovascular disease. ANTHROPOMETRIC MEASUREMENTS IN UNIVERSITY
Disclosure of Interest: None declared. STUDENTS?
G. Ede1 *, I. Türkoğlu1, A. Açıkgöz1, T. Yalçın1, F. Ilgaz1,
SUN-P190 A. Aksan1, A. A. Yürük1, K. Tel Adıgüzel1, A. Kabasakal Çetin1,
ANALYSIS OF ENERGY EXPENDITURE IN CIRRHOTIC PATIENTS: H. Gökmen Özel1, E. Yıldız1, G. Samur1. 1Nutrition and
COMPARISON OF INDIRECT CALORIMETRY AND PREDICTION Dietetics, Hacettepe University, Ankara, Turkey
EQUATIONS
Rationale: Mediterranean Diet (MD) has been widely used to
G. Belarmino1, M. C. Gonzalez2, R. S. Torrinhas1, W. Andraus1, describe the healthy eating behavior and the Mediterranean
L. A. C. D’Albuquerque1, L. Damiani3, P. Sala1, Diet Quality Index for Children and Adolescents (KIDMED) is
S. B. Heymsfield4, D. L. Waitzberg1 *. 1Faculdade de Medicina used to evaluate adherence to the MD. The aim of this study
Da Universidade de São Paulo, São Paulo, 2Post-Graduate was to examine the association between the Mediterranean
Program in Health and Behavior - Catholic University of Diet Quality Index (KIDMED) and anthropometric measurements
Pelotas, Pelotas, 3Instituto de Pesquisa – Hospital do Coração in university students.
de São Paulo, São Paulo, Brazil, 4Pennington Biomedical Methods: Nine-hundred fifty university students (426 men, 524
Research Center, Louisiana State University, Baton Rouge, women) aged between 17 and 28 years (mean ± SD = 21.5 ±
United States 1.85 yrs) were included. The KIDMED index was used to assess
the degree of adherence to the MD. Mean (±SD) total score was
Rationale: Malnutrition, which implies an imbalance between
3.71 ± 2.59 ranged from −4 to 11 (men = 3.96 ± 2.5 and women =
energy intake and energy requirements, is common in patients
3.41 ± 2.6). KIDMED score was classified into 3 levels: ≥8
with cirrhosis. Predictive equations are used for estimating
reflects “optimal”; 4–7, average; ≤3 very low diet quality. Body
resting energy expenditure (REE) when the measurements
weight, height, waist and hip circumference was measured.
obtained from indirect calorimetry (IC) are not available. Our
Body mass index (BMI) and waist-hip ratio was calculated and
aim was estimates the resting energy expenditure through
classified according to WHO Standards.
indirect calorimetry and compares with energy requirements
Results: In our population, 46.9%, 45.1%, 8.0% of the students
according to Harris-Benedict equation (HB), ESPEN (EG) and
had poor, average, and optimal diet quality, respectively. The
Brazilian guidelines - DITEN (BG).
percentage of overweight and obese students was 22.3% in poor
Methods: In a prospective design, REE was measured in 124
score group and 18.2% in the optimal score group. Mean BMI
male cirrhotic patients by indirect calorimetry and predicted
(kg/m2) (22.4 ± 2.9 vs. 23.0 ± 3.9), waist-hip ratio (0.81 ± 0.8
by Harris-Benedict, EG (35 Kcal/kg current weight) and BG
vs. 0.80 ± 0.8), neck circumference (cm) (34.2 ± 3.2 vs.
(30 Kcal/kg current weight) guidelines.
34.0 ± 3.5) was not significantly different between poor and
Results: The predicted REE by EG and BG were higher than the
optimal score groups. There was a strong negative correlation
measured (Table 1). The HB equation presented results closer
between KIDMED scores and waist-hip ratio (r = −0.74,
to the reference method, with a positive Pearson correlation
p < 0.05).
(r = 0.77), excellent accuracy (Cb = 0.98) and a positive Lin’s
concordance correlation (CCC = 0.75) observed between these
Conclusion: In this study we found a significant negative medical patients. Conducted at five hospitals, each site
relationship between KIDMED index and waist-hip ratio but no tailored strategies to improve nutrition care. This multi-
significant relationship was found between KIDMED index and method study included a variety of data collection measures.
other anthropometric measurements. Additional researches Eligible patients were recruited each month for 15 months to
are necessary to evaluate negative factors and to find ways to demonstrate potential improvements in nutrition care pro-
improve the dietary pattern in our university population. cesses, including mealtime barriers. MATwas completed on ∼20
Disclosure of Interest: None declared. patients per month/site during baseline and implementation
phases. Prevalence of barriers across the entire study are
summarized and contrasted by site with a chi-squared test. The
SUN-P192
change in prevalence barriers over time was determined with a
FEEDING BEHAVIOR IS ASSOCIATED WITH GENDER OF PARENTS
linear trend test.
IN KINDERGARTEN CHILDREN
Results: 963 patients with an average age of 68.2 (SD 15 = 4)
G. G. Topal1 *, M. Tengilimoglu Metin1, D. Gumus1, S. Sevim1, years, 55.8% female completed a MAT assessment. The average
M. Kizil1. 1Nutrition and Dietetics, Hacettepe University, number of barriers experienced over the entire study was 2.24
Ankara, Turkey (SD 1.9) and there was a consistent decrease in barriers (3.16–
1.56/patient/month ( p < 0.0001)) with implementation of
Rationale: It has been reported that irregularity in the eating
interventions. The three most common barriers were: not
habits of adult obese patients is associated with parental
having all food/drink items (22.2%), unappetizing meal
nutritional status. Although it is a fact that the mother still has
(23.9%), not visited by staff mid-meal (54.6%). Site differences
a primary role in the child’s feeding; the efficacy of fathers’
( p < 0.0001) were noted for 14/20 barriers assessed.
feeding of children may be increased compared to the past.
Conclusion: Mealtime intake barriers are common in medical
Studies conducted in recent years have shown that fathers are
patients and vary by site. The MAT is a useful tool for identifying
beginning to take up more space in childhood and meal times.
these barriers. Each site tailored interventions to reduce
The aim of this study was to determine the feeding practices
barriers (e.g. volunteer assistant, increased food availability
and styles of the children of their parents.
outside mealtimes), and these strategies were successful at
Methods: This study was conducted on children between the
reducing barriers overall. Further research will determine
ages of 3 and 5 between May and June 2015 at a Kindergarten.
impact on food intake for these patients.
The Child Feeding Questionnaire (CFQ) was used to investigate
the relationship between parents’ beliefs and attitudes Disclosure of Interest: H. Keller Speaker Bureau of: Abbott Nutrition,
towards child feeding and the susceptibility of children to Nestle Health Sciences, T. McNicholl: None declared, R. Valaitis: None
declared, C. Laur: None declared, Y. Xu: None declared, J. Dubin: None
obesity. The BMI of the parents was calculated and classified as
declared.
normal or abnormal.
Results: As a result of the study have reached 42 children and
SUN-P194
their 67 parents. 42 parents of the children completed the
SUCCESSFUL MULTI-SITE IMPLEMENTATION OF NUTRITION
questionnaire with the mother (58.3%) and 25 as the father
RISK SCREENING AND ASSESSMENT TRIAGE IN MEDICAL
(34.7%). The mean scores of the CFQ were 96.44 ± 13.60. The
INPATIENTS: THE MORE-2-EAT STUDY
mean scores of the father’s feeding questionnaire (88.40 ±
14.83) were found to be significantly lower than the mean scores H. Keller1 *, R. Valaitis1, T. McNicholl1, C. Laur1, J. Bell2,
of the mother’s feeding questionnaire (99.97 ± 10.66) ( p < on behalf of More-2-Eat. 1Applied Health Sciences, University
0.001). But, there was no significant relationship between of Waterloo, Waterloo, Canada, 2School of Human Movement
parents’ BMI and the Child Feeding Questionnaire scores. and Nutrition Sciences, University of Queensland, St Lucia,
Conclusion: This study shows that mothers as a parent are more Australia
restrictive in feeding their children. Despite the increased role
Rationale: Improving detection of malnourished patients is a
of mothers in working life, they are still predominant in feeding
priority. The purpose of this study was to document how 5
their children.
diverse hospitals tailored implementation of screening and
Disclosure of Interest: None declared. assessment in a single medical unit.
Methods: Sites worked towards implementing the Integrated
SUN-P193 Nutrition Pathway for Acute care, including screening
ASSESSING AND PREVENTING BARRIERS TO FOOD INTAKE IN (Canadian Nutrition Screening Tool) and triage with
ACUTE CARE MEDICAL PATIENTS: FINDINGS OF THE MORE-2- Subjective Global Assessment (SGA) to detect and diagnose
EAT STUDY malnourished patients over a 12 month period. At baseline,
H. Keller1 *, T. Mcnicholl1, R. Valaitis1, C. Laur1, Y. Xu2, three sites were screening with other tools. Multi-method data
J. Dubin2, on behalf of More-2-Eat. 1Applied Health Sciences, collection included: monthly audits of patient charts to
2
Statistics and Actuarial Science, University of Waterloo, identify care practices (n = 3890); tracking and tallying
Waterloo, Canada behaviour change techniques (BCT) used through written
scorecards (n = 190) and monthly coaching telephone calls
Rationale: Food intake barriers are common in acute care (n = 11); and baseline focus groups (n = 11) and key informant
patients and can lead to poor intake that slows recovery. A new interviews (n = 40) that identified the key facilitators to making
Mealtime Audit Tool (MAT) systematically assesses these these changes.
barriers. Results: Different screening and assessment models were
Methods: The More-2-Eat study is an implementation project, implemented across sites. Fidelity with screening and SGA
focused on preventing, detecting and treating malnutrition in to triage patients increased from baseline to end of
S126 Poster
implementation (Screening: 0–76% to 66–89%; SGA 0% to 76– SUN-P196

100% of those identified at risk). Data established environmen- NEW PREDICTIVE EQUATIONS FOR ESTIMATING RESTING
tal restructuring (e.g. adding screening question to existing ENERGY EXPENDITURE IN NORMALWEIGHTAND OVERWEIGHT
forms; n = 117/326 BCT) and education (n = 110/326 BCT) as SUBJECTS
key drivers of nutrition care practice changes. Key facilitators I. Cioffi1 *, M. Marra1, R. Sammarco1, E. Speranza1,
to screening and assessment with SGA included: building a O. Di Vincenzo1, L. Santarpia1, F. Contaldo1, F. Pasanisi1.
strong team, involving the relevant people and accounting for 1
Federico II University, Naples, Italy
context and climate of the unit and hospital.
Conclusion: Preliminary results suggest successful multi-site Rationale: Some of the most commonly used predictive
implementation of nutrition risk screening and assessment equations for estimating resting energy expenditure (REE) are
triage in medical inpatients. Drivers of success are coordinated based on anthropometric measurement collected in the first
effort and tailored behaviour change techniques that build on part of century. Body weight and height are changed in the last
the current values, practices and strengths of each unit. three decades due to different lifestyle; therefore, the aim of
Disclosure of Interest: H. Keller Speaker Bureau of: Abbott Nutrition, this study was to develop new predictive equations to estimate
Nestle Health Sciences, R. Valaitis: None declared, T. McNicholl: None REE in normal and overweight subjects.
declared, C. Laur: None declared, J. Bell: None declared. Methods: Anthropometric measurements were obtained from
854 outpatients (M: 164; F: 690) aged between 18 and 40 y
SUN-P195 (M = weight: 75.1 ± 11.7 kg, BMI: 24.5 ± 2.9 kg/m²; F: weight
DIAGNOSTIC ACCURACY OF BIA VERSUS DXA IN ADULT 62.9 ± 9.2 kg, BMI: 24.0 ± 3.0 kg/m²). As first, we compared REE
MITOCHONDRIAL DISEASE PATIENTS measured (MREE) by indirect calorimetry versus REE predicted
(PREE) by using Harris& Benedict (HB) and FAO predictive
H. Zweers1, V. Bodier2,3, M. Janssen4, G. Wanten1, S. Leij1,2 *.
1 equations. Then, we developed new predictive equations with
Department of Gastroenterology and Hepatology,
anthropometric variables (age, weight, height and BMI) as
Radboudumc, 2Dietetics, HAN University of Applied Sciences,
predictors.
Nijmegen, Netherlands, 3Nutrition, cSwiss Federal Institute of
Results: We found that HB and FAO equations provide a good
Technology, Zürich, Switzerland, 4Department of Internal
PREE-MREE difference, showing a bias lower than 5%y in both
Medicine, Radboudumc, Nijmegen, Netherlands
sexes, whereas the level of accuracy was good for females with
Rationale: In clinical practice, bioelectrical impedance ana- HB equation (76%), but nor for males. We developed new
lysis (BIA) is a cheaper, non-invasive alternative for DXA (Dual- predictive equation for REE by using a multiple regression
energy X-ray absorptiometry) to assess body composition (BC). analysis.
The validity of this double indirect technique, however, has not All subjects: REE (kcal/d) = 17.4 * weight + 155 * sex – 11.6 *
been established yet in patients with mitochondrial disease BMI + 600
(MD). Therefore, the aim of this study was to test the accuracy Predictive equations specific for sex:
of BIA in comparison to DXA in MD patients. Males subjects: REE (kcal/d) = 15.5 * weight + 612
Methods: BC was assessed after overnight fasting in adult MD Females subjects: REE (kcal/d) = 17.9 * weight – 13.9 * BMI + 630
patients by both BIA (at 50 Hz) and DXA. BIA fat free mass (FFM) Conclusion: Although HB and FAO equations can be used for
was calculated using the formulas of Kyle (intended for healthy estimating REE at the population level, the accuracy was not
subjects) and Dey (intended for the elderly). Linear regression always adequate at individual level, therefore new predictive
analysis was performed for FFM to determine the association equations should be considered.
(R2) and the standard error of the estimate(SEE) to compare Disclosure of Interest: None declared.
these data with the results obtained for BIA and DXA in healthy
subjects as reported by Kyle (R2 = 0.97, SEE 1.8 kg). Sensitivity SUN-P197
and specificity were calculated using the formula of Kyle. For IS COMPUTED TOMOGRAPHY A BETTER ASSESSMENT TOOL
diagnosing malnutrition, FFM Index cutoff points were used, FOR CANCER PATIENTS COMPARED TO BODY MASS INDEX?
15 kg/m2 for males and 17 kg/m2 for females. To define J. A. Leyva Islas1, M. A. García Castañeda1,
obesity, cutoff points for fatpercentage of >25% in males and I. Martinez Del Rio Requejo1 *, A. F. Santini Sánchez1,
>30% in females were set. O. O. Olea Salinas1. 1Clinical Nutrition Department, Lic. Adolfo
Results: 36 MD patients (age 42 ± 12 yrs, 40% males) were López Mateos ISSSTE Hospital, Ciudad de México, Mexico
studied. R2 for FFM by Kyle was 0.90, with SEE 2.6 kg and for
Dey’s formula values of 0.89 and 2,4 kg, respectively, were Rationale: Inflammation and poor nutritional status contri-
found. Sensitivity and specificity were 77% and 93% for butes to cancer cachexia, which is associated with poor
diagnosing malnutrition, and 86% and 29% for diagnosing outcomes including increased risk of infection, prolonged
obesity, respectively. hospitalizations, and mortality. Traditionally, BMI has been
Conclusion: For BIA-derived FFM, both the formulas of Kyle and used to assess nutritional status of cancer patients. However,
Dey show a good association with DXA, although less in MD BMI does not discriminate between the loss of lean or fat mass.
patients compared to healthy subjects. Since BIA sensitivity to Other techniques, such as computed tomography (CT) may be
diagnose malnutrition is low and specificity to diagnose obesity more suitable for the assessment of nutritional status of cancer
is even worse, DXA remains the preferred method to assess BC patients. Therefore, the aim of the study is to determine the
in MD patients. Whenever BIA is used it should be taken into utility of CT vs. BMI in sarcopenia diagnosis
account that BIA overestimates FFM in this setting. Methods: A retrospective cross-sectional study of 100 cancer
patients referred to the Clinical Nutrition Department with a
surgical, pharmacology or palliative treatment were assessed.
Patients were included if BMI was documented, as well as one predictor of poor outcome than the whole score which might
CT scan. The cut-point for sarcopenia was established in men simplify nutritional risk screening.
<50 mm2 and <40 mm2 for women at the L3 level. Disclosure of Interest: None declared.
Results: A total of 45 patients (56%men 66 ± years old) were
included in the study. According to BMI related to sarcopenia SUN-P199
see Table 1. FRAILTY SYNDROME AMONG PATIENTS UNDERGOING
NUTRITION SUPPORT THERAPY IN A BRAZILIAN TERTIARY
Table 1:
HOSPITAL
BMI <18 18.1–24.9 25–29.9 >30
I. A. O. Souza1 *, T. S. Vieira2, P. C. Ribeiro3, L. U. Taniguchi1,
# Patients 4 23 14 4 on behalf of Nutrition Support Team Hospital Sirio-Libanes.
Sarcopenia 2 4 2 0 1
Intensive Care Unit, Hospital Sirio-Libanes, 2Intensive Care
% 50.00 17.39 14.29 0
Unit, Hospital Beneficência Portuguesa Mirante, 3Nutrition
Support Team, Hospital Sirio-Libanes, Sao Paulo, Brazil
Conclusion: BMI assessment may not be suitable for the Rationale: Frailty is a multidimensional syndrome character-
assessment of nutritional status in cancer patients as it may ized by loss of physiologic and cognitive reserves that confers
underestimate patients that have sarcopenia. Other assess- vulnerability to adverse outcomes during hospitalization, with
ments, such as CT scans may provide more information higher morbidity and mortality rates. We aimed to describe the
regarding body composition, especially lean body mass, prevalence and outcomes associated with frailty among
which is a predictor of mortality in cancer patients. patients who required nutrition support therapy in a Brazilian
Disclosure of Interest: None declared. tertiary hospital.
Methods: We conducted a prospective single-center cohort
SUN-P198 study of patients admitted to Hospital Sirio-Libanes (Sao Paulo,
NUTRITIONAL RISK ASSESSMENT IN PATIENTS UNDERGOING Brazil), between October 2015 and March 2017. Frailty
GASTROINTESTINAL SURGERY: CAN NRS 2002 SCORE BE syndrome was classified using the Canadian Study on Health
SIMPLIFIED? and Aging Clinical Frailty Scale (CFS). Patients were divided in
three sub-groups according to the CFS: CFS 1–3, CFS 4–6, CFS 7–
́ , I. Palibrk1,2 *, M. Žnidaršič2, S. Zec2,
J. Veličkovic1,2 9. Multivariable analyses were used to evaluate the independ-
M. Marnić , M. Đukanovic1́ . 1Center for Anesthesiology, Clinical
2
ent association between frailty and hospital mortality.
Center of Serbia, 2School of Medicine, University of Belgrade, Results: We studied 848 patients during the study period (mean
Belgrade, Serbia age was 72.2 years, 73.0% were admitted for non-surgical
reasons, 45.2% had cancer and 64.6% required ICU admission).
Rationale: The NRS 2002 score is a tool for identification
602 (71.0%) patients undergone enteral nutrition, 178 (21.0%)
of patients at nutritional risk who may benefit from nutritional
parenteral nutrition and 68 (8%) required enteral and paren-
support. The aim of our study was to determine the prevalence
teral nutrition. The distribution of patients between the three
of nutritional risk and its impact on postoperative complica-
groups was: 220 (25.9%) CFS 1–3, 358 (42.2%) CFS 4–6 and 270
tions (POC) and length of hospital stay(LOS) following gastro-
(31.8%) CFS 7–9. The mortality rates were 9.5% in the CFS 1–3
intestinal surgery in a Serbian teaching hospital. We also aimed
group, 24.9% in the CFS 4–6 group and 24.4% in the CFS 7–9
to establish which components of NRS 2002 score show the
group. After controlling for baseline differences, adjusted odds
strongest association with postoperative outcomes.
ratios for hospital death were 2.68 (95% CI 1.53–4.70) and 2.00
Methods: We evaluated 132 unselected patients in a cross-
(95%CI 1.10–3.63), for sub-groups CFS 4–6 and CFS 7–9
sectional study during the Nutrition Day (ND) 2016. Data
compared to CFS 1–3, respectively.
regarding nutritional intake and health status were collected
Conclusion: Frailty is very common among patients undergoing
from questionnaires prepared by ND organization. For each
patient NRS 2002 score was calculated. Patients were followed nutrition support therapy, and it was associated with higher
for complications until hospital discharge or readmission. adjusted odds ratio for hospital mortality.
Results: The overall prevalence of nutritional risk (NRS ≥ 3) was Disclosure of Interest: None declared.
37.1%. Median LOS was significantly longer in patients at SUN-P200
nutritional risk (24 vs 14 days, p < 0.001). Patients with NRS ≥ 3 VALIDITY OF EQUATIONS USING KNEE HEIGHT TO PREDICT
had a significantly higher complication rate of 57.1% (28/49) OVERALL HEIGHT AMONG OLDER PEOPLE IN BENIN
compared to 13.3% (11/83) in patients with a normal score
P. Jésus1,2,3, P. Fayemendy1,2,3, C. Mizéhoun-Adissoda4,5,
( p < 0.001). Postoperative morbidity was increased 3.84 times
D. Houinato2,3,5, P. M. Preux2,3, J. C. Desport1,2,3 *. 1Nutrition
for each positive response to the initial four screening
Unit, University Hospital of Limoges, 2INSERM UMR1094,
questions (OR 3.84; 95% CI 2.31–6.39). Positive answer to the
Tropical Neuroepidemiology, School of Medicine, 3UMR_S 1094,
question regarding weight loss in the last 3 months increased
Tropical Neuroepidemiology, Institute of Neuroepidemiology
the risk for POC by 88.21 (95% CI 11.53–674.42). AUROC for
and Tropical Neurology, CNRS FR 3503 GEIST, University of
discrimination between patients with and without POCs with
Limoges, Limoges, France, 4School of Nutrition and Dietetic,
this question was 0.84 (0.77–0.90) as compared to 0.75 (0.65– 5
Laboratory of Non-communicable and Neurologic Diseases
0.81) with the entire score.
Epidemiology (LEMACEN), Faculty of Health Science,
Conclusion: The prevalence of nutritional risk in patients
University of Abomey-Calavi, Cotonou, Benin
undergoing gastrointestinal surgery in Serbia is high. The initial
screening questions of NRS2002 were strong predictors of POC Rationale: Chumlea’s formulas are a validated means of
and LOS. Weight loss in the last three months was stronger predicting overall height from knee height (KH) among
S128 Poster
people over 60 years old, but no formula is validated for use in phases for SMI and SMD were calculated using intra-class
African countries, including Benin. The purpose of this study correlation coefficients (ICCs).
was to compare height provided by predictive formulas using Results: Mean SMI was 42.5 (±9.9) cm2/m2 on the unenhanced
KH to measured height in an elderly population in Benin. phase, compared with 42.8 (±9.9) and 43.6 (±9.9) cm2/m2 for
Methods: People over 60 years of age in Benin underwent the arterial and portal-venous phase, respectively (both
nutritional assessment with determination of weight, body p < 0.01). Mean SMD was lower for the unenhanced phase
mass index (BMI), height and KH. A Bland and Altman analysis (30.9 ± 8.0 HU) compared with the arterial (38.0 ± 9.9
was carried out by gender and age. The percentage of Hounsfield units [HU]) and portal-venous (38.7 ± 9.2 HU)
predictions accurate to ± 5cm compared to the measured phase (both p < 0.001). No significant difference was found
height was calculated. The tested formulas were Chumlea’s between SMD in the portal-venous and arterial phase ( p =
formulas for non-Hispanic Black people (CBP) and two formulas 0.161). The ICCs were excellent (≥0.992) for all SMIs and for
for use among Caucasians (CC1, CC2). SMD between the contrast-enhanced phases (0.949). The ICCs
Results: Data from 396 subjects were analysed. The mean age for the unenhanced phase compared with the arterial (0.676)
was 66.6 ± 5.2 years and mean height of 165.4 ± 8.0 cm. The and portal-venous (0.665) phase were considered fair to good.
sex-ratio was of 4.3. The three formulas achieved 98.0% Conclusion: Statistically significant, but not clinically relevant
accuracy, but with 4.6% risk of error (±2 SD: −6 to +9 cm), which differences were found in SMI between enhancement phases.
appeared to make them unfitted for the whole population. The Contrast-enhancement strongly influenced SMD values. Studies
predictions of the three formulas in the total population are using this measure should therefore use the portal-venous
presented in Table 1. Nevertheless, if a level of prediction ± phase of contrast-enhanced CT-examinations.
5 cm is considered acceptable in clinical practice, the CBP Disclosure of Interest: None declared.
formula achieved 83.1% accuracy. Moreover, there was no
significant difference in BMI calculated with the measured and
SUN-P202
the predicted height, and the nutritional status based on BMI
SERUM ELECTROLYTES AND OUTCOME IN PATIENTS
did not differ.
UNDERGOING ENDOSCOPIC GASTROSTOMY
Table 1: Predictions of the three formulas studied. J. Vieira1, G. Nunes1, C. A. Santos1 *, J. Fonseca1. 1Artificial
n = 396 Acurate Overestimation Underestimation Feeding Team, Hospital Garcia de Orta, Almada, Portugal
prediction (%) (+5 cm) (%) (−5 cm) (%)
CBP 83.1 12.4 4.5 Rationale: Endoscopic Gastrostomy (PEG) is a gold standard
CC1 80.3 15.9 3.8 for long term enteral feeding. Neurological dysphagia and head
CC2 78.5 18.2 3.3 or neck cancer are the main indications. Sodium, calcium,
chlorine are extracellular electrolytes, while potassium,
Conclusion: CBP formulas seem applicable in 83% of cases magnesium, phosphorus are mostly intracellular. Changes in
(±5 cm) to assess the height with KH of older people in Benin serum electrolytes may have significant impact on metabolic
and do not overestimate the prevalence of malnutrition. balance. The aim of our study is to evaluate the changes in
Disclosure of Interest: None declared. serum concentrations of the main electrolytes and its possible
association with the outcome.
Methods: Prospective study of patients followed in our
SUN-P201
Artificial Nutrition Clinic, submitted to PEG from 2010 to
CONTRAST-ENHANCEMENT INFLUENCES SKELETAL MUSCLE
2016 and who died using PEG. Serum electrolytes, albumin,
DENSITY, BUT NOT SKELETAL MUSCLE MASS, MEASUREMENTS
transferrin and reactive C protein (RCP) were evaluated
ON COMPUTED TOMOGRAPHY
immediately before to the gastrostomy procedure. Survival
J. Van Vugt1 *, R. Coebergh van den Braak1, H.-J. Schippers1, was recorded in months after PEG until death.
K. Veen1, S. Levolger1, R. de Bruin1, M. Koek2, W. Niessen2, Results: We evaluated 92 patients, 51 with electrolyte
J. Ijzermans1, F. Willemssen3. 1Surgery, 2Medical Informatics, alterations at the time of the gastrostomy. Sodium was
3
Radiology and Nuclear Medicine, Erasmus MC University altered in 28 (27.2%), magnesium in 18 (19.6%), chlorine in 17
Medical Center, Rotterdam, Netherlands (18.5%), potassium in 14 (15.2%), calcium and phosphorus in 9
(9.7%) each. The mean post-gastrostomy survival was 6.65
Rationale: Low skeletal muscle mass and density are predictive
months. The survival of low sodium patients (<135 mmol/mL)
parameters to guide interventions in various populations,
was compared with patients with normal/high values. The
including cancer patients. The gold standard for body
survival was 2.76 months vs 7.80 months ( p = 0.007). There was
composition analysis in cancer patients is computed tomog-
also a negative correlation between survival and RCP
raphy (CT). To date, the effect of contrast-enhancement on
(R = −0.22; p = 0.034).
muscle composition measurements has not been established.
Conclusion: Changes in serum electrolytes of patients under-
We sought to determine the effect of contrast-enhancement on
going PEG are very common. More than half showed at least one
skeletal muscle mass and density measurements on four-phase
abnormality, at the time of the procedure. The most frequent is
CT studies.
hyponatremia, which is associated with significantly shorter
Methods: In this observational study, two observers measured
survival, probably reflecting severe systemic metabolic dis-
cross-sectional skeletal muscle area corrected for patients’
tress. The RCP reflects the inflammation. Higher RCP values are
height (skeletal muscle index [SMI]) and density (SMD) at the
associated with lower survival.
level of the third lumbar vertebra on 50 randomly selected CT-
examinations with both unenhanced, arterial, and portal- Disclosure of Interest: None declared.
venous phases. The levels of agreement between enhancement
SUN-P203 Disclosure of Interest: J. Pinho: None declared, R. Marinho: None

DIAGNOSTIC ACCURACY OF THE PG-SGA SHORT FORM AND declared, J. Silveira: None declared, S. Silva: None declared,
NRS 2002 IN INTERNAL MEDICINE WARD A. Amado: None declared, A. Pessoa: None declared, J. Rosinhas:
None declared, M. Lopes: None declared, F. Ottery Other: Copyright
J. Pinho1 *, R. Marinho2, J. Silveira3, S. G. Silva4, A. Amado5, holder of the Patient-Generated Subjective Global Assessment (PG-
A. Pessoa6, J. Rosinhas7, M. Lopes8, F. D. Ottery9,10, SGA), co-owner and co-developer of the PG-SGA based Pt-Global app,
H. Jager-Wittenaar9,11, A. Marinho12, on behalf of APNEP - H. Jager-Wittenaar Other: Co-developer of the PG-SGA based Pt-Global
Nutrition and Internal Medicine Working Group. 1Nutrition app, A. Marinho: None declared.
Services, CHMA, EPE, 2Internal Medicine Service, Centro
Hospitalar do Porto, 3Nutrition Services, Eurico de Almeida, SUN-P204
ORL Clinic, Porto, 4Nutrition Services, BioParadigma, VALIDATION OF BIO-ELECTRICAL IMPEDANCE ANALYSIS TO
Integrative Medicine Clinic, Barcelos, 5Nutrition Services, ASSESS SARCOPENIA IN OLDER ADULTS
PortugalFoods, 6Internal Medicine Service, CHMA, EPE, Porto,
7 J. V. D. Helder1 *, I. Jansen1, S. Kruijning1, C. Dronkelaar1,
Internal Medicine Service, Unidade Local de Saúde de
R. Engelbert2,3, M. Tieland1, P. Weijs1,4. 1Faculty of Sports and
Matosinhos, Matosinhos, 8Hemato-Oncology Service, Centro
Nutrition, 2Faculty of Health, Amsterdam University of
Hospitalar do Porto, Porto, Portugal, 9Research Group Healthy
Applied Sciences, 3Department of Rehabilitation, Academic
Ageing, Allied Health Care and Nursing, Hanze University of
Medical Center, 4Nutrition and Dietetics, VU University
Applied Sciences, Groningen, Netherlands, 10Ottery &
Medical Center, Amsterdam, Netherlands
Associates, Vernon Hills (Chicago), United States,
11
Maxillofacial Surgery, University Medical Center Groningen, Rationale: The increasing aging population causes sarcopenia
Groningen, Netherlands, 12Intensive Care Department, Centro to be a rising phenomenon. Sarcopenia can be indicated by
Hospitalar do Porto, Porto, Portugal whole body or low fat free mass (FFM). An easy, cheap and
feasible technique to measure these variables is bio-electrical
Rationale: The PG-SGA is a validated instrument to assess
impedance analysis (BIA). The aim of this study was to validate
malnutrition and its risk factors. Its patient component, i.e.
FFM measurements by BIA with dual energy X-ray absorpti-
the PG-SGA Short Form (SF), can be used as screening
ometry (DXA).
instrument. In this multicenter study, we aimed to assess
Methods: Older adults included into the VITAMINE trial were
diagnostic accuracy of the PG-SGA SF and NRS 2002, in patients
assessed at baseline for whole body and appendicular FFM by
at the Internal Medicine ward.
BIA (Tanita MC-780; 8-polar) and DXA (Hologic A). Pearson-
Methods: In 192 patients (76.0 ± 13.5 years; 53% female) in 9
correlation was used to determine correlation between the FFM
Portuguese internal medicine wards, malnutrition risk was
of the BIA and DXA. The paired t-test was used to determine
assessed by PG-SGA SF and NRS 2002. PG-SGA SF ≤8 was defined
whether there was a significant difference between the two
as low/medium malnutrition risk and NRS 2002 ≤2 as low risk.
techniques. Agreement between the two techniques was
PG-SGA SF ≥9 and NRS 2002 ≥3 were defined as high
assessed by the Bland-Altman plot.
malnutrition risk. Nutritional status was assessed by the full
Results: Included were 45 older adults. Correlation between
PG-SGA (reference method). Malnutrition was defined as PG-
whole body FFM by BIA and DXA was high (r = 0.952, p < 0.0001).
SGA Stage B (moderate/suspected malnutrition) or Stage C
Whole body FFM by BIAwas not different from DXA (47.71 ± 6.78
(severely malnourished). Diagnostic accuracy was tested by
vs 47.87 ± 6.14, p = 0.615). However, Bland-Altman plot showed
sensitivity, specificity, positive and negative predictive value,
wide limits of agreement (LoA-3.94, 4.25). Appendicular FFM
and receiver operating curve. Agreement between PG-SGA and
of the BIA was significantly associated with appendicular FFM of
NRS-2002 was tested by McNemar’s test and Cohen’s kappa (κ).
DXA (r = 0.934, p < 0.0001). Appendicular FFM by BIA was
Results: Forty-six % and 53% were categorized as at risk of
significantly lower by 2.2% than from DXA (19.94 ± 2.81 vs
malnutrition by PG-SGA SF and NRS 2002, respectively. In total,
20.38 ± 3.33, p = 0.019). Bland-Altman plot showed wide limits
55% were malnourished. Sensitivity, specificity, positive and
of agreement (LoA −1.96, 2.84).
negative predictive value of PG-SGA SF and NRS 2002 were
Conclusion: The Tanita MC-780 appears to be accurate for
0.84, 1.00, 1.00, 0.83 and 0.74, 0.74, 0.77 and 0.70,
sarcopenia diagnosis on group level, however variation is high
respectively. Area under curve of PG-SGA SF and NRS 2002
for individual level.
was 0.987 and 0.778 respectively. McNemar’s test showed no
significant disagreement ( p = 0.86) between PG-SGA SF and Disclosure of Interest: None declared.
NRS 2002. Cohen’s kappa showed weak agreement (κ=0.492;
p < 0.001) (Table 1). SUN-P205
Table 1: Agreement between PG-SGA SF and NRS 2002.
INDICATION AND PRESCRIPTION OF ORAL NUTRITIONAL
SUPPLEMENTS IN A SWISS UNIVERSITY HOSPITAL
NRS 2002 Low risk NRS 2002 High Total
risk J. Mareschal1 *, J. Altwegg2, D. Berthet3, M. Chikhi1,
P. Chopard4, S. Graf1, C. Sierro5, C. Pichard1, L. Genton1.
PG-SGA SF Low/medium risk 73 31 104 1
PG-SGA SF High risk 18 70 88 Nutrition Unit, Geneva University Hospitals, Geneva,
2
Total 91 101 192 Nutradom - Homecare, Cortaillod, 3On behalf of Fresucare -
Homecare, 4Division of Quality of Care, Geneva University
Hospitals, Geneva, 5Proximos - Homecare, Carouge,
Conclusion: Our findings indicate that in patients at the Switzerland
internal medicine ward, PG-SGA SF shows better diag-
nostic accuracy than NRS 2002, i.e. better sensitivity and Rationale: Oral nutritional supplements (ONS) are a simple and
specificity. effective medical treatment of nutritional risk. In our hospital,
S130 Poster
ONS can be provided on medical prescription or on the Results: The number of patients included in the survey was 418
caregivers’ personal initiative. At discharge for home, in (Y1) and 411 (Y2). Screening with the DI increased from 38% to
Switzerland, a Nutrition Risk Screening-2002 (NRS-2002) ≥ 3, 59%. In both years just above one quarter of the patients had a
a medical prescription and an ONS delivery at the patient’s healthy diet and about one fifth had considerably unhealthy
home by a homecare service are required for the reimburse- diets. In this group the men were more likely to have unhealthy
ment of ONS by the public insurance. This survey aimed at diet, 78% (Y1) and 60% (Y2). In Y1 22% and in Y2 13%, of these
documenting: (1) the adequacy and existence of ONS medical were underweight and 16% and 21% had a BMI >30. About 65%
prescription during hospitalization and discharge for home, and had normal BMI in both years. Only one (Y1) and two (Y2)
(2) the persistence of ONS treatment one month after discharge patients with unhealthy diet received dietary counselling.
for home. Conclusion: The goal of screening 50% of the patients was
Methods: Data of this prospective observational survey were obtained the second year. In this survey the number of
collected in patients hospitalized in surgery, medicine or hospitalized patients with unhealthy diet corresponds fairly
rehabilitation and about to receive ONS on their meal trays. well to the national prevalence. Men were more likely to have
Patients already on ONS, with major consciousness disorders or unhealthy diets. Most patients had a “normal” BMI. Unhealthy
refusing to consume ONS were excluded. Adequacy of ONS diets did not correspond to BMI. The goal of offering dietary
indication assessed by a NRS-2002 ≥ 3 and ONS prescription counselling was not obtained. Continuous improvement of the
were evaluated at first ONS delivery on the meal tray and at nutrition process is ongoing.
hospital discharge. One month after discharge, the persistence Disclosure of Interest: None declared.
of ONS consumption was evaluated by the homecare service.
Results are presented as mean ± SD or percentages.
SUN-P207
Results: 416 patients (71.7 ± 14.1yrs, 52.6%♂, BMI 23.6 ± 5.2
TOWARDS A NEW MARKER OF NUTRITIONAL STATUS IN
kg/m2) were included. At first ONS delivery on the meal tray,
ENTEROCUTANEOUS FISTULAE: LEAN BODY MASS IN CT
82.7% (n = 344) of patients had an NRS-2002 ≥ 3 and 44.5%
(n = 185) had no ONS medical prescription. Out of 207 patients K. C. Fragkos1 *, K. Cheung2, D. Thong3, N. Keane4, S. Mehta1,
discharged for home, only 24.2% (n = 50) had an adequate F. Rahman1, A. Plumb2, S. Di Caro1. 1GI Services, 2Imaging,
homecare ONS prescription. One month after discharge, 76.3% University College London Hospitals NHS Foundation Trust,
3
(n = 29) were still on ONS. Division of Medicine, University College London, 4Dietetics,
Conclusion: During hospitalization, ONS are mostly given to University College London Hospitals NHS Foundation Trust,
patients at nutritional risk but medical prescription is often London, United Kingdom
missing. At discharge for home, few patients receive ONS
Rationale: We aimed to investigate the correlation between
prescription and homecare service. If a medical ONS prescrip-
body weight, body mass index, albumin levels and radiological
tion is performed, ONS are generally continued one month
indices of lean body mass in patients undergoing
after discharge.
Enterocutaneous fistula (ECF) repair with surgical outcomes.
Disclosure of Interest: None declared. Methods: Biochemistry parameters and anthropometric
characteristics at the time of ECF surgery were collected for
SUN-P206 a set of patients undergoing ECF repair. Skeletal muscle and
UNHEALTHY DIET AMONG HOSPITALIZED PATIENTS – FOOD visceral and subcutaneous adiposity was measured at the level
INTAKE ASSESSMENT AS PART OF A ONE-DAY SURVEY OF of the L3 region (slice and volumetric analysis, Image J).
NUTRITIONAL STATUS Statistical analysis was performed with percentages, means,
K. Kauppi1 *, S. Wegener2, I. Martinsson3. 1Unit for Health Spearman’s rho and dendrograms.
Promoting Hospital, 2Unit for Clinical Nutrition, 3Unit for Results: 27 patients (14F, 55 ± 3.0 years) were identified in one
Quality and Care, Uppsala University Hospital, Uppsala, year. Aetiology of ECF was: surgical complications in 13
Sweden patients, extensive bowel disease in the remaining (Crohn’s
disease, diverticulitis, radiation enteropathy). 36% of patients
Rationale: Unhealthy diet is the strongest contributor to the had a BMI less than 18.5 kg/m2, 50% had albumin less than 30 g/
burden of disease in Sweden. Approximately 20% of the general L. None of the L3 measurements were statistically different
population has considerably unhealthy diet. There is a lack of when compared between patients with albumin less or over
studies in hospitalized patients. The aim was to investigate the 30 g/L. Parenteral nutrition was given peri-operatively in 48.1%
prevalence of unhealthy diet among hospitalized patients and of patients. Pre-operative albumin had a strong positive
if they were offered dietary counselling. correlation with all radiological indices (rho 0.402–0.522,
Methods: A dietary index (DI) developed by the Swedish p < 0.05) when sepsis was cleared. Weight and BMI were
National Board of Health and Welfare was included in a yearly strongly positively correlated with radiological indices (rho
one-day survey of malnutrition at Uppsala University Hospital in 0.527–0.918). Dendrograms identified two clusters that corre-
2015 (Y1) and 2016 (Y2). The index identifies individuals with lated with imaging indices: heamatological parameters (largely
unhealthy diet from a disease-preventive perspective, to whom negative correlations) and nutritional parameters (weight,
dietary counselling should be offered. The DI is based on albumin and others) (mainly positive correlations) None of the
consumption of fruit, vegetables, fish and low nutritious foods. L3 measurements were different with respect to ECF recur-
The hospital’s goal is to screen >50% of the patients, using the rence and PN administration ( p > 0.05).
DI and >70% of those at risk should be offered dietary Conclusion: L3 measurements strongly correlate with nutri-
counselling. tional parameters at the time of surgery when sepsis is cleared.
Surgical outcomes might be improved with early identification
5
of patients requiring nutritional optimisation at initial radi- Department of Geriatric Medicine, Carl von Ossietzky
ology scan. University, Oldenburg, Germany, 6School of Agriculture and
Disclosure of Interest: None declared. Food Science, University College Dublin, Dublin, Ireland
Rationale: Many nutritional screening tools (NSTs) are used to

SUN-P208 screen for malnutrition risk in older adults. An objective of the
EVALUATION OF NUTRITIONAL STATUS OF PATIENTS WITH EU Malnutrition in the Elderly Knowledge hub (MaNuEL) project
TRAUMATIC UNILATERAL LOWER EXTREMITY AMPUTATION is to devise recommendations on the best NSTs to use in older
K. Tel Adıgüzel1 *, P. Bilgiç1, E. Adiguzel2, G. Kaner3, I. Safaz2. adults in different healthcare settings across Europe.
1
Department of Nutrition and Dietetics, Faculty of Health Methods: Forty-eight published NSTs were identified. Criteria
Sciences, Hacettepe University, Ankara, Turkey, 2Gaziler to rate each tool were developed, based on scientific evidence
Physical Medicine and Rehabilitation Education and Research and expert opinion. These criteria were translated into a
Hospital, University of Health Sciences, Ankara, 3Department scoring system with three equally weighted sections; valid-
of Nutrition and Dietetics, Faculty of Health Sciences, Izmir ation, parameters and practicability.
Katip Celebi University, İzmir, Turkey Results: Overall, the highest scoring NSTs were DETERMINE your
health checklist for the community setting, the Nutritional
Rationale: This study was aimed to evaluate the anthropomet- Form for the Elderly (NUFFE) for the rehabilitation setting,
ric measurements and nutritional status of patients with lower the Short Nutritional Assessment Questionnaire-Residential
extremity amputation. Care (SNAQ-RC) for institutions and both the Malnutrition
Methods: Demographic data and anthropometric measure- Screening Tool (MST) and the Mini Nutritional Assessment
ments such as body weight, height, body mass index (BMI), Short Form (MNA-SF) version one (using BMI) for the hospital
middle upper arm circumference (MUAC), and triceps skinfold setting. In terms of practicability alone, the Malnutrition
thickness (TST) were recorded. Corrected BMI was calculated Screening Tool (MST), Canadian NST, Simplified Nutritional
for each amputation level by adjusting weight with the Appetite Questionnaire (SNAQ-US) and the Short Nutritional
formula: adjusted weight = actual weight/ (1- amputation Assessment Questionnaire (SNAQ-NL) scored highest. The
percentage). Controlling Nutritional Status (CONUT) and the Nutrition Risk
Results: Nine patients with above knee amputation and 11 Screening (NRS-2002) were ranked highest for validity alone.
patients with below knee amputation were included in this Conclusion: These results will be used to create recommenda-
study. All patients were male. Mean age of patients was tions for the management of geriatric malnutrition across
35.1 ± 8.4 yrs. Mean BMI, mean corrected BMI, MUAC and TST Europe, as part of the MaNuEL project.
measurements were 26.4 ± 6.2 kg/m2, 28.7 ± 6.9 kg/m2, 31.4 ± This work was supported by funding from the Department of
6.1 cm and 15.2 ± 5.3 mm; respectively. Energy, protein, carbo- Agriculture, Food and the Marine and Health Research Board
hydrate, fat and fiber intake was 2421.1 ± 479.6 kcal, 90.8 ± through the Joint Programming Initiative - A Healthy Diet for a
13.7 g, 274.9 ± 85.1 g, 102.7 ± 20.4 g, 21.5 ± 6.2 g, respectively. Healthy Life (JPI HDHL) Knowledge Hub on Malnutrition in the
Protein and carbohydrate intake per kg body weight per day was Elderly (MaNuEL).
1.2 ± 0.4 g and 3.5 ± 1.3 g. Cholesterol, saturated, mono-unsat-
urated and polyunsaturated fat intake was 317.0 ± 76.8 mg,
32.4 ± 5.8 g, 43.1 ± 7.8 g, 27.1 ± 11.2 g. Mean percentage of
energy from carbohydrates, protein and fat were 46.2 ± 5.8%, SUN-P210
15.6 ± 2.2% and 38.2 ± 4.5%, respectively. PREVALENCE AND CHARACTERISTICS OF RISK FOR
Conclusion: The results of this study showed that, fiber intake MALNUTRITION IN PATIENTS WITH NEWLY DIAGNOSED HEAD
was lower while fat and cholesterol intakes were higher than AND NECK CANCER
recommended intakes in this cohort. Since an unbalanced L. ter Beek1,2,3 *, L. Bras4, J. L. Roodenburg3,
nutritional pattern will lead to many chronic diseases including C. P. van der Schans1,5,6, F. D. Ottery1,7, G. B. Halmos4,
cardiovascular diseases; it is thought that nutrition education H. Jager-Wittenaar1,3. 1Research Group Healthy Ageing, Allied
to be given to amputees has an important place in the Health Care and Nursing, Hanze University of Applied Sciences,
2
prevention of chronic diseases that may occur in the future. Department of Pulmonary Diseases and Tuberculosis,
3
Disclosure of Interest: None declared. Department of Maxillofacial Surgery, 4Department of
Otorhinolaryngology, Division of Head and Neck Surgery,
5
SUN-P209 Department of Rehabilitation Medicine, 6Department of
CREATION OF A SCORING SYSTEM TO RATE NUTRITIONAL Health Psychology Research, University of Groningen,
SCREENING TOOLS FOR USE IN OLDER ADULTS University Medical Center Groningen, Groningen, Netherlands,
7
Ottery & Associates, Vernon Hills (Chicago), United States
L. C. Power1,2 *, M. A. de van der Schueren3,4, S. Leij-Halfwerk4,
J. Bauer5, E. R. Gibney2,6, M. Clarke2,6, L. A. Bardon2,6, Rationale: Prevalence of malnutrition in patients with head
C. Corish1,2, on behalf of the MaNuEL Consortium. 1School of and neck cancer (HNC) ranges from 15% > 55%, as assessed by
Public Health, Physiotherapy and Sports Science, 2Institute of weight loss. However, knowledge on the prevalence of
Food and Health, University College Dublin, Dublin, Ireland, malnutrition operationalized as multidimensional construct is
3
Department of Nutrition and Dietetics, VU University Medical lacking. Therefore, we aimed to assess prevalence and
Centre, Amsterdam, 4Department of Nutrition and Health, characteristics of malnutrition risk by the Patient-Generated
HAN University of Applied Sciences, Nijmegen, Netherlands, Subjective Global Assessment Short Form (PG-SGA SF) in
patients with newly diagnosed HNC.
S132 Poster
Methods: Between August 2015 and January 2017, malnutrition status and BMI, were tested by Pearson Chi-Square and Mann
risk was assessed by PG-SGA SF in 236 newly diagnosed HNC Whitney U test. Fisher’s exact was used to test difference in
outpatients. The PG-SGA SF includes four Boxes. Box 1 prevalence of risk between MUST and PG-SGA SF scores.
addresses history of weight loss; Box 2 changes in food Results: According to the PG-SGA SF, 24% of patients were
intake; Box 3 nutrition impact symptoms (NIS); and Box 4 categorized as medium or high risk for malnutrition. In these
activities and function. “Medium risk” was defined as 4–8 patients, domain scores were highest for nutrition impact
points, and “high risk” as ≥9 points. PG-SGA ≥9 points indicates symptoms (NIS) (median 3.5; IQR: 2–5) and for activities and
critical need for interventions. function (median 2; IQR: 1–3). Patients who smoke (28/87) were
Results: In total, 25.8% (61/236) of the patients were at significantly more often at risk than non-smoking patients
medium risk for malnutrition, and 11.0% (26/236) were at high (29/147) (P = 0.03). No differences in risk between patients with
risk. Overall, median total point score was 2 (IQR: 0.0–5.75), BMI <25 kg/m2 (31/107) and BMI ≥25 kg/m2 (26/126) were
and 7 (IQR: 5.0–9.0) in patients at medium/high malnutrition found (P = 0.14). Malnutrition according to MUST was 8% (9/
risk. In patients at medium/high risk, highest score was on Box 3 107).
(median 4; IQR: 2.0–5.0), mainly due to pain in the mouth or Conclusion: Prior to vascular surgery, a substantial proportion
throat area (76.7%; 66/86), difficulties with swallowing (38.3%; of patients (24%) is at risk for malnutrition, which is mainly
33/86), and lack of appetite (25.6%; 22/86). Median scores on characterized by NIS and limitations in activities and function.
Box 1, 2 and 4 were 1. Mean weight loss in all patients was 1.3% BMI appeared to be not discriminative for risk. Prevalence
in the last month and 2.9% in the last 6 months. In patients with of risk for malnutrition by PG-SGA SF is 3.5 times higher than
malnutrition risk, mean weight loss was 3.1% and 5.9%, by MUST.
respectively. Disclosure of Interest: L. ter Beek: None declared, L. Banning: None
Conclusion: Our findings show that a substantial proportion of declared, L. Visser: None declared, J. Roodenburg: None declared,
newly diagnosed HNC patients (36.8%) are at medium/high risk C. van der Schans: None declared, R. Pol: None declared, H. Jager-
for malnutrition, which is mainly related to specific NIS. These Wittenaar Other: Co-developer of the PG-SGA based Pt-Global app.
findings demonstrate that interdisciplinary symptom manage-
ment and nutritional intervention are indicated in this patient SUN-P212
population. ASSESSMENT OF RESTING METABOLIC RATE: COMPARISON OF
Disclosure of Interest: L. ter Beek: None declared, L. Bras: None PREDICTION EQUATIONS WITH INDIRECT CALORIMETRY
declared, J. Roodenburg: None declared, C. van der Schans: None VALUES; UN UPDATE
declared, F. Ottery Other: Developer of the PG-SGA, co-developer of L. Valeriani1 *, F. Anzolin1, L. Zoni1. 1UOC Dietologia E
the PG-SGA based Pt-Global app, G. Halmos: None declared, H. Jager-
Nutrizione Clinica, ASL Bologna, Italy
Wittenaar Other: Co-developer of the PG-SGA based Pt-Global app.
Rationale: The evaluation of energy expenditure is a basic step
SUN-P211 in the assessment of nutritional status. Indirect calorimetry is
PREVALENCE AND FEATURES OF RISK FOR MALNUTRITION IN the “gold standard” for measuring the resting metabolic rate
PATIENTS PRIOR TO VASCULAR SURGERY (RMR), but requires the use of expensive and not easily
L. ter Beek1,2,3 *, L. B. Banning4, L. Visser4, J. L. Roodenburg3, transported equipment. Recently, a new handled indirect
C. P. van der Schans1,5,6, R. A. Pol4, H. Jager-Wittenaar1,3. calorimeter was introduced as an easy technique to assess
1
Research Group Healthy Ageing, Allied Health Care and RMR. In clinical practice, energy requirements are calculated
Nursing, Hanze University of Applied Sciences, 2Department of by means of prediction equations, validated for use mainly in
Pulmonary Diseases and Tuberculosis, 3Department of healthy populations. The purpose of this study is to verify the
Maxillofacial Surgery, 4Department of Surgery, Division of correspondence between measured RMR and RMR estimated
Vascular Surgery, 5Department of Rehabilitation Medicine, with different formulas available in the literature.
6 Methods: We selected 945 patients who presented to our
Department of Health Psychology Research, University of
Groningen, University Medical Center Groningen, Groningen, Clinical Unit from May 2004 to the end of January 2017 (mean
Netherlands age = 40 years; mean BMI = 31.8; 258 males and 687 females). A
MedGem device was used to measure RMR. In the same
Rationale: Malnutrition is an important indicator for adverse patients, we calculated the RMR with 4 commonly used
post-operative outcomes. We aimed to assess prevalence and equations: Harris Benedict, Owen, Mifflin-ST Jeor and Korth.
features of malnutrition risk, using the Patient-Generated We then stratified patients according to their BMI and made a
Subjective Global Assessment Short Form (PG-SGA SF), and to statistical study to determine whether the values of RMR
test how risk relates to co-variables, i.e. smoking, Body Mass measured and those estimated are significantly different.
Index (BMI), comorbidities, and type of scheduled surgery. Results: The results showed that across the full spectrum of
Second, we aimed to compare the prevalence of risk for BMI, there is no statistically significant difference between
malnutrition between the PG-SGA SF and the Malnutrition measurements obtained with the MedGem device and the
Universal Screening Tool (MUST). values obtained with the formula of Mifflin-St Jeor. Owen
Methods: In total, 236 patients visiting the vascular surgery equations gives correct results for underweight and normal
outpatient clinic in 2015 were assessed for malnutrition risk by weight patients. The Harris-Benedict and Korth equations
PG-SGA SF. Demographics, medical history and data on MUST overstimate the REE in all the patients.
were retrieved from the electronic hospital registry. Medium Conclusion: We have shown that only one equation selected
risk was defined as PG-SGA 4–8 points, and high risk as ≥9 from the literature gives correct RMR values. The Harris
points. Associations between risk for malnutrition and smoking Benedict equation overestimates the RMR of our patients by
1–10%, and this is of particular clinical relevance since this patients with end-stage liver disease experience fluid dis-
equation is the most widely used in clinical practice. turbances, nutritional screening and nutritional assessment
Disclosure of Interest: None declared. (NA) is a challenge. Campillo validated alternative body mass
index (BMI) cut-off values depending on the degree of ascites to
define malnutrition. Cross-sectional skeletal muscle mass on
SUN-P213
CT has been described as an objective measurement of
SKELETAL MUSCLE MASS AND PHASE ANGLE EVALUATION IN
malnutrition. However, it remains unknown whether NA (i.e.
SUBSTANCE ADDICTION
Malnutrition Universal Screening Tool (MUST), mid upper arm
M. P. P. Coelho1, K. G. D. Diniz1, T. Bering1, L. S. A. Ferreira1, circumference (MUAC), food intake and BMI) are herewith
M. I. T. D. Correia2, R. Teixeira1, G. A. Rocha3, F. D. Garcia4, correlated.
D. A. Vieira1, L. D. Silva1 *. 1Internal Medicine, 2Department of Methods: Patients (n = 54) screened for LT from January 2013
Surgery, 3Laboratory of Research in Bacteriology, 4Department until November 2014 underwent NA by a dietitian. Patients
of Mental Health, Faculdade de Medicina da Universidade were classified as well-/malnourished according to Campillo.
Federal de Minas Gerais, Belo Horizonte, Brazil Furthermore the cross-sectional skeletal muscle area adjusted
for patients’ height (skeletal muscle index (SMI, cm2/m2)) at
Rationale: The illicit drug abuse is a global health problem that
the level of the third lumbar vertebra was measured on CT. Non-
affects approximately 246 million people worldwide. Among
parametric statistical tests were used to explore the associ-
the adverse consequences of drug addiction, the nutritional
ation between NA measures and SMI.
disorders should be highlighted. The aim of this study was to
Results: Malnourished patients identified by the dietitian
evaluate the prevalence of low skeletal muscle mass (SM) and
(MUST ≥ 2, n = 40) or by Campillo (n = 9) had lower SMI (both
low phase angle (PhA) among substance users (SU).
P = 0.013) and lower BMI (both P < 0.001), while no significant
Furthermore, the association between demographic, clinical
differences were found in intake compared with well-nourished
and life style data with nutritional parameters as SM and PhA
patients. SMI significantly decreased per incremental MUST
was also investigated.
score (P = 0.003). MUAC was also significantly correlated with
Methods: 63 SU [65.1% males; mean age, 46.0 ± 13.2 years]
SMI (Pearson’s correlation coefficient 0.59, P < 0.002). Due to
were prospectively included. The diagnosis of substance
small numbers type II failures may have occurred.
addiction was based on the Diagnostic and Statistical Manual
Conclusion: Bedside nutritional assessment tools significantly
of Mental Disorders IV (DSM IV) and the International
correlate with SMI in patients awaiting liver transplantation.
Classification of Diseases (ICD-10) criteria. SM and PhA were
CT-assessed skeletal muscle mass may be an objective
estimated by BIA. Absolute SM was converted to an SM index
measure to diagnose malnutrition. Nevertheless, validation
(SMI) by dividing height by meters squared (kg/m2). Subjective
in larger cohorts is indicated and we are currently enlarging
Global Assessment (SGA) was used to assess the nutritional
our cohort
status. The data were analysed by logistic regression model.
Results: Low SMI and low PhA was identified in 15.8% and 44.5% Disclosure of Interest: None declared.
of SU, respectively. Subjects with heavy alcohol consumption
had lower SMI and PhA values than those without heavy alcohol SUN-P215
drinking pattern. Low SMI was independently associated with NUTRITIONAL STATUS ASSOCIATED WITH SLEEP IN
heavy alcohol consumption (OR = 2.02; 95%CI = 1.01–4.05; p = UNIVERSITY STUDENTS: CHILEAN MULTICENTRIC STUDY
0.05). Low PhA was also independently associated with heavy M. Valladares1 *, M. Croveto2, V. Espinoza3, F. Mena4, G. Oñate5,
alcohol consumption (OR = 2.11; 95%CI = 1.30–3.42; p = 0.002). F. Macarena6, A. Muñoz7, A. M. Obregón8, S. Durán-Aguero9.
Conclusion: Heavy alcohol drinking was associated with low SMI 1
Departamento de ciencias químicas y biológicas, Universidad
and low PhA. Considering substance addiction as a serious Bernardo ÓHiggins, Santiago, 2Facultad de salud, Universidad
public health problem in the world, all efforts must be made to de Playa Ancha, Valparaiso, 3Escuela de nutrición y dietética,
control the substance use. Furthermore, nutritional aspects as Universidad Católica de Temuco, Temuco, 4Departamento de
SM and PhA should be meticulously evaluated in SU. An nutrición y dietética, Universidad de Antofagasta,
integrated clinical/psychiatric/nutritional care must be pur- Antofagasta, 5Escuela nutrición y dietética, 6Escuela de
sued in the management of patients with substance addiction. nutrición y dietética, Universidad Autónoma de Chile, 7Escuela
Disclosure of Interest: None declared. de nutrición y dietética, Universidad Bernardo ÓHiggins,
Santiago, 8Escuela de nutrición y dietética, Universidad San
SUN-P214 Sebastián, Concepción, 9Facultad de Ciencias de la Salud,
BEDSIDE NUTRITIONAL ASSESSMENT TOOLS COMPARED WITH Universidad San Sebastián, Santiago, Chile
CT BASED SKELETAL MUSCLE MASS ANALYSIS IN PATIENTS
Rationale: Is there an association between eating habits and
AWAITING LIVER TRANSPLANTATION
sleep in Chilean University students? How correlate sleep,
M. C. van Kemenade1 *, J. L. A. van Vugt2, S. Riemslag Baas1, eating habits and anthropometric measures in University
H. J. Metselaar3, R. A. de Man3, J. N. M. Ijzermans2. students?
1
Department of Nutrition and Dietetics, 2Department of Methods: 1,287 students from different universities and
Surgery, Division of HPB and Transplant Surgery, 3Department regions of Chile were recruited, to which weight and height
of Gastroenterology and Hepatology, Erasmus MC University were evaluate. “Survey on alimentary habits” was applied,
Medical Center, Rotterdam, Netherlands which is composed of two areas; healthy habits (9 questions)
and consumption of unhealthy foods or promoters of chronic
Rationale: Malnutrition is an independent predictor of mortal-
non-communicable diseases (6 questions). In addition,
ity in patients awaiting liver transplantation(LT). Because many
S134 Poster
insomnia (determined by Insomnia Severity Index ISI) and controlled and uncontrolled groups. The changes in fat free
somnolence (evaluated with Epworth somnolence scale) were mass with the disease duration and glycemic control remained
determined. To compare between groups, t student test was insignificant (Table 1).
used; additionally, univariate logistic regression adjusted for Conclusion: The early T2DM is linked with more fat mass, which
different variables was performed. The study was developed get reduced with the long lasting disease, with insignificant
following the Declaration of Helsinki regarding work with effect of the glycemic control.
human beings and approved by the Ethics Committee of the Disclosure of Interest: None declared.
participating universities.
Results: The 80% correspond to women, a mean of age and BMI
SUN-P217
of 21.5 ± 2.6 years old and 23.4 ± 3.2 kg/m2 respectively in the
CONSEQUENCES OF DELAY OF A SPECIALIZED NUTRITIONAL
total sample. Women presented higher levels of somnolence
SUPPORT IN HOSPITALIZED PATIENTS
than men (P < 0.001) and no significant differences were found
according to nutritional status. Somnolence was positively C. Garcia-FIgueras Mateos1, M. Cayon-Blanco2 *,
correlated with insomnia (correlation coefficient 0.134 p < L. Garcia Garcia-Doncel2. 1Internal Medicine Unit,
2
0.01) and sleeps latency (correlation coefficient 0.065 p < 0.05) Endocrinology and Nutrition Unit, Hospital Sas De Jerez De La
and negatively correlated with the amount of sleep (−0.109 Frontera, Jerez de la Frontera, Spain
p < 0.01) adjusted for sex, smoking, breakfast, sugar drinks and
Rationale: Specialized nutritional support (SPS) is crucial to
alcohol. An association between greater amount of sleep and
improve health status and nutritional outcomes in malnour-
risk of obesity is observed (OR = 0.54; IC95%:0.31–0.98) in a
ished in-patients. Ideally, it must be performed by a nutrition
model adjusted for physical activity, age, breakfast consump-
support team (NST) but usually, intervention by NST is only
tion, fruits, vegetables and dairy products.
performed when it is required by other specialists. Our aim is to
Conclusion: There is an association between the amount of
investigate the effects on clinical and analytical outcomes
sleep, the risk of developing obesity and eating habits.
related to delay SPS and identify potential factors related to it.
Disclosure of Interest: None declared. Methods: Prospective study carried out in standard clinical
practice conditions. 52 hospitalized malnourished patients
SUN-P216 (NRS_2002 criteria) attended by NSTof a tertiary hospital were
THE IMPACT OF GLYCEMIC CONTROL AND DISEASE DURATION included. Date of onset of insufficient intake was defined as the
OF TYPE 2 DIABETES ON THE BODY COMPOSITION first day when patient’s intake was lower than 50% of daily
T. A. Alaidarous1, M. M. A. Abulmeaty1,2 *, N. M. Alkhtani3. energy requirements. Date of nutritional assesment was
1
Clinical Nutrition Program, Community Health Sciences, King defined as the first day that patient received SPS. Number of
Saud University, Riyadh, Saudi Arabia, 2Medical Physiology days between insufficient intake and SPS onset were divided in
Department, Zagazig University, Zagazig, Egypt, 3Department tertiles (1st tertile: 0–3 days; 2nd tertile: 4–8 days; 3th tertile
of Medicine, King Faisal Specialist Hospital & Research Centre, ≥9 days).
Riyadh, Saudi Arabia Results: Though there wasn’t significant difference among the
3 groups regarding to albumin levels at admission, patients who
Rationale: Are the glycemic control and duration of type 2 received SPS after 9 days of insufficient intake had lower levels
diabetes (T2DM) have an impact on the body composition. of albumin (2.5 ± 0.7 vs 2.9 ± 0.5 g/dL; p = 0.021) when NST
Methods: Case-control study was done in King Faisal Specialist intervention was initiated. and at discharge (2.7 ± 0.6 vs
Hospital, Riyadh, SA. 25 non-diabetic controls (C) and 93 T2DM 3.3 ± 0.4 g/dL; p = 0.022). SPS was usually required later in
cases were used (20–60 y). Cases were divided into 4 groups surgical departments as compared to medical (83.3% of
according to the disease duration (early ≈ 6 months of diagnosis patients admitted in surgical wards in 3th tertile vs 62.5% in
and long lasting = >5 years) and glycemic control (based on A1C medical wards; p = 0.016) and if the patients required previous
level); the newly diagnosed controlled (NC, n = 25), the newly ICU admission (44% vs 14.8%; p = 0.02). According to length of
diagnosed uncontrolled (NU, n = 17), the long lasting controlled stay, no significant differences were observed among tertiles.
(LC, n = 25), and the long lasting uncontrolled (LU, n = 25). Conclusion: An early introduction of SPS by a NST improves
Tanita BC-418 was used for body composition analysis along nutritional parameters among malnourished in-patients.
with the anthropometric measurements. One-way ANOVA test Nevertheless, it does not improve length of hospital stay. Our
was used. results may encourage other specialists to require an early
Results: The fat mass was significantly higher ( p < 0.05) in all nutritional intervention by NST.
new diabetics versus C group whatever their glycemic control, Disclosure of Interest: None declared.
while the old diabetics showed insignificant changes in both
Table 1: (abstract: SUN-P216). The study parameters.

Parameters C Group NC Group NU Group LC Group LU Group
a a,b a a,c
HbA1cFraction 0.052 ± 0.00 0.060 ± 0.00 P < 0.001 0.087 ± 0.01 P < 0.001 0.064 ± 0.00 P < 0.001 0.094 ± 0.01 P < 0.001
2 a a b a a c
BMIkg/m 26.3 ± 5.8 31.8 ± 4.6 P < 0.05 33.1 ± 4.5 P < 0.05 P > 0.05 30.6 ± 5.1 P < 0.05 30.7 ± 6.2 P < 0.05 P > 0.05
a a b a a c
WCcm 89.8 ± 11.6 108.0 ± 10.7 P < 0.001 108.5 ± 8.7 P < 0.001 P > 0.05 105.3 ± 12.5 P < 0.001 104.1 ± 11.3 P < 0.001 P > 0.05
a a,b a a,c
Percent body fat% 30.3 ± 10.04 38.5 ± 8.7 P < 0.05 35.7 ± 8.3 P > 0.05 34.8 ± 9.1 P > 0.05 35.4 ± 9.0 P > 0.05
a a b a a,c
Fat massKg 22.3 ± 10.2 34.1 ± 10.6 P < 0.001 32.8 ± 9.2 P < 0.05 P > 0.05 28.3 ± 9.7 P > 0.05 29.5 ± 11.7 P > 0.05
a a,b a a,c
Fat free massKg 49.9 ± 12.6 53.9 ± 11.1 P > 0.05 58.4 ± 8.4 P > 0.05 52.6 ± 10.9 P > 0.05 51.8 ± 7.3 P > 0.05
a b c
significant vs C, significant vs NC, & significant vs LC.
Nutritional epidemiology 1 S135
10
Nutritional epidemiology 1 Istituto oncologico della Svizzera italiana, Ente Ospedaliero
Cantonale Canton Ticino, Bellinzona, Switzerland
SUN-P218
PROTEIN INTAKE IS ASSOCIATED WITH MUSCLE INJURIES IN Rationale: Malnutrition continues to be an unsolved and
CIRCUS ATHLETES: A PILOT STUDY relevant problem in the elderly. The prevalence of malnutrition
A. Bouville1, R. van Rhenen1 *, M. Engberink1, H. Zijlstra1, is variable and depends on how it is measured. In nursing homes
R. V. van Rijn2, P. Weijs1,3, J. Stubbe1,2. 1Faculty of Sports and (NHs) approximately 20% of residents are malnourished (Bell,
Nutrition, Amsterdam University of Applied Sciences, 2015). A low food intake is the main etiological factor. The aim
Amsterdam, 2Codarts University of the Arts, Rotterdam, of this study was to investigate the prevalence of malnutrition
3
Department of Nutrition and Dietetics, Internal Medicine, VU and its associated factors in NHs. We also monitored food and
University Medical Center, Amsterdam, Netherlands liquid intake.
Methods: We conducted a cross sectional study in NHs in
Rationale: Protein intake may play an important role in Northern Italy. In accordance to the ESPEN Consensus state-
preventing muscle injuries in athletes, however data on this ment we used Body Mass Index (BMI) <18.5 Kg/m2 in order to
potential association is scarce. In the present pilot study, we detect malnourished residents (Cederholm et al., 2015). We
explored whether protein intake (quantity, type) was related to performed a descriptive analysis and logistic regression to
muscle injuries in circus athletes. identify associated factors effecting malnutrition.
Methods: Of the 34 invited athletes, 24 were willing to Results: We recruited 1,793 residents that lived in 29 NHs
participate (mean age: 22 y). Mean protein intake was between Oct-Dec 2016. 76% were female, with an average age
111 ± 35 g/d and all athletes achieved the recommended of 85.4 ± 8.5 years. 15.5% were malnourished. Malnutrition was
protein intake of 1.2–1.7 g/kg bodyweight/d. During 3 months associated to: age, cognitive impairment, disability in daily life
34 injuries occurred of which 6 (17,6%) were classified as a activities, eating ability, swallowing and chewing problems.
muscle injury. Mean animal protein intake was significantly and Residents drank an average of 1,189 (±310 mL) per day. 2.8%
inversely related to muscle injuries (OR 0.93, p < 0.05), while (27/951) of residents ate at most half of their meals, of those
mean total protein intake tended to be related (OR 0.95, 26% had a BMI < 18.5 Kg/m2.
p = 0.08) and plant protein was not related (OR 1.00, p = 0.88). Conclusion: This is one of the only multicenter studies
Higher protein intake (>1,7 g/kg) tended to be associated with investigating the prevalence and risk factors of malnutrition
lower prevalence of muscle injuries ( p = 0.09). in NHs in Italy. Results confirm that malnutrition in NHs is a
Results: Of the 34 invited athletes, 24 were willing to complex concern. We found a prevalence of malnourishment in
participate (mean age: 22 y). Mean protein intake was agreement with existing literature. Monitoring food and liquid
111 ± 35 g/d and all athletes achieved the recommended intake is a simple, cheap method for tracking residents’ eating.
protein intake of 1.2–1.7 g/kg bodyweight/d. During 3 months Interventions to prevent malnutrition is a priority for future
34 injuries occurred of which 6 (17,6%) were classified as a research in NHs.
muscle injury. Mean animal protein intake was significantly and References
inversely related to muscle injuries (OR 0.93, p < 0.05), while Cederholm T, et al. Diagnostic criteria for malnutrition – An ESPEN
mean total protein intake tended to be related (OR 0.95, Consensus Statement. Clin Nutr. 2015 Jun;34(3):335–40.
p = 0.08) and plant protein was not related (OR 1.00, p = 0.88). Bell CL, et al. Malnutrition in the nursing home. Curr Opin Clin Nutr
Higher protein intake (>1,7 g/kg) tended to be associated with Metab Care. 2015 Jan;18(1):17–23.
lower prevalence of muscle injuries ( p = 0.09). Disclosure of Interest: None declared.
Conclusion: Protein intake was inversely related to muscle
injuries in first and second year circus athletes. Integrating
SUN-P220
nutritional education and/or intervention when studying to
FUNCTIONAL FOOD PREFERENCES OF TURKISH CONSUMERS
become a professional athlete may be of importance in
ACCORDING TO FOOD VALUE SCALE
preventing muscle injuries. However, more research is
needed including larger sample sizes and possible confounding A. S. Erdinc1 *, E. E. Ozturk-Duran1, D. Dikmen1. 1Nutrition and
factors. Dietetics, Hacettepe University, Ankara, Turkey
Disclosure of Interest: None declared. Rationale: Food choice attitudes of consumers has an
important effect on health. Food value scale was developed
SUN-P219 to understand human values and food preferences. This study
THE PREVALENCE OF MALNUTRITION ASSOCIATED WITH aimed to determine the attitudes of Turkish consumers to
FOOD INTAKE IN NURSING HOMES. A MULTICENTER CROSS functional foods with food value scale when purchasing yoghurt
SECTIONAL STUDY and probiotic yoghurt.
A. Castaldo1 *, E. Zanetti2, M. Lusignani3, M. Zani4, A. Nobili5, Methods: In order to determine consumers’ attitudes towards
A. Verardi6, M. Magri7, A. Ianes8, G. Ardoino8, M. C. Gugiari1, food choices two main food types have evaluated as yoghurt
G. Marano9, P. Boracchi9, L. Bonetti10. 1Education, Provincia and probiotic yoghurt. The food value scale evaluates 11 food
Religiosa Di S. Marziano Di Don Orione - Piccolo Cottolengo, value (naturalness, taste, price, safety, convenience, nutri-
Milan, 2Research, Gruppo di Ricerca Geriatrica, Brescia, tion, tradition, origin, fairness, appearance, environment) and
3
Nursing Bachelor, University of Milan, Milan, 4Nursing Home, 55 questions which consist of binary combinations of these food
Le Rondini, Brescia, 5Quality, Mario Negri, 6Nutrition -Audit, values. Questions on socio-demographic characteristics and
Health Agency, 7Research, Nurse Council, 8Medical Direction, nutritional behaviours were also included. The sample com-
Korian Group, 9Statistic, University of Milan, Milan, Italy, prised 385 women and 123 men, ranged from 18 to 64 years.
S136 Poster
Results: Participants mean age was 27.55 ± 11.70 years. More Conclusion: Half of the hospitalized patients in internal
than half of the consumers were normal weight (60%) and medicine clinics are at malnutrition risk and most of them eat
nearly 29% of them were overweight and obese. Consumers less then half of the meals served. Nutritional support is also
declared that safety, nutrition and naturalness were the most inadequate. Precautions should be taken with the analysis of
important values when purchasing yoghurt and probiotic the reasons to reduce the inadequate food consumption during
yoghurt. While purchasing these products male consumers hospital stay, and to increase the nutritional support in
pay more attention to origin than environment value when common and individual basis.
compared with females ( p < 0.05). Both healthy and unhealthy Disclosure of Interest: None declared.
participants pay more attention naturalness than other food
values except for safety ( p < 0.05). Environment value was
SUN-P222
important in healthy eaters compared to convenience however
OVERWEIGHT AND SEDENTARY LIFESTYLE AMONG STUDENTS
convenience was more important value in unhealthy eaters.
IN A SCHOOL FROM SOUTHERN BRAZIL
Both groups pay attention to nutrition compare to other food
values ( p < 0.05). C. W. Gallon1 *, K. G. Mendes1, H. Theodoro1, F. R. Motter2,
Conclusion: This study showed that safety, nutrition and J. R. Bernardi3, J. P. Formolo1, J. Siviero1. 1Universidade De
naturalness of foods were the most important food values for Caxias Do Sul, Caxias do Sul, 2Unisinos, São Leopoldo,
3
participants. Consumers food value preferences were same Universidade Federal do Rio Grande do Sul, Porto
while purchasing yoghurt and probiotic yoghurt as a Alegre, Brazil
functional food.
Rationale: In recent decades, the nutritional profile of the
Disclosure of Interest: None declared. Brazilian population has presented important changes follow-
ing the nutritional transition process that has affected various
SUN-P221 countries in the world. An increase in the number of individuals
MALNUTRION AND INADEQUATE FOOD CONSUMPTION IN with overweight and obesity has been observed in children. It is
HOSPITALIZED PATIENTS know that children with overweight spend more time watching
O. Gonen1, A. Erbakan2, I. Bozkurt Cakir3, B. Alparslan Mesci1, television and playing video games than eutrophic children,
M. V. Keskinler1, A. Oguz1 *. 1Internal Medicine, Istanbul who are more active and have a lower body mass index (BMI)
Medeniyet University Goztepe Training and Research Hospital, and fat percentage. This study evaluated the association
2
Internal Medicine, Nisa Hospital, Istanbul, 3Internal between sedentary lifestyle and overweight in students aged
Medicine, Ardahan State Hospital, Ardahan, Turkey 6–14 years enrolled in an elementary school of the municipal
system in Brazil.
Rationale: Hospital stay worsens inpatients’ nutritional status Methods: In order to evaluate the duration of sedentary
including the patients without malnutrition at baseline. We behavior, the sum of daily hours spent watching television,
evaluated the nutritional risk status, adequacy and the factors using a computer, and playing video games was calculated.
affecting the consumption of provided meals in patients Data were collected using a standardized questionnaire with a
hospitalized in internal medicine clinics. sample of 88 students. This study was approved by the Research
Methods: A total of 200 patients, hospitalized in Istanbul Ethics Committee of the University of Caxias do Sul (No.
Medeniyet University Goztepe Training and Research Hospital 339.903).
Internal Medicine Clinics between February-March 2017, were Results: A high prevalence of overweight (21.6%; CI 95% 13.6–
screened by Nutrition Risk Score (NRS-2002) within the first 48 29.6) was found. The daily average duration of sedentary
hours of admission. Patients were questioned after the third behavior was of 5.3 (SD = 2.6) hours; higher among boys (6.1,
day of admission. SD = 2.4 hours) than among girls (4.7, SD = 2.6 hours); and
Results: Mean age was 66 ± 18 years (F/M = 1). NRS score was higher in students aged 10–14 years (6.1, SD = 2.8 hours)
found to be ≥3 in 48% (n:96) of the patients. In this group, 38.5% compared those aged 6–9 years (4.7, SD = 2.3 hours).
(n:37) of the patients were receiving nutritional support. In the Conclusion: Although the student presented a high prevalence
whole group, the rate of the consumption of less than half of of overweight and spent a substantial amount of time in
the meals provided by the hospital was 75% in total, and 86.5% activities considered sedentary. Is important to emphasize the
in patients at nutritional risk at baseline. need for educational interventions regarding healthy lifestyles
Seventy-five percent of the patients stated that the meals were promoted in the family environment.
not served at proper temperature, 70.5% of them stated the Disclosure of Interest: None declared.
meals were not appealing and only about 4% of the patients
expressed that they could prefer the hospital menus as a SUN-P223
dietary model after hospital discharge. SHORT AND LONG-TERM OUTCOMES FROM PERCUTANEOUS
ENDOSCOPIC GASTROSTOMY (PEG)
Nutritional Risk Grade p- C. Joaquin1 *, A. Palanca1, J. M. Sanchez-Migallon1,
value M. J. Sendros2, E. Martinez1, M. Martin1, M. Cachero1, R. Puig1.
NRS < 3 NRS ≥ 3 1
(n = 104) (n = 96)
Endocrinology and Nutrition, Germans Trias i Pujol Hospital,
2
Endocrinology and Nutrition, Institu Català d’Oncologia-
Consumption of meals Complete meal 37(35,6%) 13(13,5%) 0,001 Badalona, Badalona, Spain
provided by hospital, Almost 50% 27(26%) 26(27,1%)
number, proportion About one-third 32(30,8%) 38(39,6%)
Nothing 8(7,7%) 19(19,8%) Rationale: To review short and long-term outcomes from PEG
at a university hospital.
Methods: All patients referred to our Nutrition Unit to assess regression to calculate odds ratios (OR) and 95% confidence
PEG placement between 2011 and 2017 were included. intervals (CI) across tertiles of the HLI for reproductive
Results: 96 patients (66%men), age 60.4 ± 14.3 years, BMI outcomes and adjusted for multiple covariates, including
22.2 ± 4.7 kg/m2. Neurological dysphagia was the most age, cause of infertility and supplements use.
common reason for referral for PEG placement (57.7%) Results: Overall, 104 women (45.6%) had intrauterine gestation
followed by dysphagia due to head and neck cancer (38.1%). and 98 (43.2%) had a live birth. No association was found
PEG was not placed in 19 patients due to obesity (1), patient between the HLI and the intermediate IVF outcomes. However,
decision (6), pharyngo-oesophageal stenosis (4), other ana- the highest versus lowest tertile in the HLI was associated with
tomic causes (7) and exitus (1). In patients who had PEG placed a significant higher likelihood of achieving clinical pregnancy
(77), mean follow-up was 223 (34–471) days. All patients except (OR 2.46, 95%CI 1.24–4.77) and live birth (OR 2.22, 95%CI 1.12–
4 presented weight loss(WL) in the previous 6 months 4.39, both p for trend <0.05).
(11.4 ± 7.6%) although 77.9% of them were fed by nasogastric Conclusion: Adopting healthy lifestyle behaviors could be
tube prior to PEG insertion. PEG related complications occurred important for increasing the chance of achieving clinical
in 48.1% of the subjects. 22 patients (28,6%) had early pregnancy and live birth rates in women undergoing IVF.
complications (<30 days): 10.4% gastroparesis, 9.1% granuloma, Disclosure of Interest: None declared.
6.5% wound infection, 5.2% ileus, 1.3% tube dislodgement, 1.3%
tube removal, 1.3% cardiorespiratory arrest that responded to
SUN-P225
CPR and 1 patient (1.3%) died due to peritonitis. Late
ASSESSMENT OF CONSUMERS’ NUTRITION LABEL READING
complications occurred in 21 patients (28,4%): 23.4% granu-
HABITS IN TURKEY
loma, 5.2% peristomal leakage, 3.9% tube removal, 1.3% wound
infection, 1.3% tube dislodgement and 1.3% tube obstruction. E. E. Ozturk Duran1 *, L. Ozgen2. 1Hacettepe University, 2Gazi
During follow-up, 62.3% of the patients died: 7.8% within the University, Ankara, Turkey
first month and 20.8% within 3 months. In multivariate logistic
Rationale: The incidence of obesity is rapidly increasing all
regression analyses we did not find a correlation between global
over the world. Reading and understanding nutrition labels on
or early mortality and the indication for PEG, diabetes, age,
food packaging can change the food choices of consumers and
gender, BMI, WL%, albumin, nor cholesterol levels at baseline.
create healthy eating behaviors in individuals. This study has
Albumin concentration improved after 6 month of tube
been planned and conducted to determine Turkish consumers’
placement (34.3 ± 5.2 vs. 37.8 ± 5.1, P < 0.0001).
nutrition label reading habits.
Conclusion: Initiation of PEG feeding improved albumin levels
Methods: In order to determine consumers’ attitudes towards
in our patients. However, minor PEG-related complications
nutrition label, a questionnaire consists of 15 questions about
were frequent and 3-month mortality rate after PEG placement
information nutrition labeling was applied. There were also
was high.
questions on socio-demographic characteristics. Field inter-
Disclosure of Interest: None declared. views conducted in a random selected. The sample comprised
410 women and 190 men (14.5% normal weight, 46.7%
SUN-P224 overweight, 38.8% obese), ranged from 19 to 64 years. The
ADHERENCE TO A HEALTHY LIFETYLE AND IN VITRO questionnaires were analyzed with the statistical program
FERTILIZATION OUTCOME version SPSS 23.0.
D. Karayiannis1 *, M. Kontogianni1, C. Mendorou2, Results: Approximately ¾ of the consumers did not read the
M. Mastrominas2, N. Yiannakouris1. 1Nutrition and Dietetics, nutrition labels information. There is not a statistically
School of Health Science and Education, Harokopio University, significant relationship between participants’ gender and
2
Assisted Conception Unit, Embryogenesis, Athens, Greece nutrition label reading status ( p > 0.05). Nutrition label
reading status is higher in normal weight individuals when
Rationale: Several modifiable lifestyle factors, including compared to overweight and obese ( p < 0.001). In addition,
smoking, physical activity, diet and anxiety may independently normal weight consumers are more careful about labeling
influence assisted reproductive outcome; however, their information regarding brand name, date of manufacture, date
combined impact on reproductive performance is unknown. of expiry, product information, usage pattern and the name of
We aimed at investigating the joint influence of these behaviors the additives used in the preparation of the product ( p < 0.05).
on IVF outcomes in women attempting fertility. The expected characteristics of nutrition labels vary according
Methods: We constructed a healthy lifestyle index (HLI) from to whether individuals are in normal weight, overweight or
five health related behaviors/factors (smoking, physical obese ( p < 0.05). While obese and overweight individuals
activity, diet - assesed by the Mediterranean Diet Score, prefer to be easy to understand on the nutrition label, the
anxiety and waist circumference) and examined the association normal weight individuals opt to see well designed packet on
of this HLI with IVF clinical outcomes. Nulliparous women the nutritional label.
(n = 228, 22–41 years old, BMI < 30 kg/m2) undergoing their first Conclusion: Since nutrition labels play an important role in the
IVF cycle were recruited from an Assisted Conception Unit in prevention of obesity, health policies should be produced and
Athens, Greece, and completed questionnaires related to education programs may be organized to inform individuals
lifestyle behaviors prior to the IVF. We assigned scores of 0, 1 about the correct use of nutrition labels.
or 2 to categories of each of the five components, for which Disclosure of Interest: None declared.
higher values indicate healthier behaviors, and added the five
scores to produce a combined HLI for each participant ranging
from 0 (least healthy) to 10 (healthiest). We used logistic
S138 Poster
SUN-P226 literature, no special cut point has been declared for SF36.
MALNUTRITION PREVALENCE AMONG SECONDARY-CARE Therefore, GHP and MH scores were subjectively divided into
HOSPITAL PATIENTS IN LATVIA two groups in this study. 0–49 was considered low (GHP-L; MH-
E. P. Borins1,2, G. Moisejevs1,3 *, J. Avdjukevics3, O. Zukova3, L). 50–100 was considered high (GHP-H; MH-H). Descriptive
J. Pokrotnieks1,4. 1Riga Stradins Unviersity, Riga, 2Northern statistics (mean±SD) were used. The independent samples t
Kurzeme Regional Hospital, Talsi, 3Riga East Clinical University test was used to test differences between the food choice
Hospital, 4Pauls Stradins Clinical University Hospital, factors and the subgroups of GHP and MH. P < 0.05 was
Riga, Latvia considered significant.
Results: Participants’ mean age was 43.7 ± 18.6. Sensory
Rationale: The prevalence of malnutrition at secondary-care appearance (8.05 ± 1.61), price (7.44 ± 1.90) and convenience
hospitals has never been thoroughly assessed in Latvia. Various (7.33 ± 2.01) were the most effective factors. The mean GHP
studies show that the prevalence is very variable, ranging 10– and MH scores were 57.9 ± 20.4 and 66.1 ± 17.7, respectively.
50% of hospital patients. The aim of this study was to assess the The most important factors in GHP-L (n = 141) and GHP-H
prevalence of malnutrition at secondary-care hospitals in (n = 249) were sensory appearance (GHP-L:7.94 ± 1.63/GHP-
Latvia on the basis of the Nutritional Risk Assessment H:8.11 ± 1.60), price (GHP-L:7.50 ± 1.81/GHP-H:7.41 ± 1.95)
(NRS2002) tool, also associating malnutrition with various and convenience (GHP-L:7.34 ± 2.16/GHP-H:7.33 ± 1.92).
potentially predictive factors. There was no difference between GHP-L and GHP-H ( p > 0.05).
Methods: The study was conducted at the Talsi clinic of the The most important factors in MH-L (n = 78) were convenience
Northern Kurzeme Regional Hospital in May–June 2016. All (7.79 ± 1.78), sensory appearance (7.73 ± 1.80) and price
patients were weighed, their height was measured, and they (7.28 ± 2.01). The most important factors in MH-H (n = 312)
were assessed on the basis of NRS2002 by an experienced were sensory appearance (8.13 ± 1.55), price (7.48 ± 1.87) and
physician (E.P.B.) within 24 hours of admission. The diagnosis of familiarity (7.22 ± 1.69). Only convenience was found signifi-
malnutrition was made if the NRS2002 score was ≥3. Data cantly different between MH-L and MH-H ( p = 0.037).
related to age, gender, length of hospital stay (LOS) and health Conclusion: The effective factors at food choice in Turkey were
conditions were collected. Age and LOS are shown as median sensory appearance, price and convenience. GHP didn’t affect
(interquartile range). The association of malnutrition with age, food choice, but MH did.
LOS and various existing bodily organ pathologies was assessed Disclosure of Interest: None declared.
on the basis of binary logistic regression (SPSS 20.0). The local
ethics committee approved the study protocol.
SUN-P228
Results: Malnutrition was identified in 28.7% (64/223) of
NUTRITIONDAY 2016 AUDIT IN CHINA
patients. Patients with malnutrition were older 69 (55–78)
versus 78.5 (70.25–85) years, p = 0.001 and had longer LOS 5 (3– H. Sun1 *, L. Zhang1, P. Zhang2, J. Yu3, W. Kang3, S. Guo3,
8) versus 7 (5.25–10) days, p = 0.012. During their hospital stay, W. Chen3, X. Li4, S. Wang4, L. Chen5, J. Wu5, Z. Tian6, X. Wu7,
6 patients who were malnourished died ( p = 0.001). X. Liu8, Y. Liu9, X. Zhang9, X. Wang1. 1Department of General
Malnutrition is associated with oncological diseases OR 5.0, Surgery, Jinling Hospital, Medical School of Nanjing University,
p = 0.05 and was more frequently diagnosed among patients Nanjing, 2Department of Clinical Nutrition, School of
with lung disease OR 3.2, p = 0.064. Medicine, the Second Affiliated Hospital Zhejiang University,
Conclusion: Malnutrition is prevalent in secondary-care hospi- Hangzhou, 3Peking Union Medical College Hospital, Beijing,
4
tals in Latvia, mostly affecting elderly patients, patients with Department of General Surgery, The First Affiliated Hospital
oncological and lung diseases. Patients with malnutrition have of Xi’an Jiaotong University, Xian, 5National Cancer Center/
longer hospital stays and higher rates of mortality. The NRS2002 Cancer Hospital, Chinese Academy of Medical Sciences and
tool may be used in secondary-care hospitals in Latvia to Peking Union Medical College, Beijing, 6Department of
diagnose malnutrition. Gastroenterology, the Affiliated Hospital of Qingdao
University, Qingdao, 7The First Affiliated Hospital of Guangxi
Disclosure of Interest: None declared. Medical University, Nanning, 8Department of Gastrointestinal
Surgery, the First Affiliated Hospital Zhejiang University,
SUN-P227 Hangzhou, 9Nutrition Department of People Liberation Army
FOOD CHOICE ACCORDING TO GENERAL HEALTH General Hospital of China, Beijing, China
PERCEPTIONS AND MENTAL HEALTH
G. Arman1 *, E. Tuncil1, M. Fisunoglu1. 1Nutrition and Dietetics, Rationale: We aimed to provide an actual and comprehensive
Hacettepe University, Ankara, Turkey situation of nutrition characteristics, nutritional therapy and
malnutrition risk factors of hospitalized patients in China.
Rationale: Food choice that has a clinical importance in terms Methods: We enrolled the data of NutritionDay audit 2016 in
of some health problems such as obesity is an interaction China that we have received by far. The international daylong
between non-sensory and sensory factors. The aim of the study cross-sectional survey was performed on November 10, 2016 via
is to show the most effective factors at food choice in Turkey filling out four questionnaires about nutritional care, patients’
according to General Health Perceptions (GHP) and Mental illness, food intake history and weight change. Re-assessment
Health (MH). of patients’ outcome questionnaire was performed 30 days
Methods: 209 women and 181 men (n = 390) participated in the later. Malnutrition was defined as BMI <18.5 kg/m2 or uninten-
study voluntarily in Ankara, Turkey. Short Form 36 (SF36) and tional weight loss >5% in last 3 months.
Food Choice Questionnaire validated in Turkey were used. GHP Results: Total of 628 patients from 7 hospitals and 8 kinds of
and MH scores were found with SF36. According to the departments were enrolled. 188 (29.9%) patients were
identified as malnutrition, and most frequently in general therapeutic approach could provide relevant benefit to them’
surgery (39.4%) and gastroenterology & hepatology (internal was 38.8% in Japan, 52.3% in the world.
medicine) department (37.1%). Parenteral nutrition (176/594, Conclusion: nutiritionDay makes it possible to objectively
29.6%) was the primary nutrition support therapy for hospita- evaluate the current situation of cancer patients and nutri-
lized patients, of which, 42.0% was supported via central tional therapies in Japan and will be the basic data for
venous. However, there were still 37.9% (69/182) malnutrition improving nutritional therapy in the future.
patients not received any form of nutritional support, and Disclosure of Interest: None declared.
36.4% (150/412) well nourished patients did. Moreover, major
diseased organ, nutritional support form, self-rated health,
SUN-P230
and food intake during last week were independent risk factors
INSIGHT FROM ANALYSIS OF FEEDING PRACTICES AND
for malnutrition (all p < 0.05). Patients with malnutrition had
GROWTH OUTCOMES AMONG TIBETAN CHILDREN LESS THAN
higher hospital stay rate and lower discharge rate compared to
3 YEARS OF AGE: WHAT, WHY AND HOW?
well-nourished patients according to 30-day outcomes.
Conclusion: The prevalence of malnutrition is still high and H. Shi1 *, J. Chen1. 1Shanghai Children Hospital, Shanghai,
associated with poor 30-day outcomes in Chinese hospital. China
Inappropriate nutritional therapy is a common and burning
Rationale: Children residence at highland are faced with an
problem to be solved. Specific nutritional intervene should be
unique set of nutrition problems. This study aimed to
taken in patients with poor self-rated health or critical organ
investigate the infant feeding practices and the nutritional
disease. Moreover, further study may focus on the risk factors
outcomes among Tibetan children aged 0–3 years.
for food intake loss and efficient method for protecting
Methods: Data of 1,434 Tibetan children aged 0–3 years were
patients from malnutrition.
collected with multistage random sampling in Dec, 2016. The
Disclosure of Interest: None declared. outcomes of anthropometric measurement were defined as
stunning, underweight and wasting by common age- and sex-
SUN-P229 cutoff value. Age-specific logistic regression was performed to
NUTRITIONAL STATUS OF CANCER PATIENTS SEEN FROM construct correlation between various categories of under-
NUTRITIONDAY ONCOLOGY IN JAPAN 2015 nutrition and feeding risk factors.
H. Takemoto1 *, R. Fukushima2, S. Ishii3, R. Endo4, Y. Koyama5, Results: The prevalence of malnutrition was 18.0% for stunting,
K. Saito6, S. Noda7, C. Mihara8, M. Yamaguchi9, J. Kotani10, 49.2% for underweight and 25.4% for wasting, respectively. The
on behalf of nutrition Day Working Group in JSPEN. 1Kinki rate for mothers who could conduct exclusive breastfeeding
Central Hospital, Itami, 2Teikyo University, Tokyo, 3Kurume (EBF) for at least 4 complete months was only 10.4% among
University, Kurume, 4Iwate Medical University, Morioka, infants older than 4 months. A considerable amount of infants
5
Niigata University, Niigata, 6Tokyo Medical and Dental (66.12%) were introduced solids before 4 months old while
University, Tokyo, 7Takamatsu Hospital, Takamatsu, 8Yamada 11.63% of the caregivers started complementary feeding (CF)
Kinen Hospital, Mihara, 9Inabe General Hospital, Inabe, later than 7 months. Significant association was detected
10
Hyogo College of Medicine, Nishinomiya, Japan between early introduction of solids before 4 months of age and
wasting in 0–3.99 months (95%CI 1.20–5.95), 4–6.99 months (95%
Rationale: A survey specializing in cancer patients has also CI 2.25–7.24) and underweight in 7–23.99 months (95%CI 1.80–
been conducted on nutiritionDay since 2012. In response to the 5.86). Delay introduction of solids was risk factors for under-
publication of the 2015 national report this time, I will report weight (95%CI 2.36–13.04) and wasting (95%CI2.19–11.43) in 7–
on the current situation of cancer patients in Japan. 23.99 months. Relationship could be seen between suboptimal
Methods: In 2015, we conducted an investigation on November breastfeeding (non-EBF or EBF less than 4 months) and stunting in
10. In Japan, 1,114 patients were registered at 62 units, of children aged older than 24 months (95%CI 1.36–3.80 for
which 303 were cancer patients. We compared with 2,607 stunting). Delay introduction of CF kept a negative impact on
cancer patients registered from 275 units in the whole world. child height at 23–35.99 months group (95%CI 5.52–93.86).
Results: The average age was 71 in Japan, 65 in the world, the Conclusion: There is an urgent need to improve EBF and timely
female ratio was 44.8% in the world compared with 36.5% in introduction of complementary as an element of crucial public
Japan. BMI was 21.4 in Japan and the world was 24.4. For goal health policy to diminish health threats and problems in Tibet.
of therapy, curative, palliative, terminal was 53.8%, 38.6%, Disclosure of Interest: None declared.
4.3% worldwide, compared to 39.7%, 43.9%, 15.1% in Japan,
and the proportion of hospitalization not aimed for cure was
SUN-P231
higher in Japan. Over 10% of cancer sites were colon, stomach,
SHORT BOWEL SYNDROME EPIDEMIOLOGY, ANALYSIS FROM
lung, liver in Japan, colon, lung and stomach in the world.
NATIONAL HPN REGISTRY
Looking at nutritional therapy, ‘no special diet’ was the largest
number of people in both the world and Japan, however 21.5% J. Gojda1 *, M. Senkyrik2, P. Tesinsky1, on behalf of Czech
patients had been undergoing ‘pareteral nutrition’ in Japan, HPN working group. 12nd Internal Departement, Centre for
9.2% in the world. Conversely, ‘energy rich/protein rich ONS’ Research on Diabetes, Metabolism and Nutrtion, Charles
was only 3.2% in Japan, whereas in the world it was 16.3%. University in Prague, Prague 10, 2Internal and
According to a questionnaire survey of patients, the proportion Gastroenterology Dept., University Hospital Brno, Brno,
of ‘patients having difficulties in complying with treatment’ is Czech Republic
20% in the world compared with 3.5% in Japan. The proportion
Rationale: Short bowel syndrome (SBS) is the most common
of ‘patients believing that including nutrition in their
indication for HPN in the Czech Republic. As new treatment
S140 Poster
modalities in SBS emerges, it is important to stratify the Results: 267 patients received HEN in our nutritional unit (119
group of HPN patients to identify those who could benefit women and 148 man). The median age was 75+ -24 years. The
from it. main indication was neurogenic dysphagia (56.2%), followed by
Methods: Retrospective analysis of data from national registry major surgery (14.6%), chemo-radiotherapy (9.7%), head and
of HPN patients was performed. Time-to-event analysis was neck surgery (8.2%), inflammatory bowel disease (3%), short
performed for catheter realted sepsis (CRS) using competing- bowel syndrome (3%), pancreatopathy (3%), and others (2.2%).
risks regression (Fine and Gray model) and was expressed as The types of enteral nutritional support were: oral nutritional
hazard ratio (HR) with SBS syndrom category being the supplements (ONS) (55.8%), nasogastric tube feeding (18.7%),
reference. Other data are presented as median (min-max) or gastrostomy feeding (17.2%) and adapted oral diet (8.2%).
mean with 95% CI, p value <0.05 was considered significant. Conclusion: Patients who require enteral nutritional support in
Results: From total of 753 records (1993–2016), 311 patients our area are elderly, so the main indication was neurogenic
were classified as SBS. Prevalence trends in the SBS group were dysphagia. The main type of nutritional support was ONS,
stable for the last 5 years, mean 28.684 (27.023–33.871) followed by nasogastric tube feeding. Given the predictable
catheter days. 40.8% of patients were categorized to be life- high prevalence of malnutrition or risk of malnutrition in our
long dependent on HPN. Major diagnose of SBS is cancer area, we understand that few patients are treated in our
(28.0%), vascular (22.5%) and non-cancer surgical (20.6%). nutritional unit, probably due to an underdiagnosis of malnu-
Majority of SBS were type I (59.1%) and II (21.3%), mean length trition. Better strategies for malnutrition screening are needed
of residual bowel was 77.8 cm (0–250 cm). 50% of SBS patients for adequate detection and treatment of these patients.
terminates HPN (weaning or death) within the first year. Disclosure of Interest: None declared.
Incidence of CRS was 0.39 per 1,000 catheter days in 2016.
When compared to other syndromes indicating HPN, signifi-
SUN-P233
cance was reached only in comparison with GIT obstruction
EDUCATION ON SELF-MONITORING OF BLOOD GLUCOSE AS A
where the risk of CRS was lower (HR 0.23, [0.1–0.5]).
STATE-CONTROLLING ISSUE CAN BE EFFECTIVE IN PATIENTS
Prevalence of metabolic bone disease in the whole sample is
WITH TYPE 2 DIABETES MELLITUS WHO ARE NOT TAKING
34.2% with median time to manifestation 43.5 (1.7–194.5)
INSULIN: A SYSTEMATIC LITERATURE REVIEW
months and of liver disease is 36.4% with median time to
manifestation 28.9 (2.4–121.1) months. K. Viligorska1,2 *, E. Kasapidou1, M. Chourdakis1. 1Laboratory of
Conclusion: Prevalence of SBS among HPN patients in Hygiene, Dept. of Medicine, School of Health Sciences,
the Czech Republic is stable in the last years. Majority of Aristotle University of Thessaloniki, Thessaloniki, Greece,
2
SBS patients are expected to be life-long dependent on HPN. Internal Medicine, Clinical Pharmacology and Occupational
Risk of CRS in SBS is higher when compared to other syndromes Diseases, Bukovinian State Medical University, Chernivtsi,
but the actual prevalence is low when compared to other Ukraine
countries.
Rationale: Clinical guidelines point out the benefits of self-
Disclosure of Interest: None declared. monitoring of blood glucose (SMBG). The aim was to system-
atically review evidence on effectiveness of SMBG educational
SUN-P232 interventions encouraging lifestyle changes in type 2 diabetes
INDICATIONS AND TYPES OF HOME ENTERAL NUTRITIONAL mellitus (T2DM) adults who are not using insulin.
SUPPORT IN THE HEALTH AREA OF CUENCA (SPAIN) Methods: In October 2016 according to Preferred Reporting
J. Pérez Rodríguez1 *, J. González López1, D. Martín Iglesias1, Items for Systematic Reviews and Meta-analyses guidelines a
M. Alramadan1, D. Calderón Vicente1. 1Endocrinology and publication search in 4 electronic databases was conducted.
Clinical Nutrition, Virgen de la Luz General Hospital, Papers published in English, Spanish, French reporting on SMBG
Cuenca, Spain education that promotes frequent glucose control with
exercise regimen and/or dietary adjustments in T2DM adults
Rationale: Enteral nutrition is indicated in patients who, with 3 and >month follow-up period, estimated progress in
having a functioning and accessible gastrointestinal tract, can comparison to control group were included. Glycated haemo-
not meet all their nutritional needs. Home enteral nutrition globin (HbA1c,%) was chosen as psychical evidence of SMBG
(HEN) allows to receive it at home, which with proper education success.
management and monitoring avoid hospitalization, prevents Results: 10 studies (2,658 patients) were included and
and treats malnutrition and reduces morbidity and mortality. stratified by intervention type. Positive effects were generally
The objectives of this study are to know the number of patients observed in studies incorporating face-to-face counseling but
with HEN being followed in our nutritional unit, as well as to interventions using culture-tailored approach or self-monitor-
analyze the main indications and types of enteral nutritional ing of urine glucose (SMUG) measurement seemed to present
support (ENS) in our area. sufficient alternative. Studies focused on SMBG impact on
Methods: We collected information from patients with HEN in quality of life regular SMBG was mentioned as the most
our nutrition unit between 2014 and 2016. For them we use as a substantial problem causing statistically significant increase
source the medical record. We classified the patients according of HbA1c up to 9.6% ( p = 0.02). Multicomponent interventions
to the clinical situation that justified the need for ENS, as well on SMBG training and SMUG had better results, stable HbA1c
as the type of ENS they received. target level (6.5%): 35.3% ( p = 0.277) in SMBG patients and
38.9% ( p = 0.172) in SMUG group.
Obesity and the metabolic syndrome 1 S141
Conclusion: SMBG training in combination with SMUG provides Obesity and the metabolic syndrome 1
positive effect in population subgroups (45% of reviewed
articles). More research is required to explore effectiveness SUN-P235
of specific components of interventions particularly exercise SEMEN FLUID QUALITY AND ANTIOXIDANTS SUPPLEMENT IN
and diet regimen in different populations. RATS FED HIGH FAT DIET
Disclosure of Interest: None declared. A. Vahidinia1 *, S. M. Hosseinipanah2, H. Abbasi3,
H. Mossavibahar4, H. Mahjoub5. 1Nutrition Sciences, 2Anatomy,
3
SUN-P234 Hamadan University of Medical Sciences, Hamadan, Islamic
INFLUENCE OF A CHANGE IN COST COVERAGE FOR Republic of Iran, 4Endourology, 5Biostatistic, Hamadan
ORAL NUTRITIONAL SUPPLEMENTS IN HOME ARTIFICIAL University of Medical Sciences, Hamadan, Islamic
NUTRITION Republic of Iran
L. J. Vogt1 *, M. Rühlin1,2, N. Wagener3, C. Möltgen2,4, Rationale: Obesity is associated with low serum antioxidant
L. Genton2,5, P. E. Ballmer1,2. 1Departement of Medicine and capacity, alterations in sex hormone concentrations and male
Division of Dietetics and Clinical Nutrition, Winterthur infertility. Dietary Antioxidants are necessary for normal semen
Cantonal Hospital, Winterthur, 2Swiss Society for Clinical quality and reproductive function in both animals and human.
Nutrition (GESKES), Geneva, 3SVK, Swiss Consortiums of The present study was designed to investigate effects of high-
Health Insurance Companies for Joint Tasks in the Field of fat diet with and without antioxidants supplement on quality of
Transplantation, Dialysis, HAN and Home Ventilation, male rat’s semen fluid.
Solothurn, 4Hospital Pharmacy, Aarau Cantonal Hospital, Methods: Forty-eight male wistar rats were randomly assigned
Aarau, 5Clinical Nutrition, Geneva University Hospitals, to high-fat purified diet ad libitum (FD), high fat restricted diet
Geneva, Switzerland (FDR) (−30%wt), high-fat antioxidants ad libitum (HFA) and high
fat restricted (HFR) for 12 weeks. Antioxidants supplements
Rationale: Before 01.07.2012, the costs for oral nutritional
contain vitamin C, E and astaxanthin. Daily food intake, weekly
supplement (ONS) were not covered by health insurance
Weight gain, serum total antioxidant capacity, 8-epi-PGF2α,
providers in Switzerland. Since 01.07.2012, the costs for ONS
and semen analysis measured.
have been covered, if the use is medically indicated. The aim of
Results: Dietary antioxidants suppress body weight gain in HFA
this study is to examine whether the change in cost coverage for
(−9.8%), and HFR (−18.1%) groups. 8-epi- PGF2α levels in FD
ONS has influenced home artificial nutrition (HAN).
was 1,416.2 pg/ml and in FDR group was 1,209 pg/ml and equal
Methods: This study examined retrospectively all new cases of
for other groups. lowest TAC was seen in FD group and highest
HAN in Switzerland from 2010 to 2015 that were registered by
was in HFA group ( p < 0.005). Total sperm count in left testes
the Swiss Consortium of Health Insurance Companies (SVK).
was 132.7 million and in right testes was 119.8 million. Mean
Type of HAN, duration and cost of HAN before and after the due
normal sperm morphology was 77.6% and abnormal morphology
date 01.07.2012 were examined.
was %23.4. High frequency of grade 4 motility and grade 0
Results: A total of 39,624 patient cases were registered in six
motility in both testes were seen in HFA group.
years and the number of cases with HAN increased from 4,667 in
Conclusion: These results suggest that antioxidants supple-
2010 and 3,829 in 2011 to 6,147 in 2012, 7,315 in 2013, 8,097 in
ment might be of value in reducing likelihood of obesity in rats
2014 and 9,575 in 2015. After 01.07.2012, patients receiving
fed high-fat diet, especially if accompanying with restricted
ONS increased from 61.4% to 87.7% while patients receiving
diets. Antioxidants supplement and/or caloric restriction may
enteral nutrition (EN) and parenteral nutrition (PN) decreased
be improved TAC and partially suppressed stress oxidative
from 35.4% to 11.3% and from 3.1% to 1.0%, respectively. The
index, but in semen analysis, without effects on morphology
mean treatment duration for ONS significantly decreased from
and sperm count, may be improved sperm motility grade 4
329 ± 492 days to 181 ± 305 days ( p < 0.001), for EN from
motility and grade 0 motility in both testes were seen in HFA
455 ± 586 days to 323 ± 493 days ( p < 0.001) and for PN from
group.
331 ± 524 days to 187 ± 363 days ( p = 0.003). The total cost for
ONS significantly decreased since 01.07.2012 for ONS from Disclosure of Interest: None declared.
2,689 ± 7,558 € to 1,603 ± 4,117 € ( p < 0.001) and for EN from
14,202 ± 21,019 € to 11,314 ± 17,484 € ( p < 0.001). The cost for SUN-P236
PN did not change significantly ( p = 0.108). LOW-GRADE INFLAMMATION IN OVERWEIGHT AND OBESE
Conclusion: The change in cost coverage caused an increase in ADULTS IS AFFECTED BY WEIGHT LOSS PROGRAM
use of ONS while the use of EN und PN decreased. This change in A. Petelin1 *, M. Stubelj1, M. Černelič Bizjak1, M. Jurdana1,
treatment combined with the shorter treatment period led to T. Jakus1, Z. Jenko Pražnikar1. 1Faculty of Health Sciences,
an important reduction of cost despite the increasing number University of Primorska, Izola, Slovenia
of patient cases.
Disclosure of Interest: None declared. Rationale: Low grade systemic inflammation due to obesity is
considered to be the key link between obesity and obesity-
related disorders. The hypothesis was tested that significant
alterations in inflammatory markers and adipokines would
occur over a multidisciplinary intervention and that these
changes might also be important for improvement of cardio-
vascular risk factors.
S142 Poster
Methods: Thirty-tree overweight adults completed a 6-month adiponectin concentrations of CAF and CAFT dams were
of multidisciplinary intervention program to evaluate the significantly higher than CON and CONT mothers (CON: 3.10 ±
effects of a personalized dietary program based on the 1.60 μg/mL, CONT: 3.50 ± 1.48 μg/mL, CAF: 11.53 ± 1.60 μg/mL
individual’s resting metabolic rate (RMR) on anthropometric and CAFT: 13.92 ± 1.60 μg/mL) ( p < 0.01).
parameters, aerobic and anaerobic capabilities, metabolic Conclusion: Maternal exposure to a cafeteria diet and
profile, inflammation and body image satisfaction. Body taurine supplementation during pre-gestation, gestation and
composition, physical activity, anaerobic capabilities, RMR, lactation resulted in different body weights and plasma
metabolic profile and low-grade inflammation were measured. adiponectin levels. Future studies will continue to examine
Diet composition and body image dissatisfaction were also the influence of maternal cafeteria diet and taurine supple-
assessed. mentation on physiological and metabolic changes and
Results: After 6-month of multidisciplinary intervention the maternal health.
participants showed significantly decreased body weight, waist Disclosure of Interest: None declared.
circumference (WC) and the inflammatory markers tumor
necrosis factor-α, C-reactive protein and visfatin. They also
SUN-P239
showed increased anti-inflammatory adiponectin and conse-
EFFECTS OF DIETING ON INTRA-ABDOMINAL FATNESS AND
quently decreased serum insulin, HOMA-IR and total choles-
WAIST CIRCUMFERENCE
terol. The important findings of the study were that reduction
of sugars and saturated fatty acids in the diet, coupled with an A. Ozdemir1 *, D. Dikmen1. 1Nutrition and Dietetics, Hacettepe
increase in exercise, significantly correlated with reduction of University, Ankara, Turkey
WC and body mass index. In addition, positive correlations
Rationale: There is an evidence that abdominal obesity is
between Δ BMI, Δ WC, Δ trunk fat, inflammation and
associated with increased risk of morbidity and mortality. Waist
cardiovascular risk factors were demonstrated.
circumference and waist–hip ratio are abdominal adiposity
Conclusion: Weight loss in combination with increased physical
indicators (1). This study was planned with the object of
activity, a negative energy balance and diet adjustment was
examining and comparing the changes that emerge in waist
associated with lower inflammation and consequently with
circumference, waist hip ratio, intra-abdominal fat mass and
lower cardiovascular risk factors.
body compositions of the individuals who follow weight-loss
Disclosure of Interest: None declared. diets.
Methods: This study carried out with 26 overweight/obese
SUN-P238 subjects. They were followed with weight-loss diets calculated
EFFECT OF MATERNAL CAFETERIA DIET AND TAURINE by specialized dietitians using Harris-Benedict formula includ-
SUPPLEMENTATION ON MATERNAL WEIGHT CHANGE AND ing their basal metabolic rates. Body composition analyses
PLASMA ADIPONECTIN LEVELS IN RATS examined with BIA, intra-abdominal fat percentage was
A. Kabasakal Çetin1 *, A. Güleç1, A. Akyol Mutlu1. 1Hacettepe analyzed with VISCAN. All the individuals’ anthropometric
University, Ankara, Turkey measurements were assessed once in a month who followed
their diet program for 3 months.
Rationale: Maternal obesogenic environment leads to adverse Results: The mean age of subjects was 47,2 ± 10,71 and mean
pregnancy outcomes and the effect of taurine supplementation body mass index (BMI) was 32,8 ± 4,49 kg/m2. Of participants,
on maternal over nutrition and physiological changes are not 47,2% were men and 57,5% were women. Mean waist
well documented. The aim of the present study was to evaluate circumference was decreased from 108 ± 7,42 cm to 100,3 ±
the effect of maternal cafeteria diet and taurine supplemen- 9,87 cm, and from 107,1 ± 11,89 cm to 98,7 ± 9,71 cm, respect-
tation on maternal weight change and plasma adiponectin ively in men and women ( p < 0.05). Intra-abdominal fat
levels in rats. percentages and body fat percentages were decreased from
Methods: Female Wistar rats were fed a control (CON) diet, 43,2 ± 6.2% to 42,4 ± 6,39% and from 35,8 ± 8,28% to 34,9 ±
CON supplemeted with 1.5% taurine in drinking water (CONT), 8,61%, respectively ( p < 0.05). A significant decrease was seen
cafeteria diet (CAF) or CAF supplemented with taurine from waist circumference (cm), waist/hip ratio, intra-abdominal fat
weaning. After 8 weeks all animals were mated and maintained percentages, between beginning, 1st month, and 3rd month
on the same diets during pregnancy and lactation. Maternal ( p < 0.05). There was a significant correlation between waist
food consumption, water intake and body weights were circumference and intra-abdominal fat mass ( p < 0.05).
measured during pre-gestation, gestation and lactation. At Conclusion: The results obtained from this study show that
the end of lactation animals were culled and blood samples there were significant changes in some anthropometric
were collected. measurements and body composition with weight loss diets.
Results: Maternal energy intake did not differ between groups Reference
(CON: 330.4 ± 6.76 kJ/day, CONT: 330.3 ± 6.26 kJ/day, CAF:
Waist circumference and waist-hip ratio. (2008). Report of a WHO
339.3 ± 6.26 kJ/day and CAFT: 336.5 ± 6.26 kJ/day) ( p > 0.05),
Expert Consultation. Geneva: World Health Organization, 8–11.
but maternal cafeteria diet resulted in an overall increase in
maternal body weights in CAF group compared to CON (CON: Disclosure of Interest: None declared.
207.7 ± 1.81 g and CAF: 215.5 ± 1.68 g)( p < 0.01). CAFT dams
remained significantly leaner than CONT mothers (CONT:
219.4 ± 1.68 g and CAFT: 210.0 ± 1.68 g) ( p < 0.01). Plasma
SUN-P240 eutrophic women ( p = 0.045). Among those with abdominal

EVOLUTION OF BODY COMPOSITION WITH DIFFERENT obesity, it was observed that all obese women presented waist
BARIATRIC PROCEDURES: SLEEVE GASTRECTOMY VS circumference above 88 cm ( p < 0.001). A higher LAP was found
BILIOPANCREATIC DIVERSION VS GASTRIC BYPASS in those with overweight (22.1%) and obesity (36.6%), when
B. Pintor De La Maza1 *, M. D. Ballesteros-Pomar1, compared to eutrophic women (1.3%) ( p < 0.001). As for
A. Urioste-Fondo1, L. M. Gajete-Martín1, M. Alejo-Ramos1, glycemia above 100 mg/dL or use of hypoglycemic medication,
D. Barajas-Galindo1, P. Fernández-Martínez1, an increase was observed when compared to eutrophic,
A. Hernandez-Moreno1, L. González-Herráez1, overweight and obese (9.6%, 28.8%, 61.6%, respectively)
I. Cano-Rodríguez1. 1High Risk Obesity Unit, Complejo ( p = 0.004). Regarding HDL, the trend was the same (9.4%,
Asistencial Universitario de León, León, Spain 33.0%, 57.5%) ( p = 0.001). Metabolic syndrome was present in
5.8% of the eutrophic, 26.4% of overweight and 67.8% of obese
Rationale: Bariatric surgery is an effective intervention women ( p = 0.001).
strategy in obesity, resulting in sustained weight loss which Conclusion: After the information collection and analysis of
might differ among elected procedures. The aim of this study the observed variables, it can be concluded that the majority of
was to assess the evolution of body composition in patients that postmenopausal women are obese, have low schooling, have
underwent Sleeve gastrectomy (SG), Biliopancreatic diversion had more than three pregnancies, have abdominal obesity,
(BPD) and Gastric Bypass (GB). have elevated LAP and glycemia, metabolic syndrome and low
Methods: The study was performed between July 2015 and HDL cholesterol.
February 2017. All patients that underwent bariatric surgery Disclosure of Interest: None declared.
were included. Body composition was determined with a
Bioelectrical Impedance Analyzer (BIA – Tanita MC780) before SUN-P242
surgery and 6 and 12 months after surgery. The statistical DEVELOPMENT OF A ROUX-EN-Y GASTRIC BYPASS MODEL IN
analysis included ANOVA test. OBESE YUCATAN MINIPIGS: FEASIBILITY AND PRELIMINARY
Results: 24 patients with a mean age of 44.67 (10.39) were RESULTS ON WEIGHT LOSS AND GLP-1 SECRETION
included. 75% were female. Mean weight before surgery was
121.36 (22.60) kg. 8 patients underwent BDP, 12 SG and 4 GB. 6 D. Bergeat1,2 *, Y. Gautier1, S. Blat1, S. Guerin1, K. Boudjema2,
months after surgery, weight loss among groups was 44.38 D. Val-Laillet1, R. Thibault1,3. 1UR 1341 ADNC, NuMeCan, INRA,
(12.94) kg in BDP vs 29.09 (7.45) kg in SG vs 35.12 (4.62) kg in GB St Gilles, 2Hepatobiliary and Digestive Surgery, 3Department of
( p = 0.007). The fat mass loss after 6 months was 34.62 (9.66) Nutrition, CHU Rennes, Rennes, France
kg in BDP vs 21.35 (5.59) kg in SG vs 25.97 (4.65) kg in GB
Rationale: Gut-brain axis is truly involved in the regulation of
( p = 0.002). No significant differences were found among
food behavior after obesity surgery. To prepare an original study
techniques 12 months after surgery.
aimed at identifying the intestinal phenotypes correlated with
Conclusion: The weight loss and fat mass loss is lower in those
neuro-behavioral patterns, we developed a model of Roux-en-Y
patients that underwent SG than the other two techniques,
gastric-bypass (RYGBP) in obese minipigs
although long term studies are needed.
Methods: After a period of 6 weeks of an obesogenic diet, we
Disclosure of Interest: None declared. performed a RYGBP and a sham operation using obese Yucatan
minipigs (mean weight 82.6 kg ± 2.8). Postoperative feeding
SUN-P241 protocol was the same between groups. To appreciate the
OBESITY IN POSTMENOPAUSAL WOMEN IN THE SOUTH OF incretin effect, a meal test (with the equivalent of 1 g of
BRAZIL glucose per kg) was performed before surgery, at 1 week and 1
C. W. Gallon1 *, K. G. Mendes1, H. Theodoro1, M. T. A. Olinto2, month after surgery. Plasma GLP1 concentrations were
E. M. F. E. Silva1. 1Universidade de Caxias do Sul, Caxias do Sul, evaluated before the meal test and at 15, 30, 60, 120, and
2
Unisinos, São Leopoldo, Brazil 180 min after the meal test. Results were compared using a
two-way ANOVA, Bonferroni post-hoc test.
Rationale: Obesity is a public health problem that affects Results: Thirteen obese Yucatan mini pigs were operated, 7
women in the climacteric. There is an increase in premeno- RYGBP and 6 sham. We observed 1 brutal death by sepsis in the
pausal prevalence and is directly related to the occurrence of RYGBP group at postoperative day 3 and 1 gastrojejunal
hypertension, diabetes mellitus and cardiovascular diseases. anastomosis stenosis limiting food intake. Otherwise the
This study aims to evaluate the prevalence of obesity in postoperative outcome was uneventful. At 1 month, the
postmenopausal women treated at the Central Ambulatory of mean percentage of weight loss was higher in RYGBP group
the University of Caxias do Sul. compared to sham group (−15 ± 3 vs −12 ± 2%, P = 0.049). One
Methods: For this purpose, 201 women were interviewed from week after surgery, postprandial GLP1 concentrations (n = 4 in
January 2010 to April 2011, in the age group from 44 to 65 each group) were dramatically increased at each point in the
years. This study was approved by the Research Ethics RYGBP group (P < 0.01 for all), especially at 30 min
Committee of the University of Caxias do Sul (No. 124/08) (29.85 ± 4.31 vs 6.67 ± 1.73 pM), and after 1 month at 15, 30,
Results: Of the 201 women investigated, 50.7% were obese. 60, and 120 min (P < 0.01) in the RYGBP group compared to the
Statistically significant differences were found in the variables sham group.
schooling, abdominal obesity, LAP (Lipid Accumulation Conclusion: RYGBP induced a major increase in postprandial
Product), high blood glucose, low HDL and presence of GLP1 secretion, as observed in patients undergoing RYGBP.
metabolic syndrome. Regarding schooling, it was observed These results validate our model of RYGBP in obese minipigs for
that the higher the level, the higher the percentage of further studies on gut-brain axis.
S144 Poster
Disclosure of Interest: D. Bergeat Grant/Research Support from: Methods: This descriptive case-control study was conducted at
ESPEN fellowship grant 2015, Y. Gautier: None declared, S. Blat: None the National Research Center. The study included a sample of
declared, S. Guerin: None declared, K. Boudjema: None declared, 64 overweight and obese mothers and 75 children, compared
D. Val-Laillet: None declared, R. Thibault: None declared. with apparently healthy non-obese mothers and their children
of matched age and social class. Tested questionnaires were
SUN-P243 used to collect information of the studied subjects.
HERBAL SUPPLEMENT USE FOR WEIGHT LOSS AMONG WOMEN Results: A statistically significantly higher incidence of
AGED BETWEEN 19 AND 64 YEARS unemployment, large family size was observed in overweight
E. D. Ors1 *, Z. Goktas1. 1Nutrition and Dietetics, Hacettepe & obese women compared to controls (P < 0.05). Those women
University, Ankara, Turkey who consumed vegetables more than 3 times a week were less
likely to be overweight or obese (P < 0.05). No significant
Rationale: Weight loss therapies require a lifestyle change and association were detected between mothers’ physical activity,
this might be challenging for some people. Hence, additional dietary behaviour variables and children’s BMI except for
treatment options like supplement use are considered. Global consuming beverages with added sugar (95%CI = 0.074–0.985, P
use of herbal products among individuals who try to lose weight Conclusion: Improper dietary patterns, nonworking mothers,
is increasing. The purpose of this study is to evaluate herbal and big family size are associated with obesity among Egyptian
supplement use for weight loss among women who aim to lose women. Emphasis should be given to increasing physical
weight. activity and encourage healthier diets among Egyptian
Methods: A total of 565 women aged between 19 and 64 years mothers and their children.
participated in the study and subjects were recruited from Disclosure of Interest: None declared.
several sports centers. All the subjects completed a seven part
questionnaire form which included 50 questions and a 24-hour
SUN-P245
recall dietary and energy expenditure assessment form.
AVOIDANCE OF MICRONUTRIENT MALNUTRITION AFTER
Questions intended to collect data about demographic
BARIATRIC SURGERY – A SINGLE CENTER EXPERIENCE OF
characteristics, nutritional habits, nutritional supplement use
PROTOCOL-BASED JOINT FOLLOW-UP PROGRAM
for weight loss and physical activity levels. Anthropometric
measurements were collected using bioelectrical impedance E. K.-W. Ng1 *, S. K. Wong1, S. Y. Liu1. 1Surgery, The Chinese
analysis. Statistical significance was set at p < 0.05. University of Hong Kong, New Territories, Hong Kong
Results: In this study 38.1% of the women used at least one
dietary supplement or herbal supplement in the last year for Rationale: Bariatric surgery is increasingly accepted as a
various reasons. The most commonly used supplements were treatment for morbid obesity and obese diabetes in Asia.
vitamin B12 (32.6%), iron (7.30%) and vitamin D (20.9%). In the Prevalence of post-op micronutrients deficiency in Asian
last 12 months 43.5% of women (n = 246) used food or herbal patients remains unknown. We report our center’s experience
supplements for weight loss. The most commonly used weight of protocol-based follow-up (FU) program in prevention of
loss supplements were respectively green tea (58.9%) and micronutrients malabsorption after bariatric procedures.
lemon (27.2%). In the study, 89.8% of individuals that were using Methods: Data were retrieved from our multidisciplinary
herbal supplements claimed no adverse effects. Subjects that metabolic surgical clinic’s database. Patients having either
use supplements to lose weight had a greater total daily energy laparoscopic sleeve gastrectomy (LSG) or laparoscopic gastric
expenditure than subjects that don’t use any supplement. bypass (LGBP) with at least 2 yrs of FU data were reviewed.
Conclusion: In this study we demonstrated a trend for herbal or LGBP patients were given regular daily multivitatmin, calcium,
food supplement use among women who aim to lose weight. For vit D and also iron supplements, with B12 injection every 3
a healthy weight loss, it is necessary to develop healthy eating months. LSG patients were given oral multivitamin only. Blood
habits, increase physical activity levels and ensure these habits tests were taken 6-monthly.
to become life style changes under the supervision of a Results: Between Nov 2008 and Oct 2014, 92 patients (M/F:35/
dietetics expert. 57) with LSG and 38 patients (M/F:19/19) with LGBP done had
complete sets of 2-year FU data. The two groups were
Disclosure of Interest: None declared. comparable in preop demographics. Both groups also had
comparable magnitude of postop % total wt loss by 2 years (LSG:
SUN-P244 26.2% vs LGBP: 19.7%). Patients with known type II diabetes had
DIETARY BEHAVIOUR PATTERN AND PHYSICAL ACTIVITY IN significant improvement in HbA1c. However, in both groups,
OVERWEIGHT AND OBESE EGYPTIAN MOTHERS: there was significant drop in Hb level (LSG: 16.9 g/dL to 13.0 g/
RELATIONSHIPS WITH THEIR CHILDREN’S BODY MASS INDEX dL; LGBP: 16.0 g/dL to 12.8 g/dL) by 2 years. Despite
E. R. Abdelhamid1 *. 1Child Health Department, National supplements given, % Fe-saturation dropped in the LGBP
Research Center, Cairo, Egypt group but not in the LSG group. There were also decrease in
serum vit B12 level but the magnitude was more marked in the
Rationale: Obesity and related morbidity increase in Egyptian LGBP group (from 204 down to 125) than the LSG group.
women and their children. A better understanding of dietary Conclusion: With a structured protocol-based joint FU
and activity patterns is needed to reduce obesity prevalence. program, no measurable micronutrients malnutrition was
The present study aimed to assess dietary patterns and physical seen after bariatric surgery. However, patients with bypass
activity in Egyptian overweight and obese mothers and to procedures tend to have a lower trend in Fe saturation and B12
explore its relationships with their children’s body mass in blood. Long-term monitoring and substitution is recom-
index (BMI). mended for this group of patients.
Disclosure of Interest: None declared. habits, dietary record, physical activity level and sleep quality.
Individuals’ fasting blood glucose, LDL (low density lipopro-
SUN-P246 tein), HDL (high density lipoprotein), triglycerides and blood
PREVALENCE OF METABOLIC SYNDROME IN CHILDREN WITH pressure findings were evaluated.
OBESITY Results: Shift workers’ LDL values were determined higher
( p < 0.05) than daytime workers and metabolic syndrome was
F. Esfarjani1 *, F. Mohammadi1, M. Khalafi1, R. Roustaee1,
more common in shift workers. Body mass index and waist
H. Alikhanian1, R. Kelishadi2. 1Department of Food and
circumference values were also higher in the shift workers
Nutrition Policy and Planning Research, National Nutrition and
( p < 0.05). According to sleep quality evaluation, shift workers
Food Technology Research Institute, Faculty of Nutrition
sleep quality was worse than daytime workers ( p < 0.05). In
Sciences and Food Technology, Shahid Beheshti University of
relation of physical activity level, both groups (shift workers
Medical Sciences, Tehran, Iran, 2Department of Pediatrics,
and daytime workers) were inactive. Average values of energy,
Child Growth and Development Research Center, and Faculty of
carbohydrate, protein, fat, sodium, sucrose, saturated and
Medicine, Isfahan University of Medical Sciences, Isfahan,
mono-unsaturated fatty acid and cholesterol intakes were
Tehran, Islamic Republic of Iran
found higher in the shift workers ( p < 0.05) but calcium and
Rationale: Childhood obesity increases the risk of metabolic vitamin A intake were higher in the daytime workers ( p < 0.05).
syndrome (MetS) both in childhood and adulthood. The present Conclusion: In conclusion, shift workers’ shift hours should be
study was determined the prevalence of MetS and its potential rearranged, they should educate about the healthy nutrition
determinants in a representative sample of obese children. and dietitians should determine their nutrition programs.
Methods: This cross-sectional study was conducted among 150 Disclosure of Interest: None declared.
obese children. Body mass index (BMI ≥ 95th percentile) with
seven years of age. They were randomly selected from 9 health SUN-P248
centers in 3 districts of the north Tehran. Trained nutritionists IS SLEEP QUALITY ASSOCIATED WITH OBESITY AND
completed a socio-demographic questionnaire by interviewing DEPRESSION AMONG TURKISH ADOLESCENTS?
parents, and conducted the physical examination. Mets was B. Öge Yılmaz1, B. Cicek2, G. Kaner3 *. 1Department of Obesity,
defined based on modified ATP III criteria. Diabetes and Metabolic Diseases, Republic of Turkey, Ministry
Results: The mean (SD) of weight, height, and BMI was 37.5 of Health, Ankara, 2Faculty of Health Sciences, Department of
(6.3) kg, 127.2 (4.7) cm and 23.08 (2.9) kg/m2, respectively. Nutrition and Dietetics, Erciyes University, Kayseri, 3Faculty of
The prevalence of MetS was 13.4%, without significant Health Sciences, Department of Nutrition and Dietetics, Izmir
difference in terms of gender. The most common component Katip Celebi University, İzmir, Turkey
of MetS was abdominal obesity (79%). While 21.3% of children
did not have any component of MetS, 42% of them had at least Rationale: As the importance of sleep to physical and
one component. Most children with MetS had a history of psychological health becomes increasingly clear, there is a
breastfeeding for less than 6 months. Waist circumference, growing need to establish the mechanisms through which the
systolic and diastolic blood pressure, fasting blood glucose, and relationships operate. This study aimed to investigate the
triglyceride levels were higher in Mets compared to controls relationship between sleep quality, obesity and depression
( p < 0.05). Logistic regression model revealed that children among adolescents aged 14–17 years in Turkey.
with birth weight of ≤2,500 gr. were at higher risk of MetS than Methods: According to the data obtained from the Kayseri
children with a higher birth weight (OR = 4.3; 95%CI: 1.1–9.7). Provincial Directorate for National Education, 67 high-schools
Conclusion: Primordial prevention of childhood obesity, located in Kayseri city center were accepted. Twelve schools
screening the components of MetS among obese children and were selected amongst the 67 high-schools using the random
assessing the clustering of risk factors is associated with an cluster sampling method. A total of 1,072 adolescents aged 14–
increased risk of cardiovascular disease. Therefore, these 17 years were recruited into the study. Sleep quality was
components should be considered as a health priority at assessed by the Pittsburg Sleep Quality Index (PSQI). Depression
individual and public levels. symptomatology was measured using the Child Depression
Disclosure of Interest: None declared. Scale (CDS). Body weight and height were measured and body
mass index (BMI, kg/m2) were calculated.
Results: Of the adolescents; 43.9% (n = 471) were boys and
SUN-P247
56.1% (n = 601) girls and the mean age was 15.54 ± 1.08 years.
THE RELATIONS BETWEEN NUTRITIONAL STATUS, SLEEP
Mean body weight and BMI were significant among genders
QUALITY AND BLOOD LIPID PROFILE OF SHIFT WORKERS
( p < 0.001). Depression was higher among girls (9.8%) than boys
G. Cakmak1 *, M. Kizil1. 1Hacettepe University, Ankara, Turkey (5.7%) ( p < 0.05). According to CDS, in the depressed group
body weight and BMI values were higher than the non-
Rationale: Several studies reported that shift working might
depressed group but the difference is not statistically
relate with metabolic syndrome, obesity and cardiovascular
significant. A negative weak relationship was determined
diseases due to affect circadian rhythm. The aim of this study
between PSQI and CDS (n = 1,072, r = 0.131, p = 0.000).
was the find out the relations between shift working and
Conclusion: This study supports a negative relationship
nutrition habits, some biochemical findings, physical activities
between sleep quality and depression. Although statistically
and sleep quality.
insignificant, this study also suggests a putative link between
Methods: This study was conducted on 70 shift and 70 daytime
weight status and sleep quality.
workers. Questionnaire was performed face to face to them in
order to find out demographical characteristics, nutrition Disclosure of Interest: None declared.
S146 Poster
SUN-P249 Methods: A total of 298 women who applied to endocrinology,

THE RELATIONSHIP BETWEEN BODY MASS INDEX, ABDOMINAL internal medicine or diet clinic and did not diagnose with
OBESITY, METABOLIC PARAMETERS AND DEPRESSION AMONG metabolic syndrome or did not have an infection history were
REPRODUCTIVE AGED WOMEN included in this study. Anthropometric measurements (waist
G. Kaner1 *, E. Bellikci Koyu1, N. Seremet Kürklü2, and hip circumference) and fasting blood samples (fasting
K. Tel Adıgüzel3. 1Faculty of Health Sciences, Department of blood glucose, triglyceride, HDL cholesterol, CRP, WBC,
Nutrition and Dietetics, Izmir Katip Celebi University, İzmir, ferritin) were taken. Metabolic syndrome was assessed accord-
2
Department of Nutrition and Dietetics, Akdeniz University ing to the International Diabetes Federation (IDF) criteria.
Antalya School of Health, Antalya, 3Faculty of Health Sciences, Results: The prevalence of metabolic syndrome was deter-
Department of Nutrition and Dietetics, Hacettepe University, mined 34.2%. The levels of WBC and CRP were statistically
Ankara, Turkey higher in women with metabolic syndrome (7.4 ± 2.45 mm3 and
1.5 ± 3.94 mg/dL; respectively) than in women without meta-
Rationale: Obesity has been widely regarded as a public health bolic syndrome (6.7 ± 1.45 mm3 and 0.7 ± 2.25 mg/dL; respect-
concern because of its adverse impact on individuals’ health. ively) while ferritin levels were not different between groups
The aim of this study is to examine the relationship between ( p > 0.005). In addition, waist circumference, which is the
body mass index, abdominal obesity, metabolic parameters and indicator of abdominal obesity, was found to be positively
depression among reproductive aged women. correlated with WBC (r = 0.287, p = 0.000) and ferritin (0.140,
Methods: Two hundred seventy-one women who applied to the p = 0.016).
diet polyclinic of a state hospital in Izmir were included. Conclusion: In this study, it was determined that the metabolic
Sociodemographic characteristics were gathered using a data syndrome and increased waist circumference were associated
collection form. Biochemical findings were examined in fasting with chronic inflammation markers; and chronic inflammation
blood samples and anthropometric measurements were taken. markers could be used to assess metabolic syndrome.
Depressive symptoms of participants were measured with Beck Disclosure of Interest: None declared.
Depression Inventory.
Results: Mean score of participants for Beck Depression SUN-P251
Inventory was 17.8 ± 11.8. Body weight, body mass index and DO SOLUBLE TRANSFERRIN RECEPTOR LEVELS INCREASE IN
waist circumference were higher in the group with high level of
METABOLIC SYNDROME?
depressive symptoms ( p < 0.05). Fasting blood glucose, fasting
insulin, HOMA-IR, triglyceride and LDL cholesterol were also G. Kaner1 *, N. Seremet Kürklü2. 1Faculty of Health Sciences,
higher in the group with high level of depressive symptoms; but Department of Nutrition and Dietetics, İzmir Katip Çelebi
only HOMA-IR and triglyceride differences were statistically University, İzmir, 2Department of Nutrition and Dietetics,
significant. Being overweight or obese was associated with Akdeniz University, Antalya School of Health, Antalya, Turkey
increased risk of high level of depressive symptoms (OR: 4.853,
Rationale: The level of soluble transferrin receptor (sTfR) is
95% CI: 2.646–8.903). Although, the ratio of having high level of
indicative of the organism’s need for the iron. In iron
depressive symptoms was higher in women with abdominal
deficiency, the level of sTfR increase. Since the metabolic
obesity (%50.3) comparing to women without abdominal
syndrome (MetS) is a chronic inflammatory process, serum iron
obesity (%39.5), the difference was not statistically significant
deficiency, elevated ferritin and sTFR are expected in
( p = 0.078).
individuals with MetS. The aim of this study was to determine
Conclusion: In this study, it was determined that the level of
the levels of sTfR in individuals with MetS. In addition, the
depressive symptoms was higher in overweight or obese women
other aim of this study was to determine the relationship
than women with normal body weight. It may be useful to
between visceral fat and sTfR, the most important determi-
monitor women who apply for weight control in terms of risk of
nants of MetS.
depression.
Methods: A total of 204 women aged 20–49 years who applied
Disclosure of Interest: None declared. to the diet clinics were included in this study. Body weight,
height, and waist circumference (WC) were measured; Body
SUN-P250 Mass Index (BMI) was calculated based on the following
ASSOCIATION BETWEEN METABOLIC SYNDROME AND CHRONIC formula: body weight (kg)/height (m2). Fasting blood
INFLAMMATION MARKERS glucose, triglyceride, sTfR levels were determined as well as
G. Kaner1 *, N. Seremet Kürklü2. 1Faculty of Health Sciences, systolic and diastolic blood pressures were measured. The
Department of Nutrition and Dietetics, İzmir Katip Çelebi prevalence of MetS was assessed according to the US National
University, İzmir, 2Department of Nutrition and Dietetics, Cholesterol Education Programme Adult Treatment Panel III
Akdeniz University, Antalya School of Health, Antalya, Turkey (NCEP-ATPIII) and the International Diabetes Federation (IDF)
criteria.
Rationale: The increase in proinflammatory cytokines due to Results: Mean age, body weight, BMI, and WC of women were
visceral fat causes low grade-chronic inflammation in indivi- the 33.3 ± 7.75 year, 77.6 ± 16.4 kg, 29.8 ± 6.28 kg/m2, 94.6 ±
duals with the metabolic syndrome. C-reactive protein (CRP), 12.92 cm; respectively. According to NCEP-ATPIII and IDF
white blood cell (WBC) and ferritin levels are associated with criteria, 45.6% and 36.3% of women diagnosed with MetS,
chronic inflammation. From this point of view, this study was respectively. There were no significant differences between
conducted to evaluate the relationship between metabolic the sTfR levels of in women with and without MetS according to
syndrome and chronic inflammatory markers. both criteria. Although statistically insignificant, a low level of
positive correlation between WC and sTfR levels were found SUN-P253

(r = 0.101, p > 0.05). PREVALENCE OF AND FACTORS ASSOCIATED WITH CHILDHOOD
Conclusion: The increase in visceral fat-related inflammation OVERWEIGHT AND OBESITY IN PUBLIC SCHOOLS IN EL
was associated with MetS and sTfR levels, no relationship was SALVADOR. A CASE-CONTROLLED STUDY
found between sTfR levels, MetS and WC in this study. Lack of a J. W. Pena1 *, A. Oliva1. 1Medical Speciality, Universidad de El
relationship between these parameters in this study may be Salvador, San Salvador, El Salvador
due to the inadequate sample size of the study.
Disclosure of Interest: None declared. Rationale: The aim of this study was to assess the prevalence
and the factors associated with overweight and obesity among
SUN-P252 children aged 5–9 years old in four urban public schools in El
EVALUATING THE EFFECTS OF BODY COMPOSITION ON Salvador.
METABOLIC PROFILE IN PATIENTS WITH SCHIZOPHRENIA Methods: A two phases cross-sectional study was conducted
from april to august, 2016. During the first phase, anthropo-
I. Türkoğlu1 *, E. Akal Yıldız2, S. M. Mercanlıgil2, G. Yoca3, metric data was collected of 336 children aged 5–9 years, from
K. Yazıcı4. 1Department of Nutrition and Dietetics, Hacettepe Suchitoto, El Salvador, and the corresponding body mass index
University Faculty of Health Sciences, Ankara, Turkey, was calculated. The prevalence of overweight and obesity was
2
Department of Nutrition and Dietetics, East Mediterranean reported as percentage. During the second phase, 91 children
University Faculty of Health Sciences, Famagusta, Cyprus, were identified as overweight or obese. Controls were matched
3
Ministry of Health Erbaa Government Hospital, Tokat, by age and gender. A personal interview was performed with
4
Department of Psychiatry, Hacettepe University Faculty of the parents of each participant to obtain background data. The
Medicine, Ankara, Turkey chi-square test was used to identify factors associated with
overweight and obesity.
Rationale: Treatment with certain atypical antipsychotics
Results: Childhood overweight and obesity prevalence was
(AAP) may act an important role, carrying increased risk for
34.5% (13.2% and 21.3%, respectively). The principal risk
adiposity and metabolic abnormalities in patients with
factors found were maternal overweight or obesity at preg-
schizophrenia. The aim of this study was to clarify the impact
nancy onset (adjusted odds ratio [aOR] = 17.1, 95% confidence
of body composition on metabolic profile in patients with
interval: 4.5–110), high birth weight (aOR = 5.0, 95% IC: 1.1–
schizophrenia treated with AAP and to compare it with healthy
34.6) and a leisure time of more than two hours (aOR = 4.6, 95%
controls.
IC: 2.3–9.6). A protective factor was found to be a basic
Methods: The study was conducted on 148 individuals with
education status of the mother (aOR = 0.43, IC = 0.2–0.9).
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
Conclusion: Childhood overweight and obesity have
diagnosis of schizophrenia or schizoaffective disorder and 77
significant prevalence in El Salvador, with every third child
age, gender matched healthy controls. We examined the
being affected. This conditions are multifactorial. Familiar,
detailed body composition and antropometric measurements
perinatal and posnatal history and current habits, as maternal
(height, weight, waist and hip circumference, fat percentage,
overweight or obesity at the pregnancy onset, and first degree
fat mass and fat-free mass) of people with schizophrenia and
of consanguinity with overweight or obesity or with a chronic
healthy controls.
disease and leisure time are significant factors associated with
Results: The patients and healthy controls were similar in age,
childhood overweight and obesity. One protective factor was
gender. Both in male and female, the mean body mass index
found, the basic education status of the mother. Multicentric
was not significantly different between groups ( p > 0.05). The
studies are needed to confirm the findings.
prevalence of metabolic syndrome was 54.5% in patients and
24.7% in healthy controls according to IDF criteria, respectively Disclosure of Interest: None declared.
( p < 0.01). The waist circumference of the patient group
(respectively, male 106.9 ± 10.9 cm, female 100.5 ± 12.9 cm) SUN-P254
was significantly higher than healthy controls (respectively, OBESITY IS QUITE PREVALENT IN PATIENTS WITH
male 94.7 ± 9.1 cm, female 91.6 ± 13.7 cm) ( p < 0.01). Also GASTROPARESIS
women with schizophrenia had signifantly higher body fat L. Maric1 *, S. Rodriguez1, A. Alvarez1, A. Cabrera2, F. Martinez3,
percentage, body fat mass and fat mass index than healthy A. Schneider1, A. Ukleja1. 1Gastroenterology and Hepatology,
controls ( p < 0.05). When we examine individuals with MetS, 2
Internal Medicine, 3Radiology, Cleveland Clinic Florida,
waist circumference of patient group (both in male and Sunrise, United States
female), was significantly higher than healthy controls
( p < 0.01). Rationale: Gastroparesis (GP) is a chronic disorder of gastric
Conclusion: Individuals with schizophrenia have metabolically motility defined as delayed gastric emptying of a solid meal in
unfavorable body composition, comprising abdominal obesity, the absence of mechanical obstruction. Clinical characteristics
high fat percentage. Fat mass relative to BMI was increased in of GP include early satiety, nausea, vomiting, upper abdominal
schizophrenia patients receiving AAP. This may lead to pain and bloating.
increased risk of metabolic and cardiovascular diseases. Methods: This was an IRB approved retrospective chart review
Disclosure of Interest: None declared. of 260 pts conducted at a tertiary center who underwent GES
from Jan to Dec 2015. 88 pts were diagnosed with GP using a 4-
hr gastric emptying scintigraphy, and were included in final
analysis. Data collected included pts age, sex, race, symptoms,
S148 Poster
etiology of gastroparesis, BMI, presence of other gastrointes- Results: Six countries participated, including 58 centres.
tinal conditions, history of gastric surgery and narcotic use. Among 1,926 observations collected, 1,781 were analysed
Results: (mean age: 6.1 ± 5.3 years). A weight-for-height z-score
(Z-WFH) was <-2SD in 8% of cases: Ivory Coast 40% (n = 20),
BMI GP: Mild Moderate Severe
Democratic Republic of Congo 18% (n = 84), France 8% (n =
1,583), Algeria 7% (n = 28), Gabon 6% (n = 17) and Belgium 5%
Low 4 0 4
(n = 63). Nutritional support was present in 26% of cases. Fifteen
Normal 18 7 4
Overweight 14 4 7 % of malnourished children had no nutritional support. Twenty-
Obesity (>30) 14 5 7 one centres returned 147 questionnaires for the role of
caregivers. Child care assistants (CGAs) and nurses had a
88 out of 260 pts met the inclusion criteria with presence major role in anthropometric measurements (85%), meal
of delayed gastric emptying on GES. 82% of pts were Non- (66%) and nutritional support delivery (53%). Dieticians had
Hispanic with mean age at diagnosis of 54. Mean BMI was a central role in nutritional plan (42%), dietary counselling
determined to be 26.8. In 88 patients with GP, nausea was (50%) and explanations of nutritional support (57%). Nursing
present in 63%, vomiting (42%), abd pain (55%) and bloating care was perceived as increasing care in 41% of cases, including
(48%). The etiology of GP was idiopathic in 73% and diabetic in for nurses (19%) and CGAs (10%), but only 2% of parents.
20%. Regarding the BMI, 8 had low BMI, 29 had normal BMI (18.5– Conclusion: PEM frequency in hospitalized children appears to
24.9), 25 were overweight (25–29.9) and 26 were obese decrease in this survey compared to previous editions. All
(>/=30). caregivers are involved in the management of PEM with a
Conclusion: Based on our study population, majority of pivotal role of nurses, CGAs, and dieticians.
patients were non-Hispanic females. The most common Disclosure of Interest: A. De Luca Grant/Research Support from:
etiology of GP is idiopathic. 58% of the patients with diagnosis Nutricia Nutrition Clinique France, C. Guidon: None declared,
of GP were found to have BMI above normal, and 30% were D. Guimber: None declared, N. Peretti: None declared, H. Piloquet:
obese. There was a direct correlation between BMI >25 and None declared, R. Hankard: None declared.
diagnosis of GP not only in diabetic group of patients, but also
in idiopathic and post-surgical patient population. Regarding SUN-P256
the severity of GP and BMI, 56% of patients with above normal LIPID AND FATTY ACID INTAKE IS LINKED TO
BMI were found to have mild or moderate GP, and 64% of ANTHROPOMETRIC PARAMETERS AT DIFFERENT MEALTIMES
patients had severe GP. Despite the common concern, only 20% IN CHILDREN
of patients in our study population were on chronic narcotics. C. Mayorga-Mazón1,2 *, L. Ligerini1, C. Menendez1,
Disclosure of Interest: None declared. A. Monzón1, M. Guerendiain1,3. 1Metabolism and Nutrition
Disorders Research Group, 2School of Nursing, 3School
of Medicine, National University of Chimborazo,
Paediatrics 1 Riobamba, Ecuador
SUN-P255 Rationale: In childhood, the organism needs the contribution

7TH PAEDIATRIC NUTRITION WEEK: 2016’s EDITION of fatty acids for growth and developed, which become vital at
A. De Luca1 *, C. Guidon1, D. Guimber2, N. Peretti3, this physiological stage. Children living in Andean region of
H. Piloquet4, R. Hankard1, on behalf of The Pediatric Ecuador have greater nutritional vulnerability. For this reason,
Nutritional Assessment Network (www.epinut.fr). 1Unité our objective was to evaluate the relationship between lipid
Mobile de Nutrition, CHU TOURS, INSERM U1069, Tours, and fatty acid intake and anthropometric parameters at
2
Paediatrics, CHU, Lille, 3Paediatrics, CHU, Lyon, 4CHU, different mealtimes in children of highlands.
Nantes, France Methods: A cross-sectional descriptive study was developed in
98 children (5–11 years, 53.1% female) from San Juan,
Rationale: For 30 years, the prevalence of protein-energy Chimborazo, Ecuador (EVANES project participants). Lipid and
malnutrition (PEM) remains around 10% in Paediatrics wards. fatty acid (FA) intake was calculated at each mealtime
Our aim was to assess the evolution of PEM frequency in our 7th (breakfast, mid-morning collation, lunch, mid-afternoon col-
annual survey and to describe the role of the nursing staff in its lation and dinner) from the data of nutritional survey. Weight
management. and height were measured, and the body mass index (BMI) and
Methods: This two-week observational cross-sectional survey standard deviation score of height and BMI were determined.
included patients under 18 admitted in participating centres. Results: Means of BMI, height, daily intake of total lipids and
All children were weighed and measured at admission. Children saturated, monounsaturated and polyunsaturated FA were
below the 3rd centile of body mass index for age and sex had a 16.74 ± 1.88 Kg/m2, 117.59 ± 12.22 cm, 16.45 ± 37.17 g, 18.17 ±
full diagnostic procedure, according to the guidelines of the 27.47 g, 18.64 ± 9.84 g and 9.97 ± 2.94 g, respectively. An
French Society of Paediatrics. Diagnoses and nutritional inverse relationship between total fat intake and weight,
supports were collected. Data were recorded on the e-Pinut height and BMI at mid-morning collation was observed, while
internet tool (www.epinut.fr). The role of caregivers in the monounsaturated and polyunsaturated FA were negatively
care of PEM was recorded by questionnaire for malnourished related to BMI and standard deviation score-BMI, and weight
children. and BMI, respectively. A positive association was found
between saturated FA and BMI at lunch. Regarding dinner,
total fat was associated with weight and BMI.
Paediatrics 1 S149
Conclusion: The relationship between total fat intake and SUN-P258

anthropometric parameters differs according to the mealtime. DETERMINATION OF KNOWLEDGE AND ATTITUDES OF
At mid-morning collation, children with poorer nutritional PEDIATRIC NURSES WORKING IN ATRAINING HOSPITAL ABOUT
status consume more fats, but, at dinner, those with better PARENTERAL NUTRITION
weight and BMI intake more lipids. Monounsaturated and D. Yildiz1 *, D. Suluhan1, S. Kiliç1. 1Gulhane Science Health
polyunsaturated FA are inversely related to anthropometry, University, Ankara, Turkey
and saturated FA positively.
Disclosure of Interest: None declared. Rationale: Parenteral nutrition (PN) represents an alternative
or additional approach when other routes are not succeeding
SUN-P257 (not necessarily having failed completely) or when it is not
EVALUATION OF EDUCATIONAL EFFICIENCY BASED ON OREM’s possible or would be unsafe to use other routes. The main goal
SELF-CARE THEORY GIVEN TO PARENTS OF CHILDREN WITH of PN is to deliver a nutrient mixture closely related to
GASTROSTOMY requirements safely and to avoid complications.
Methods: The study was carried outat the Department of
D. Suluhan1 *, D. Yildiz2, B. Eren Fidanci2, I. Sürer3. 1Pediatric Pediatric Surgery and Department of Pediatrics between May 5
Hospital, Gulhane Reserch and Trainig Hospital, 2Pediatric and June 01, 2012. The population of the study was consisted of
Nursing, Health Sciences University, 3Department of 33 volunteered pediatric nurses. A quastionnaire was devel-
Pediatric Surgery, Gulhane Reserch and Trainig Hospital, oped by the researchers.
Ankara, Turkey Results: The score of nurses’ knowledge were minimum 48.75,
maximum 81.25 and median 61.75. Nurses knowledges were
Rationale: This study was aimed to determinete of the effect
25–60 (6.1%), 50.1–60 (24.3%), 60.1–70 (60.6%) and 70.1–80
of based on Orem’s Self Care Theory educating on satisfaction
(6%). The percent of nurses that scored over 80.1 was 3%. When
of gastrostomy feeding, quality of life, caregiver burden, state-
the education level was compared, it was found that there was
trait anxiety and complication rates regarding parents of
statistically significant diffirence between graduate and
children with gastrostomy.
undergraduate pediatric nurses’ score
Methods: The study was conducted between January and July
Conclusion: It is recommended to plan in-service training for
2015 at GMMA Research and Training Hospital, Ankara
pediatric nurses in order to ensure the desired level of
Hematology Oncology Children’s Hospital, Sami Ulus
knowledge and skill and parenteral nutrition practices in safe
Obstetrics, Children Health and Diseases Training and
manner.
Research Hospital. Between these dates, 78 mothers whom
have children with gastrostomy were included in the study. Reference
Data were collected by Child and Parent Data Form, Singer P, et al., ESPEN Guidelines on Parenteral Nutrition: Intensive
Complication Checklist, Satisfaction of Gastrostomy Feeding care, Clinical Nutrition 28 (2009) 387–400.
Scale, Caregiver Burden Scale, State-Trait Anxiety Scale, Disclosure of Interest: None declared.
Quality of Life Scale and Practice Check List. IBM Statistical
Package for Social Sciences 15.0 (SPSS) package program was
SUN-P259
used for the statistical analysis of the data.
EXTRAUTERINE GROWTH RETARDATION IN VERY LOW BIRTH
Results: All primary caregiver parents are mothers. 65.4% of
WEIGHT INFANTS AFTER CSPEN GUIDELINES FOR NUTRITION
the mothers are between the ages of 21–30 and 43% of them are
SUPPORT IN NICU
primary school graduates. Mean score of Caregiver Burden
Scale is 47.52 ± 14.88 before the education and 35.07 ± 14.25 H. Shan1 *, L. Hong1. 1Shanghai Children’s Medical Center,
after the education ( p < 0.001). Mean score of Satisfaction of Shanghai, China
Gastrostomy Feeding Scale is 18.48 ± 3.36 at the end of first
Rationale: Extrauterine growth retardation (EUGR) in very low
month after the training and 24.61 ± 2.94 at the end of third
birth weight (VLBW) infants indicates that the nutrient
months after the education ( p < 0.001). Mean score of State-
requirements have not been adequately met intrauterine
Trait Scale is 49.59 ± 3.16 before education and 44.20 ± 4.55
growth. The aim of this study is to describe the growth and
after education ( p < 0.001). After the education, it is deter-
nutritional practices in VLBW infants during NICU after CSPEN
mined other sub-dimensions of Quality of Life Scale mean score
guidelines for nutrition support in neonates (2013), and
increase except physical functioning ( p = 0.278) and pain
compare the incidences of EUGR at discharge.
( p = 0.071) sub-dimensions compared to the before education.
Methods: We retrospectively studied 227 VLBW infants (115
Conclusion: As a result, after education which based on Orem’s
boys and 112 girls) from Shanghai Children’s Medical Center in
Self-Care Theory given to parents of children with gastrostomy,
Shanghai from January 1, 2014 to December 31, 2016. When
it was found that primer caregivers’ outcomes were effected
admission, these infants were grouped small gestation age
positively.
(SGA) and appropriate gestation age (AGA). Growth retardation
Disclosure of Interest: D. Suluhan Grant/Research Support from: THE was defined according to weight or head circumference
SCIENTIFIC AND TECHNOLOGICAL RESEARCH COUNCIL OF TURKEY, (HC) ≤10th percentile of the growth value expected based
D. Yildiz: None declared, B. Eren Fidanci: None declared, I. Sürer:
on estimated postmenstrual age by Fenton Preterm Growth
None declared.
Chart (2003). Nutritional practices were analyzed between
AGA and SGA.
Results: At discharge, the incidences of EUGR are 65.2% by
weight and 39.6% by HC. SGA had a significantly higher rate of
EUGR compared with AGA (97.8% vs 55.8% by weigh, p < 0.05;
S150 Poster
69.7% vs 32.0% by HC, p < 0.05). By brief parenteral nutrition SUN-P261

analysis, there were no significances of energy, glucose, amino HOME PARENTERAL NUTRITION FOR PAEDIATRIC PATIENTS:
acid and lipid. There is significance of PN duration and the SAFETY, EFFECTIVENESS AND OUTCOME WHEN USING
use of PICC between AGA and SGA (31.4 VS 19.9, p < 0.05; 47.5% STANDARD AIO ADMIXTURES
VS 32.6%, p < 0.05). At the end of PN, there is significance J. De Cloet1 *, E. Oudaert1, A. Somers1, S. Commeyne1,
of calories percent in EN between AGA and SGA (67.5% VS M. Van Winckel2. 1Pharmacy Department, 2Paediatric
61.7%, p < 0.05). Meanwhile, Days to reach full feeds shows a Gastroenterology Department, University Hospital Ghent,
significance between the two groups (23.6 VS 15.0, p < 0.05). Ghent, Belgium
Conclusion: The incidence of EUGR might be decreased after
CSPEN guidelines for nutrition support in neonates (2013). But Rationale: Since decades home parenteral nutrition (PN) for
there is higher incidence of EUGR in AGA group, and SGA group patients suffering from intestinal failure is seen as the best
still shows growth retardation. It is crucial to determine the option to reduce hospital costs and to improve the quality of
optimal enteral nutrition for VLBW infants. life. Based on the ESPGHAN/ESPEN guidelines on PN for
Disclosure of Interest: None declared. paediatric patients, standard all-in-one PN admixtures
(STAIO) for 4 different weight categories were developed in
SUN-P260 2008 at the University Hospital of Ghent: 3–10 kg (P1), 11–20 kg
TOTAL INTELLIGENCE QUOTIENT IS ASSOCIATED WITH (P2), 21–30 kg (P3) and >31 kg (P4). We aimed to evaluated the
MACRONUTRIENT AND ENERGY INTAKE IN PRESCHOOL AND effectiveness and safety of these STAIO in the home care
SCHOOL CHILDREN setting.
Methods: A single centre retrospective cohort study was
I. Cando1,2, C. Mayorga-Mazón2,3, M. Guerendiain2,4 *. 1School performed which included all patients <18 years that were
of Clinical Psychology, 2Metabolism and Nutrition Disorders discharged on HPN sinds 2000. Children receiving individually
research group, 3School of Nursing, 4School of Medicine, compounded admixtures (ICA; cohort 1) and children receiving
National University of Chimborazo, Riobamba, Ecuador STAIO (cohort 2) were compared in terms of effectiveness and
complications of HPN. Data collected were: age at HPN onset,
Rationale: Childhood is a critical period for brain development,
duration, frequency and reason for HPN discontinuation,
which may be affected by the nutrition. In Ecuador, especially
composition of PN admixture, length and weight, catheter
in rural and indigenous communities, children are more
related infections and occlusions and metabolic complications.
vulnerable to food deficits. Therefore, our objective was to
Results: The total cohort consists of 34 patients: 13 received
explore the relationship between total intellectual quotient
ICA, 18 received STAIO and 3 received both. Growth in terms of
and energy and macronutrient intake in preschool and school
weight and length were statistically significant in both cohorts.
children at different mealtimes.
After the implementation of the STAIO, the incidence of
Methods: Sixty-two schoolchildren (5–13 years), EVANES
catheter related bloodstream infections decreased from 2.39
project participants, were randomly selected. Total intelli-
to 1.16 episodes per 1000 HPN days and the incidence of
gence quotient (IQ) was evaluated using Wechsler Preschool
catheter occlusions from 0.65 to 0.24 events per 1000 HPN
and Primary Scale of Intelligence (WPPSI) and Wechsler
days. A lower incidence of electrolyte (Na+, K+, Ca2+, Mg2+)
Intelligence Scale for Children (WISC), and was divided into
disturbances was reported for cohort 2. Abnormal liver function
quartiles. To know the dietary intake a nutritional survey was
tests were reported for 13 patients in cohort 2 with only 1
applied. Energy and macronutrients ( proteins, carbohydrates,
patient suffering from PN associated liver disease.
lipids and saturated, monounsaturated and polyunsaturated
Conclusion: According to the findings in this study, we can
fatty acids) were determined at different mealtimes (break-
conclude that the STAIO are effective and safe for routine use in
fast, mid-morning collation, lunch, mid-afternoon collation
a population of paediatric patients receiving HPN.
and dinner).
Results: The means of total IQ, energy, protein, carbohydrates, Disclosure of Interest: None declared.
lipids, saturated, monounsaturated and polyunsaturated fatty
acids were 80.82 ± 11.74 score, 206.80 ± 211.15 g, 4.58 ± 6.11 g, SUN-P262
33.39 ± 33.52 g, 6.52 ± 7.82 g, 1.08 ± 1.82 g, 1.28 ± 1.62 g and ANALYSIS OF FACTORS CONDUCIVE TO WEANING OFF HOME
0.90 ± 1.13 g, respectively. When we analyzed the relationship PARENTERAL NUTRITION PROGRAM IN CHILDREN IN 2014–
between dietary intake and IQ, only at mid-morning collation 2016
was found statistically significant associations. Thus, energy, K. Tobota1 *, K. Popińska1, M. Danko1, K. Olszewska1,
proteins, carbohydrates and total lipids were directly related M. Sibilska1, J. Zydak1, J. Ksiazyk1. 1Pediatrics Nutrition and
to total IQ. On the other hand, caloric intake was higher in Q4 of Metabolic Disorders, The Children’s Memorial Health
total IQ than Q1, and total fat consumption was greater in Q3 Institute, Warsaw, Poland
than Q1.
Conclusion: The associations between variables were found Rationale: There are around 125–130 patients every year on
only at mid-morning collation, which is provided at school. Home Parenteral Nutrition (HPN) program in Children’s
Children with higher energy and macronutrient intake have Memorial Health Institute in Warsaw. 49 of them have been
better total intelligence quotient. weaned off the program due to distinct factors in 2014–2016.
Disclosure of Interest: None declared. Methods: Retrospective analysis of factors to weaned off HPN
in our hospital in years 2014–2016 including indications and
duration of HPN and nutritional status at the end of the
procedure.
Perioperative care 1 S151
Results: At the beginning of HPN the age of patients was (r = 0.459), BMI (r = 0.392) and MUAC (r = 0.402) and FEV1
between 2 and 221 month (range 6). At the end of the (r = 0.325), but not with FM% centile (ρ = 0.10; p = 0.873).
procedure the age was between 6 and 268 (range 41). Duration Stepwise linear regression showed that %HGF was significantly
of HPN was between 0,5 and 221 months, range 53. Most of the (F = 35.6, p < 0.001; r2 = 0.34) predicted by HFA (β = 0.368), FVC
patients (37) was qualified for HPN because of partial resection (β = 0.181), age (β = 0.145) and BMI (β = 0.236).
of small bowel. Second reason were neuromuscular bowel Conclusion: CF children and adolescents have a lower handgrip
diseases (6), then Crohn disease (2) and other factors (4). The force in accordance with their nutritional status assessed by
reasons of resections of small bowel were: intestinal torsion–6, standard anthropometry, irrespective of their pulmonary
bowel obstruction-6, necrotizing enterocolitis (NEC)-4, mes- status.
enteric torsion-4, congenital gastroschisis-4, Pagoda’s syn- Disclosure of Interest: None declared.
drome-3, intestinal atresia - 3 and others-7. Most of the
patients (37) had preserved the ileocecal valve. From 10
patients who during parenteral nutrition have done intestinal
anastomosis half of them weaned off HPN in the first year after
Perioperative care 1
the procedure, the rest-between 2 and 6 years. Patients after SUN-P264
congenital gastroschisis despite small resections of short THE IMPACT OF PREOPERATIVE EXCLUSIVE ENTERAL
bowel, needed long-term parenteral nutrition (range 30 NUTRITION IN MALNOURISHED PATIENTS WITH CROHN’s
months). From 49 analyzed patients at the end of HPN 34 DISEASE
achieved regular weight and height according to WHO growth
A. S. Ferreira1 *, M. P. S. Costa1, C. Palmela2, S. Velho1,
charts.
J. Torres2, S. Ouro2, G. Luisa2, M. Cravo2. 1Nutrition, 2Hospital
Conclusion: The most frequent indication for HPN was
Beatriz Angelo, Atouguia da Baleia, Portugal
resection of small bowel. Essential factors to weaned off
parenteral nutrition were: length of small bowel, presence of Rationale: Our aim was to evaluate the impact of exclusive
ileocecal valve and intestinal anastomosis. Nutritional status at enteral nutrition (EEN) in undernourished patients with
the end of HPN of most of the patients was satisfying. stricturing or penetrating CD and surgical indication.
Disclosure of Interest: None declared. Methods: Prospective study including CD patients with surgical
indication admitted at our institution between January 2016
SUN-P263 and March 2017. Patients with BMI <18.5 kg/m2, weight
HANDGRIP FORCE IN CHILDREN AND ADOLESCENTS WITH loss > 10% and/or serum albumin <3 g/dL received EEN supple-
CYSTIC FIBROSIS: IMPACT OF NUTRITIONAL AND mented with TGF beta for at least 2 weeks. Clinical (Harvey
PULMONARY STATUS Bradshaw- Index -HBI) and laboratorial parameters were
K. Huysentruyt1 *, B. Hauser1, E. De Wachter2, A. Malfroot2, evaluated before and after EEN support. Surgical outcomes
K. Van De Maele3, I. Gies3, J. De Schepper3. 1Pediatric were compared with patients with adequate nutritional status
Gastroenterology, 2Pediatric Pneumology, 3Pediatric who went for direct surgery.
Endocrinology, Universitair Ziekenhuis Brussel, Vrije Results: 20 patients were included, mean age of 43.8 ± 17.3
Universiteit Brussel (VUB), Brussel, Belgium years. Of these, 7 underwent direct surgery and 13 performed
EEN, with compliance (higher than 75% of prescribed) in 85% of
Rationale: To analyze the hand grip strength (HGS) in relation patients (n = 11). Mean preoperative EEN duration was
to nutritional and pulmonary status in children and adolescents 43.4 ± 20.4 days. In the EEN group, we observed a significant
with cystic fibrosis (CF). decrease in HBI mean value (9 vs 4, P < 0.001), CRP (12.2 vs
Methods: Hand grip data of CF children (aged 5–15 years) 0.7 mg/dL, P = 0.003) and faecal calprotectin values (1003.1 vs
having a body composition and lung function measurement at a 679, 3 μg/g p = 0.215); also, a significant increase in hemoglo-
yearly follow up were analyzed. Body fat percentage (FM%) bin (12.5 vs 13.5 g/dL, P = 0.061) and albumin (3.1 vs 4.1 g/dL,
calculated from skin fold measurements using the method of P = 0.002) mean values was observed. A positive correlation
Slaughter, was expressed as centile from the NHANES IV between duration of EEN and HBI decrease (r = 0.809, P = 0.003)
database (FM% centile). Z-scores for weight (WFA), height was observed. For fecal calprotectin decrease (r = 0.498,
(HFA), body mass index (BMI) and mid-upper arm circumference P = 0.255), as well as increase in hemoglobin (r = 0.455,
(MUAC) were calculated using Belgian reference data. HGS was P = 0.160) and albumin values (r = 0.489, P = 0.219) there was
expressed as a percentage of the mean value of Belgian a positive but non-significant correlation. Incidence of post-
reference data for the according age (%HGS). Forced vital operative complications (25% vs 37.5%, P = 1.000) and the
capacity (FVC) and forced expiratory volumes in one second postoperative hospital stay (8.0 ± 5.4 vs. 8.1 ± 4.4 days,
(FEV1) were expressed as % for age and body height. P = 0.832) were similar in both groups.
Results: HGS was assessed 269 times in 60 (24 female) patients Conclusion: Preoperative EEN in undernourished patients with
(6 (10.3%) pancreas sufficient). Their mean (95% CI) WFA, HFA, Crohn’s disease, decreased disease activity, possibly contrib-
BMI and MUAC z-scores were −0.60 (−0.71;−0.48), −0.38 uting for a better postoperative outcome.
(−0.49;−0.26), −0.58 (−0.70;−0.45) and −0.59 (−0.70;−0.47) Disclosure of Interest: None declared.
and their median (Q1;Q3) FM% centile and FEV1 were 50 (25;50)
and 97% (84.8%; 105.7). Median (Q1;Q3) %HGS was 72.4%
(58.7%;85.4%). %HGS was not different according to sex
( p = 0.696) and pancreatic involvement ( p = 0.561). %HGS
correlated significantly ( p < 0.001) with WFA (r = 0.517), HFA
S152 Poster
SUN-P266 weeks before surgery. An early oral diet was given from one day
NUTRITIONAL STATUS OF COLORECTAL CANCER PATIENTS IN after surgery and continued until one month later.
KHOO TECK PUAT HOSPITAL, SINGAPORE Anthropometrics data, lab test and BIA Phase Angle (PhA)
C. H. Toh1 *, H. Cheng1, K. Y. Tan2, M. Ho1. 1Nutrition & were collected on several steps, from preadmission (3 weeks
Dietetics, 2Department of Surgery, Khoo Teck Puat Hospital, before surgery), admission, after surgery, dimission and 1 month
Singapore, Singapore after dimission. Mean lenght of hospital stay (LOS) was
registered. Data were compared using paired T-test and ANOVA
Rationale: The aims of the study: test. A p < 0.05 was considered statistically significant. Results
1. To study the prevalence of malnutrition in patients with are expressed in mean and standard deviation and numbers.
colorectal cancer who underwent surgery in KTPH, Results: From February to September 2016, 100 consecutive
Singapore; patients were enrolled. 55 were male, 45 female. Mean age was
2. To explore the validity of albumin, prealbumin and 67.8 (±12.4). At preadmission, mean weight, BMI and PhA were
Malnutrition Universal Screening Tool (MUST) in detecting 71.4 (±15.3), 26.9 (±4.5), 5 (±0.86) respectively. At hospital
malnutrition in this population; admission, no statistically differences were noted in the overall
3. To investigate the effectivenss of a 2 week pre-operation population compared to preadmission data. However in >68
nutrition optimization in this patient population. years old patients mean PhA significantly increased from 4.6 to
Methods: 36 colorectal cancer patients with a mean age of 68.3 4.8 (±0.8) ( p = 0.02). Mean LOS was 5 (±3,6) days.
years (±10.6) were recruited in this study. The mean BMI was Conclusion: A personalized diet, started 3 weeks before
23.54 kg/m2 (±3.98). An objective assessment of nutritional surgery is effective in improving nutritional status in more
status was undertaken for all patients 2 weeks prior to surgery. frail and older patients waiting for colorectal cancer surgery
SGA and MUST were used to assess patients’ nutritional status. and may contribute to lower LOS.
Weight, height and BMI were obtained. Blood samples including References
albumin and prealbumin were collected. BIA was performed to 1. Scott MJ, et al. ERAS® for gastrointestinal surgery, part 1:
assess patients’ muscle mass. For malnourished patients, a 2 pathophysiological considerations. Acta Anaesthesiol Scand.
week nutrition optimization (diet education + additional 2015;59:1212–31.
600 kcal ONS) was provided. Above measurements were 2. Gustafsson UO, et al. Guidelines for perioperative care in elective
repeated 1 day before or on the day of surgery for all patients. colonic surgery: ERAS® Society recommendations. Clin Nutr.
Results: 16 (44%) patients were found to be malnourished by 2012;31:783–800.
using SGA. The mean body weight, peralbumin and albumin Disclosure of Interest: None declared.
level of these patients were 59.8 kg (±6.4), 16.1 d/L (±6.8) and
35.0 d/L (±4.9). The sensitivity of albumin, peralbumin and SUN-P268
MUST to detect malnutrition are 56%, 75% and 75% respectively, AN EARLY NURSING NUTRITION INTERVENTION FOR
whereas the specificity of these markers are 95%, 85% and 95% UNDERNOURISHED OUTPATIENTS PLANNED FOR SURGERY
respectively. After 2 weeks of nutrition optimization, patient’s
H. V. Noort1 *, R. Ettema2, M. Heinen1, G. Huisman - de Waal1,
muscle mass and pre-albumin incresaed significantly by 0.9 kg
on behalf of the Basic Care Revisited Research Group. 1IQ
(±0.2) and 5.9 d/L (±1.4) respectively (P < 0.05).
Healthcare, Radboud UMC, Nijmegen, 2Instituut voor
Conclusion: 44% of colorectal cancer patients who underwent
Verpleegkundige Studies, Hogeschool Urecht, Utrecht,
colorectal surgery were malnourished. A 2 week nutrition
Netherlands
optimization intervention was found to be effective in
improving nutritional status of these patients. Prealbumin Rationale: Undernutrition among patients planned for surgery
and MUST can be used to identify malnutrition in these influences outcomes, e.g. higher complication rates, longer
patients. length of hospital stay (LoS) and increased mortality. The aim of
Disclosure of Interest: None declared. this study was to evaluate the feasibility and effectiveness of an
early nursing nutrition intervention (NNI) in outpatients
SUN-P267 planned for surgery.
NUTRICATT PROTOCOL: A NEW ITEM IN ERAS PROGRAM FOR Methods: The NNI was performed in a multicentre pilot RCT.
COLORECTAL CANCER SURGERY? Patients at risk for undernutrition, who received surgery
between June 2015 and September 2016, were randomly
E. Rinninella1 *, M. Cintoni1, R. Persiani2, D. D’ugo2, A. Biondi2,
assigned to receive either the NNI (nutritional advice, food
F. Pennestrì2, F. Scialanga1, L. Basso1, S. Leone1,
diary, counselling and telephone follow up before hospitalisa-
G. A. D. Miggiano1, A. Gasbarrini1, M. C. Mele1. 1Clinical
tion) or usual care. The outcome variables nutritional intake,
Nutrition, Gastroenterology Area, 2Abdominal and General
weight, and LoS were assessed by food diaries and medical file
Surgery, Fondazione Policlinico Agostino Gemelli Roma, Rome, analysis. Feasibility was assessed with nurses’ adherence to the
Italy study protocol, and patients’ motivation to improve their
Rationale: Nutritional support is considered a need in elective nutritional intake.
gastrointestinal surgery. ERAS protocols are spreading in large Results: From two anaesthesia outpatient clinics, 143 patients
volume centers to enhance recovery after surgery (1,2). participated in the study analysis. Nutritional intake was
Methods: In an ERAS program context, we developed a specific significantly higher in the intervention group (IG). No differ-
nutritional protocol for elective patients awaiting surgery for ences in weight and LoS were found (Table 1). Counselling was
colon rectal cancer (NutriCatt). Clinical evaluation, nutri- completed in 50% of the contacts. 83% of patients received the
two contacts as planned. 67% and 56% patients in the IG and
tional advices and a personalized diet were performed three
control group were very motivated to increase their nutritional SUN-P270

intake (P = 0,036). IMPACT OF SARCOPENIA ON PREOPERATIVE PULMONARY
Conclusion: The NNI did improve nutritional intake and it is an FUNCTION IN HEPATO-BILLIARY PANCREATIC CANCER
effective tool to decrease undernutrition in patients planned H. Shirai1 *, T. Kaido1, S. Okumura1, S. Yao1, A. Kobayashi1,
for surgery. The NNI is feasible in patients planned for surgery, Y. Hamaguchi1, S. Yagi1, N. Kamo1, H. Okajima1, S. Uemoto1.
but the intervention performance needs improvement. 1
Division of Hepato-Biliary-Pancreatic Surgery and
Table 1: Outcomes for intervention and control group. Transplantation, Department of Surgery, Kyoto University,
Control group Intervention Independent Sample Kyoto, Japan
N = 73 group N = 60 T-Test (p-value)
Rationale: The impact of sarcopenia on preoperative pulmon-
Energy Intake in
Kcal/day
ary function in hepato-billiary pancreatic (HBP) cancer patients
Mean (SD) 1,499 (665) 2,368 (865) 0.000 remains unclear.
Protein intake Methods: This study comprised 461 patients with hepatocel-
in gram/day
lular carcinoma (HCC), 180 patients with bile duct cancer (BDC)
Mean (SD) 57 (28) 93 (31) 0.000
Length of stay and 297 patients with pancreatic cancer who underwent
Mean (SD) 5.2 (8.9) 5.2 (5.8) 0.963 resection between 2003 and 2015. Using preoperative CT
Change in Weight imaging at the L3 level, the quantity and quality of skeletal
in kg
Mean (SD) −0.5 (2.6) −0.3 (2.6) 0.754 muscle were evaluated by psoas muscle mass index (PMI) and
intramuscular adipose tissue content (IMAC), respectively. (1)
The correlation between preoperative pulmonary function and
Disclosure of Interest: None declared. sarcopenic factors. (2) Preoperative pulmonary function
according to preoperative sarcopenia status based on the sex-
cut-off values for PMI and IMAC.
SUN-P269 Results: (1) In males, PMI was significantly correlated with
ENHANCED RECOVERY PROGRAMS AFTER THORACIC preoperative VC and FEV1.0 in HCC patients, VC and FEV1.0 in
ESOPHAGEAL CANCER SURGERY FOR HIGH RISK PATIENTS BDC patients, and %VC, VC, and FEV1.0 in pancreatic cancer
H. Sato1 *, Y. Miyawaki1, M. Aikawa1, K. Okamoto1, patients. IMAC was significantly correlated with preoperative
S. Sakuramoto1, S. Yamaguchi1, I. Koyama1. 1Gastrointestinal VC and FEV1.0 in HCC patients, %VC, VC and FEV1.0 in BDC
Surgery, Saitama International Medical Center, Saitama patients, and FEV1.0% and FEV1.0 in pancreatic cancer
Medical University, Hidaka-shi, Saitama, Japan patients. In females, IMAC was significantly correlated with
preoperative VC and FEV1.0 in HCC patients and VC and FEV1.0
Rationale: Data on enhanced recovery programs after in pancreatic cancer patients.
thoracic esophageal cancer surgery for high risk patients (2) In males, preoperative %VC, VC, FEV1.0 in HCC patients, VC
are sparse. The aim of this study was to evaluate the impact and FEV1.0 in BDC patients and %VC, VC in pancreatic cancer
of an enhanced recovery after surgery (ERAS) program in patients were significantly lower in the preoperative sarcope-
patients with high risk who underwent a transthoracic nia group than in the normal group. In females, preoperative
esophagectomy. pulmonary function had no significant difference between the
Methods: 33 patients who underwent a transthoracic esopha- two groups.
gectomy were put enrolled into ERAS program for high risk Conclusion: Preoperative sarcopenia has a strong negative
patients (Group H). This group was then compared with a group impact on pulmonary function in HBP cancer patients.
of 99 patients who had a standard risk (Group S). The outcome
measures comprised the morbidity rate, the average post-
operative days when the patients started walking and enteral
nutrition, postoperative pneumonia, anastomotic leak, and SUN-P271
length of postoperative hospital stay and readmission rates PERCUTANEOUS ENDOSCOPIC DERIVATION STOMA (PEDS) VS
within 30 days. This was a retrospective study. VACUUM THERAPY IN ENTERO-ATMOSPHERIC FISTULA
Results: The morbidity, anastomotic leak, postoperative PATIENTS
pneumonia and readmission rates were 52%, 21%, 9% and 0%, J. Sobocki1 *. 1Department of General Surgery and Clinical
and 39%, 13%, 6% and 1%, in Groups H and S, respectively Nutrition, Medical Universty of Warsaw, Warsaw, Poland
( p < 0.01, n.s, n.s, and n.s). The average postoperative days
when the patients started walking and enteral nutrition in Rationale: Patients with entero-atmospheric fistula (EAF) are
Groups H and S were 1.0, 1.4 and 1.2, 1.0 days, respectively characterized with high nutritional loses from fistula, long
( p < 0.01, and n.s). The length of postoperative hospital stay hospital stay and high mortality.
was reduced in Group S in comparison to that in Group H The aim of the study was to evaluate effects of percutaneous
(average 21.7 versus 32.3 days; p < 0.01). endoscopic derivation stoma (PEDS) vs vacuum therapy with
Conclusion: Groups H was inferior in starting walking, hospital regard to nutritional improvement and time to hospital
stay and mortality rate, compared with group S. However, there discharge.
were no statistical differences in morbidity rates including Methods: Twenty patients with EAF were included into the
postoperative pneumonia. Even in high risk patients, an ERAS study and divided into two groups: A- PEDS and B – vacuum. All
protocol is managed safely and is effective for the prevention of patients were fed totally parenteraly. The following para-
postoperative complications. meters were evaluated: time to patient mobilization, vigour
improvement in one week time (self estimation scale −3 to +3),
S154 Poster
number of stoma bag/dressing replacement per day, weight pre-operative carbohydrate drink. HCP’s reported advising
gain in 4 weeks, time to discharge from hospital. PEDS is a pre-operative fasting from solids and liquids for a mean of 9.59
percutaneously introduced catheter to the small bowel, placed hours (SD 5.69) and 4.30 hours (SD 4.31), respectively. Seventy
proximally to fistula with endoscopic assistance and accom- five percent of HCP’s reported advising post-operative fasting
panied with fistula closure by running suture. according to ERAS guidelines. Lack of co-operation of the
Results: multidisciplinary team, resistance to change and the lack of a
formal ERAS policy were identified as major barriers to
implementation.
A B
Conclusion: Implementation of the ERAS guidelines was found
Avr. age 61,5 58,0 to be lacking. This study highlights the need for implementa-
Avr. area of EAF (cm2) 381 320
Time to total patient mobilization (days) 3 22
tion of ERAS guidelines in South Africa and will assist in
Vigour improvement in one week time +2 −1 developing targeted strategies for successful implementation.
(self estimation)
Disclosure of Interest: J. Visser: None declared, J. Kotlowitz: None
Number of stoma bag/dressing replacement 1 2,2
per day declared, J. Kriel Other: Janine Kriel is employed by Fresenius Kabi
Weight gain in 4 weeks 2,1 −0,5 South Africa as a clinical nutrition sales representative. She is not
Albumine (at admission/after 4 weeks) mg% 1,7/2,4 1,9/2,1 working in a management position and her current position had no
Time to discharge 41 118 impact on this descriptive observational study. The research project
Time to reconstructive surgery (months) 10,5 15,1 was conceptualised with the rest of the authors while Janine was a
clinical dietitian at Tygerberg Hospital., N. Ahmed: None declared.
The following complications were observed: PEDS – one

SUN-P273
bleeding from suture site of the fistula, one suture leak, both
successfully treated with another suture placement. Vac- THE EFFECTS OF ORAL ADMINISTRATION OF CYSTINE/
therapy- bleeding from area covered by sponge (two pts), air THEANINE DURING THE PERIOPERATIVE PERIOD IN PATIENTS
leak requiring replacement of dressing (3 pts several times, 6 UNDERGOING LAPAROSCOPIC COLORECTAL SURGERY: A
pts at least 3 times). PILOT STUDY
Conclusion: PEDS facilitates mobilization of patients, stoma K. Hiyama1 *, H. Terashima2, H. Tsukizaki1, Y. Sumi1, Y. Nakano1,
care and weight gain, shortens time to discharge from hospital F. Imamura1, M. Kamiga1. 1Surgery, Hitachi Ltd, Hitachinaka
and definitive reconstructive surgery. General Hospital, 2Hitachinaka Medical Education and
Research Center, University of Tsukuba Hospital,
Hitachinaka, Japan
SUN-P272 Rationale: Cystine and Theanine (CT) are known to have

ASSESSMENT OF THE IMPLEMENTATION OF THE PERI- immunomodulatory effects such as attenuating inflammation.1
OPERATIVE NUTRITION ERAS GUIDELINES IN ELECTIVE The aim of this study was to examine whether perioperative
COLORECTAL SURGERY PATIENTS IN A TERTIARY HOSPITAL IN supplementation with CT can achieve more prompt recovery in
SOUTH AFRICA the setting of minimally invasive surgery.
J. Visser1 *, J. Kotlowitz1, J. Kriel2, N. Ahmed3. 1Human Methods: Until December 2016, 25 colon cancer patients aged
Nutrition, Stellenbosch University, Tygerberg, 2Fresenius- 75 or younger, who had no other abdominal surgical history than
Kabi, Cape Town, 3Tygerberg Academic Hospital, Tygerberg, appendectomy, were randomly assigned to two groups: CT
South Africa group (13 patients) and control group (12 patients). In CT
group, patients received CT supplement (Cystine & Theanine,
Rationale: Implementation of the ERAS guidelines in South Ajinomoto Co.) containing Cystine 700 mg and Theanine
Africa is yet to be studied and has the potential to lower costs 280 mg for continuous 10 days (5 days before to 5 days after
for the public health system. Understanding the current surgery). All procedures were planned through laparoscopic
practices and barriers to implementation will allow for surgery. The postoperative data such as serum C-reactive
targeted strategies for effective implementation. protein (CRP) levels, appetite, bowel motility and fluid therapy
Methods: An observational descriptive cohort study was were recorded for each patient of two groups.
conducted. Thirty colorectal surgery patients were observed Results: All of CT group could complete CT supplementation
via the use of an observational checklist and an interviewer- without side effects such as GI discomfort. There were no
administered questionnaire. Knowledge, attitudes, practices significant differences in patient characteristics. No significant
and barriers to implementation were assessed via a self- differences in CRP levels on POD1/3 could be seen. There were
administered questionnaire to 58 Health Care Professionals also no significant differences in bowel motility such as time to
(HCP’s). first flatus and defecation. CT group had significantly higher
Results: Seventy percent of patients were weighed on appetite scores on POD1 (P = 0.022), leading to a significant
admission. Patients were fasted pre-operatively from solids reduction in the total volume of infusion (P = 0.044).
and liquids for a mean of 19.5 hours (SD 13.2) and 14.92 hours Conclusion: Despite the fact that anti-inflammatory proper-
(SD 7.8) respectively. Pre-operative carbohydrate loading ties could not be detected in terms of CRP and bowel motility,
drinks were not received by any patients. Patients were perioperative CT supplementation might prevent post-
fasted for a mean of 13.64 hours (SD 8.6) post-operatively. operative loss of appetite and thereby ensure effectively
The mean knowledge score of HCP’s was 36% (SD 27.7). Seventy reducing fluid administration, suggesting the clinical benefit in
three percent of nurses reported weighing patients on accelerating nutritional independence by mouth.
admission and 71% of HCP’s reported not ordering a
Protein and amino acid metabolism 1 S155
Reference disturbances and associated metabolic abnormalities, is

1. Kurihara S, et al., Cystine and theanine: amino acids as oral unknown among acute gastrosurgical patients without pre-
immunomodulative nutrients, SpringerPlus 2013;2:635. ceeding periods with semi-starvation. Both RFS and refeeding
Disclosure of Interest: None declared. phenomenon (RFF), characterised by a drop in plasma
phosphate, is observed among this group of patients, where
symptoms have been oedema and hypotension. This study seeks
SUN-P274
to enlighten the undescribed condition, here named refeeding-
ENHANCED RECOVERY AFTER SURGERY BY PERIOPERATIVE
like syndrome (RLS). We wanted to establish the incidence rate
SUPPORT CENTER -REALIZATION OF EARLY DRINKING,
of RLS and determine, if a dose-response relationship exists
EATING, MOBILIZING (DREAM) AND STUDY OF RECOVERY
between RLS and a positive sodium balance in acute gastro-
SURVEY-
surgical patients.
K. Ushigome1, H. Taniguchi1 *, M. Takenouchi1. 1saiseikai Methods: The incidence rate was observed by the means of a
Yokohamashi Tobu Hospital, Yokohama-City, Kanagawa, Japan prospective cohort study. The hypothesis regarding a dose-
response relationship was investigated by dividing the partici-
Rationale: Tobu Hospital Perioperative Support Center (TOPS)
pants into three groups based on their sodium balance.
has provided medical care team focusing on nutrition and pain
Results: A significant positive correlation between develop-
management that achieves early postoperative drinking,
ment of RLS and the degree of a positive sodium balance was
eating, and mobilizing (DREAM).
found, both when dividing the groups by the cumulated and
Methods: The study was a prospective controlled interven-
mean sodium balances. The incidence rate of RLS was 1/3,45
tional study. We investigated the TOPS support intervention
person-days. The highest rate (1/1,00 person-days) was
effects by evaluating recovery outcomes of patients undergoing
observed in participants (N = 6) with positive balances within
gastrointestinal surgery by using the Japanese version of the
the interval of [330,54–559,95] mmol/day. Determination of
quality of recovery score (QoR-40J). The subjects included 28
the threshold for this relationship is affected by a low number
patients before the intervention, and 30 patients after the
of participants in the group with the most positive balances.
intervention. In addition, the TOPS support intervention
The results can therefore be associated with type-2 error. It was
effects on POD1 were evaluated retrospectively using the
not possible to detect an association between low sodium fluid
numerical rating scale (NRS). The subjects were patients
therapy during operation and the development of RLS.
undergoing gastrointestinal surgery. A logistic regression
Conclusion: The existence of a dose-response relationship
analysis was performed in 77 patients who received pre-
between a positive sodium balance and the development of RLS
intervention (group A), 164 patients who received post-
is possible. Further investigation is needed to determine if a
intervention(group B), and 38 patients with a pain treatment
causal-relation exists.
protocol(group C).
Results: Regarding results of QoR-40J in the long-stay group, Disclosure of Interest: None declared.
post-intervention ‘pain’ scores were significantly better than
pre-intervention ‘pain’ scores (P < 0.05). In group L, post-
intervention ‘emotional condition’ scores on POD1 tended to be Protein and amino acid metabolism 1
better than pre-intervention ‘emotional condition’ scores on
POD1. Among patients with an NRS score of <3, NRS score SUN-P276
decreased in the following group order: A > B > C. The number PROTEIN RESTRICTED DIET DURING GESTATION AND/OR
of patients with an NRS score of 0 in group C was higher than LACTATION IN MICE AFFECTS ORGANs’ 15N NIA IN THE
that in groups A and B. OFFSPRING: EFFECT OF DIET 15N CONTENT AND GROWTH
Conclusion: In groupL, recovery rates of ‘pain’ and ‘emotional K. Bernardo1, C. Jousse2,3, P. Fafournoux2,3, R. Robins4,5,
condition’ on POD1 and ‘total score’ on POD1 and 3 were R. Hankard1,6, A. De Luca1 *. 1Unité Mobile de Nutrition, CHU
significantly higher, showing the effect of the TOPSsupport TOURS, INSERM U1069, Tours, 2University, 3INRA UMR 1019,
intervention. Thus, the support intervention at the TOPS Clermont-Ferrand, 4University, 5CEISAM, CNRS UMR 6230,
improves the recovery rate of postoperative patients. Nantes, 6University, Tours, France
Rationale: This study aimed at measuring the effect of 15N NIA
of normal to restricted protein diets given during gestation
SUN-P275 and/or lactation and growth on organs’ 15N NIA in dams and the
THE INCIDENCE-RATE OF REFEEDING LIKE SYNDROME (RLS) offspring.
AND THE RELATION TO SODIUM BALANCE IN PATIENTS Methods: Female mice were fed normal diet (ND) containing
ADMITTED FOR ACUTE G-I SURGERY 22% protein or isocaloric low protein diet (LPD) 10% protein
K. K. Mikkelsen1 *, M. Djurhuus1, V. A. Lin2, T. Boel2, throughout gestation. At birth litters were equalized and dam’s
A. W. Volby3, J. R. Andersen1. 1Department of Nutrition, diet either maintained (ND-ND or LPD-LPD) or switched to the
Exercise and Sports, University of Copenhagen, 2Section for other diet (ND-LPD or LPD-ND) until weaning at d30. All animals
Acute Surgery D 105, Department of Gastroenterology, Herlev were fed standard chow thereafter (A03). Offspring were
Hospital, Copenhagen, 3Department of Surgery, Holbæk sacrificed at d1, d11, d3, d60, d480 and dams at d1. Growth was
Hospital, Holbæk, Denmark modeled as an exponential function on the group followed up
until d480. Fur, liver and muscle were sampled at sacrifice and
Rationale: The incidence rate of refeeding syndrome (RFS), analyzed for bulk 15N NIA using irm-MS coupled with elemental
which is characterised by acute electrolyte and water analyzer after combustion. We used two-way ANOVA to test for
S156 Poster
fixed effect and interactions between fixed effects and random P < 0.05). RaCIT was negatively related to leg extension
element. Post-hoc tests were performed using Tukey test for strength (r = −0.7, P < 0.01).
more than two groups. Conclusion: Metabolic phenotyping using novel tracer pulse
Results: Higher 15N NIA in the diet resulted in higher organ 15N methodology showed that disturbances in glutamine related
NIA. Switching from one diet to another changed 15N NIA in each metabolism are associated with muscle wasting and weakness
organ. Although dam and offspring shared the same isotopic in patients with cancer.
environment during gestation 15N NIA at d1 was higher in dams. Disclosure of Interest: B. Van Der Meij Grant/Research Support from:
Growth rate did not differ between groups and decreased from ESPEN Research Fellowship, N. Deutz: None declared, R. Rodriguez:
m1 to m5. 15N NIA differed between organs and was affected by None declared, F. Koeman: None declared, T. Smit: None declared,
growth and gestation/lactation. M. Engelen: None declared.
Conclusion: Diet 15N NIA is a major determinant of organs’ 15N
NIA. 15N NIA depended on organ and age i.e. growth suggesting SUN-P278
an effect of metabolism and/or dilution space. Post-natal NP PROGESTERONE-REGULATED ARGININE DECLINE AT LUTEAL
regimen of lactating dams could reverse the effect of a protein- PHASE OF THE MENSTRUAL CYCLE AND ASSOCIATIONS WITH
restricted diet during gestation on the offspring growth. RELATED AMINO ACIDS AND DERIVATIVES AND NUCLEAR
Measuring 15N NIA in various matrices may open a field of FACTOR KAPPA B P65 ACTIVATION
application particularly useful in the pre- and post-natal origins B. M. Winklhofer-Roob1 *, G. Faustmann1,2, A. Meinitzer3,
of health and disease. C. Magnes4, B. Tiran3, B. Obermayer-Pietsch5, H.-J. Gruber3,
Disclosure of Interest: None declared. J. Ribalta6, E. Rock7, J. M. Roob2. 1Human Nutrition &
Metabolism Research and Training Center, Institute of
SUN-P277 Molecular Biosciences, Karl Franzens University of Graz,
2
METABOLIC PHENOTYPING TO PROVIDE INSIGHT IN Clinical Division of Nephrology, Department of Internal
MECHANISMS UNDERLYING MUSCLE WEAKNESS AND WASTING Medicine, 3Clinical Institute of Medical and Chemical
IN PATIENTS WITH CANCER Laboratory Diagnostics, Medical University of Graz, 4HEALTH,
B. S. Van Der Meij1,2,3 *, N. E. Deutz1, R. E. Rodriguez4, Institute of Biomedicine and Health Sciences, Joanneum
F. Koeman1, T. C. Smit1, M. P. Engelen5. 1Center for Research, Forschungsgesellschaft m.b.H., 5Clinical Division of
Translational Research in Aging and Longevity, Texas A&M Endocrinology, Department of Internal Medicine, Medical
University, College Station, United States, 2Faculty of Health University of Graz, Graz, Austria, 6Unitat de Recerca de Lipids I
Sciences and Medicine, Bond University, Gold Coast, 3Nutrition Arteriosclerosi, Facultat de Medicina, Universitat Rovira I
and Dietetics, Mater Group, Brisbane, Australia, 4Division of Virgili, Tarragona, Spain, 7Unité de Nutrition Humaine, Centre
Hematology/Oncology, Scott and White Memorial Hospital, Auvergne Rhône-Alpes, Institut National de la Recherche
College Station, United States, 5Center for Translational Agronomique, Clermont-Ferrand, France
Research in Aging and Longevity, Texas A&M University, College
Rationale: Given their role in female reproduction, the effects
Station, Australia
of progesterone on arginine (Arg) and related amino acids as
Rationale: Cancer is characterized by low plasma concentra- well as polyamines and NF-κB p65 activation were studied
tions of arginine (ARG), glutamine (GLN) and citrulline (CIT). across the menstrual cycle.
This study investigates the relationship between glutamine- Methods: Plasma Arg, ornithine (Orn), citrulline (Cit), lysine
related metabolism and muscle strength in patients with (Lys), homoarginine (hArg), asymmetric dimethylarginine
advanced cancer using metabolic phenotyping. (ADMA), putrescine (Put), spermidine (Spmd), spermine
Methods: In 16 patients with solid tumours (C) and 16 age- and (Spm), and N-acetyl-putrescine (AcPut) were determined, as
gender-matched healthy controls (H), fasted plasma amino acid were NF-κB p65 activation in peripheral blood mononuclear
concentrations and whole body ARG, GLN, CIT and GLU rates of cells and serum progesterone in 28 women at early (T1) and late
appearance (Ra) were assessed by pulse IV administration of L- follicular (T2) and mid (T3) and late (T4) luteal phase.
[Guanidino-15N2]-Arginine, L-[5–15N]-glutamine, L-[ureido- Results: (a) Increase from T1 and T2 to T3 and T4 in
13C-2H2]-Citrulline, L-[1,2–13C2]Glutamate and 2H3-Leucine progesterone and decrease in Arg (−20%; to ∼10th percentile
(LEU), and clearance rates calculated. Handgrip, inspiratory of men), Orn, Cit and Lys, as well as hArg and ADMA; (b) Inverse
and leg muscle strength and physical function (EORTC-QLQc30 regressions on progesterone of Arg, Orn, Cit and Lys, as well as
questionnaire) were assessed, and amino acid concentrations of ratios Arg to ADMA and Orn to Put, Spmd, Spm, and AcPut,
and isotope enrichments by LC-MS/MS. Statistics was done by resp; (c) Inverse regressions on changes in progesterone of
unpaired t-tests and spearman correlation tests. changes T3-T2 in Arg, Orn, Cit and ADMA, and changes T3-T2 in
Results: Ra and clearance rate of GLN were higher in C than in H ratios Arg to ADMA, Arg to Cit and Orn to Put, Spmd and Spm,
(Ra GLN: 491.4 ± 32.0 vs. 325.2 ± 51.5 μmol/kg ffm/h, p = resp. At T3, positive relations of Orn, Cit and Lys with Arg, and
0.008, clearance GLN 1.13 ± 0.08 vs 0.70 ± 0.09, p < 0.001) as of hArg with both Arg and Lys. Positive relations of changes (T3-
well as that of the GLN related amino acids ARG, CIT and LEU T2) in Arg with changes in Orn, Cit and ADMA; (d) Positive
( p < 0.05). The conversion of ARG to CIT (marker of NO relation of NF-κB p65 activation with Arg at T2. All results
synthesis), CIT to ARG (de novo ARG production) and GLU to P < 0.001 or P < 0.01.
GLN (marker of muscle GLN production) were also higher in C Conclusion: These data provide strong evidence of a physio-
(P ≤ 0.01) and negatively correlated to FFMi (r < −0.5, logical regulatory node aimed at preparing for successful
P < 0.05). Plasma BCAA was positively correlated to handgrip pregnancy, including progesterone-regulated luteal phase-
and inspiratory muscle strength, and physical function (R > 0.4, specific declines in Arg and related amino acids, and linking
reduced Arg at luteal phase to the role of NF-κB p65 in the SUN-P280
TH1-TH2 immune response shift required for materno-fetal REALLOCATION OF ENERGY FLUX TO PROTEIN SYNTHESIS BY
immune tolerance. For the first time, longitudinal changes CITRULLINE IN MUSCLE CELLS
were shown for hArg and ADMA, which were closely related to A. Goron1, S. Blanchet2, E. Fontaine1, C. Moinard1 *. 1LBFA,
(changes in) Arg. INSERM U1055, Université Grenoble Alpes, 2Institute for
Disclosure of Interest: None declared. Advanced Biosciences, Grenoble, France
SUN-P279 Rationale: Citrulline (CIT) is known to stimulate muscle protein

MODULATION OF MUSCLE PROTEIN SYNTHESIS BY AMINO synthesis. However, protein synthesis has an important energy
ACIDS: CONSEQUENCES ON THE SECRETOME – A PRELIMINARY cost and the regulation of energy metabolism by CIT is not
IN VITRO STUDY known. Thus, we proposed to determine the CIT effect on
protein synthesis and on the energy metabolism.
C. Breuillard1 *, A. Goron1, V. Cunin2, S. Bourgoin-Voillard2, Methods: Myotubes derived from primary culture of mouse
M. Sève2, C. Moinard1. 1Laboratory of Fundamental and myoblasts were used. Cells were incubated in a complete DMEM
Applied Bioenergetics, INSERM U1055, 2Laboratory of medium (Ctrl+) or in a DMEM medium without amino acid nor
Fundamental and Applied Bioenergetics, INSERM U1055, serum for 16 h (in order to decrease protein synthesis) followed
Proteomic plateform PROMETHEE, Grenoble Alpes University, by an incubation for 2 h without (Ctrl−) or with CIT (5 mM) (CIT)
Grenoble, France (n = 8/group). Then, cells were lysed in order to measure
protein synthesis by SUnSET method, or cells were used to
Rationale: Recently, a new view has emerged regarding muscle
measure the respiration by oxygraphy (using Seahorse) at the
functions, in particular its capacity to secrete proteins.
basal state and after inhibitors addition (cycloheximide (40 μM)
However, its nutritional regulation is largely unknown. Since
for protein synthesis, ouabaïne (300 μM) for Na+/K+ pumps or
amino acids (AA) are major regulator of muscle function, we
actinomycine D (10 μM) for DNA/RNA synthesis). This approach
propose to investigate the in vitro effect of hyperaminoacide-
allows to evaluate the energy part of these energy-consuming
mia (HAA) or specific AA (citrulline -Cit- or leucine -Leu-) on
processes.
muscle protein synthesis (MPS) and on the modulation of
Results:
muscle secretome.
Methods: Myotubes stemming from mouse primary culture of
Ctrl+ Ctrl- CIT
myoblasts were incubated in DMEM without serum (DMEM+) or
without serum and AA (DMEM−)±5 mM Cit (CIT) or 5 mM Leu Protein synthesis (A.U.) 100 ± 3a 65 ± 3b 88 ± 4c
Respiration allocated to protein 41 ± 1a 36 ± 1b 46 ± 2c
(LEU) for 14 h (n = 6). Culture media were pooled to analyze synthesis (%)
secretome by a proteomic approach (using an iTRAQ labeling Respiration allocated to Na+/K+ 15 ± 1a 17 ± 1a 15 ± 1a
and LC-MALDI-MS/MS analysis) and cells were lysed to evaluate pumps
MPS with SUnSET method. Respiration allocated to DNA/RNA 13 ± 1a 16 ± 1a 14 ± 1a
synthesis
Results: HAA, Leu or Cit addition stimulated the MPS compared Estimation of remaining 31 ± 2a 31 ± 1a 25 ± 2b
to control without AA (DMEM+: 154 ± 4, CIT: 136 ± 7, LEU: respiration allocated to others
131 ± 4 vs DMEM−: 100 ± 5, UA; p < 0.05). Concerning the energy expenditures (%)
secretome, HAA was able to mostly upregulate proteins Anova + bonferroni test. Values with different superscript letters are significantly
involved in cell development and angiogenesis (i.e. Sema3c, different (p < 0.05).
Sema3d, Follistatin-related protein 1, Angiopoietin-like 2,…)
whereas it downregulated proteins involved in calcium homeo- Conclusion: CITenhances muscle protein synthesis (+36%) via a
stasis (i.e. FKBP1A, Metastasin, Phosphohistidine phosphatase reallocation of energy flux to protein synthesis (+27%).
1,…). The modulation of secretome by Leu is widely different Disclosure of Interest: A. Goron: None declared, S. Blanchet: None
since mostly downregulated proteins are related to cytoskel- declared, E. Fontaine: None declared, C. Moinard Shareholder of:
eton (i.e. cofilin-2, Calponin-3,…). Finally, the modulation of Citrage.
secretome by Cit is more complex to interpret but it seems that
modulated proteins by Cit are involved in the cardiovascular
SUN-P281
homeostasis (i.e. Calumenin, Cystatin C,…).
PLASMA AMINO ACID PROFILE IN OBESE PATIENTS WITH
Conclusion: In conclusion, besides the positive effect of HAA or
PURINE METABOLISM DISORDERS
specific AA on the protein synthesis in muscle cells, this
preliminary work demonstrates that muscle secretome is E. Livantsova1,2 *, E. Saginova1, T. Krasnova1, A. Starodubova2,3,
modulated from different ways and underlines the complexity S. Kosyura2,3. 1M.V. Lomonosov Moscow State University,
2
of the regulation of protein homeostasis by nutrients. Federal Research Centre of Nutrition, Biotechnology and Food
Safety, 3N. I. Pirogov Russian National Research Medical
Disclosure of Interest: C. Breuillard Shareholder of: Citrage Company,
University, Moscow, Russian Federation
A. Goron: None declared, V. Cunin: None declared, S. Bourgoin-Voillard:
None declared, M. Sève: None declared, C. Moinard Shareholder of:
Rationale: The amino acids play an important role in the
Citrage Company.
formation of metabolic status because they tightly link all
metabolic pathways. The disturbances of uric acid metabolism
are probably associated with changes in plasma amino acid
profile.
Methods: The study included 59 patients (25 male and 34
female); the median age is 52 years [36; 60]. The number of
S158 Poster
obese patients was 38 (64%) (body mass index (BMI) >30 kg/m2). Results: After the protein restricted diet, 30.2% ± 7.7 of the
The control group consists of subjects with a normal BMI (36%). 30 g 13C-milk protein was oxidized over 330 min, compared to
Hyperuricemia was detected in 20 (34%), of which 16 (80%) had 30.6%±6.2 (NS) after the subject’s habitual diet (1.4 ± 0.3 g
obesity. We evaluated the results of biochemical tests and protein/kg bw/day). Within subjects, both increase and
anthropometry. The analysis of amino acid blood composition decrease in oxidation was found. During the 4-day protein
was performed using HPLC-MS. restricted diet, urinary urea:creatinine ratio decreased by
Results: A statistically significant positive correlation was 56% ± 10, consistent with a reduction in protein intake of 44% ±
observed between serum uric acid level and concentrations of 15 (g/day) and 53%±12 (g/kg bw/day), based on urea and food
three amino acids: glutamic acid (r = 0.416; p < 0.01), leucine diary, respectively.
and isoleucine (r = 0.318; p < 0.05). In the group of obese Conclusion: The breath test shows variation within subjects
patients, there were no relationships between BMI and and between diets, which could be related to the sensitivity of
concentration of any amino acid. In contrast, the control the test. We cannot explain the variation by the measured
group demonstrated a highly significant positive correlation variables. Alternatively, our results may implicate that in some
BMI with concentration of alanine (r = 0.482; p = 0.027) and of our subjects, protein intake did not sufficiently decrease to
glutamic acid (r = 0.521; p = 0.015). Most of the amino acids levels that could alter protein metabolism.
(alanine, glutamic acid, leucine, and isoleucine) showed a Disclosure of Interest: G. Reckman: None declared, G. Navis: None
statistically significant or close to significant correlation with declared, C. van der Schans: None declared, R. Vonk Other: In kind
the level of uric acid in obese patients. Thus, an increase in contribution of 13C-milk protein, H. Jager-Wittenaar: None declared.
body weight in the normal range is associated with alteration of
the amino acid profile. SUN-P283
Conclusion: Our study showed that purine metabolism dis- LEUCINE-ENRICHED WHEY PROTEIN MEDICAL NUTRITION
orders in obese patients are associated with the metabolism of DRINKS IN POWDER AND LIQUID FORMAT RESULT IN HIGHER
leucine/isoleucine and glutamic acid. The findings suggest the POSTPRANDIAL SERUM AMINO ACID LEVELS COMPARED TO
importance of amino acid metabolism in a variety of metabolic STANDARD CASEIN-DOMINANT MEDICAL NUTRITION DRINKS
conditions and can be used in further studies of the mechanism J. P. Van Wijngaarden1 *, S. Verlaan1, Y. C. Luiking1. 1Nutricia
of hyperuricemia and worsening of other metabolic disorders in Research, Nutricia Advanced Medical Nutrition, Utrecht,
obese patients. Netherlands
Rationale: To adequately stimulate muscle protein synthesis
(MPS) in older people it is suggested that higher postprandial
SUN-P282
blood levels of leucine (Leu) and essential amino acids (EAA)
SENSITIVITY OF A 13C-PROTEIN OXIDATION BREATH TEST
are needed. Therefore, a Leu-enriched whey protein medical
INVESTIGATED WITH A PROTEIN RESTRICTED DIET IN
nutrition (MN) drink was developed, in powder and in liquid
HEALTHY SUBJECTS
format. This study evaluated the bio-equivalence of these
G. A. R. Reckman1,2 *, G. J. Navis1, C. P. van der Schans2,3, formats on postprandial serum levels of Leu and EAA, and
R. J. Vonk4, H. Jager-Wittenaar2,5. 1Internal Medicine, Division evaluated superiority on serum levels of Leu and EAA compared
of Nephrology, University of Groningen, University Medical to standard MN drinks.
Center Groningen, 2Research Group Healthy Ageing, Allied Methods: 12 healthy older subjects (65–75 y) participated in
Health Care and Nursing, Hanze University of Applied Sciences, this randomized, single blind cross-over study. On 4 occasions
3
Rehabilitation and Health Psychology, 4Center for Medical subjects consumed: a Leu-enriched whey protein MN drink
Biomics, 5Maxillofacial Surgery, University of Groningen, (150 kcal, 21 g protein) in powder (150 ml; WHEY-P) or liquid
University Medical Center Groningen, Groningen, Netherlands format (200 ml; WHEY-L), a casein-protein MN drink (300 kcal,
18 g protein, 125 ml; CAS) or a mixed-protein casein-dominant
Rationale: Disturbed protein metabolism may result in MN drink (300 kcal, 18 g protein, 200 ml; MIX). Blood samples
malnutrition. A non-invasive low cost clinical tool to measure were taken right before and at 15–30 min intervals until 4 h
protein metabolism is lacking. Explorative research (n = 1) with after product intake, and were analysed for serum AA levels.
a newly developed non-invasive 13C-protein breath test Bio-equivalence was tested as the 90%CI for the ratio of group
suggested a decrease in protein oxidation after a protein averages vs. pre-specified bio-equivalence limits (0.7–1.43).
restricted diet. Now, we aimed to test the effect of protein Superiority was tested by ANOVA. Data are shown as mean ± SD.
restriction in more subjects, to assess sensitivity of the test. Results: WHEY-P and WHEY-L were bio-equivalent in max Leu
Methods: In this exploratory study, 14 healthy male subjects concentration (Cmax; 469 ± 52 and 390 ± 51 μmol/L, resp), EAA
(23 ± 3 y) participated. Habitual intake was assessed by a 4-day Cmax and iAUC of Leu and EAA. Leu Cmax was higher for WHEY-P
food diary. Next, subjects were instructed to use a 4-day and WHEY-L vs CAS and MIX (197 ± 19 and 216 ± 28 μmol/L, resp;
isocaloric protein restricted diet (0.25 g protein/kg bw/day). p < 0.001). Similar differences were observed for EAA Cmax and
After an overnight fast, a 30 g naturally enriched 13C-milk
iAUC of Leu and EAA ( p < 0.001).
protein test drink was consumed, followed by collection of
Conclusion: The Leu-enriched whey protein MN drinks in
breath samples up to 330 min. Protein oxidation was analyzed
powder and liquid format are bio-equivalent for postprandial
by Isotope Ratio Mass Spectrometry. 24-h urine was collected
AA response, and result in higher serum levels of Leu and EAA
on day 4 of the habitual diet, and on every day of the 4-day
than standard casein-dominant MN drinks. Therefore, these
protein restricted diet, to assess actual change in protein
products seem preferable to provoke MPS in older adults.
intake.
Qualitative design studies S159
Disclosure of Interest: J. Van Wijngaarden Other: Employee of Nutricia Qualitative design studies
Research, S. Verlaan Other: Employee of Nutricia Research, Y. Luiking
Other: Employee of Nutricia Research. SUN-P286
INFANT FEEDING CHOICES: A QUANTITATIVE AND
SUN-P284 QUALITATIVE EVALUATION OF EXPECTANT PARTICIPANT’S
HIGHER PROTEIN INTAKE IS ASSOCIATED WITH LESS INJURIES INTENTIONS OF FEEDING IN THE COMMUNITY HEALTHCARE
IN FRESHMAN ROWERS DURING COMPETITION SEASON: A ORGANISATION 1 (CHO 1) IN IRELAND
PILOT STUDY C. Bradshaw1 *, A. Breen1, L. Doherty2, R. Lennon3, R. Lydon4,
J. V. D. Helder1 *, M. Tieland1, D. Diemer1, J. Jansen1, E. Mooney4, C. Moriarty5, L. Martin6, A. Mc Cloat4,
J. Stubbe1, P. Weijs1,2. 1Faculty of Sports and Nutrition, L. Stoddard5, M. Mc Loone1, G. McMonagle1. 1Science, Sligo
Amsterdam University of Applied Sciences, 2Nutrition & Institute of Technology, Sligo, 2Health Promotion, Letterkenny
Dietetics, Internal Medicine, VU University Medical Center, University Hospital, Letterkenny, 3Health Science, Sligo
Amsterdam, Netherlands UniversityHospital, 4Home Economics, St Angelas NUIG,
5
Public Health, 6Health Promotion, Sligo UniversityHospital,
Rationale: Freshman rowers have an increased risk for injuries, Sligo, Ireland
especially during high training load. Dietary protein may
stimulate recovery and therefore may reduce the risk for injuries Rationale: The National Maternity Strategy in Ireland reports1 i
during extensive training periods. In this pilot, we studied the ‘a health and wellbeing approach is adopted to ensure that
association between protein intake and the incidence of injuries babies get the best start in life’. Breastfeeding (BF), rates in
in freshman rowers during competition season. Ireland remain the lowest in the Organisation for Economic Co-
Methods: Freshman rowers (n = 28) were included from four operation and Development (OECD).2 CHO1,(North West)an
boats: 2 coxed eights (8+), 1 coxed four (4+) and 1 coxed quad area with low rates of BF.3 This study looks at thoughts/
(4x+). Clarsen injury questionnaire (1) and 3-day food record attitudes/opinions of expectant women (n = 312) in the CH01.
were performed at start and after 8 weeks of competition. Methods: Ethical clearance was obtained from the 3
Correlation between protein intake and injury incidence was hospitals. Data was collected by a self-administered question-
analyzed with chi-square test. naire with open/closed questions and distributed to consenting
Results: For 22 out of 28 included freshman rowers data women at the first appointment with obstetrics.
collection was complete for analysis (mean age 21 ± 2 years). In Results: Quantitative: n = 293 valid, 146 (49.8%) intend to BF,
total, 64% (14/22) of the athletes reported an injury and in 81 (27.6%) intend to formula feed, 35 (11.9%) to use a mixture
total 20 injuries were reported. Next to this reported injuries and 31(10.7%) undecided. Qualitative: four themes emerged
27% (6/22) of the athletes had to interrupt rowing because of Lived Experience, Motivation, Knowledge, and Environment
the injury (mainly airway/flue). Chi-square test showed from codes. The women who intended to BF, 77 best for baby/
significant correlations with injury for protein intake lower 42 health benefits 37 cost/29 bonding/20 natural the con-
than 1.2 g/kg/day ( p = 0.04), protein intake lower than 1.6 g/ straints, 22 tried previously/15 said both parents can formula/
kg/day ( p = 0.05), and less than 20 energy% protein ( p = 0.02). 8 social concerns about BF.
Conclusion: CH01 Participants’ paradigm on infant feeding is
analyzed, areas to improve, are identified as create awareness,
Injured Non-injured Chi-Square
increase knowledge and ultimately increase BF.
(n = 14) (n = 8) test
References
<1.6 g protein/kg/day 57% (8) 13% (1) 0.04
<1.2 g protein/kg/day 36% (5) 0% (0) 0.05 1. DoH (2016) Creating a Better Future Together; National Maternity
<20 energy % as protein 86% (12) 38% (3) 0.02 Strategy 2016–2026. Dublin: Healthy Ireland, Department of Health
<30 g protein per meal 64% (9) 25% (2) 0.08 & Patient Safety First.
2. OECD (2009) Family Database C01.5: Breastfeeding Rates [online]
Conclusion: Freshmen rowers are prone to injuries early during Updated 1/10/2009. Available: http://http://www.oecd.org/els/
the competition season. Dietary protein intake is associated family/database [accessed 27 Nov 2016]
with less injuries in freshman rowers. Further research needs to 3. Health Information and Research Division, ESRI (2011) Perinatal
be conducted to investigate the role of protein intake on Statistics Report 2000. Dublin
injuries in freshman rowers or other sports with related high Disclosure of Interest: None declared.
training load.
Reference SUN-P287
1. Clarsen et al. British Journal of Sports Medicine. 2013;47 WOMEN’S BEHAVIORS AND VIEWS ON HOME FOOD SAFETY
(8):495–502. IN TEHRAN: A QUALITATIVE STUDY
Disclosure of Interest: None declared. F. Esfarjani1 *, R. Khaksar2, H. Hosseini3, F. Mohammadi1,
R. Roustaee1, H. Alikhanian1. 1Department of Food and
Nutrition Policy and Planning Research, National Nutrition and
Food Technology Research Institute, Faculty of Nutrition
Sciences and Food Technology, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, 2Department of Food Science
and Technology, National Nutrition and Food Technology
Research Institute, Faculty of Nutrition Sciences and Food
Technology, Shahid Beheshti University of Medical Sciences,
S160 Poster
Tehran, Iran, 3Department of Food Science and Technology, interviews was used. Data was analysed using thematic
National Nutrition and Food Technology Research Institute, analysis.
Faculty of Nutrition Sciences and Food Technology, Shahid Results: Many participants experienced a significant delay in
Beheshti University of Medical Sciences, Tehran, Islamic obtaining a diagnosis and discussed the impact that ‘feeling
Republic of Iran delegitimised’ and the ‘lack of coherent understanding of GID’
had on their relationships and mental health. Participants
Rationale: The aim of this study was to explore food safety reported having their mental health questioned and felt they
knowledge and behavior of housewives in the city of Tehran, had to fight to prove their symptoms had a physical origin to
Iran. receive appropriate treatment. Although a diagnosis helped
Methods: In this qualitative study twelve Focus Group legitimise symptoms, participants stated that GID was gener-
Discussions by directed content analysis method (n = 96), ally misunderstood by them, family and non-specialist health
were conducted among women who were responsible for food professionals.
handling in their households, in 10 health centers. Each session Conclusion: Symptoms of GID reported by patients are vast and
was held with 7–10 participants and their voices were recorded. debilitating, compounded with a delay in validating symptoms
The final transcripts were read to obtain categories until and lack of coherent understanding. More knowledge of GID is
developing themes by using constant comparison method. needed for health professionals to speed up diagnosis and offer
Results: Three categories in nine themes were emerged as more coherent information. The psychological impact of a GID
follows: Personal hygiene and poisoning (1) Washing hands as diagnosis should be acknowledged early to help facilitate
priority in personal hygiene. Food safety, preparation and adjustment.
storage (2) Inadequate knowledge about proper time for boiling
raw milk, (3) Lack of awareness about temperature of
refrigerator, (4) Incorrect storage of food in the refrigerator,
(5) Storage of unwashed and unpacked eggs, fresh fruits and SUN-P289
vegetables in the refrigerator, (6) Thawing frozen raw meat and UNDERSTANDING BEHAVIORAL MECHANISMS FOR PHYSICAL
chicken at room temperature, (7) Incorrect separation and ACTIVITY IN HEAD AND NECK CANCER PATIENTS: A
sanitization of cutting boards for fresh vegetables, raw QUALITATIVE STUDY
meat, chicken, (8) Inappropriate washing of fresh leafy M. J. Sealy1,2 *, M. M. Stuiver3,4,5, J. Midtgaard6,7,
vegetables. Safety of cooked foods (9) Improper reheating of C. P. van der Schans1,8, J. L. Roodenburg2,
leftover foods. H. Jager-Wittenaar1,2. 1Research Group Healthy Ageing, Allied
Conclusion: The findings of this study illustrated that there was Health Care and Nursing, Hanze University of Applied Sciences,
2
lack of knowledge about food safety. It was evident that the Department of Maxillofacial Surgery, University Medical
majority of the participants were not familiar with practices to Center Groningen, University of Groningen, Groningen,
3
prevent cross contamination and food handling. Therefore ACHIEVE, Faculty of Health, Amsterdam University of Applied
home food safety education should be conducted for Sciences, 4Department of Physiotherapy and Department of
housewives. Head and Neck Surgery and Oncology, Netherlands Cancer
Institute, 5Department of Clinical Epidemiology, Biostatistics
and Bioinformatics, Academic Medical Center, Amsterdam,
Netherlands, 6University Hospitals Centre for Health Research,
SUN-P288 Copenhagen University Hospital, 7Department of Public
‘AN ORCHESTRA WITHOUT A CONDUCTOR’: A QUALITATIVE Health, Section of Social Medicine, University of Copenhagen,
EXPLORATION OF THE JOURNEY FROM SYMPTOM ONSET TO Copenhagen, Denmark, 8Department of Rehabilitation
DIAGNOSIS IN PEOPLE WITH GASTROINTESTINAL Medicine and Department of Health Psychology Research,
DYSMOTILITY University Medical Center Groningen, University of Groningen,
K. Twist1, J. Ablett2 *, A. Wearden1, P. Paine2, D. Vasant2, Groningen, Netherlands
S. Lal2, S. Peters1. 1University of Manchester, Manchester,
2
Salford Royal Foundation Trust, Salford, United Kingdom Rationale: Head and neck cancer (HNC) patients often have
adverse changes in body composition. Loss of muscle mass and
Rationale: Gastrointestinal dysmotility (GID) is a relatively rare strength frequently occur, even when dietary intake is
spectrum of disorders where disruption to complex enteric adequate. Nascent evidence suggests that a healthy lifestyle,
neuromuscular co-ordination leads to intractable gastrointes- including adequate physical activity (PA) and diet, may prevent
tinal symptoms, malnutrition and is a recognised cause of muscle wasting. HNC patients often show suboptimal health
chronic intestinal failure. To date, no study has provided an in- behavior pre-diagnosis, and additional barriers to PA can arise
depth account of the experiences of patients with GID and their from cancer treatment. Better understanding of the behavioral
psychosocial needs. This study aimed to explore patient’s mechanisms of PA in this mostly sedentary group is needed to
experiences from symptom onset and the process of seeking design effective individualized PA-supporting interventions.
and receiving a diagnosis. It specifically explored the psycho- This qualitative study explored the perspective of HNC
logical impact of this process and the impact on personal and patients on PA.
professional relationships. Methods: We conducted 9 semi-structured interviews in HNC
Methods: Participants (n = 20, mean age = 47.6, female n = 16, patients, 6–8 weeks after treatment (surgery +/−(chemo)
Parenteral Nutrition = 13) were recruited from a UK centre with radiation). The interviews were guided by the Theory of
tertiary Neurogastroenterology and Intestinal Failure services. Planned Behavior (TPB) key concepts, including: attitude;
A qualitative explorative design with semi-structured in-depth social norm (with emphasis on role of healthcare
Qualitative design studies S161
professionals); self-efficacy; intention; barriers/facilitators, SUN-P291

knowledge/skills; and current PA behaviour. Interviews were ENTERAL NUTRITIONAL SUPPORT IN OUR HOSPITAL- ONE DAY
analysed by directed content analysis. FOTOGRAPHY
Results: Important themes identified for PA were: physical S. Amálio1, S. Pina1 *, M. Figueiras1, P. Cabrita1,
barriers, health as stimulus, role of habits, and lack of interest. H. Carrasqueira1, A. Lopes1. 1Medicina Interna 1, Centro
While all themes could be fitted within the key concepts of TBP, Hospitalar Do Algarve-Unidade Faro, Faro, Portugal
there was little interaction between intention and other
concepts. In fact, PA intention was not an explicit consideration Rationale: Enteral nutritional support plays a very significant
for most patients. part in the management of patients with poor voluntary oral
Conclusion: HNC patients perceived physical barriers, health, intake, chronic neurological or mechanical dysphagia Nasal
habits, and lack of interest as important themes with regard to tubes should be used for short-term enteral feeding (4–6 weeks).
PA. Our tentative results suggest that the TPB may not be the ESPEN Guidelines for enteral nutrition in dementia do no
most appropriate model for explaining PA in HNC patients. For recommend enteral nutrition in patients with severe dementia.
future research aiming to understand PA in HNC patients, Methods: At 4th October of 2016 all patients hospitalized with
theories less focused on rational reasoning and more on an enteric tube were registered. Patients in the Intensive care
autonomy, such as Self Determination Theory, may be better Unit and Emergency department (ER) were excluded. For all of
suited. them demographic data, clinical data and data refering to de
Disclosure of Interest: None declared. enteric tube were collected. The MDS Cognitive Performance
Scale was apllied to all.
SUN-P290 Results: Observational, descriptive, prospective Study. 52
NUTRITION-RELATED ORDER-WRITING PRIVILEGES OF patients (30 men and 22 women) were identified on enteral
DIETITIANS IMPROVES THE TIMELINESS OF PATIENTS feeding (1 nasojejunal tube, 2 PEG and 48 naso gastric tubes).
RECEIVING APPROPRIATE NUTRITION PRESCRIPTIONS IN 37 patients (71,1%) were admited in an Internal Medicine
ACUTE HOSPITALS department and all except one was admitted through the ER.
The most important primary diagnosis was pneumoniae (28,8%)
Y. P. Lim1, E. Low1, R. J. Zhang1 *. 1Nutrition and Dietetics, Tan followed by ischemic stroke (11,5%). Dehydration, elevated
Tock Seng Hospital, Singapore, Singapore sodium and dementia were the most reported secondary
diagnosis. Dysphagia was the main cause of intubation. More
Rationale: Malnutrition is prevalent in acute hospitals and
than 50% ofthe analyzed patients had severe dementia at the
patients are at risk of developing poor nutrition during
admition by de MDS Cognitive Performance Scale and in more
hospitalization. The prescription of oral nutrition supplements
than 70% of these a nasogastric tube was introduced during the
(ONS) is an evidence-based nutrition intervention to manage
hospital stay. In many of these patients the nasogastric tube was
malnutrition in hospitalized patients. The project aimed to
a long term solution for enteral nutrition. All the nasogastric
evaluate the timeliness and accuracy of ONS prescriptions
tubes were of polyurethane material. The main complications
received by patients before and after granting nutrition-
reported were hyperglicemia and diarrhea.
related order-writing privileges to dietitians in an acute
Conclusion: With these study we were able to identify mistakes
hospital in Singapore.
associated with enteral feeding in our hospital. As consequence
Methods: Dietitians provide recommendations on nutrition
a protocol for enteral nutrition in dementia was elaborated.
prescription upon patient consultation; following which,
doctors will transcribe the prescriptions in an electronic Disclosure of Interest: None declared.
order system. Nurses then follow-up on the orders by
scheduling and serving ONS. To avoid unnecessary delay SUN-P292
between dietitians’ recommendations and patients receiving COUNSELLING CLIENTS WITH CHRONIC DISEASES – ISSUES OF
ONS, ordering privileges were granted to dietitians to input DIET MAINTENANCE
nutrition orders directly in the electronic system. Chart audits T. Tran1 *, S. T. Kristensen1. 1Department of Nutrition and
were completed in 2014 and 2016 to compare the orders for Midwifery, Methropolitan University College, Copenhagen,
ONS, including its timeliness, accuracy before and after Denmark
implementation of dietitians’ order-writing privileges.
Results: Following dietitians’ direct access to the order system, Rationale: Diet compliance is a critical component in the
there was a 2.5 fold increase (40%, n = 30–98.1%, n = 53) in ONS management of chronic diseases. This study examines main-
prescriptions transcribed based on dietitians recommenda- tenance in healthy eating habits and how this is experienced to
tions. The average duration between dietitian recommenda- be affected by psychosocial and environmental issues.
tions and the order of ONS in the electronic system, decreased Methods: 20 clients having or being at risk of developing type 2
10-fold, from 4.1 (0.17–13) days to 0.4 (0–6) days. 86.5% (n = 52) diabetes and/or cardiovascular diseases were recruited. 10
of dietitians recommended prescriptions were transcribed into men and 8 women (age: 66 ± 11.9 years) completed the study
the system within the same day. and received in average 2–3 counselling sessions using
Conclusion: Granting order-writing privileges to dietitians Motivational interviewing (MI) by dieticians. A food frequency
improves the timeliness and accuracy of nutrition interventions questionnaire was answered 4 times. The qualitative data
received by hospitalised patients who benefit from early and consisted of observations of 18 counselling sessions, semi-
appropriate nutrition care. structured interviews with 8 of the clients and 1 semi-
Disclosure of Interest: None declared. structured interview with 2 dieticians.
S162 Poster
Results: At baseline the intake of breakfast rich in dietary fibre days increased from 33% to 81%); enhancing meal provision to
5–7 times/week was seen in 56% of the clients and increased to malnourished patients and meal tray tagging.
67% at 1. follow-up ( p > 0.05). The daily intake of at least 2 Conclusion: The inter-professional collaborative model is
slices of fibre rich bread increased from 56% to 67% ( p > 0.05). impactful in influencing and effecting changes within the
The daily intake of fish for lunch increased from 17% to 39%. hospital resulting in improvements achieved in key areas
However, the intake of fish for dinner did not change ( p > 0.05). identified in the seven nutrition quality statements.
The daily intake of at least 3 portions of vegetables increased Disclosure of Interest: None declared.
from 0% to 6% while the corresponding intake of fruits
decreased from 28% to 22%. At 3. follow-up the intakes of
fibre and fish were normalised to baseline values, the intake of
vegetables remained at 6% and the intake of fruits increased to
Vitamins, antioxidants and minerals 1
33% ( p > 0.05). SUN-P294
The qualitative data showed that both individual and structural VITAMIN D STATUS OF HOSPITALISED PATIENTS RECEIVING
eating issues affected clients’ maintenance in healthy eating NUTRITIONAL SUPPORT
habits and that MI was difficult to align with the complexity of
A. E. Woollacott1 *, B. Lai1, P. Nair2, V. Flood3. 1Dietetics
food and eating practices.
Department, St Vincent’s Private Hospital, 2Intensive Care
Conclusion: Maintenance in diet compliance is a critical issue in
Unit, St Vincent’s Hospital, 3Faculty of Health Sciences,
dietary counselling and the complexity of food and eating habits
University of Sydney, Sydney, Australia
needs to be taken further into account. A narrative approach is
suggested as a more context sensitive approach. How this can be Rationale: The importance of vitamin D (VD) beyond its role in
done will be examined in another part of this study. musculoskeletal health, particularly for immunity, is well-
Disclosure of Interest: None declared. recognised. VD deficiency is common in Australia with the
Australian Health Survey reporting a 23% prevalence. VD
SUN-P293 deficiency is associated with poorer intensive care and surgical
MAKING A DIFFERENCE IN NUTRITION CARE FOR outcomes, greater risk of falls and hospital acquired infections
HOSPITALISED PATIENTS: AN INTER-PROFESSIONAL (HAI). The aim of the study was to prospectively identify the risk
COLLABORATIVE MODEL of VD deficiency in hospitalised patients receiving nutritional
Y. P. Lim1 *, E. Low1, L. Ho2, J. Uthirapathy2, H. Tan2, W. S. Teo3, support.
C. Lim4, E. Kong5, J. L. Baldevarona6, T. L. Tan7. 1Nutrition and Methods: Serial patients were studied over a 1-year period in a
Dietetics, 2Nursing Service, 3Speech Therapy, 4Hospitality and private hospital. Demographic data, BMI, sun exposure, prior
Environmental Services, 5Occupational Therapy, 6Geriatric VD supplementation and skin colour were collected. VD levels
Medicine, 7General Medicine, Tan Tock Seng Hospital, were measured in patients at risk. Information on falls risk, HAI,
Singapore, Singapore intravenous antibiotics, surgery and an intensive care stay were
collected in patients with a VD level.
Rationale: Patients are at risk of developing poor nutrition Results: Of 392 patients studied, 185 (47.2%) were male. The
during hospitalisation due to multiple challenges. It is critical mean (SD) age was 73.9 (15.5) years with a median (IQR) length
that a systematic and coordinated approach is developed to of stay of 16 (10–24) days. 165 (42.1%) patients had prior
ensure safe and optimal nutrition care delivery within a vitamin D3 supplementation (≥1,000 IU/day). 109 (27.8%)
healthcare facility. This project aimed to describe the inter- patients were at risk for VD deficiency. In those, the mean
professional collaborative model utilised to implement (SD) 25-hydroxy-vitamin-D was 44.5 (20.6)nmol/L with 99
improvement initiatives and the outcomes achieved within an (90.8%) having insufficient (<75 nmol/L) and 69 (63.3%) having
acute hospital in Singapore. deficient (<50 nmol/L) levels. A quarter of all patients had
Methods: A nutrition committee comprising doctor, nurses, insufficient or deficient levels and of these 50.5% had a falls
speech therapist, occupational therapist, dietitians and cater- risk, 28.3% had a HAI, 52.2% required intravenous antibiotics,
ing staff was formed in 2015. It aimed to drive nutrition as one 24.2% had an intensive care stay and 48.5% underwent surgery.
of the key priorities in patient care, influence optimal nutrition Conclusion: Given high incidence of falls risk and morbidity in
care culture within the institution, plan and implement those patients with low VD levels it would seem prudent for
strategies in an inter-professional approach, and monitor dietitians to conduct VD risk assessment on all referred patients.
nutrition-related quality indicators. Disclosure of Interest: None declared.
Results: Seven nutrition quality statements were developed:
nutrition screening, nutrition care plan, feeding support, SUN-P295
feeding environment, availability of meals and snacks, pres- VITAMIN D TESTING AND SUPPLEMENTATION IN CLINICAL
entation of meals, and monitoring and review. Based on these PRACTICE: A CROSS-SECTIONAL STUDY AMONG LEBANESE
quality statements, improvement initiatives implemented PHYSICIANS IN A MIDDLE EASTERN URBAN SETTING
included granting nurses ordering privileges to refer nutritional
A. Aoun1 *, T. Karimeh1, N. El Gerges1, C. Obeid1, A. Wehbe2,
at risk patients to dietitian (referral of nutritional at risk
S. Hlais2. 1Notre Dame University, Louaize, Zouk Mosbeh,
patients to dietitian increased from 27% to 65%); granting 2
Saint Joseph University, Beirut, Lebanon
dietitians nutrition ordering privileges (appropriate nutrition
orders increased from 40% to 98%); improving serving compli- Rationale: This observational cross-sectional study evaluated
ance of oral nutrition supplements (21% to 87%); enhancing the knowledge and practice of Vitamin D (VitD) measurement
enteral feeds grade-up protocol (target feeds achieved within 3 and supplementation among physicians in North Lebanon.
Vitamins, antioxidants and minerals 1 S163
Methods: A convenience sample of physicians, working at Conclusion: The large majority of dysphagic patients proposed
hospitals and private clinics in North Lebanon, was recruited to PEG exhibit vitamin D deficiency. Underlying diseases, age,
during February and March 2016. Data was collected from a gender did not significantly influence the prevalence of
face-to-face interview performed by a trained local dietician. A vitamin D deficiency. Homemade meals were insufficient to
total of 270 physicians (231 men and 39 women) were included normalize serum vitamin D in most patients. More researches is
in the analysis. Informed consent form was signed by all needed to prepare guidelines for vitamin D supplementation in
physicians prior to participation. PEG patients.
Results: The knowledge and practice were very diverse among Disclosure of Interest: None declared.
physicians. Only 23 (8.5%) were able to identify good
nutritional sources of VitD. Fifty one (18.9%) physicians never
SUN-P297
measure VitD and 107 (39.6%) measure it in all patients.
THE ROLE OF CALCIUM, IRON, MAGNESIUM, PHOSPHORUS,
Moreover, 265 (98.1%) physicians do not recommend any
POTASSIUM, SELENIUM, SODIUM, AND ZINC ON MUSCLE MASS,
specific method of testing and 253 (93.7%) rely on the different
MUSCLE STRENGTH, AND PHYSICAL PERFORMANCE IN OLDER
cut-off levels of VitD set by the laboratories. Respectively, 162
ADULTS: A SYSTEMATIC REVIEW
(60%) and 174 (64.4%) ignore the approximate cost of the test
and supplementation. Additionally, 28 (10.4%) physicians C. van Dronkelaar1 *, A. van Velzen1, M. Abdelrazek1,
prescribe VitD supplements without diagnostic testing and A. van der Steen1, P. J. Weijs1,2, M. Tieland1. 1Faculty of Sports
254 (94.1%) consider that VitD supplementation does not have and Nutrition, Amsterdam University of Applied Sciences,
2
any side effects. Finally, 243 (90%) believe that physicians are Department of Nutrition and Dietetics, VU University Medical
over-prescribing VitD supplements. Center, Amsterdam, Netherlands
Conclusion: Confusion among physicians regarding when and
Rationale: Minerals may contribute to prevent and treat
how to diagnose and treat VitD deficiency is apparent. Local
sarcopenia, the age-related loss of muscle mass, muscle
and international guidelines are urgently needed to regulate
strength, and physical performance. The aim of this systematic
VitD testing and supplementation.
review is to evaluate the role of calcium, iron, magnesium,
Disclosure of Interest: None declared. phosphorus, potassium, selenium, sodium, and zinc on muscle
mass, muscle strength, and physical performance in older
SUN-P296 adults.
HYPOVITAMINOSIS D IN DYSPHAGIC PATIENTS THAT Methods: A systematic search was conducted between March
UNDERWENT ENDOSCOPIC GASTROSTOMY 2016 and July 2016, in the PubMed database using pre-defined
C. Santos1 *, A. Barata1, G. Nunes1, J. Fonseca1. 1Hospital search terms. Articles on the role of dietary mineral intake or
Garcia de Orta, Almada, Portugal mineral serum concentrations on muscle mass, muscle
strength, physical performance, and the prevalence of
Rationale: Vitamin D deficiency is a major public health sarcopenia in healthy or frail older adults (average age ≥ 65
problem and increased risk to develop vitamin D deficiency years) were selected. Meta-analyses statistic will be performed
comprise insufficient sunlight and reduced alimentary intake. when possible.
Dysphagic endoscopic gastrostomy (PEG) candidates may be at Results: From the 3,346 articles found, ten studies met the
risk due to low dietary intake and reduced motility, with inclusion criteria. Observational studies showed that serum
limited sun exposure. This study aimed to determine the selenium and calcium intake were significantly associated with
prevalence of hypovitaminosis D in dysphagic patients that muscle mass. Magnesium, based on one randomized controlled
were proposed and underwent gastrostomy and to assess trial, selenium, iron, and zinc intake were significantly and
potential relationships between vitamin D levels, age, gender positively associated with physical performance in older adults.
and underlying diseases. Magnesium, selenium, calcium, and phosphorus intake were
Methods: Prospective observational study during a 4 weeks’ associated with the prevalence of sarcopenia. No studies on the
period after gastrostomy. Data was collected at initial PEG role of sodium or potassium on muscle mass, muscle strength,
procedure (T0) and after 4 weeks (T1). Initial evaluation or physical performance were found. Meta-analysis was not
included: age, gender, disorder causing dysphagia, possible.
Neurological Dysphagia (ND) or Head and Neck Cancer (HNC), Conclusion: Minerals may be important nutrients to prevent
albumin, transferrin, Vitamin D. At T1, a blood sample was and treat sarcopenia. Particularly, magnesium, selenium, and
collected for Vitamin D, albumin and transferrin. Patients were calcium seem to be most promising. Most of the included
fed with homemade meals. studies, however, were observational studies. Therefore, more
Results: We initially evaluated 200 patients (118 males), 21–95 randomized controlled trials are needed to elucidate the
years: HNC-57, ND-143. Initial low Vitamin D in 181; low potential benefits of mineral intake to prevent and treat
albumin in 96, low transferrin in 121. Protein levels increase T0- sarcopenia and support healthy aging.
T1, most patients reaching normal values. Vitamin D has a Disclosure of Interest: None declared.
slower evolution, most patients still displaying low Vitamin D at
T1. Nevertheless, there were significant differences between
the 2 moments for vitamin D ( p = 0.000), as for albumin
( p = 0.000) and transferrin ( p = 0.014). No associations were
found between Vitamin D, age, gender or underlying disease.
S164 Poster
SUN-P298 vitamin D serum levels in autoimmune thyroid disease in Turkish

EFFECT OF ISOLATED OR COMBINED PARENTERAL INFUSION population.
OF FISH OIL EMULSION AND GLUTAMINE ON THE TISSUE Methods: The subjects with Hashimato thyroiditis (HT) (n = 67,
ANTIOXIDANT POTENTIAL OF RATS SUBMITTED TO ACUTE mean age 45.1 ± 10.9, female/male-61/6), control subjects
PANCREATITIS MODEL matched with age and sex (n = 29, mean age 42.1 ± 15.7,
R. S. Oliveira Filho1, P. C. Garla1, R. S. M. D. M. Torrinhas1, female/male-26/3) and only 6 patients with Graves’ disease
R. A. Garib1, A. Tesser1, F. G. G. Aprobato1, É. M. Tamanaha1, (mean age 42.5 ± 13.3, female/male-5/1) were recruited for
M. S. Antunes1, D. L. Waitzberg1 *. 1Department of the study during October–November 2016. Thyroid function
Gastroenterology, LIM 35, Faculdade de Medicina da tests, thyroid antibodies (AntiTg, AntiTPO, TSHRAb), ultra-
Universidade de São Paulo, São Paulo, Brazil sound features, demographic and antropometric variables
were recorded.
Rationale: Experimental acute pancreatitis (AP) is a well- Results: The mean vitamin D level was 53.1 ± 24.7 and
established oxidative stress model.1 Evidence suggests that fish 54.1 ± 19.8 nmol/L in the HT and control groups, respectively
oil (FO) and glutamine (GLN) can improve oxidative stress.2,3 ( p = 0.482). Vitamin D deficiency (≤50 nmol/L) was present in
The present study aimed to evaluate the tissue antioxidant 48% of the whole study group. Vitamin D deficiency was not
response to isolated or combined parenteral infusion(PI) of FO significantly different in HTand control group (48.7% vs. 37.9%,
and GLN prior the induction of experimental AP. p = 0.254). All 6 Graves’ patients had vitamin D deficiency
Methods: After central venous catheterization, isogenic rats which was 42.5 ± 13.3 nmol/L. Vitamin D insufficiency
received PI of FO10% (n = 2), GLN20% (n = 2), FO10%+GLN20% (between 51 and 74 nmol/L) was not significantly different
(n = 2) or not received PI (SHAM;n = 2) for 48 h. After this between HT and control groups (68.6% vs. 66.7%, p = 0.88,
period, the animals were submitted to the induction of AP. respectively). There was no correlation between vitamin D
After 12 h of AP induction, the rats were euthanized for lung level and thyroid antibodies (AntiTg and AntiTPO). Vitamin D
and spleen collection and subsequent analysis of antioxidant levels were significantly higher in subjects with L-thyroxine
enzymes glutathione peroxidase (Gpx) and superoxide dismu- replacement compared to those who were not taking replace-
tase (SOD) by immunohistochemistry. The intensity of these ment in HT group (58.7 vs. 46.0, p = 0.03, respectively).
enzymes cell marking was determined according to the Conclusion: Vitamin D level was not different significantly
following classification: 0-negative, 1-weak (<35%), 2-inter- between HTand control groups. It was significantly higher in HT
mediate (35–75%) and 3-strong (>75%). The genetic similarity of subjects with thyroid hormone replacement. Vitamin D could
the animals and the high specificity of the immunohistochem- be taking role in the development of autoimmune process.
istry technique allowed these analyzes to be explored in a small Besides, vitamin D deficiency could occur as a consequence of
sample of animals. the disease process. Further studies are needed to enlighten
Results: In the lung tissue, the Gpx cell marking showed the relationship between HT and vitamin D.
intensities 3 in the FO group, 2 in the FO + GLN and 1 in the GLN Disclosure of Interest: None declared.
and SHAM groups (FOvsGLN;SHAM p < 0,05); while SOD pre-
sented intensities 1 in the FO, GLN and SHAM groups and 0 in the
SUN-P300
FO + GLN. At the spleen, Gpx cell marking presented intensities
KIWIFRUIT FAVORABLY AFFECTS PARAOXONASE 1 ACTIVITY
3 in the FO and FO + GN groups and 1 in the GLN and SHAM
AND PREVENTS LIPID PEROXIDATION IN HIGH FAT DIET FED
groups (FO;FO + GLNvsGLN;SHAMp < 0,05); while SOD pre-
HAMSTERS
sented intensities 2 in the FO and FO + GLN groups and 1 in
the GLN and SHAM groups. H. Tayebinia1 *, N. Rezaei1, I. Khodadadi Kholan1,
Conclusion: The previous PI of FO, but not GLN, improved the S. Moradkhani1, E. Abbasi1, M. Saidijam1. 1Hamadan University
tissue antioxidant potential. This effect was partially lost when of Medical Sciences, Hamadan, Islamic Republic of Iran
FO + GLN was infused.
Rationale: Kiwifruit with high content of antioxidants improves
References serum HDL-cholesterol (HDL-C) level and shows beneficial
1. Armstrong JA, et al. Free Radic Res. 2013. effects on human health. The aim of this study was to
2. Manzanares W, et al. Crit Care. 2015. investigate the effects of kiwifruit on the activity and the
3. Wischmeyer PE, et al. Crit Care. 2014. gene expression level of paraoxonase 1 (PON1), the main
Disclosure of Interest: None declared. antioxidant enzyme of HDL, in high fat diet (HFD) fed hamsters.
Methods: Forty two male Syrian hamsters were divided into six
SUN-P299 groups and fed control diet, control diet with kiwi (1.86 or
ASSESSMENT OF VITAMIN D LEVEL IN AUTOIMMUNE THYROID 3.73 g/kg), or HFD (15% butter fat + 0.05% cholesterol) with or
DISEASE IN TURKISH POPULATION without kiwi for 8 weeks. Serum lipids profile and the
arylesterase and paraoxonase activities of PON1 were mea-
B. P. Sarer-Yurekli1, E. Bellikci-Koyu2 *, H. Ozisik1, D. Ongan2, sured by spectrophotometry whereas serum malondialdehyde
G. Ozgen1. 1Endocrinology and Metabolism, Ege Unversity, (MDA) and oxidized LDL (ox-LDL) were determined by fluor-
Faculty of Medicine, 2Nutrition and Dietetics, Izmir Katip ometry and ELISA, respectively. Liver gene expression level of
Celebi University, Faculty of Health Sciences, Izmir, Turkey PON1 was assessed by real time quantitative PCR. Results were
analyzed by one-way ANOVA followed by post hoc Tukey test and
Rationale: It has been reported that vitamin D is an
statistical significance was set at p < 0.05.
immunomodulatory factor beyond its role in the calcium-
Results: A significant increase in HDL-C and decrease in LDL-C
phosphorus homeostasis. The aim of this study was to assess
as well as a remarkable reduction in ox-LDL and MDA were
observed after consumption of kiwi in HFD-fed hamsters. Disclosure of Interest: H. Akatsu Grant/Research Support from:
Paraoxonase activity of PON1 significantly increased and research support, S. Arai: None declared, T. Tanaka: None declared,
arylesterase activity almost tripled after consumption of kiwi A. Kamiya: None declared, K. Arakawa: None declared, Y. Masaki: None
in treated groups compared with untreated hamsters. Kiwi declared, H. Tanaka: None declared, T. Kanematsu: None declared,
H. Ohara: None declared, K. Inoue: None declared, J.-Z. Xia: None
supplementation also significantly reduced PON1 gene expres-
declared, M. Maruyama: None declared.
sion level in the liver.
Conclusion: Our data suggest that in HFD-received hamsters,
kiwifruit supplementation improved lipid profile and prevented SUN-P302
lipid induced oxidative stress probably through increasing EVALUATING THE EFFECTS OF DIETARY FATTY ACID AND
arylesterase and paraoxonase activities of PON1. Increased ANTIOXIDANT VITAMIN INTAKE ON METABOLIC PROFILE IN
PON1 activity accompanied with decreased its gene expression PATIENTS WITH SCHIZOPHRENIA
level might suggest that incline in PON1 activity down-regulate I. Türkoğlu1 *, E. Akal Yıldız2, S. M. Mercanlıgil2, G. Yoca3,
the gene expression through a negative feedback control K. Yazıcı4. 1Department of Nutrition and Dietetics, Hacettepe
pathway. University Faculty of Health Sciences, Ankara, Turkey,
2
Department of Nutrition and Dietetics, East Mediterranean
University Faculty of Health Sciences, Famagusta, Cyprus,
3
Ministry of Health Erbaa Government Hospital, Tokat,
SUN-P301 4
Department of Psychiatry, Hacettepe University Faculty of
INVESTIGATION ON THE EFFECT OF AMINOLEVULINIC ACID ON
Medicine, Ankara, Turkey
INTESTINAL ENVIRONMENT OF AGING MICE
H. Akatsu1,2 *, S. Arai2,3, T. Tanaka4, A. Kamiya4, K. Arakawa1, Rationale: Esseantial fatty acid deficiencies in cellular
Y. Masaki1, H. Tanaka1, T. Kanematsu1, H. Ohara1, K. Inoue5, membranes have been observed in schizophrenia. There are
J.-Z. Xia3, M. Maruyama2. 1Department of Community-Based few studies in schizophrenia patients whether intake of dietary
Medical Education, Nagoya City University, Nagoya, fatty acids and antioxidant vitamins is inadequate and
2
Department of Mechanism of Aging, Research Institute, contributes observed deficits. The aim of the study was to
National Center for Geriarics and Gerontology, Ohbu, assess fatty acids and antioxidant vitamins intake and to
3
Morinaga Milk Industry Co., Ltd., Zama, 4SBI Pharmaceuticals evaluate effects of these nutrients on metabolic profile in
Co., Ltd., Tokyo, 5College of Pharmaceutical Sciences, patients with schizophrenia.
Ritsumeikan University, Kusatsu, Japan Methods: The study was conducted on 148 individuals with
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
Rationale: With aging, oxidative stress accumulates and diagnosis of schizophrenia or schizoaffective disorder and 77
potential of biodefence and immunity are decreased. age, gender matched healthy controls. Sociodemographic and
Aminolevulinic acid is indispensable as a raw material of medical data were obtained through interviews and question-
home for respiratory chain and oxygen transport. However, it is naires. Food and beverage intake was recorded by using a 24-
relatively insufficient due to aging, although it is a natural hour dietary record.
amino acid synthesized in vivo. Recently, it became possible to Results: The patients and healthy controls were similar in age,
obtain and ingest it as a supplemental material. There are gender and there is no statistical difference on body mass index
accumulated data that indicated the effects in impaired between the groups ( p > 0.05). Total fat and saturated fatty
glucose tolerance or so. The effect of oral ingestion on the acid intake was significantly higher in schizophrenia patients
intestinal environment is not well known. than in controls ( p < 0.05). There is no differences were found
Methods: 19-month-old C57BL/6 mice were fed for 6 weeks in omega-6/omega-3 ratio between the groups ( p > 0.05).
with food supplemented with ALA as a conventional diet. As Beta-carotene and C intakes were significantly lower in
non-aging controls, young mice at 6 weeks were performed for schizophrenia patients than in controls ( p < 0.05). When we
the similar intervention. Furthermore, as a positive controls, examine individuals with MetS total fat intake and saturated fat
young and aged mice fed conventional diet and given special intake of women with schizophrenia were significantly higher
water with oligosaccharide were included. Each group con- than healthy controls ( p < 0.01). No differences in antioxidant
tained 3 mice. Food and water intake, weight, and fecal flush vitamins intake were found between the groups who had MetS.
were carried out every week. For feces, gene extraction was Conclusion: It is needed the development of special dietary
carried out and the bacterial DNA sequencing was performed interventions for schizophrenia patients as increased intake of
comprehensively with the next generation sequencer for dietary fat and low antioxidant vitamin intake may contribute
analysis of microbiota composition. to the development of metabolic side effects of antipsychotic
Results: In the positive control groups given oligosaccharide- treatment.
containing water, young group took much more the water than
regular water group but result of aged mice was opposite. On
the other hand, the influence of ALA intervention was not
observed for both young and aged mice. There was no special
effect on the microbiota composition by ALA intervention.
Conclusion: No obvious effect was observed for ALA intake in
the study. This may be owing to the intensive individual variety
of the mice and short administration period. We are considering
future research with increasing number of animals and long-
term intervention.
S166 Poster
SUN-P303 Methods: A sample of 200 functionally independent patients

THE RELATION BETWEEN TRACE ELEMENTS LEVELS, TIME (111 women and 89 men) aged 65 years or older (mean age:
COURSE AND CLINICAL OUTCOMES IN CRITICALLY ILL 74.97 ± 7.44) was selected from Medicine Faculty of Ankara
SURGICAL PATIENTS University. Standardized Mini Mental State Examination (S-
J. Yang1 *, S. K. Hong2. 1Department of Pharmacy, Asan Medical MMSE) was used to evaluate cognitive function, Geriatric
Center, 2Department of Surgery, Asan Medical Center, Depression Scale (GDS) to assess depression status for all
University of Ulsan College of Medicine, Seoul, Republic of patients. 24-hours physical activity records were obtained to
Korea assess physical activity level (PAL). Patients with advanced
visual and auditory impairment, delirium, cancer and disabled
Rationale: This study aimed to determine trace elements were excluded.
levels, time course and relation to clinical outcomes in Results: Thirty eight of two hundred (%19) patients were
critically ill surgical patients. diagnosed with dementia. Those with dementia and without
Methods: We reviewed retrospectively patients’ electronic dementia were divided into two groups. The dementia group’s
medical records that were admitted to an adult surgical mean scores of S-MMSE, GDS and PAL were 17.63 ± 3.93, 8.81±.41
intensive care unit (ICU) from January 2016 through December and 1.2 ± 0.14, respectively. Non-demented group’s mean scores
2016 and managed for more than 7 days. We analyzed whole of S-MMSE and GDS were 25.61 ± 3.43, 5.37 ± 2.9 and 1.49 ± 0.26,
blood selenium level, serum zinc level, serum copper level at respectively. In all groups; S-MMSE, GDS and PAL scores of men
interval of week during the ICU stay and investigated length of were significantly higher than women (p < 0.05). When we
stay (LOS) in the ICU, LOS in the hospital, and 90-day mortality. analyzed the relationship between S-MMSE values and the results
Data were analyzed using SPSS 21. of the PAL and GDS, we found significant positive correlation for
Results: A total of 87 patients were evaluated and selenium, S-MMSE versus PAL (n = 200, r = 0.56, p < 0.001) and negative
zinc, copper levels were collected 152, 154 and 154 respectively correlation S-MMSE versus GDS (n = 200, r = −0.55, p < 0.001).
at ICU day 1∼28. Overall, mean selenium level was 10.5 ± 4.1 Conclusion: The study revealed that the cognitive impairment
(range, 6–45) mcg/dL and mean zinc level was 68.0 ± 25.9 (16– was significantly associate with depression. This may be due to
169) mcg/dL, and mean copper level was 78.7 ± 34.5 (13–159.7) the association between depression and physical disability or
mcg/dL. No selenium levels were below normal range. But, the depression may have been reduced their active lifestyles.
zinc and copper levels were below in 51.9% and 42.9% Disclosure of Interest: None declared.
respectively. The zinc levels were steadily increased during
the ICU stay (R2 = 0.21, p < 0.001). In subgroup, patients with
SUN-LB305
continuous renal replacement therapy (CRRT) had correlation
THE EFFECT OF NUTRITIONAL INTERVENTION IN OLDER
(R2 = 0.36, P < 0.001). Fourth zinc levels were higher in the
ADULTS ON HANDGRIP STRENGTH AND MORTALITY: RESULTS
nonsurvivor group (114.9 ± 41.2 mcg/dL) than in the survivor
FROM 9 POOLED RCTS
group (80.8 ± 19.8 mcg/dL, p = 0.022). Second copper levels
were inversely correlated with LOS in the hospital in the survivor J. I. Van Zwienen-Pot1 *, I. Reinders2, C. P. de Groot3,
group (R2 = 0.11, p = 0.037). Other levels were not correlated A. M. Beck4, I. Feldblum5, I. Jobse6, F. Neelemaat1,
with LOS in the ICU and hospital and 90-day mortality. M. A. de van der Schueren1,7, D. R. Shahar5, E. T. Smeets3,
Conclusion: There was no selenium deficiency in surgical ICU M. Tieland3, H. A. Wijnhoven2, D. Volkert6, M. Visser1,2.
1
patients within 4 weeks after ICU admission. Whole blood Department of Internal Medicine, Nutrition and Dietetics, VU
selenium level was no different over time and was not University Medical Center, 2Department of Health Sciences,
correlated with clinical outcomes. Serum zinc level has steadily Faculty of Earth and Life Sciences, Vrije Universiteit,
increased during the ICU stay in patients with CRRT and was Amsterdam, 3Division of Human Nutrition, Wageningen
higher in the nonsurvivor. University, Wageningen, Netherlands, 4Clinical Nutrition
Research Unit, Herlev University Hospital, Gentofte, Denmark,
Daniel Abraham International Center for Health and Disease
Department of Public Health, Faculty of Health Sciences, Ben-
Gurion University, Beer-Sheva, Israel, 6Institute for
Late Breaking Abstract 1 Biomedicine of Aging, Friedrich-Alexander-Universität
Erlangen-Nürnberg, Nuremberg, Germany, 7HAN University of
SUN-LB304 Applied Sciences, Nijmegen, Netherlands
ASSOCIATIONS BETWEEN PHYSICAL ACTIVITY, DEPRESSION
AND COGNITIVE FUNCTION Rationale: Nutritional intervention studies in older malnour-
A. Ilhan1 *, P. Bilgic1, M. Varli2. 1Hacettepe University Faculty of ished adults or at risk of malnutrition focus on improving
Health Sciences Department of Nutrition and Dietetics, nutritional status through increasing energy and protein intake.
2
Department of Internal Medicine, Ankara University, Faculty While this often results in weight gain, limited information is
of Medicine, Ankara, Turkey available on the effect on clinical outcomes such as handgrip
strength (HGS) and mortality.
Rationale: The burden of dementia among older individuals is
Methods: Individual patient data from 1,263 participants from
an important public health problem, considering the increasing
9 nutritional intervention RCTs were pooled (4 hospital setting,
number of elderly population in Turkey. The prevalence of
3 community dwelling, 2 institutionalized). Intervention
depression has also grown in Turkish older adults. Therefore, the
consisted of ONS, dietary counselling or both. HGS change
aim of this study was to investigate the relationship between
was measured in 7 RCTs (N = 676: 308 control) and mortality in 6
physical activity level, depression and cognitive function in
RCTs (N = 793: 426 control). A ≥3 kg increase in HGS was
community-dwelling older adults living in Ankara, Turkey.
Late Breaking Abstract 1 S167
considered clinically relevant. Logistic generalized estimating participants were required to be over 65 years of age to be
equations analyses were used to test intervention effect. eligible. Study quality was assessed using Newcastle Ottawa
Results: Mean baseline age of those with measured HGS was 80 Scale by two independent reviewers. A meta-analysis was not
(SD8) years and 64% was female. In the intervention group, 26% conducted due to study heterogeneity.
had a relevant HGS increase versus 24% in controls ( p = 0.59). Results: 24 prospective cohort studies were included. The
Overall, GEE showed no treatment effect on HGS (OR 1.15 95% majority of studies failed to control for confounders limiting
CI 0.81–1.62). However, interaction was found between setting the generalisability of these study results. The studies that did
and treatment ( p = 0.076): a stronger effect on HGS was control for confounders displayed that frailty, polypharmacy,
observed for hospital patients versus other settings. For the 793 poor self reported general health, cognitive decline, dementia,
participants with mortality data mean age was 79 (9) years and eating dependencies, loss of interest in life, poor appetite
65% women. In the intervention group, 8% died versus 12% in and impaired swallowing were significant predictors of
controls ( p = 0.08). Overall, no treatment effect was observed malnutrition.
(OR 0.65 95% CI 0.36–1.16). However, interaction was found Conclusion: This is the first systematic review to investigate
between treatment and sex ( p = 0.07) and setting ( p = 0.02): the potentially modifiable determinants of malnutrition in
effect on mortality was greater for women versus men and for older adults. Targetting the modifiable factors identified in the
institutionalized participants versus other settings. results will inform better screening tools for malnutrition and
Conclusion: This pooled analysis showed that nutritional the development of more interventions for the effective
intervention in older persons has no overall effect on handgrip treatment and prevention of malnutrition in older adults.
strength and mortality. However, positive effects were References: Not published yet.
observed in specific subgroups. Disclosure of Interest: None declared.
SUN-LB307
SUN-LB306 ABDOMINAL ULTRASOUND FINDINGS OF GASTROINTESTINAL
POTENTIALLY MODIFIABLE DETERMINANTS OF MOTILITY ARE EFFECTIVE IN PREDICTING THE RISK OF FEVER
MALNUTRITION IN OLDER ADULTS: A SYSTEMATIC REVIEW DUE TO RESPIRATORY INFECTIONS IN PATIENTS WITH FEEDING
M. O’keeffe1 *, M. Kelly1, E. O’herlihy2, P. O’toole2, P. Kearney2, TUBES
S. Timmons2, C. Stanton2, Y. Rolland3, C. Sulmont Rosse4, M. Ishii1 *, Y. Yamaguchi1, S. Osumi2, Y. Tanaka2, S. Ogawa1,
I. Maitre5, H. Boeing6, M. Stelmach6, G. Nagel7, M. Wolters8, M. Akishita1. 1The Department of Geriatric Medicine, The
A. Hebestreit8, L. De Groot9, R. Teh10, M. Agnes Peyron11, University of Tokyo, Tokyo, 2Okamoto-Ishii Hospital,
D. Dardevet11, I. Papet11, M. Streicher12, G. Torbahn12, Yaizu, Japan
E. Kiesswetter12, M. Visser13, D. Volkert12, E. O’connor14,
on behalf of MaNuEL. 1Biological Sciences, University of Rationale: Decreased gastrointestinal motility including gas-
Limerick, Limerick, 2University College Cork, Cork, Ireland, troesophageal reflux is one of the causes of the aspiration
3
Gerontopole Toulouse, Toulouse, 4INRA au Centre des Sciences pneumonia in elderly patients with feeding tubes.
du Goût et de l’Alimentation, Dijon, 5School of Agricultural Methods: We studied 33 patients with feeding tubes who were
Studies (ESA) Angers, Angers, France, 6German Institute for admitted to the long-term care hospital for more than 90 days.
Nutrition Potsdam-Rehbruecke, Potsdam, 7Ulm University, The febrile days of 37.5°C or greater in each patient were
Ulm, 8Leipniz Institute for Prevention Research and counted during the past 90-day records. Fever due to
Epidemiology, BIPS GmbH, Bremen, Germany, 9Wageningen respiratory infections was determined by excluding the fevers
University Research Centre, Wageningen, Netherlands, diagnosed as resulting from other causes. The cross-sectional
10
University of Auckland, Auckland, New Zealand, 11INRA area of and proximal stomach and the antrum were measured
Clermont, Lyon, France, 12Friedrich-Alexander-Universität by ultrasonography before and after administration of liquid
Erlangen-Nürnberg, Nürnberg, Germany, 13VU University diet (1 kcal/ml, 400 ml/hr, 400 ml × 3/day). We evaluated the
Amsterdam, Amsterdam, Netherlands, 14University of function of gastric discharge and dilatation at 1-min and 30-min
Limerick, Limerick, Ireland intervals after the administration.
Results: We evaluated the relationships between gastrointes-
Rationale: Malnutrition is widespread among older adults tinal motility and febrile days for the screening of respiratory
worldwide. To develop effective prevention strategies, evi- infections in patients with feeding tubes. In the multivariate
dence-based knowledge is needed on the modifiable determi- analysis the febrile days were associated with the decreased
nants of malnutrition in this population. Many cross-sectional motility of the discharge in the antrum of stomach at 30-min
studies and narrative reviews exist, but systematic reviews of intervals after the administration ( p < 0.05). The logistic
prospective studies are lacking. Identifying the potentially regression analysis showed that decreased motility of the
modifiable determinants of malnutrition could inform screen- dilatation in the proximal stomach was associated with a
ing tool/clinical prediction rule development and the forma- history of lower respiratory infections ( p < 0.05).
tion of preventative interventions. Conclusion: Decreased gastrointestinal motility is one of the
Methods: A systematic review was performed in accordance causes of fever due to aspiration in the elderly patients with
with the PRISMA statement. It was registered on PROSPERO. feeding tubes. The findings of decreased gastrointestinal
Eight electronic databases were searched using an agreed motility in the abdominal ultrasound examination are effective
range of keywords by two independent reviewers. Prospective in predicting the risk of fever due to respiratory infections in
studies with at least one determinant measured at baseline and the elderly patients.
malnutrition as outcome at follow-up were included. Study Disclosure of Interest: None declared.
S168 Poster
SUN-LB308 and healthcare costs in the community setting in China is

THE COST OF SARCOPENIA RELATED HOSPITALIZATIONS IN limited. This paper aims to study the association between
OLDER ADULTS malnutrition and hospital costs among community-dwelling
S. Goates1 *, K. Du2, S. Pereira3, M. E. Arensberg3, T. Gaillard4. older Chinese adults.
1
Abbott Laboratories, Columbus, 2Abbott Laboratories, Methods: A sample of 7,768 adults aged 60 years or older from
Urbana-Champaign, 3Abbott Laboratories, Columbus, the 2013 China Health and Retirement Longitudinal Study were
4
University of Cincinnati, Cincinnati, United States included in the analysis. Handgrip strength, body mass index
and weight loss were used as indicators of malnutrition status.
Rationale: There are few estimates of the cost burden of Negative binomial regressions were employed to analyze the
sarcopenia in older aduts, and none that use the modern associations between malnutrition and the number of hospital
definition incorporating both low lean body mass and func- admissions and outpatient visits. A two-part model was used to
tional limitation. Our objective is to provide an updated analyze the impact of malnutrition on hospital cost. The first
estimate of the cost burden of sarcopenia related hospitaliza- part studied the impact of malnutrition on the use of inpatient
tions in American adults age 65 and older. and outpatient services, and the second part investigated the
Methods: We used the National Health and Nutrition impact of malnutrition on inpatient and outpatient cost,
Examination Survey (NHANES) from 1999–2004 to identify conditional on using medical services. Analysis controlled for
sarcopenic individuals – those with low appendicular lean socio-demographics, health status, health insurance, and
mass adjusted for body mass index (<0.789 kg/m2 for men; quality of healthcare.
<0.512 kg/m2 for women) who report functional limitation. Results: Malnutrition was associated with 32% more hospital
The annual cost of hospitalization was imputed using episode admissions and 31% higher inpatient cost per year; 17% more
cost data from the Health Care Utilization Project 2014, based outpatient visits, and 9% more outpatient cost per month (all
on age, race, gender and number of hospitalizations. The p < 0.01). In total, malnutrition was associated with ¥32.37
impact of sarcopenia on annual hospitalization costs was ($4.62) billion and ¥13.47 ($1.92) billion additional inpatient
estimated using two-part multivariate regression. Population and outpatient costs every year (all p < 0.01) in China.
total costs were estimated for race-gender subgroups using Conclusion: Malnutrition was associated with significantly
population counts from the US Census 2014, the subgroup more hospital admissions, higher hospital outpatient visits
prevalence of sarcopenia estimated from NHANES, and and associated costs. These results suggest that malnutrition is
marginal costs estimates of sarcopenia. Confidence intervals an independent predictor of hospital cost and healthcare
were estimated by simulation. resource utilization, thus highlighting the importance of
Results: The total cost of sarcopenia-related hospitalizations in malnutrition screening, identification, and treatment for
the United States for this population is $18.4 billion annually older Chinese adults living in the community.
(95% CI: $7.5 billion, $28.5 billion). The estimated burden for Disclosure of Interest: S. Goates: None declared, Y. Zhang: None
women is greater than for men ($10.4 billion vs. $8.0 billion; p- declared, L. Fan Other: Employee of Abbott Nutrition, S. Li Shareholder
value = 0.09), and the cost per person varies significantly by at: Abbott Nutrition, Other: Employee of Abbott Nutrition, L. Claytor
race ( p < 0.01): $322 for Whites (CI: $131, $503); $140 for Shareholder at: Abbott Nutrition, Other: Employee of Abbott Nutrition,
Blacks (CI: $46,$261); $741 for Hispanics (CI:$280, $1161) and J. Partridge Shareholder at: Abbott Nutrition, Other: Employee of
$697 for Other (CI: $157,$1445). Abbott Nutrition, S. Sulo Shareholder at: Abbott Nutrition, Other:
Conclusion: Sarcopenia increases hospitalization and imposes Employee of Abbott Nutrition.
a heavy burden on health care spending for the elderly. These
findings emphasize the need for early identification and SUN-LB310
treatment in at-risk older adults to reduce hospitalization. EFFICACY OF ACTIVE HEXOSE CORRELATED COMPOUND
Disclosure of Interest: S. Goates Shareholder at: Shareholder of Abbott
AGAINST NASOPHARYNGEAL COMPLAINTS: A RANDOMIZED,
Nutrition, Other: Employee of Abbott Nutrition, K. Du Other: Employee DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL
of Abbott Nutrition, S. Pereira Shareholder at: Shareholder of Abbott T. Hisajima1,2,3 *, H. Waki1,3, A. Sato4, T. Miura4, T. Suzuki2,
Nutrition, Other: Employee of Abbott Nutrition, M. E. Arensberg Y. Tanaka2, K. Tamai2, K. Uebaba1,2,3, K. Imai1,2,3. 1Research
Shareholder at: Shareholder of Abbott Nutrition, Other: Employee of Institute of Oriental Medicine, 2Graduate School of Health
Abbott Nutrition, T. Gaillard: None declared. Science, 3Faculty of Health Care, Teikyo Heisei University,
Tokyo, 4Amino Up Chemical Co., Ltd., Sapporo, Japan
SUN-LB309
ASSOCIATION BETWEEN MALNUTRITION AND HOSPITAL COST Rationale: The aim of this study was to investigate the
AMONG COMMUNITY-DWELLING OLDER CHINESE ADULTS potential of active hexose correlated compound (AHCC) on
S. Goates1,2 *, Y. Zhang3, L. Fan4, S. Li5, L. Claytor6, nose symptom affected by autonomic nervous system (ANS)
J. Partridge1, S. Sulo7. 1Abbott Laboratories, Columbus, United activity.
States, 2Abbott Laboratories, Columbus, United States, Methods: The randomized, double-blind, placebo-controlled,
3
National Health Development Research Center, Beijing, cross-over trial was conducted on 18 adult subjects. AHCC (3 g/
China, 4Abbott Laboratories, Urbana-Champaign, United day) or placebo was scheduled, each of 14 days, with a 14-days
States, 5Abbott Laboratories, Shanghai, China, 6Abbott wash-out. The degree of a runny nose was evaluated
Laboratories, Singapore, Singapore, 7Abbott Laboratories, subjectively by Wisconsin Upper Respiratory Symptom Survey-
Chicago, United States 21 (WURSS-21). Low-frequency (LF) and high-frequency (HF)
components of heart rate (HR) variability were measured
Rationale: China has a large and growing elderly population. during sitting rest as markers of ANS function. LF/HF ratio and
However, research on the association between malnutrition HF were used for the index of the activity level of the
sympathetic nerve and the parasympathetic nerve, respect- (0.27), p = 0.04). Circulating insulin levels were significantly
ively. The data were analyzed statistically by paired and higher in the risk allele groups compared to the TT genotype
unpaired t-test. (21.9 mIU/L (12.8) vs 14.2 mIU/L (4.3), p = 0.04). Liver
Results: From Day1 through Day14, the amount of changes in stiffness measures did not differ between the groups, although
sneezing, runny nose, nasal congestion, and postnasal drip in liver fat was notably higher in the risk allele groups compared
the placebo group were 0.67 ± 1.87, 0.83 ± 2.17, 0.42 ± 2.61, to the TT genotype (13.7% (10.5) vs 8.8% (8.7) ns).
and 0.67 ± 1.78, respectively, showing an increase in all Conclusion: Patients with NAFLD carrying the unfavourable
participants, whereas in the AHCC group these were AA/AT genotype of rs9939609 polymorphism had a more
−0.42 ± 1.08, −0.58 ± 1.88, −0.58 ± 1.88, and −0.92 ± 1.62, unfavourable anthropometric, biochemical, liver stiffness
respectively, showing a decrease in all participants, especially measure and hepatic steatosis phenotype. Larger numbers
decreases in the nasal congestion ( p < 0.05) and postnasal drip are needed to determine true prevalence rates and associated
( p = 0.08) conditions. In addition, with respect to postnasal metabolic features.
drip, the AHCC group showed a significant difference ( p < 0.05) Disclosure of Interest: None declared.
compared to the placebo group. In comparison between Day1
and Day14, in the AHCC group, HR increase ( p = 0.01) and HF
SUN-LB312
suppression ( p = 0.08) were confirmed, whereas in the placebo
BODY COMPOSITION SIGNIFICANTLY INFLUENCES ENERGY
group, no significant changes were observed. From Day1
EXPENDITURE IN CIRRHOSIS
through Day14, in the AHCC group, there was a significant
difference ( p = 0.04) between groups, along with an increase in J. K. Heyman1 *, G. W. McCaughan2, K. Liu2, B. Rijksen3.
1
the sIgA amount ( p = 0.08) in the saliva. Nutrition and Dietetics, 2Liver Transplant, Royal Prince Alfred
Conclusion: These data indicated that AHCC was effective in Hospital, Sydney, Australia, 3Radiation Oncology, The
improving nasal congestion and postnasal drip symptoms. Netherlands Cancer Institute, Amsterdam, Netherlands
Disclosure of Interest: None declared. Rationale: ESPEN guidelines recommend measuring energy
expenditure in cirrhosis. We conducted a retrospective analysis
SUN-LB311 of our indirect calorimetry results in our cohort of adults with
FTO RS9939609 POLYMORPHISM IN NON ALCOHOLIC FATTY cirrhosis (2003–2017) to determine the normal energy expend-
LIVER DISEASE – FREQUENCY AND CHARACTERISTICS OF RISK iture range and to identify the influence of energy expenditure
GENOTYPES on nutrition.
A. C. Tierney1 *, E. George1, A. Reddy1, M. Ryan2, S. Sood3, Methods: 209 adults with cirrhosis [155 male: 54 female, mean
A. Nicoll4, S. Roberts5. 1La Trobe University, 2St Vincent’s age (range) 52.7 (17–75) years], who consented to have indirect
Hospital, 3Royal Melbourne Hospital, 4Eastern Health, 5Alfred calorimetry were included. Skin fold anthropometry measures
Health, Melbourne, Australia were done on each participant as part of their nutritional
assessment and compared to normal values to determine body
Rationale: The Fat Mass and Obesity-Associated Protein (FTO) composition. Our results were normally distributed and
gene rs9939609 single nucleotide polymorphism (SNP) has been analysed using ANOVA and chi-square in statistical software
associated with metabolic diseases in the general population. (SPSS).
As such, it may also play a role in the development and Results: 105 adults in our normal range for energy expenditure
progression of Non Alcoholic Fatty Liver Disease (NAFLD). The (25th–75th %tile) utilised 1,461.8–1,909.8 kcal/day at rest. The
aim of this study was to examine the prevalence of the majority of the 52 adults with faster than normal energy
rs9939609 FTO polymorphism in a NAFLD cohort and describe expenditure (>75th %tile) 41/52(78.8%) had muscle mass in or
the metabolic and liver factors in the risk allele A groups. above the normal range and 44/52 (84.6%) had fat stores in or
Methods: A cross-sectional study in 28 patients with diagnosed above the normal range for age and gender. The majority of the
NAFLD. FTO rs9939609 polymorphism was genotyped by 52 adults with slower than normal energy expenditure (<25th %
Fitgenes Limited. Anthropometric, biochemical and metabolic tile) 31/52(59.6%) had less than normal muscle mass and 35/52
risk factors were assessed. Patients underwent transient (67.3%) had less than normal fat stores for age and gender.
elastography, Fibroscan™ to determine liver stiffness measures These differences in body composition were highly significant
and Magnetic Resonance Spectroscopy for intrahepatic lipid ( p < 0.002).
content. Conclusion: In our cohort body composition significantly
Results: Ten percent of patients with NAFLD in this cohort were influences energy expenditure in cirrhosis while other factors
carriers of the rs9939609 AA genotype, 53.6% were AT carriers such as disease severity, diagnostic group and ethnicity do not.
and 35.7% were homozygote TTcarriers. Patients with the risk A Hypermetabolic adults with cirrhosis are usually described in
allele had a significantly higher waist-to-hip ratio compared to the literature as malnourished as their nutritional require-
the non-risk TT genotype group (1.0 (0.1) vs 0.9 (0.04), ments are high and difficult to meet. However our data indicate
respectively, p = 0.04) and neck circumference (41 cm (4.1) v that these patients have well maintained muscle and fat stores.
37 cm (3.3), respectively, p = 0.02). The AA group had Early nutrition assessment including measuring energy expend-
significantly higher ALT levels (88.3 U/L (43)) compared to iture and nutritional intervention may assist in providing
the AT (55.4 U/L (21.6)) and the TT (42.2 U/L (23.6)) groups, nutritional requirements in cirrhosis.
p = 0.04. AST values were also significantly higher (AA 60 U/L Disclosure of Interest: None declared.
(27), AT 35 U/L (12.6) and TT 27 U/L (10.5), p = 0.004). HDL
cholesterol was significantly lower in the risk allele groups (AA
1.0 mmol/L (0.26), AT 1.1 mmol/L (0.23) TT 1.37 mmol/L
S170 Poster
SUN-LB313 for intensive postoperative care. Until recently a suitable

CORRELATION BETWEEN MUSCLE STRENGTH AND PROGNOSIS biochemical marker to identify high risk patients has not been
IN CHRONIC LIVER DISEASE PATIENTS available. Now the Albumin Copper Binding Assay (ACuB Assay)
M. Shiraki1 *, T. Hanai1, M. Shimizu1. 1Department of Internal has been developed to improve the detection of ischemia-
Medicine, Gifu University School of Medicine, 1–1 Yanagido, modified albumin (IMA), traditionally detected by cobalt
Gifu, Japan binding assay. The aim of the presented work was to test the
ability of the assay to predict the development of dehiscence.
Rationale: In recent years reported associations between Methods: Patients (n = 117) suffering from colorectal cancer
various diseases and sarcopenia have attracted attention. In and undergoing surgery were enrolled in the study. In 5
chronic liver disease patients, there are a lot of articles about patients, dehiscence of anastomosis developed (4.3%). Blood
the quantity of muscle, but there are few articles about the samples were drawn prior to and 2 hours after the surgery. The
quality of muscle. We investigated muscle strength, prognosis, Albumin Copper Binding Assay was performed to detect IMA
and associated factors in chronic liver disease patients. using copper(II) ions and the fluorescent dye lucifer yellow. The
Methods: The subjects were 263 chronic liver disease patients results are expressed as the pre- and post-operative difference
(men:women, 153:110; age 71 (19–89) years; chronic hepatitis: in fluorescence units (FU) per g of albumin (mean±SD). These
cirrhosis, 79:174; Child-Pugh classification A:B:C, 96:57:21; values correlate with usually increased concentration of
hepatocellular carcinoma yes:no, 152:111; etiology HBV:HCV: ischaemia-modified albumin postoperatively, due to tissue
alcohol:others, 35:159:22:47; observation period 695 (1–1603) ischemia.
days). Sarcopenia was diagnosed using the Assessment Criteria Results: Patients suffering from dehiscence (365 ± 159 FU/g)
for Sarcopenia in Liver Disease 2016 of the Japan Society of had a significantly higher concentration of ischemia-modified
Hepatology. albumin compared to controls (97 ± 240 FU/g, p = 0.017). Using
Results: 1. The frequency of sarcopenia complications was a cut-off value of 270 FU/g for discriminating positive vs.
15.0% in all subjects, with muscle weakness in 27.6% and negative results, the diagnostic sensitivity was 100%, specifi-
reduced muscle mass in 46.7%. 2. Grip strength was 33.0 (12.0– city 80% and efficiency 81%. The negative predictive value was
59.8) kg in men and 19.1 (8.3–28.6) kg in women. 3. A 100% and positive predictive value 20%.
significant relationship was observed between muscle strength Conclusion: This recently developed method offers new
and prognosis. 4. Using survival prognosis as the outcome, the diagnostic help in postoperative intensive care. In particular,
optimal cut-off values calculated using receiver–operating the high negative predictive value may help to exclude patients
characteristic curves were 28.9 kg for men (area under the not threatened by dehiscence of anastomosis. Possible analyt-
ROC curve [AUC], 0.78; sensitivity, 82%; specificity, 70%) and ical improvements of this promising assay may even improve its
17.6 kg for women (AUC, 0.65; sensitivity, 63%; specificity, diagnostic efficiency.
67%). 5. Muscle strength was significantly related to sex, age, Supported by grant of Ministry of Commerce No FV 10454,
clinical condition, albumin level, branched chain amino acid Czech Republic.
level, and zinc level. In multivariate analysis, muscle strength Disclosure of Interest: None declared.
was significantly related to age (odds ratio (OR) 1.08 (1.03–
1.11) P < 0.01), branched chain amino acids level (OR 0.99
SUN-LB315
(0.99–0.999) P = 0.03), and zinc level (OR 0.98 (0.95–0.99)
CURCUMIN PROTECTS LIVER INFLAMMATION BY SUPPRESSING
P = 0.04).
INOS INDUCTION IN RAT HEPATOCYTES
Conclusion: The frequency of sarcopenia complications was
15.0%, with muscle weakness in 27.6%and reduced muscle mass R. Nakatake1 *, H. Hishikawa1, H. Matushima1, Y. Nakamura1,
in 46.7%. A significant relationship was observed between M. Ishizaki1, K. Matsui1, M. Kaibori1, M. Nishizawa2,
muscle strength and prognosis. There was significant correl- T. Okumura1,3, A.-H. Kwon1. 1Surgery, Kansai Medical Universiy,
ation between muscle strength and serum branched chain Osaka, 2Biomedical Sciences, College of Life Sciences,
3
amino acids and zinc concentrations. These findings suggest Research Organization of Science and Technology,
that nutritional intervention with branched chain amino acids Ritsumeikan University, Shiga, Japan
and zinc would be effective the treatment of muscle weakness
Rationale: Curcumin has a variety of beneficial effects on
or the prognosis in chronic liver disease patients.
organ metabolism. However, there is little evidence that
Disclosure of Interest: None declared. curcumin affects inflammatory mediators, such as tumor
necrosis factor (TNF)-α and nitric oxide (NO). In inflamed
SUN-LB314 liver, proinflammatory cytokines stimulate liver cells, followed
ALBUMIN COPPER BINDING ASSAY AS A PREDICTOR OF by induction of inducible NO synthase (iNOS). Excessive NO
ANASTOMOSIS DEHISCENCE IN PATIENTS AFTER COLORECTAL produced by iNOS is one of the factors in liver injury. Therefore,
SURGERY inhibiting iNOS induction for preventing liver injury is import-
R. Hyspler1 *, A. Ticha1, L. Zaloudkova2, I. Svobodova1, ant. This study aimed to investigate liver protective effects
M. Kaska3, Z. Zadák1. 1Department of Research and of curcumin by examining interleukin (IL)-1β-stimulated
Development, 2Department of Clinical Chemistry, hepatocytes.
3
Department of Surgery, University Hospital Hradec Kralove, Methods: Hepatocytes were isolated from rats (Wistar male,
Hradec Kralove, Czech Republic 200 g) and cultured. Cells were treated with IL-1β (1 nM) in the
presence or absence of curcumin (5–25 μM). Induction of NO
Rationale: Dehiscence of anastomosis is an infrequent but production and iNOS, and the signaling pathway of iNOS were
serious complication of colorectal surgery and a difficult task analyzed.
Results: Simultaneous addition of IL-1β and curcumin SUN-LB317

decreased expression levels of iNOS protein and mRNA, THE APPLICATION OF ONODERA PROGNOSTIC NUTRITIONAL
resulting in inhibition of NO production. Curcumin also INDEX AND NEUTROPHIL-LYMPHOCYTE-RATIO IN RISK
reduced mRNA expression of TNF-α and IL-6. Curcumin EVALUATION OF POSTOPERATIVE COMPLICATION AND
inhibited two essential signaling pathways for iNOS induction, PREDICTING THE PROGNOSIS OF GASTRIC CANCER PATIENTS
NF-κB activation and type I IL-1 receptor upregulation. ACCEPTED GASTRECTOMY
Transfection experiments showed that curcumin reduced iNOS D. Liu1 *, W. Kang1. 1General Surgery Ward 3, Peking Union
mRNA levels at the promoter activation and mRNA stabilization Medical College Hospital, Beijing, China
steps. Delayed administration of curcumin after IL-1β addition
also inhibited iNOS induction. Rationale: To investigate the application of Onodera prognostic
Conclusion: Curcumin affects induction of inflammatory nutritional index and Neutrophil-Lymphocyte ratio in risk
mediators, such as iNOS and TNF-α, in part through inhibition evaluation of postoperative complication and predicting the
of NF-κB activation in hepatocytes. Curcumin may have outcomes of gastric cancer patients accepted gastrectomy.
therapeutic potential for organ injuries, including the liver. Methods: Clinical data of 877 patients with pathologically
Disclosure of Interest: None declared. proved gastric cancer who had undergone gastrectomy in
Beijing Peking Union Medical College Hospital between October
2006 and March 2011 were extracted and analyzed retrospect-
SUN-LB316
ively. The distributions of OPNI and NLR in clinical features
INFLUENCES OF AGING ON THE PHAGOCYTIC ACTIVITY OF were analysed. The Receiver Operating Characteristic (ROC)
KUPFFER CELLS IN MICE curve and Youden index were used to determine the cutoff
S. Murakoshi1 *, K. Fukatsu1, M. Noguchi1, T. Watanabe2, values for OPNI and NLR, which had the best sensitivity and
K. Higashizono3, A. Watkins1, H. Yasuhara1. 1Surgical Center, specificity. We analyzed the correlation between OPNI and
The University of Tokyo Hospital, Tokyo, 2Surgery, National NLR. Logistic regression model was used to investigate the
Defense Medical College, Tokorozawa, 3Gastrointestinal application of OPNI and NLR in risk evaluation of postoperative
Surgery, The University of Tokyo Hospital, Tokyo, Japan complications. The Cox proportional hazard model was used to
explore the influencing factors of predicting the outcomes.
Rationale: The hepatic immunity generally declines with Results: The mean OPNI was 46.54 ± 7.08, and the mean NLR
aging. Clinically, the consequences of impaired hepatic was 2.96 ± 1.81. On the basis of the complications, the optimal
immune function in the elderly include an increased suscep- cutoff value of the OPNI was set at 40. 9, and the NLR was set at
tibility to infections. Kupffer cells (resident hepatic macro- 4.13. Logistic regression analysis model showed that preopera-
phages) are important in the elimination of pathogens. tive prealbumin, low OPNI and surgical procedure were
However, the changes in the function of Kupffer cells independent risk factors. On the basis of five years survival
associated with aging remains unclear. In the present study, rate, the optimal cutoff value of the OPNI was set at 42.98, and
we examined how aging would affects phagocytic activity of the NLR was set at 3.74. Kaplan Meier - method was used to
Kupffer cells in mice. construct survival curves. Using the COX proportional hazards
Methods: We examined Kupffer cells of young adult (6 weeks model on the postoperative outcomes of patients with gastric
old, n = 7) and aged (65–70 weeks old, n = 7) ICR mice. Whole cancer factor of single factor analysis and multifactor analysis.
liver was harvested and hepatic mononuclear cells (including The multivariate analyses showed that depth of invasion,
Kupffer cells) were isolated. Hepatic mononuclear cells and lymph node metastasis, preoperative OPNI value and preopera-
microspheres were incubated with or without lipopolysacchar- tive NLR value were independent factors in predicting overall
ide (LPS) in vitro. Microsphere phagocytosis by Kupffer cells was survival rate of patients who underwent gastrectomy.
evaluated using flowcytometry. We also counted the number of Conclusion: Onodera Prognostic Nutritional Index and
Kupffer cells isolated. Neutrophil-Lymphocyte-Ratio were important reference
Results: Kupffer cells’ numbers were not significantly different values in risk evaluation of postoperative complication and
between young adult and aged groups. Without LPS stimula- predicting the outcomes of gastric cancer patients accepted
tion, there were no significant differences in the positive ratios gastrectomy. Patients whose OPNI was less, NLR was higher
of microsphere phagocytosis by Kupffer cells between the 2 were at higher risk of postoperative complications and poorer
groups. However, with LPS stimulation, those of microsphere prognosis.
phagocytosis was significantly less in the aged than in the young
adult group. Disclosure of Interest: None declared.
Table: Kupffer cells’ numbers and positive ratios of microsphere phagocytosis.

SUN-LB318
Young adult group Aged group CHANGES IN SMELL, TASTE AND FOOD PREFERENCES IN
Kupffer cells’ numbers/liver 1 g (1 × 106) 1.28 ± 0.22 1.28 ± 0.17 COLORECTAL CANCER PATIENTS
Microsphere phagocytosis without LPS (%) 56.1 ± 7.6 59.1 ± 2.7 E. M. Postma1,2 *, S. Boesveldt2, D. E. Kok2, E. Kampman2. 1Top
Microsphere phagocytosis with LPS (%) 79.7 ± 2.7 63.9 ± 3.6*
Institute Food and Nutrition, 2Division of Human Nutrition,
*p < 0.01 vs. Young adult group, Mann-Whitney’s U test, means ± SE. Wageningen University & Research, Wageningen, Netherlands
Conclusion: Aging induced-reduction of phagocytic activity of Rationale: Changes in smell and taste are common side effects
Kupffer cells might lead to impaired hepatic immunity in of chemotherapy in patients and might affect dietary habits,
inflammatory condition. nutritional status and quality of life, although changes vary in
prevalence, duration and severity. Therefore, this study
S172 Poster
investigated occurrence and duration of chemosensory changes assessment: anthropometric parameters, food history (once a
and food preferences in colorectal cancer patients. month); bioimpedentiometry, blood biochemistry (T0, T2).
Methods: Smell and taste function and food preferences were Adherence: excess <15% in prescribed kcal in almost 2/3 of
assessed among colorectal cancer patients undergoing chemo- controls. Pathological response: by pathological examination
therapy at 6, 12 or 24 months after diagnosis as part of an according to Pinder classification.
ongoing cohort study among newly diagnosed colorectal cancer Results: 12 women enrolled, 8 reached T2 (4 CRA, 4 SDA).
patients. Sniffin’ Sticks and Taste Strips were used to Safety: no major adverse events. Median body weight varia-
objectively measure smell and taste function. Perceived tions (T2 vs T0): body weight −2,0 kg (−6; 1.7), −3.42%
alterations in smell, taste and appetite were measured with (−10.91; 2.69); phase angle −0.2° (−0.7; 0.1), −3.34% (−17.5;
the Appetite, Hunger and Sensory Perception questionnaire 2,22); fatty free mass 1.65 kg (0,7; 1.9), 3.59% (1.85; 4.39);
(AHSP). Food preferences were measured using the fatty mass −3.05 (−6.7; −0.1) kg, −23.72% (−39.18; −0.7);
Macronutrient and Taste Preference Ranking Task (MTPRT) (1). total proteins −0.6 g/dl (−0.9; 0.1), −8.11% (−12.5; 1.59).
Results: Preliminary results (n = 13) from patients at 12 and 24 Adherence: 80% for 50% TEE diet, 60% for 70% TEE diet.
months after diagnosis show on average normal smell Efficacy: residual disease 0 or <50% of initial value: 100% (3/4)
(30.5 ± 4.1 out of 48) and taste function (11.4 ± 3.55 out of in CRA, 25% (1/4) in SDA; residual disease >50% or progression:
16), with no differences between time points. Within the 0% in SDA, 75% (3/4) in SDA.
MTPRT, preference was highest for high-protein foods Conclusion: Although the limited sample size, our data
(3.0 ± 0.63 out of 4) and lowest for high-carbohydrate foods indicate CR as a safe treatment, potentially successful to
(1.9 ± 0.34 out of 4). No differences in AHSP scores were found enhance standard neoadjuvant CT response rates.
between time points. Mean scores did indicate better self- References
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Herbert RL, Longo DL, et al. Impact of caloric restriction on
Conclusion: These results from a small sample suggest no health and survival in rhesus monkeys from the NIA study. Nature.
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reported smell and taste function. Changes in smell and taste Cancer Prevention and Treatment. Recent Result Cancer Results
during treatment might distort recalling the sense of smell and 2016;2017–214.
taste before treatment, which may affect self-reported smell Disclosure of Interest: None declared.
and taste function after treatment. Further research will
therefore include a larger group of patients (n = 60) and
SUN-LB320
prospective measurements before, during and shortly after
THE IMPACT OF ENHANCED RECOVERY AFTER SURGERY ON
chemotherapy.
NUTRITION CARE
Reference L. M. Gramlich1 *, L. Martin2, M. Atkins3, M. Gillam3,
1. de Bruijn SE, et al. The reliability and validity of the Macronutrient C. Sheppard4, S. Buhler3, C. Basualdo Hammond3, G. Nelson5.
1
and Taste Preference Ranking Task: A new method to measure food University of Alberta, 2University of Alberta, 3Nutrition
preferences. Food Quality and Preference, 2017. 57:32–40. Services, Alberta Health Services, 446 St Georges Crt,
Disclosure of Interest: None declared. University of Alberta, Edmonton, 5Surgery, Alberta Health
Services, Calgary, Canada
SUN-LB319
Rationale: Enhanced Recovery After Surgery (ERAS) is a
CALORIC RESTRICTION IN BREAST CANCER WOMEN
multimodal evidenced based care pathway designed to
UNDERGOING TO NEOADJUVANT CHEMOTHERAPY: SAFETY,
optimize recovery. ERAS implementation was phased in for
FEASIBILITY AND EFFICACY PRELIMINARY DATA
elective colorectal surgical patients at 6 hospitals in Alberta,
E. Finocchiaro1 *, A. De Francesco2, A. Collo1, I. Castellano3. Canada from 2013 to present. This study describes changes in
1
Department of Clinical Nutrition Molinette Hospital, nutrition care with ERAS in Alberta Health Services.
2
Department of Clinical Nutriton Molinette Hospital, Methods: ERAS care pathway data was collected at 6 hospitals
3
Department Pathology, Turin, Italy between 2013 and 2017. Data collection began prior to ERAS
implementation (Pre-ERAS group, N = 476) and was compared
Rationale: Unlike the physiological counterpart, cancer cells
with that after ERAS implementation (ERAS group, N = 3,496).
exploit aerobic glycolysis to maintain their high proliferation
Data for nutrition care elements were analyzed for compliance
rate (Warburg effect). Caloric restriction (CR) could enhance
and completeness. Nutrition care elements included screening
oxidative stress in cancer cells, favoring apoptosis, reducing
for malnutrition, carbohydrate loading (yes/no) and assess-
proliferation and angiogenesis through molecular targets as
ment of early oral intake: days to patient tolerated solid food,
IGF-1/Akt mTOR and AMP-K.
and the energy (kcal) intake from ONS on post-operative days
Methods: Trial involving breast cancer patients eligible to
(POD) 0–3. Comparisons between Pre-ERAS and ERAS groups
neoadjuvant chemotherapy (CT), at the enrollment (T0)
were made to determine if improvements in nutrition care
randomized to CR (CRA) or standard diet arm (SDA) according
occurred.
to the receptorial status (EgR, PgR, Ki67, cerb b2). CR: caloric
Results: A total of 3,972 patients were included, 56% were male
intake reduced by 50% of total energy expenditure (TEE) in the
with an average age of 61.0 ± 14.2 years, and a mean BMI of
48 hours before and in the CT day; by 30% in the other days.
28.2 ± 6.2. Compliance with malnutrition screening improved
After 6 months (T2) patients undergo to surgery. Endpoints:
with ERAS (74% vs. 9% Pre-ERAS, P < 0.001). 19% of patients
safety, feasibility, tumor cells reduction. Nutritional
were not assessed, and 6% were missing data. Adoption of a clear and standardized definition of RFS in oncologic
carbohydrate loading improved with ERAS (63% vs. 3% Pre-ERAS, population.
P < 0.001). Days to tolerating solid food was significantly Disclosure of Interest: None declared.
shorter in the ERAS group compared to pre-ERAS (2.9 days vs.
5.9 p < 0.001). Compliance to ONS energy intake (kcal) from
SUN-LB322
ONS was lower than the targets in the ERAS group (20% POD 0,
GLASGOW PROGNOSTIC SCORE AS A USEFUL PROGNOSTIC
30% POD1, 12% POD 2, 13% POD3) but was improved compared
FACTOR AFTER PANCREATICODUODENECTOMY FOR
to the Pre-ERAS group (0–0.4% POD0 to POD3).
PANCREATIC CANCER
Conclusion: ERAS implementation resulted in improved com-
pliance to nutrition care for elective colorectal surgical M. Ogiku1 *, Y. Ikematsu1, T. Ogasawara2. 1Digestive Surgery,
2
patients. Gaps exist after ERAS implementation including Respiratory Medicine, Hamamatsu Medical Center,
poor compliance and documentation with regard to early ONS Hamamatsu, Japan
consumption.
Rationale: Several previous studies have revealed that the
References Glasgow Prognostic Score (GPS) is a useful scoring system to
Nelson G, et al. (2016). Implementation of enhanced recovery after predict the prognosis of patients with various kinds of advanced
surgery (ERAS) across a provincial healthcare system: The ERAS cancers. The aim of the present study was to assess the value of
Alberta colorectal surgery experience. World Journal of Surgery; the GPS as a prognostic tool in pancreatic cancer patients after
Gramlich LM et al. Implementation of Enhanced Recovery After pancreaticoduodenectomy.
Surgery: A Strategy to Transform Surgical Care Across a Health Methods: 43 consecutive patients, who underwent standard PD
System. Implementation Science. 2017.
or pylorus-preserving pancreatoduodenectomy (PpPD) at
Disclosure of Interest: None declared. Hamamatsu Medical Center between January 2005 and
December 2016, were analyzed retrospectively. GPS were
SUN-LB321 evaluated by biochemical test within 7 days before surgery.
INCIDENCE OF REFEEDING SYNDROME IN ONCOLOGIC Results: The median survival time in patients with a GPS of 0
PATIENTS and 1 was 1,139 and 316 days, respectively (only one patient
L. P. Moreira Carrasco1 *, M. G. Contreras1, F. Silva1, J. Gelvez2. with a GPS of 2). Patients with a GPS of 0 had significantly
1
Fundacion Arturo Lopez Perez, 2MEDKIN, Santiago, Chile better survival than patients with a GPS of 1 (P = 0.0382).
Multivariate analysis revealed that GPS (Hazard ratio (HR)
Rationale: Refeeding syndrome is defined by a potentially fatal 2.247; P = 0.01) and recurrence (HR 15.5; P < 0.001) were
shift of fluids and electrolytes. This may occur after reintro- independent factors for poor prognosis. But GPS were not
ducing nutrition in a malnourished patient. Due to a pro- associated with the recurrence rate (P = 0.71).
inflammatory state and an elevated metabolic rate, oncology Conclusion: The present study suggests that GPS predicts
patients are at increased risk of refeeding syndrome. In Chile overall survival in pancreatic cancer patients after
the number of oncologic patients that develop this syndrome pancreaticoduodenectomy.
has yet not been described Disclosure of Interest: None declared.
Methods: All patients admitted to the critical care unit of
the Arturo López Pérez Institute between March and May SUN-LB323
of 2017 were included. The National Institute for Health COMPLETELY LAPAROSCOPIC FEEDING JEJUNOSTOMY – OWN
and Care Excellence (NICE) criteria were applied to categorize SURGICAL TECHNIQUE MODIFICATION AND RESULTS OF A
risk of RFS. Hypophosphatemia was considered the main PILOT GROUP
indicator for the presence of this syndrome, according to
Marik et al. definition (drop of phosphorus >0,5 mg/dL to P. Kabata1 *, M. Bobowicz1, M. Swierblewski1, J. Jaskiewicz1.
1
<2,0 mg/dL). To classify patients nutritionally we used the Department of Surgical Oncology, Medical University of
Subjective Global Assessment (SGA) tool. Categorical variables Gdańsk, Gdańsk, Poland
were summarized through frequencies and percentages;
Rationale: Jejunostomy is a commonly used enteral feeding
continuous variables were summarized by mean, standard access in patients with obstructing upper gastrointestinal tract
deviation and range. disorders. Jejunum is hardly accessible with endoscopic or
Results: 59 patients were included, 34 of them were women percutaneous approach thus minilaparotomy is required to
(58%). Mean age was 61 years. 6 patients were well nourished, facilitate it. Minimally invasive approach enables better
36 were moderated malnourished and 17 were severe mal- postoperative performance and faster recovery. We would like
nourished (A, B and C category of SGA respectively). According to present our completely laparoscopic modification of surgical
to NICE criteria, 20 patients were considered at high risk and 9 technique and results of a pilot group.
at very high risk of developing RFS. 18 patients (30,5%) Methods: All consecutive patients qualified for jejunostomy
developed RFS, 9 were at low risk, 6 at high risk and 3 at very placement were screened for feasibility. Patients with
high risk according to NICE criteria. SGA and NICE classifica- history of major abdominal surgery and other significant
tions were not associated with RFS ( p > 0.05). No other contraindications for laparoscopy were disqualified. All proce-
electrolyte disturbances were identified. dures were performed with 12CH needle-jejunostomy and
Conclusion: This is the first study in Chile that provides the fixed to abdominal wall with …diamond-technique” described
incidence of RFS in oncologic patients. The incidence of RFS later.
varies widely depending on the used definition. Studies with an Results: Over the period of October 2016 till March 2017, we
increased number of patients are required. It is crucial to have
qualified 10 patients into the pilot study group. There were 4
S174 Poster
female and 6 male patients with the mean age of 60.9 years and the difference in change in HGS between younger men and
(range 51–76). Majority suffered from dysphagia or aphagia due older women.
to the neoplasms of oesophagus (N = 3), stomach (N = 3), tongue Disclosure of Interest: None declared.
(N = 2), piriform sinus (N = 1) or oesophago-tracheal fistula
(N = 1). Operating time decreased from the initial 196 min to
SUN-LB325
55 min in the last patient with the mean duration of 125,4 min.
PROGNOSTIC SIGNIFICANCE OF PERIOPERATIVE NUTRITIONAL
Patients can be discharged as soon as they tolerate enteral
PARAMETERS IN PATIENTS WITH GASTRIC CANCER
feeding. There were no complications but one patient
deceased due to the disseminated disease. In one patient the S. E. Oh1 *, M. G. Choi1, J. Y. An1, J. H. Lee1, T. S. Sohn1,
jejunostomy tube was inserted proximally that required J. M. Bae1, S. Kim1, J. M. Seo1. 1Surgery, Samsung Medical
readjustment over the guide wire. Two patients removed Center, Seoul, Republic of Korea
their catheters accidentally and required further surgery to
Rationale: It has been suggested that nutritional status is
re-establish enteral feeding.
associated with survival outcomes in cancer patients. The aim
Conclusion: Laparoscopic feeding jejunostomy is a safe and
of the current study is to evaluate the prognostic significance of
effective procedure that enables fast recovery.
various nutritional parameters during the perioperative period
Disclosure of Interest: None declared. in patients with gastric cancer.
Methods: This study enrolled patients with gastric cancer, who
SUN-LB324 underwent D2 gastrectomy at the Department of Surgery,
BODY WEIGHT AND HAND GRIP STRENGTH DURING CURATIVE Samsung Medical Center, in 2008. The prognostic significance
RADIOTHERAPY: IS THERE A GREATER DECLINE IN OLDER of nutritional parameters was analyzed, along with other
HEAD AND NECK CANCER PATIENTS? clinical- and pathological variables, preoperatively and post-
S. Lichthart1,2 *, L. van Miert3, M. Kennis3, E. Leistra2, operatively at 3, 6, and 12 months.
R. Poorter4, S. Beijer1. 1Department of Research, Netherlands Results: The total number of patients was 1,424. The mean
Comprehensive Cancer Organisation, Utrecht, 2Health values of nutritional parameters, weight, body mass index
Sciences, Vrije Universiteit, Amsterdam, 3Nutrition and (BMI), albumin, hemoglobin, total cholesterol, total lympho-
Dietetics, 4Radiation Oncology, Institute Verbeeten, Tilburg, cyte count (TLC), and prognostic nutritional index (PNI) score,
Netherlands all decreased significantly over time after surgery.
Preoperatively, low BMI (<18.5 kg/m2) and low TLC level
Rationale: Malnutrition is a common problem in head and neck (<1,000 per mm3) were revealed as independent prognostic
cancer (HNC) patients undergoing radiotherapy (RT). However, factors in the multivariate analysis. Low preoperative TLC
less is known if deterioration of nutritional status is worse in level and decline in PNI (ΔPNI < −2.2) 3 months postopera-
older patients. Therefore, this study assessed if changes in tively, decline in PNI (ΔPNI < −2.3) and low preoperative BMI 6
body weight (BW) and hand grip strength (HGS) during curative months postoperatively, and low preoperative BMI 12 months
RT differs between younger (<65 years) and older (≥65 years) postoperatively were independent nutritional prognostic
HNC patients. indicators.
Methods: Newly diagnosed HNC patients undergoing RT Conclusion: The nutritional parameters of preoperative BMI,
between 2008 and 2012 were included. BW and HGS data, preoperative TLC level, and postoperative change in PNI were
clinical and personal factors were retrieved from medical and identified as independent nutritional prognostic factors in
dietetic records and combined with tumour specific informa- patients with gastric cancer. Our results imply prognostic
tion from the Netherlands Cancer Registry. Independent t-tests benefit from careful nutritional support for patients with poor
(<65 years vs. ≥ 65 years), uni- and multivariable analyses (BW nutritional parameters.
or HGS as continuous variable) were performed to assess the Disclosure of Interest: None declared.
association between personal and clinical factors and percent-
age change in BW and HGS during RT.
SUN-LB326
Results: 227 HNC patients were included (♂ 67.4%; mean age
OVERWEIGHT, OBESITY AND RISK OF LEUKEMIA IN ADULTS: A
64.3 ± 11.3). Results showed a significant decrease in BW in HNC
META-ANALYSIS OF COHORT STUDIES
patient during RT but no significant difference in percentage
BW change between HNC patients <65 years and ≥ 65 years. T. Psaltopoulou1 *, I. Ntanasis-Stathopoulos1, I.-G. Tzanninis1,
During RT, HGS significantly increased in men <65 years (1.29 kg± I. N. Sergentanis2, A. Karadimitris3, T. N. Sergentanis1.
1
4.62; p = 0.02) and significantly decreased in women ≥ 65 years Department of Hygiene, Epidemiology and Medical Statistics,
(−1.06 kg ± 2.09; p = 0.01). Leading to a borderline significant Medical School, National University of Athens, Athens, Greece,
2
difference in percentage change in HGS between HNC patients Department of Psychiatry, University Hospital of Geneva
<65 years (2.36 ± 10.26) and ≥ 65 years (−0.26 ± 10.01; p = (HUG), Geneva, Switzerland, 3Faculty of Medicine, Imperial
0.05). Multivariable regression analyses confirmed the signifi- College London, London, United Kingdom
cant association between age and percentage change in HGS
Rationale: This meta-analysis aims to evaluate the association
during RT.
between overweight, obesity and the risk of leukemia in adults,
Conclusion: HNC patients undergoing RT significantly
assessing separately men and women.
decreased in BW independent of age. In contrast, percentage
Methods: The eligible studies were identified in PubMed using a
change in HGS was significantly different between younger and
predefined search algorithm; there were no language restric-
older HNC patients. More research is necessary to investigate
tions and the end-of-search date was May 31, 2016. Two authors
the causes for weight loss despite adequate nutritional support
independently performed the selection of studies and data
abstraction. Overweight and obesity were defined as Body Mass Conclusion: RY reconstruction was beneficial for obese patient
Index 25.0–29.9, and >30 kg/m2, respectively. The pooled of early gastric cancer than BII and BI as there was the reduction
relative risk (RR) estimates were calculated using random of BMI and total cholesterol except for reduction of other
effects (DerSimonian-Laird) models, separately by gender. nutritional parameters. Further prospective studies are needed
Analysis was performed with STATA/SE 13 statistical software; to confirm the reconstruction type after distal gastrectomy by
this study received a grant funded by Wereld Kanker Onderzoek considering the existence of obesity.
Fonds (WCRF NL) and administered by WCRF International as Disclosure of Interest: None declared.
part of the WCRF International program.
Results: In men, obesity was associated with increased
SUN-LB328
leukemia risk ( pooled RR = 1.37, 95%CI: 1.19–1.59, 10 studies),
LOW VOLUME ENERGY DENSE ORAL NUTRITIONAL
whereas no association was observed regarding overweight
SUPPLEMENTS IMPROVE MICRONUTRIENT INTAKES IN FREE
( pooled RR = 1.05, 95%CI: 0.95–1.17, nine studies). In women,
LIVING MALNOURISHED OLDER PEOPLE – A RANDOMISED
obesity ( pooled RR = 1.36, 95%CI: 1.12–1.66, eight studies) and
TRIAL
overweight ( pooled RR = 1.28, 95%CI: 1.09–1.52, six studies)
were associated with increased leukemia risk. Obesity was also A. L. Cawood1 *, T. R. Smith2, N. Guildford3, C. Wood3,
associated with acute myeloid leukemia risk in both sexes. K. Ashbolt3, E. R. Walters3, R. J. Stratton1. 1Faculty of
Conclusion: Obesity is a risk factor for leukemia in both sexes; Medicine, University of Southampton, 2Department of
further studies are needed for the evaluation of associations Gastroenterology, 3Department of Dietetics and Speech and
regarding leukemia subtypes. Language Therapy, University Hospital Southampton NHS
Foundation Trust, Southampton, United Kingdom
Rationale: We have previously shown that low volume energy
SUN-LB327 dense oral nutritional supplements (ONS) significantly increase
A COMPARISON OF THE POSTOPERATIVE NUTRITIONAL STATUS intakes of energy and protein with little suppression of food
OF THREE RECONSTRUCTION METHODS AFTER DISTAL intake (1), but the effect on micronutrients requires furthur
GASTRECTOMY IN GASTRIC CANCER PATIENTS investigation.
Y. N. Kim1 *, J. Y. An1, on behalf of Department of Surgery, Methods: 308 older people (>50 y) recruited through GPs (age
Samsung Medical Center, Sungkyunkwan University School of 71.5 ± 10.7 y; BMI 19.4 ± 2.5 kg/m2, Charleston Comorbidity
Medicine, Seoul, Republic of Korea. 1Department of Surgery, Index (CCI) 1.02 ± 0.93, 67% female) at risk of malnutrition
Samsung Medical Center, Sungkyunkwan University School of (‘MUST’) were randomised to low volume ONS (Fortisip
Medicine, Seoul, Republic of Korea Compact range, Nutricia; 2.4 kcal/ml) plus dietary advice
(DA) (as a diet sheet) (n154; ONS group) or DA alone (n154; DA
Rationale: The aim of this study was to compare the group) for 12 wks. At baseline, 4, 8, 12 wks, food and total
postoperative nutritional status of Billroth I (BI), Billroth II intake were measured, micronutrient intakes analysed and
(BII), Roux-en-Y (RY) reconstruction after distal gastrectomy in compared to EFSA reference values where available.
gastric cancer patients. Percentage difference between groups over 12 wks for 25
Methods: We retrospectively reviewed data from 1,305 gastric micronutrients was calculated (trace elements (n7), minerals
cancer patients who underwent distal gastrectomy at two (n5), vitamins (n13)), along with the extent to which ONS
hospitals from January 2011 to December 2014. From this data, intake was additive to the diet (2). Intention to treat analysis
we analyzed clinicopathologic characteristics, PNI, NRI, and was undertaken (controlled for baseline, age, sex, ‘MUST’,
nutritional status through hematologic test for each patient. CCI), results presented as mean ± SE.
Patients were divided into three groups according to the Results: Total micronutrient intake was significantly higher in
reconstruction methods: Billroth I, Billroth II, and Roux-en-Y. the ONS group compared to the DA group (for all except
We compared the nutritional status according to reconstruction sodium, chloride, vitamin B12). Overall 92 ± 4% of the ingested
methods by measuring weight change, hematologic data ONS was additive to food intake with no difference in intakes of
including hemoglobin, albumin, cholesterol, total lymphocyte micronutrients from food between groups (−1 ± 1%; NS). Total
count, total protein, and transferrin. intake in the ONS group exceeded that of DA group by 40 ± 5%
Results: Comparison of the nutritional parameters including overall (46 ± 7% vitamins, 43 ± 8% trace elements, 19 ± 7%
Hb, albumin, protein, total lymphocyte count, transferrin minerals). Over 12 wks, 86% of micronutrients (18/21) met
between Billroth I, Billroth II, and Roux-en-Y revealed that EFSA values in the ONS group compared to 43% in the DA group
there were no significant difference, but there were a (9/21) ( p = 0.004).
significant decrease in weight loss rate, BMI and serum Conclusion: This large randomised trial shows that malnour-
cholesterol change 12 months postoperatively. Although there ished free living older people are unable to achieve adequate
were weight loss, BMI and cholesterol decline in three groups, micronutrient intakes from food alone, and the addition of low
weight loss rate was significantly lowest 12 months after volume energy dense ONS is effective at significantly improving
surgery in BI reconstruction (vs other two group) ( p < 0.001). intakes, helping them to meet recommended reference
Assessment index of nutritional status between three groups intakes.
was not statistically significant differences 12 months after References
surgery, but there was significant difference in BMI and
1. Smith TR, et al., Clin Nutr Supp (in press).
cholesterol decline between BII and RY reconstruction group.
2. Stratton & Elia 1999. Clin Nutr 18, 29–84.
In multivariate analysis, reconstruction type was associated
with weight, BMI, cholesterol change.
S176 Poster
Disclosure of Interest: A. Cawood Other: Nutricia Ltd, T. Smith: None Methods: For this analysis we included all diabetes patients
declared, N. Guildford: None declared, C. Wood: None declared, admitted to internal medicine unit ‘E’ at Wolfson Medical
K. Ashbolt: None declared, E. Walters: None declared, R. Stratton Other: Center between June 1, 2016–April 30, 2017. The previously
Nutricia Ltd. reported Measuring Nutrition Risk in Hospitalized Patients,
(MENU) nutrition care plan calls for prescribing one portion
SUN-LB329 of oral nutritional supplements (ONS) or 500 ml IV 5%
LIQUID CARBOHYDRATE CONTENT OF MEALS IS A MAJOR dextrose (for fasting or non-compliance patients) during
DETERMINANT OF GASTRIC EMPTYING RATE the morning hours for hypoalbuminemic (below 3.5 g/dL)
E. Charidemou1 *, X. Li1, B. McNally1, M. Harvey2, E. Orford2, diabetes patients. Consumption of the ONS was verified
S. Wassell2, M. Venables2, T. Ashmore1, J. L. Griffin1. during the morning rounds. All glucose measurements were
1
Department of Biochemistry, University of Cambridge, 2MRC recorded automatically in the patients’ electronic medical
Elsie Widdowson Laboratory, Cambridge, United Kingdom records. A logistic regression model was used to evaluate the
effect of the nutrition support on the occurrence of
Rationale: The transition to energy-dense, Western-style diets hypoglycemia. We included age, sex, serum albumin, day
of low satiety value has led to a growing prevalence of obesity of inclusion to the protocol and percent of protocol
and Type 2 diabetes mellitus (T2DM). Around 50–75% of adherence as covariates.
diabetics suffer from dyslipidaemia and 30–50% experience Results: During the study acquisition period, there were 232
delayed gastric emptying (GE), the rate at which chyme leaves diabetes patients who were candidates for the MENU
the stomach to enter the duodenum. We aimed to define, using nutrition care plan. Of these patients, 3 were omitted from
stable isotope techniques in healthy humans, how solid/liquid the analysis because of incomplete records. Of the 229
ratios of meals and macronutrient composition affects GE and patients included in the analysis (mean age 77.2 ± 12.1 years,
lipid metabolism via blood lipid profiling. 64.2% female, mean albumin 3.13 ± 0.31 g/dL), 27.9% had at
Methods: We determined GE rate and blood lipid profile in four least one documented hypoglycemic event during the
subjects to date. After a 12-hour fast, subjects consumed one hospitalization. The average day of enrolment with the
of five randomised meals containing egg yolk labelled with 13C- MENU nutrition care plan was 4.6 ± 5.5 days. The logistic
octanoic acid, during visits separated by two-weeks. A regression model of hypoglycemia indicated that age (OR
standardised 2 MJ meal (S), low in liquid carbohydrate (CHO), 1.036, 95% CI 1.007–1.066, p = 0.015) and day of hospitaliza-
was modified to contain purely liquid CHO (MS). The MS meal tion on which the patient was included in the study (OR 1.112
was further altered to provide isoenergetic meals high in fat 95% CI 1.045–1.183, p = 0.001) increased risk of hypogly-
(HF), protein (HP) and CHO (HC). Isotope ratio mass spectrom- cemia. Participating in the MENU nutrition care plan
etry determined 13C-enrichment in breath exhalates and significantly reduced risk of hypoglycemia: OR 0.357, 95% CI
resulting blood lipid profiles were determined by liquid 0.156–0.814, p = 0.014. Age and serum albumin were not
chromatography-mass spectrometry. significantly associated with hypoglycemia risk.
Results: Our results demonstrated that macronutrient com- Conclusion: Oral nutritional supplement reduces hypogly-
position does not greatly affect GE rate or blood lipid profile. cemia risk among diabetes in-patients with hypoalbuminemia.
However, increasing liquid CHO delays GE. Blood lipidomics Disclosure of Interest: E. Leibovitz Grant/Research Support from:
showed that HP increased triglycerides (TGs) comprising 14:0, Abbott Israel, F. Moore: None declared, R. Dobinsky: None declared,
16:0, 16:1, 18:0 and 18:1 fatty acids, associated with de novo M. Boaz: None declared.
lipogenesis (DNL).
Conclusion: Increased DNL predisposes individuals to IR and is SUN-LB331
linked to T2DM. Conceivably, early delivery of CHO to the COMPARISON OF ANTHROPOMETRIC AND BIOCHEMICAL DATA
duodenum, sensed in the small intestine, may delay emptying CHANGE RESPONSES TO BREAD, WHITE RICE AND
of the solid portion. Increased TGs indicative of DNL, which GERMINATED BROWN RICE IN PRE-DIABETIC ADULTS: CROSS-
normally occurs during an over-abundance of supply, were OVER STUDY
detected after the HP meal, though the meals were isoener-
getic. Moreover, this followed a 12-hour fast, which typically H. W. Baik1 *. 1Bundang Jesaeng General Hospital, GyeongGi-
supresses DNL, and may therefore have general implications for Do, Republic of Korea
high-protein diets.
Rationale: Germinated brown rice, it is rich in dietary fiber,
Disclosure of Interest: None declared. vitamins and minerals, and contains functional materials such
as γ-Aminobutyric acid (GABA). Germinated brown rice was
SUN-LB330 found to be effective in improving fasting blood glucose in
NUTRITIONAL CARE PLAN TO PREVENT HYPOGLYCEMIA animal experiments in diabetic rats. We investigated the
DURING ADMISSION – RESULTS FROM THE MENU PROJECT difference of blood glucose and insulin concentration according
E. Leibovitz1 *, F. Moore2, R. Dobinsky2, M. Boaz3. 1Internal to the types (bread, white rice, brown rice, germinated brown
Medicine, Yoseftal Hospital, Eilat, 2Internal Medicine, Wolfson rice) consumed mainly by Koreans. This is a preliminary study
Medical Center, Holon, 3Department of Nutrition Sciences, showed the possibility of the improvement of blood sugar by
Ariel University, Ariel, Israel ingestion of germinated brown rice. Therefore, we investigated
whether germinated brown rice helps blood glucose control in
Rationale: We studied the effect of a nutritional care plan on pre-diabetic adults.
the rate of hypoglyemia among diabetes patients admitted to Methods: The subjects were selected from those who were
internal medicine departments. between 19 and 64 years of age with pre-diabetes (fasting
glucose 100 to 125 mg/dL). Those who were taking diabetic and survival (r = −0,24 p = 0,018); those patients with Cu > p75
medication and dyslipidemic medication and those with severe of population had a higher mortality ( p = 0,031). Patients with
disease were excluded. The subjects consume bread or white ferritin > 300 mg/dl had a higher mortality than those with
rice or germinated brown rice three times per day for one ferritin < 30 ng/dl (( p = 0,005). We found no relationship
month. Blood tests and body composition tests are conducted between Zn, folate, vit B12, A, E and survival.
before and after meals according to each intervention method. Conclusion: In this series of ALS patients, those with higher
The wash-out period was maintained for more than 2 weeks to serum albumin and prealbumin levels at first evaluation had a
minimize the carry-over effect of the experiment. longer survival. A decrease in vit D and an increase in ferritin
Results: The mean age was 38.6 ± 7.9 years and the mean BMI and Cu plasma levels were associated with a worse prognosis.
was 25.7 ± 3.2 kg/m2 in 44 prediabetic adults (germinated Further studies are needed to confirm these data.
brown rice; n = 16, white rice; n = 14, bread; n = 11). There was Disclosure of Interest: None declared.
no significant difference in the anthropometric and biochem-
ical data of one month after ingestion of bread, white rice and
SUN-LB333
germinated brown rice. However, groups of germinated brown
INTESTINAL PRODUCTION OF HYDROGEN WITH FRUCTOSE
rice and white rice showed a tendency to decrease in weight
SOLUTION IN RUNNERS AND PERSONS WITH NON-ALCOHOLIC
loss, waist circumference, and lipid blood test compared to
FATTY LIVER DISEASE A PILOT STUDY
bread.
Conclusion: Although research is still under way and there are J. M. F. Sicchieri1,2 *, G. Junqueira1, C. S. Manca1,
not many subjects, there is no significant effect of germination A. D. L. C. Martinelli3, A. M. Navarro1, R. B. Oliveira4.
1
brown rice, white rice, and bread intake. It is the first Department of Internal Medicine, Division of Nutrition and
meaningful study to test people with diabetes and the results Metabolism, University Hospital, Faculty of Medicine of
of the study are expected in the future. Ribeirão Preto, University of São Paulo, Brazil, 2Division of
Nutrition and Metabolism, Department of Internal Medicine,
University Hospital, Faculty of Medicine of Ribeirão Preto,
University of São Paulo, Brazil, 3Department of Internal
SUN-LB332 Medicine, Division of Gastroenterology, University Hospital,
ALBUMIN, MICRONUTRIENTS STATUS AND PROGNOSIS IN ALS Faculty of Medicine of Ribeirão Preto, University of São Paulo,
PATIENTS Brazil, 4Department of Internal Medicine, Division of
I. Breton1 *, C. Velasco1, M. Camblor1, C. Cuerda1, M. Motilla1, Gastroenterology, Ribeirao Preto, Brazil
Y. Olmedilla1, R. Jimenez2, I. Catalina2, R. Barahona2,
J. L. Muñoz-Blanco2, P. Garcia-Peris1. 1Nutrition Unit, Rationale: The increase in the intake of fructose in the
2
Neurology Unit, Hospital Gregorio Marañón, Madrid, Spain Western diet and its repercussion have raised interest of
researchers in the field. To assess gastrointestinal symptoms
Rationale: Malnutrition leads to a worse prognosis in ALS and hydrogen production after the ingestion of a fructose
patients. The effect of albumin and micronutrient status is not solution.
well known. The aim of this study is to evaluate the relationship Methods: Hydrogen test (H2 test) was performed after the
between albumin and micronutrient status and survival in ALS ingestion of a solution with 50 g fructose along with the
patients. application of a questionnaire to evaluate the consumption of
Methods: Retrospective study in an ALS population. Clinical, dietary sources of fructose and gastrointestinal symptoms
anthropometric and biochemical data (albumin, prealbumin, during the H2 test in three groups: Athletes group (AG), with
ferritin, Zn, Cu, folate, vit B12, A E, D) were analysed at first eight athletes; control group (CG), with eight healthy subjects;
evaluation in a multidisciplinary clinic. Survival time was and non-alcoholic fatty liver disease group (NAFLDG), with
calculated to death or to Dec 2016. Statistical analysis (SPSS nine subjects with the disease. Statistical analysis was
21.0) incudes a descriptive study, Pearson’s correlation and performed with analysis of variance (ANOVA) at a p ≥ 0.05
Kaplan-Meier test. Sig p < 0,05. significance level.
Results: Two hundred and ten ALS patients (120 male, 68,8% Results: The AG was the largest H2 producer followed by the CG
spinal onset) were evaluated. Mean age was 62,1 ± 13,7, BMI with significant difference between the AG and NAFLDG
25,7 ± 4,2 kg/m2 and mean time of follow-up of 33,4 ± 28 m. ( p ≤ 0.05). Fruits in natura were the most commonly men-
tioned dietary source of fructose. Most participants remained
asymptomatic during the experiment.
% of patients
Conclusion: This pilot study points out that hydrogen produc-
Prealbumin < 20 mg/dl 17,1 tion is higher in the AG and CG. Further studies are required to
vit D < 30 ng/ml <20 ng/ml) 87 (62,8)
Zn < 70 μg/dl 33 better explain the contribution of factors such as diet and
Cu < 80 μg/dl 11,2 lifestyle on hydrogen production.
Ferritin < 30 μg/dl (>300 μg/dl) 12 (20)
Rest of biochemical data were normal in >95 of patients.

Patients with albumin and prealbumin above median (4,4 g/dl
and 25 mg/dl respectively) had a longer survival (P = 0,008 and
0,046). Vit D < 20 ng/ml was associated with a higher mortality
( p = 0,047). A negative correlation was observed between Cu
S178 Poster
SUN-LB334 bioelectric impedance analysis, handgrip strength and isomet-

EVALUATION OF ADIPOSITY AND INFLAMMATION IN RATS ric knee flexion/extension strength. Serum level of C-reactive
OFFSPRING SUBJECTED TO FEED RESTRICTION DURING protein and the Disease Activity and Disability (DAS-28) score
PREGNANCY were quantified. Measured outcomes were compared among
S. Andreotti1, G. Boltes Reis1, F. D. F. Silva1, A. C. M. Komino1, patients with and without sarcopenia. Statistical analysis was
N. L. Gil2, A. P. A. Ramos2, F. B. Lima1, R. G. Landgraf2, performed using Graph Pad Prism 5.0 (San Diego, CA).
M. A. Landgraf3 *. 1Physiology, University of São Paulo, São Results: Sarcopenia was identified in 35.8% of females and
Paulo, 2Pharmaceutical Sciences, Federal University of São 33.3% of males in our study group, with no effect of disease
Paulo, Diadema, 3Pharmacology, University of São Paulo, São duration. DAS-28 scores, however, were higher among patients
Paulo, Brazil with sarcopenia, compared to those without sarcopenia
(P < 0.05). Although a higher than normal body fat percentage
Rationale: We have investigated the repercussions in the was identified in all patients, BMI was lower for patients with
adipose tissue development in adult (12-week old) rats sarcopenia (20.0 kg/m2) than in patients without sarcopenia
submitted to in utero undernourishment, which causes small (23.4 kg/m2; P < 0.05).
birth weight and hypercorticosteronemia. Conclusion: Sarcopenia was identified in 35% of patients with
Methods: Females Wistar rats (12–16 weeks old) in estrus were RA, and was associated with a higher body fat percentage as
mated and, after confirmed the presence of spermatozoa in muscle mass decreased. Therefore, the prevalence of sarco-
vaginal swab, were divided into two groups: G1 – fed with penia is high among patients with RA.
normal diet (commercial pellets) and water ad libitum; G2 – Disclosure of Interest: None declared.
50% food restriction and free water access. Offspring G1 of
normal birth weight (NBW) and offspring G2 of low birth weight SUN-LB336
(LBW). These rats were euthanized, their perivascular fat pads PREVALENCE OF DYSPHAGIA IN A COHORT OF PATIENTS WITH
were weighted and inflammatory parameters were measured. STEINERT DISEASE
Results: Body weight (g) at 12 weeks old: NBW = 323,6 ± 6,4
vs. LBW = 364,4 ± 6,5* ( p = 0,0002). Perivascular fat pad (g): P. Díaz Guardiola1 *, J. Olivar Roldán2, S. Azriel Mira1,
NBW = 2,364 ± 0,2 vs. LBW = 1,811 ± 0,1*(p = 0,0356). Adipocyte J. García de Gregorio3, C. Martín González3,
volume ( pL): NBW = 118,4 ± 8,1 vs. LBW = 167,1 ± 9,6. The C. Casanova Rodriguez4, R. Moreno Zabaleta5,
secretion of cytokines by adipocytes (TNFa, IL1β, IL6 and IL10) G. Gutierrez Gutierrez6. 1Endocrinology and Nutrition
are significantly higher in LBW animals, when compared to NBW Department, Hospital Universitario Infanta Sofia,
2
animals. Endocrinology and Nutrition Department, Horpital
Conclusion: Adult rats that presented low birth weight, in Universitario Infanta Sofía, 3Otolaryngology Department,
4
consequence to maternal undernourishment during all preg- Cardiology Department, 5Neumology Department,
6
nancy, developed alterations in their adiposity, increasing Neurology Department, Hospital Universitario Infanta Sofia,
proinflammatory cytokine levels. Madrid, Spain
Supported by FAPESP- 2014/15210-3, 2012/51104-8, 2010/
Rationale: Myotonic dystrophy type 1 or Steinert disease is a
01404-0 and CNPq
muscular dystrophy frequently seen in adults. It is an inherited
Disclosure of Interest: None declared. autosomal-dominant disease affecting multiple systems inclu-
sive of cardiac, ocular, pulmonary, digestive and endocrine
SUN-LB335 alterations.
DETECTION OF SARCOPENIA IN PATIENTS WITH RHEUMATOID It frequently affects smooth muscle tissue so many of these
ARTHRITIS patients present signs of dysphagia, which can lead to
M. Sebe1 *, R. Tsutsumi1, M. Chikugo1, J. Kishi2, M. Iuchi1, malnutrition and repeated respiratory infections subsequently
M. Kuroda1, N. Harada1, Y. Nakaya1, Y. Tsutsumi3, Y. Nishioka2, increasing risk of morbidity & mortality.
H. Sakaue1. 1Nutrition and Metabolism, 2Respiratory Medicine Objective: To understand the prevalence of dysphagia within a
and Rheumatology, 3Anesthesiology, Biomedical Sciences, cohort of patients with Steinert Disease.
Tokushima University, Tokushima, Japan Methods: A retrospective and descriptive study of patients with
Steinert Disease diagnosis followed in the Neuromuscular
Rationale: Sarcopenia is defined as a decrease in muscle mass Pathology Unit which screened dysphagia utilising the Eating
and function and is one of the determinants of age-related Assessment Tool-10 (EAT-10). The patients with suspected
disability and mortality. Differentiating sarcopenia from loss of dysphagia were referred to Nutrition and Otolaryngology.
muscle mass due to pain, limb deformity and impairment in Volume viscosity swallow test (V-VST) or swallowing fibroendo-
physical function in patients with rheumatoid arthritis is a scopy was performed in cases with positive EAT-10.
difficult yet clinically important issue due the negative effects Results: Of the 55 patients who attended the Neuromuscular
of decreased muscle mass and function on quality of life. The Disease Consultation, 27 were women and 28 men, with an
aims of our study were to determine the prevalence of average age of 46.14 ± 14.3 years. Fifty patients were screened
sarcopenia in patients with rheumatoid arthritis and to with dysphagia (EAT-10), 23 of which were positive (46%). In
evaluate the association between sarcopenia and inflammation these patients, the study was extended by performing
and disability scores in patients with rheumatoid arthritis. swallowing fibroendoscopy or V-VST. 21 patients were diag-
Methods: The study group was formed of 278 patients with nosed with dysphagia (38% of patients), more than half of which
rheumatoid arthritis (61 men and 217 women). The identifica- (13 patients, 61%) had problems with solids and 4 with liquids
tion of sarcopenia was based on muscle mass, quantified using (19%), 2 with mixed (9%) and 2 with both textures (9%).
Critical Care 2 S179
In addition to this, 13% of the evaluated patients (7) presented Methods: Weight, height, BMI and dietary intake was evaluated
malnutrition, all of them of caloric type in 69 IgE-CMA patients (44% males) and 31 volunteers without
Conclusion: Dysphagia is very common in patients with food allergies (control group, 45% males) aged ∼20 years.
Steinert’s disease therefore, it is essential to take it into Anthropometric data were compared to the general population
account and perform screenings in all of them, since its early and presented as z-scores using CDC growth charts. Nutritional
detection can avoid the risk of increased morbidity and assessment was based on 24-hour-dietary-recall and presented
mortality associated with dysphagia: respiratory infections, as percent of recommended values (DRIs). Analyses were done
malnutrition and death. using T-Test for continuous variables and Chi-Square tests for
Disclosure of Interest: None declared. categorical data.
Results: Low nutrient consumption was noted in CMA patients
(Table 1), 17 (25%) consumed less than the minimum daily
SUN-LB337
recommendation for protein vs. 1 (0.03%) in controls, p < 0.01.
LUNG ENDOTHELIAL CELLS FROM INTRAUTERINE
Height-z-score were significantly reduced in CMA patients
MALNUTRITION-INDUCED LOW-BIRTH-WEIGHT RATS FAIL TO
compared to both general population (−0.6 ± 0.9 vs.0, p <
EXPRESS THE LEPTIN RECEPTOR (OBRB) AND
0.0001) and controls (vs. 0.07 ± 0.6, p < 0.001). Twenty CMA
DOWNREGULATE INFLAMMATORY RESPONSES
patients (29%) had additional food allergies to nuts, eggs, fish
A. M. Balbino1, M. M. Silva1, G. A. Azevedo1, N. L. Gil1, and/or meat. Of these 20 participants many had significantly
M. A. Landgraf2, R. G. Landgraf1 *. 1Pharmaceuticals Science, reduced BMI (−0.6 ± 1.0 vs. 0.1 ± 0.8, p = 0.03) and were more
Federal University of São Paulo, Diadema, 2Pharmacology, likely to consume <80% of energy recommendations.
University of São Paulo, São Paulo, Brazil
Table 1: Nutritional data of participants [%DRI, Mean ± SD].
Rationale: We evaluated the expression of the long-form leptin Nutrient IgE-CMA Control Nutrient IgE-CMA Control
receptor (ObRb) in lung endothelial cells from Low birth weight
Calcium **33 ± 24 87 ± 42 Phosphorus **118 ± 66 190 ± 80
(LBW) rats and examined its role in the production of Magnesium *72 ± 30 91 ± 35 Vitamin A *43 ± 39 77 ± 70
inflammatory mediators. Potassium *48 ± 19 58 ± 22 Riboflavin **110 ± 64 166 ± 78
Methods: Lung endothelial cells were obtained from LBW or Zinc *87 ± 45 110 ± 37 Vitamin B12 **146 ± 104 201 ± 134
normal-birth-weight (NBW) rats. These cells were stimulated
*p < 0.05, **p < 0.001. No significant differences were found between groups in
with leptin (10 ng/mL), LPS (1 μg/mL) or leptin plus LPS. Six energy, protein, fat, carbohydrates or in other micronutrients.
hours after stimulation, the production of inflammatory
mediators (PGE2, LTB4, IL-1β and IL-6) and the expression of Conclusion: Individuals with CMA are at risk for inadequate
leptin receptor (ObRb) were examined. nutritional intake and short stature. Growth monitoring and
Results: Western blot assay showed that the expression of long- appropriate dietary interventions from childhood is
form leptin receptor was decreased (63%) in primary cultures of recommended.
endothelial cells derived from LBW rats. Leptin alone did not Disclosure of Interest: None declared.
induce any alteration of the levels of inflammatory mediators
evaluated, whereas LPS increased the levels of PGE2, LTB4, IL-
1β and IL-6. Only in endothelial cells from NBW rats did leptin Critical Care 2
enhance the production of lipid mediators in response to LPS.
The production of IL-1β and IL-6 was increased in NBW rat cells MON-P001
after exposure to LPS. INDIRECT CALORIMETRY VS METABOLIC LIMITS TRACING FOR
Conclusion: These results suggest that low birth weight EFFECTIVE PARENTERAL NUTRITION IN ICU PATIENT
induced by intrauterine malnutrition does not induce leptin J. Sobocki1 *. 1Department of Surgery and Clinical Nutrition,
receptor expression and downregulates inflammatory mediator Medical University of Warsaw, Warsaw, Poland
production in primary cultures of pulmonary endothelial cells
stimulated LPS. Rationale: Estimation of nutritional needs for ICU patients is
Disclosure of Interest: None declared. difficult. Nutritional needs and metabolic limits changes day by
day and hour by hour. Overnutrition and undernutrition are
SUN-LB338 both harmful. The aim of the study was to evaluate accuracy of
LIFELONG FOOD ALLERGIES CAN LEAD TO POOR IC measurement in prediction of patients needs, compared to
NUTRITIONAL STATUS metabolic limits tracing technique.
Methods: 20 patients on surgical ICU were included into the
T. Sinai1 *, R. Amizur-Levi1, A. Elizur2, M. R. Goldberg2,
study. Indirect Calorimetry (IC, Cosmed) was measured for 5
L. Nachshon2, Y. Katz2, E. Monsonego-Ornan1. 1The School of
days in each patient (100 patient-days measurements) accord-
Nutritional Sciences, The Hebrew University of Jerusalem,
ing to standardized technique. Results were compared to
Rehovot, 2Allergy and Immunology Institute, Assaf-Harofeh
metabolic limits tracing technique. TPN was administered
Medical Center, Zerifin, Israel
according to IC measurements.
Rationale: Food avoidance diets restrict the variety of foods Results: IC overestimated (defined as >10% calories over
that can be eaten and impact overall dietary consumption. This metabolic limit) in 85 measurements (85%). In two thirds
study investigated dietary intake and anthropometric measure- overestimation was more than 20% and maximal was more than
ments in young adults with IgE-mediated Cow-Milk Allergy 40%. IC was accurate (+/−10%) in 10 measurements (10%).
(IgE-CMA). Underestimation (>10% of calories deficit) was rare, but has
S180 Poster
happened in 5 days (5%). The former was observed in patients MON-P003

recovering from critical illness. CRITICAL ILLNESS REDUCES SELF-REPORTED APPETITE AND
Conclusion: IC overestimates (total energy expenditure often ORAL INTAKE BUT NOTACTUAL INTAKE ATAWEIGHED MEAL 3-
overcomes metabolic limits) or underestimates nutritional MONTHS POST-DISCHARGE
needs (when patient is undernourished). Only 10% of measure- L. Chapple1,1,2 *, L. Weinel3, Y. Ali Abdelhamid1,3, M. Summers3,
ments IC estimation was adequate. However IC is useful tool in T. Nguyen1, P. Kar1, M. Chapman1,2,3, A. Deane1,2,3. 1Discipline
ICU, it should be used with caution. of Acute Care Medicine, University of Adelaide, 2National
Disclosure of Interest: None declared. Health and Medical Research Council of Australia Centre of
Research Excellence in Nutritional Physiology, 3Intensive Care
MON-P002 Unit, Royal Adelaide Hospital, Adelaide, Australia
CO2 REMOVAL BY CVVH CAN BE CALCULATED
Rationale: Oral intake is inadequate early after ICU discharge
J. Jonckheer1 *, A. Debain2, W. Moeyerson1, P. Honore1, yet appetite and intake in survivors after hospital discharge is
E. De Waele1. 1Intensive Care, 2Internal Medecine, University unknown. The aim of this study was to assess whether ICU
Hospital of Brussels, Jette, Belgium survivors have reduced appetite and dietary intake 3-months
after ICU discharge compared to in health.
Rationale: Nutrition is a cornerstone in the care of critical ill
Methods: Adult ICU survivors were assessed 3-months after ICU
patients. Calculating the individual caloric need with the use of
discharge and compared to healthy subjects. Following an
formula has been shown by large trials to be inaccurate. The
overnight fast, all participants consumed a standardised
golden standard is Indirect Calorimetry and measures carbon
carbohydrate drink. Intake was assessed by 24-hour recall of
dioxide (CO2) production (V̇ CO2) and oxygen (O2) consumption
the preceding day (conducted by a dietitian) and a standard
(V̇ O2). By using the Weir formula, Energy Expenditure can be
weighed buffet meal 4-hours post-drink. Appetite was assessed
calculated. The use of IC is contraindicated during continuous
pre-drink (fasting) and pre- and post-buffet using visual
renal replacement therapy (CRRT) because of the potential loss
analogue scales.
of CO2 and isoforms in the dialysate. We aimed to find a way
Results: Fifty-one ICU survivors (42% male; 70 ± 9 y; BMI
to predict the tCO2 (total CO2 content) and tO2 (total O2
28 ± 6 kg/m2) and 25 healthy subjects (60% male; 67 ± 12 y;
content) exchange in the CRRT machine to enable the use of IC
BMI 27 ± 4 kg/m2) were evaluated. From the 24-hour recall ICU
during CRRT.
survivors consumed less fat (ICU 74 (48): health 104 (70) g;
Methods: In 6 patients treated with continuous veno-venous
p = 0.032) and energy (ICU 7740 (2899): health 9578 (3487) kJ;
hemofiltration (CVVH) with trisodium citrate, tCO2 and other
p = 0.018) than healthy subjects. Fasting and pre-meal, ICU
components of the blood and dialysate were measured on
survivors had less preference for fat than healthy subjects
different sample points of the CVVH circuit using a blood gas
( p = 0.033; 0.006). Oral intake from the weighed buffet was
analyzer. Citrate was stopped and replaced by an infusion of
comparable between ICU survivors and healthy subjects
Natrium Chloride 0,9% at the same flow to evaluate its effect on
(Table 1). Post-meal, ICU survivors had greater hunger ratings
tCO2 and tO2 exchange.
( p = 0.042) and less appetite satisfaction ( p = 0.019).
Results: 23% of tCO2 was removed from the blood passing
through the CVVH machine when replacement fluid without Table 1: Intake from buffet, mean (SD).
bicarbonate was used. This was independent of predilution ICU Health p
fluid used. The change in O2 was not significant (<0,5% of
average V̇ O2).
Energy, kJ 2751 (1260) 3077 (1359) 0.304
Protein, g 37 (19) 40 (17) 0.574
Using a blood gas analyzer, tCO2 in dialysate correlated with Fat, g 23 (12) 26 (13) 0.346
tCO2 extraction due to the CVVH filter. A formula to calculate Carbohydrates, g 69 (35) 79 (42) 0.298
the tCO2 exchange in the CVVH machine could be derived
which uses the settings of the machine and either blood Conclusion: ICU survivors reported less preference for fat and
obtained in the arterial CVVH circuit or tCO2 in the dialysate. less fat and energy consumption than healthy subjects. Intake
Conclusion: CO2 exchange due to CVVH can be calculated using from a weighed meal was comparable, yet ICU survivors had
our formula. A blood gas analyzer can be used to assess the greater hunger ratings and less appetite satisfaction after the
tCO2 extraction in the dialysate, although it wasn’t validated meal, suggesting other factors may influence intake.
for it. Both findings should enable and facilitate the use of Disclosure of Interest: None declared.
IC during CVVH if a correction factor is used for the
measured V̇ CO2.
MON-P004
Disclosure of Interest: None declared. DETECTING MALNUTRITION IN THE CRITICALLY ILL USING
DIFFERENT ASSESSMENT TOOLS
M. T. Al Kalaldeh1 *. 1Faculty of Nursing, Al-Zaytoonah
University of Jordan, Amman, Jordan
Rationale: Proper nutritional assessment is strongly associated

with nutritional failure and mortality in the critically ill (1).
There is a little consensus on the appropriateness of using such
nutritional in the intensive care (2). This study aimed to
assesses using diffrent measurement in predicting nutritional
status in the ICU.
Methods: This cross-sectional observational study included MON-P006

critically ill patients who were fed enterally and mechanically MINIMALLY INVASIVE TREATMENT OF ABDOMINAL
ventilated. Patients were assessed using Malnutrition Universal COMPARTMENT SYNDROME DURING ACUTE PANCREATITIS
Screening Tool (MUST), Phase Angel (PA) by Bioelectrical REDUCES INTOLERANCE OF TUBE FEEDING
Impedance Analysis (BIA), and Acute Physiology and Chronic M. Bezmarevic1 *, M. Panisic1, A. Popadic2, D. Mirkovic1. 1Clinic
Health Evaluation II (APACHE II). for General Surgery, 2Clinic of Anesthesiology and Intensive
Results: 122 patients were examined. The duration of intensive Care, Military Medical Academy, Belgrade, Serbia
care admission was 6.25 (IQR 4.3–8.7). 78 (63.9%) of patients
were acute emergency cases while 39 (32.0%) were chronic Rationale: Intolerance of tube feeding (TF) is associate with
medical cases and 5 (4.1%) were other medical diagnosis. Mean abdominal compartment syndrome (ACS) and in patients with
of APACHE II score was 17.93 (SD 7.3). Based on this, 89 patients open abdomen (OA). To compare effects of decompressive
(73.0%) were found with low PA and the other was found laparotomy with temporary abdominal closure (OA) and
normal. While MUST was ranged from 0 (Low risk) to 2 (high percutaneous puncture with placement of abdominal catheter
risk), 63 patients (51.6%) were at low risk, 27 (22.1%) were at (PP) in patients with ACS during severe acute pancreatitis (SAP)
moderate risk, and 32 (26.3%) were at high risk. Correlation regarding tolerance of TF.
revealed low significant correlation between MUST and both PA Methods: Prospective study included 15 patients divided into
and APACHE II (R = 0.41 and 0.57; p = 0.035 and 0.006, two groups (8-OA and 7-PP group). APACHE 2 score, intra-
respectively). However, high correlation was found between abdominal pressure (IAP) and tolerance of TF were assessed
PA and APACHE II (r = 0.89, p < 0.001). before and after procedures and comparison between two
Conclusion: The reliance on one tool for nutritional assessment groups were assessed.
would under-diagnose nutritional status in the critically ill. Results: Before the procedure APACHE 2 score was 19.5 ± 2.7 in
References OA group and 19.7 ± 3.9 in PP group ( p = 0.9). Before the
procedure IAP was 22 ± 1.4 mmHg in OA group and 23 ± 2.2
1. Feldblum I, German L, Bilenko NAS, Enten R, Greenberg D, et al.
mmHg in PP group ( p = 0.14). Intolerance of TF was present in
Nutritional risk and health care use before and after an acute
hospitalization among the elderly. Nutrition. 2009;25:415–20. all patients in both groups before procedure. After the
2. Heyland DK, Stephens KE, Day AG, McClave SA. The success of procedure APACHE 2 score was 15.7 ± 3.1 in OA group and
enteral nutrition and ICU-acquired infections: A multicenter before 17.3 ± 5.7 in PP group ( p = 0.52). After the procedures
observational study. Clinical Nutrition. 2011;30(2):148–55. IAP was 10 ± 2.1 mmHg in OA group and 14 ± 3.2 mmHg in PP
Disclosure of Interest: None declared. group. After the procedure intolerance of TF was present in 6
(75%) patients in OA group and in one (14%) patient in PP group
( p = 0.001). There was significant difference in APACHE 2 score
MON-P005 ( p = 0.001) and IAP ( p < 0.001) before and after procedures, but
DIABETES SPECIFIC ENTERAL FORMULAS IN ICU no significant difference in APACHE 2 score ( p = 0.394) and IAP
M. Castro1 *, L. M. Horie1, K. S. Kawamura2, F. Rascov2, ( p = 0.144) changes between groups. The significant difference
D. Toledo3. 1Gastroenterology, Faculdade de Medicina da USP, was found between number of patients who did not tolerate TF
Sao Paulo, 2Nutrition, Pronto Socorro Central, Sao Bernardo, in PP group before and after procedure ( p < 0.001), but no
3
Nutrition, Hospital Albert Einstein, Sao Paulo, Brazil differences between those patients in OA group ( p = 0.19).
Conclusion: Intolerance of TF is present in patients with ACS in
Rationale: Although standard enteral nutrition is universally SAP. Minimally invasive treatment and decompressive laparot-
accepted, the use of disease-specific formulas for hypergly- omy have an immediate effect on organ function. Minimally
cemic patients is still controversial. This study compares three invasive treatment of ACS reduce intolerance of TF more than
differents high-protein diabetes-specific formulas to verify the decompressive laparotomy in patients with SAP.
improvement of glycemic control and tolerability.
Methods: This was a prospective, open-label, randomized
study. The patient groups established according to the high-
protein formula received were: group A, Glucerna 1.5 (Abbott), MON-P007
B, Diason 1.5 (Nutricia); group C, Novasource GC 1.5 (Nestle). EVALUATION OF PROTEIN INTAKE WITH TOTAL PARENTERAL
Inclusion criteria were: expected enteral nutrition ≥5 days, NUTRITION (TPN) IN A CLINICAL SETTING
baseline glucose >180 mg/dL in the first 48 h. The targeted M. A. Van Kralingen1 *, S. Leij - Halfwerk1, J. van der Linde2,
glucose level was 110–150 mg/dL. Glycemic variability was M. Mensink2. 1Hogeschool van Arnhem en Nijmegen, Nijmegen,
2
calculated as the standard deviation, glycemic lability index Rijnstate Hospital, Arnhem, Netherlands
and coefficient of variation. We collected daily gastrintestinal
events (diarrhea and vomiting). Rationale: Sufficient protein intake in patients receiving total
Results: A total of 64 patients were consecutively enrolled (A parenteral nutrition (TPN) is important for recovery and
20, B 24 and C 18). There were no difference in glucose control reducing mortality risk. As it is suspected that protein intake
between the tthree groups (233 ± 58 vs. 224 ± 46 vs 233 ± 58 IU/ in these patients is below their protein requirements the goal of
day, p > 0.05). Gastrintestinal events were not different this study was to evaluate protein intake in patients receiving
between the groups. TPN in a clinical setting.
Conclusion: In these study, the three diabetes-specific Methods: Protein intake (g/kg body weight) and energy intake
formulas had the same effect in glucose control and gastrin- were retrospectively collected from patient records of all
testinal events. patients receiving TPN in all hospital wards of Rijnstate
Hospital in Arnhem, the Netherlands, between July and
S182 Poster
December 2016, and compared with their individual protein 1,703 cal/24 h (SD 405) and N2 excretion of 11.2 g/24 h (SD
and energy requirements. For protein requirement, 1.2 g/kg – 6.6). Mean carbohydrate oxidation was 161 ± g/24 h (SD 176),
according to the ESPEN and ASPEN guidelines– and 1.5 g/kg – much lower than prescribed carbohydrates 191 ± g/24 h (SD 76;
taking into account disease-related stress factors– were p < 0.001). Amount of carbohydrates and fat administered
used. Energy requirement was estimated with Harris & correlated to prescribed amount (r = 0.825 and 0.887
Benedict + 30%. In overweight patients requirements were respectively).
recalculated to BMI 27 kg/m2. Patients with enteral nutritional Conclusion: Substrate utilization is not in relation with
intake were excluded. substrate administration in artificially fed critically ill patients
Results: A total of 52 patients were enrolled in this study. The suffering from AKI. Standard nutrition, based on commercial
mean protein intake was 1.4 g/kg (SD ± 0.2 g/kg) which was formulas, should be challenged with a guided nutritional
significantly higher than 1.2 g/kg (t-test, p < 0.0005), but approach based on substrate utilization.
lower than 1.5 g/kg (t-test, p = 0,018). Three patients (6%) Disclosure of Interest: None declared.
received less than 1.2 g protein/kg (0.8 g/kg to 1.1 g/kg),
whereas 16 patients (31%) received more than 1.5 g/kg
MON-P009
(1.6 g/kg to 2.5 g/kg). The mean energy intake was
CAN WE USE PREALBUMIN AS A MARKER FOR NUTRITIONAL
1,930 kcal (SD ± 300 kcal), which is 99% of mean energy
STATUS IN CRITICALLY ILL SURGICAL PATIENTS?
requirement (SD ± 11%, 1,973 kcal±301 kcal).
Conclusion: Most patients received sufficient protein with TPN N.-J. Choi1 *, J. H. Jung2. 1Trauma and Surgical Critical Care,
2
per the minimum requirement of 1.2 g protein/kg. However, to Asan Medical Center, University of Ulsan College of Medicine,
reach the requirement of 1.5 g protein/kg in a clinical setting Seoul, Republic of Korea
an amino acid supplement may be indicated to avoid caloric
Rationale: Serum prealbumin (PAB) is used as a nutrition
overfeeding.
indicator because it reflects the short-term nutritional status
References with a short half-life. However, PAB is influenced by not only
1. ASPEN Guidelines for Provision and Assessment of Nutrition Support nutrition therapy, but also other several factors.
Therapy in the Adult Critically Ill Patient 2016. The purpose of this study was to evaluate the correlation
2. ESPEN Guidelines on Enteral Nutrition: Intensive Care 2006. between PAB and CRP and compare with correlation between
Disclosure of Interest: None declared. PAB and nutritional intake in critically ill surgical patients.
Methods: This retrospective cohort study included the
patients (n = 67) who had been admitted to the surgical
MON-P008
intensive care unit (SICU) for more than 7 days in 2015 and
SUBSTRATE UTILIZATION AND ADMINISTRATION IN CRITICALLY
checked the level of PAB sequentially two more times.
ILL PATIENTS WITH ACUTE KIDNEY INJURY: A PROSPECTIVE
Electronic medical records were reviewed the patient
MULTICENTER STUDY
characteristics, nutritional status, PAB, CRP and the amount
M. Hellerman1 *, A. Sabatino2, M. Theilla1, I. Kagan1, of nutritional intake. Statistical analysis was performed using
E. Fiaccadori2, P. Singer1. 1Intensive Care Unit, Rabin Medical Pearson’s correlation coefficient, independent t-test methods
Center, Petah Tikva, Israel, 2Intensive Care Unit, Parma of SPSS 21.0 program.
Hospital, Parma, Italy Results: The PAB measured just after SICU admission demon-
strated no relation with nutritional status (adequate (n = 29),
Rationale: The objective of our study is to evaluate the
9.8 ± 5.2 mg/dL vs. malnutrition (n = 38) 10.5 ± 6.3 mg/dL,
adequacy of nutritional support in intensive care unit (ICU)
p = 0.607). In addition, PAB sequentially measured (on ICU
patients with acute kidney injury (AKI). This was achieved by
14th day) showed no correlation with the amount of caloric
comparing administered amount of carbohydrates and lipids to
intake (≥25 kcal/kg/day (n = 24) 13.4 ± 6.4 mg/dL vs. <25 kcal/
substrate utilization calculated from indirect calorimetry
kg/day (n = 43) 11.2 ± 5.5 mg/dL, p = 0.149). The change of PAB
measurements.
showed correlation with not the amount of nutrition intake
Methods: A prospective multi-center study, (Rabin Medical
(r = 0.129, p = 0.296), but the level of CRP (r = −0.508,
Center ICU, Israel and the Renal ICU Parma Hospital, Italy)
p = 0.000).
included adult ICU patients with AKI (based on KDIGO criteria)
Conclusion: In acute phase of critically ill surgical patients, the
receiving enteral and/or parenteral nutrition. Resting energy
level of PAB showed a strong correlation with CRP level, rather
expenditure (REE) was measured by indirect calorimetry
than the amount of nutritional intake. Therefore, we should be
(Deltatrac II, Datex GE), nitrogen excretion was measured
careful to interpret PAB of critically ill surgical patients.
using urinary urea nitrogen and changes in plasma BUN. Fat and
carbohydrate oxidation were derived from Weir formulas and Disclosure of Interest: None declared.
compared to daily prescribed and administered fat and
carbohydrates. Study was approved by the institutional MON-P010
review board. Wilcoxon Signed Ranks Test was used for ELEMENTAL VERSUS POLYMERIC ENTERAL NUTRITION IN ICU
statistical analysis. PATIENTS: WHAT IS PREFERRED?
Results: Lipid expenditure was derived from 86 measurements N. Kazeminia1 *, M. Sistanizad1. 1Clinical Pharmacy, School of
yielding a mean REE of 1,755 cal/24 h (Standard deviation (SD) Pharmacy, Tehran, Islamic Republic of Iran
406) and an N2 excretion of 12.6 g/24 h (SD 7.4). Mean lipid
oxidation was 114 ± g/24 h (SD 66.8), while prescribed lipids Rationale: Selection of enteral nutrition (EN) formula in ICU
were 6 ± g/24 h (SD 32; p < 0.001). Carbohydrate expenditure patients has become an important topic recently due to its
was derived from 75 measurements yielding a mean REE of impact hospital expenditure as well as patient’s metabolic
balance. Semi-elemental and polymeric are two types of EN Demographic data, daily TE intakes and weekly TE plasma
product which is widely used in hospitals with manufacturer levels were retrospectively retrieved for the first 21 days. Data
reports of semi-elemental product preference in critically ill is expressed as median and (IQR).
patients. This study was designed to compare these two EN Results: 253 patients aged 43 (32) years, burned on 25 (24)%
products (semi elemental vs polymeric) in ICU patients. body surface area were included (no difference between
Methods: Fifty patients who received EN within the first 48 periods). Daily Cu, Se and Zn intakes increased significantly
hours of ICU admission divided into two groups of semi- between 1999 and 2015, allowing normalization of plasma Cu
elemental and polymeric, 25 patients in each. Patient’s (19 mg/l) and Zn (12 mg/l) levels during P4. Median plasma Se
laboratory data was noted for seven concomitant days. levels were elevated during P4, flirting with the maximal range
Moreover, six-hours urine was collected for each patient to (1,404 μg/l).
calculate nitrogen balance, while albumin level was recorded in Conclusion: The study shows that our supplementation
days 1, 4 and 7. Results of enteral feeding with these two formula protocol normalizes Cu and Zinc levels, but Se doses seem
were subsequently assessed and analyzed using SPSS software. too high, suggesting a reduction of the dose.
Results: Tolerance of nutrition and reported serum level of Disclosure of Interest: None declared.
Creatinine, K, Na and Urea had not significant difference in the
two groups in these 7 days period. The mean nitrogen balance
MON-P012
was more negative in polymeric group (−5.46 ± 8.97 vs
VALIDATION OF PREDICTIVE EQUATIONS TO ESTIMATE
3.41 ± 9.38, p-value: 0.367) and sepsis incidence was detected
RESTING ENERGY EXPENDITURE IN CRITICALLY ILL PATIENTS
in 64% and 60% of polymeric and semi-elemental groups
respectively ( p-value: 0.771). The mean serum albumin value O. Zusman1,2, I. Kagan2,3, M. Theilla3,4 *, I. Bendavid2,3,
was 0.04 lower in polymeric group with 0.88 of increase in mean J. Cohen2,3, P. Singer2,3. 1Department of Cardiology, Rabin
number of albumin vial usage ( p-value: 0.835 and 0.728). Medical Center, Petach Tiqva, 2Faculty of Medicine, Tel Aviv
Nitrogen balance had no correlation with 28-days mortality ( p- University, Tel Aviv, 3Department of General Intensive Care and
value: 0.917), ICU mortality ( p-value: 0.717) and incidence of Institute for Nutrition Research, Rabin Medical Center, Petach
sepsis ( p-value: 0.515). Tiqva, 4Faculty of Nursing, Steyer School of Health Professions,
Conclusion: According to the results of this study, no significant Tel Aviv University, Tel Aviv, Israel
difference between polymeric and semi-elemental EN was seen
Rationale: Although measuring resting energy expenditure
in ICU patients. Therefore, contrary to the claims of the
(REE) via indirect calorimetry (IC) is the gold standard
manufacturer, semi-elemental products with hydrolyzed
recommended by guidelines, technical difficulties hinder its
protein content are not preferred in critically ill patients.
use, and predictive equations are largely used in place. We
Disclosure of Interest: None declared. sought to validate commonly used equations using a large
cohort of patients.
MON-P011
Methods: Patients were hospitalized from 2003–2015 at a 16-
TRACE ELEMENT REPLETION FOLLOWING SEVERE BURN
bed ICU at a university affiliated, tertiary care hospital. Data
INJURY: A 16-YEAR RETROSPECTIVE COHORT STUDY
was drawn from a computerized system and included the IC REE
O. Pantet1 *, P. Stoecklin2, M. Charrière1, A. Vernay3, as well as other variables required by equations. Measurements
M. M. Berger1. 1Intensive Care and Burn Center, CHUV, were restricted to up to 5 REE per patient to avoid bias.
Lausanne, 2Intensive Care Medicine, Inselspital, Bern, Equation performance was assessed by comparing means,
3
Computer Sciences, CHUV, Lausanne, Switzerland standard deviations, correlation, concordance, and agree-
Rationale: Trace elements (TE) repletion has been shown to be ment, which was defined as a measurement within 85% and
beneficial in burn patients who suffer from large exudative 115% of measured REE.
losses of Cu, Se and Zn. Aim of the study was to check if our Results: A total of 3,573 REE measurements in 1,098 patients
repletion protocols were appropriate to normalize TE plasmatic were included. Median age was 64 (interquartile range, IQR
levels of our burn patients over a period of 16 years. 27), 65% were male, and 91% were ventilated. A total of 562
Methods: Inclusion criteria were: burn injury requiring an ICU patients had more than 2 REE measurements. For these
stay >7 days. The cohort was divided into 4 groups according to patients, the mean difference between maximum and
the period defined by changes in our management protocol. minimum measured REE was 500 kcal. The performance of
Period 1 (P1): 1999–2000, P2: 2001–2005, P3: 2006–2010, P4: predictive equations is presented in Table 1. Equation
2011–2015. Changes were mainly increasing TE repletion doses performance varied according to parameter, but none
and better compliance with the repletion protocol. reached more than 50% agreement with measured REE.
Table 1: (abstract: MON-P011).

Variable All periods Period 1 (99–01) Period 2 (02–05) Period 3 (06–10) Period 4 (11–15) P-value
Nr of patients 253 32 57 85 79
Daily Cu intake (mg) 2.5 (3.4) 2.7 (3.4) 2.0∗ (3.0) 2.2 (3.0) 3.3∗ (4.2) <0.001
Cu level (mg/l)∗ (12.5–23.6) 14.2 (11.7) 8.3∗ (5.2) 11.7 (16.4) 17.6 (9.3) 19.3∗ (8.7) <0.001
Daily Se intake (μg)∗ 334 (484) 300∗ (374) 323 (397) 392∗ (540) 292 (647) <0.001
Se level (μg/l)∗ (750–1,500) 1,233 (769) 530∗ (430) 1,053 (540) 1,461∗ (683) 1,404 (538) <0.001
Daily Zn intake (mg)∗ 33 (48) 27∗ (35) 30 (37) 45 (50) 40∗ (61) <0.001
Zn level (mg/l)∗ (10.1–17) 12.3 (5.8) 6.7∗ (3.9) 13 (7) 13.2∗ (5.6) 11.5 (4.2) <0.001
S184 Poster

Mean Standard % % Correlation Concordance Agreement
Difference Deviation Error Difference
Faisy 10.19 455.58 0.21 0.13 0.49 0.57 0.5

Harrison-Benedict 94.9 446.5 0.21 0.13 0.54 0.59 0.5
Ireton-Jones 26.81 461.16 0.2 0.13 0.46 0.52 0.49
Jolliet 99.26 542.04 0.24 0.14 0.51 0.62 0.44
Mifflin-St. Jeor −438.39 431.97 0.24 0.17 0.54 0.35 0.3
Penn State −206.7 453.29 0.2 0.14 0.51 0.54 0.44
25 kcal/kg 47.08 557.74 0.24 0.15 0.36 0.52 0.42
Conclusion: This is the largest study comparing predictive MON-P014

equations to resting energy expenditure measured by indirect PHOSPHATE DEFICIENCY IN SEVERE DIABETIC
calorimetry. Due to low performance, predictive equations KETOACIDOSIS
cannot be used in place of indirect calorimetry to estimate REE. P. Tesinsky1 *, A. Haken2, J. Gojda1. 1ICU, Dept. of Medicine 2,
Disclosure of Interest: None declared. Charles University Hospital, 23rd Faculty of Medicine, Prague,
Czech Republic
MON-P013
EARLY ADMINISTRATION OF PROTEIN IN CRITICALLY ILL Rationale: Severe diabetic ketoacidosis (DKA) is often accom-
PATIENTS IMPROVES SURVIVAL: A LARGE RETROSPECTIVE panied by hypophosphataemia. Clinical manifestations include
COHORT STUDY weakness, changes of state of consciousness, and muscle
O. Zusman1,2, I. Kagan1,3, M. Theilla3,4 *, I. Bendavid1,3, fatigue. The aim of this prospective study was to identify the
J. Cohen1,3, P. Singer1,3. 1Faculty of Medicine, Tel Aviv presence of hypophosphataemia in severe diabetic ketoacidosis
University, Tel Aviv, 2Cardiology, 3Department of General and to compare patients’ metabolic state with specific clinical
Intensive Care and Institute for Nutrition Research, Rabin manifestation.
Medical Center, Petach Tiqva, 4Nursing Department, Steyer Methods: Patients with severe hypophosphataemia during
School of Health Professions, Sackler School of Medicine, Tel treatment of DKA were monitored within a period of 48 hours
Aviv University, Tel Aviv, Israel after admission. Following parameters were evaluated at times
0, 12, 24, and 48 hours: pH, bicarbonate, glycaemia, potassium
Rationale: The issue of timing of nutrition provision in critically (K), phosphate (P), CRP, and urinary ketones. Simultaneously,
ill patients is under debate in the literature. While protein is cumulative doses of insulin, energy, fluids, K, and P were
recognized as a valuable macronutrient in this patient calculated.
population, it is currently not known whether early adminis- Results: Out of 3,595 patients admitted to the tertiary hospital
tration of protein improves patient outcomes. medical ICU between January 1, 2012, and December 31, 2016,
Methods: Included patients were hospitalized from 2003 to 114 patients had a diagnosis of DKA (3.17%), while 48 patients
2015 at a 16-bed ICU at a university affiliated, tertiary care from this group (42.1%) had evidence of severe hypopho-
hospital, who stayed at least 4 days in the unit. Data was drawn sphataemia (less than 0.35 mmol/L) during the treatment. Out
from a computerized system and included the demographic of these, 10 patients required temporary ventilatory support.
data, as well as SOFA score, need for parenteral nutrition, and The total dosage of insulin within the first 24 hours was
amount of protein per day. Patients that received mean daily significantly lower in these patients (60 IU) in comparison to
protein of more than 0.7 gr/kg/d in the first 3 days were the mean value of the whole study group (163 IU).
included in the early group, and those that received less in the Furthermore, only 200 kcal were delivered to these patients
first days, were included in the late-protein group. within the first 24 hours (compared to 1,956 kcal in the whole
Results: A total of 2,253 patients were included, of which 1,040 group), 4,050 ml fluids (6,437 ml), 60 mmol K (108 mmol), and
were in the early group, and 1,213 in the late group. Age and 0 mmol P (49 mmol). The clinical symptomatology resumed
sex were similar, with higher SOFA score and parenteral completely in all patients within the next 24 hours after
nutrition in the late group. After 60-days, 371 (36%) in the suplementation of fluid, energy, K, and P.
early group, and 517 (43%) in the late-adequate group had died Conclusion: Although phosphate supplementation is not
( p < 0.001 for difference). In multivariable Cox regression routinely recommended during treatment of diabetic ketoaci-
analysis, while controlling for age, sex, weight, parenteral dosis, we should be aware of danger of hypophosphataemia.
nutrition, mean delivered calories, and mean daily protein Therefore, monitoring of serum phosphate level and its
received after the first 3 days, administration of vasopressors, repletion if necessary should be considered.
and total hospital stay, early protein was associated with Disclosure of Interest: None declared.
increased survival (HR 0.84, 95% CI 0.72–0.98, p = 0.01)
Conclusion: Results of this study suggest that early delivery of
protein is associated with increased survival. RCTs are needed
to validate this result.
Disclosure of Interest: O. Zusman: None declared, I. Kagan: None
declared, M. Theilla: None declared, I. Bendavid: None declared,
J. Cohen: None declared, P. Singer Grant/Research Support from:
Unrestricted grant from Fresenius.
MON-P015 their born and consequently admittance until their discard of

NUTRITION RISK IN CRITICALLY ILL PATIENTS AND NICU and store at −80C until experiments. The fecal microbiota
OUTCOME; NUTRIC SCORE, MUST AND SERUM ALBUMIN composition was evaluated using MiSeq sequencing approach
COMPARISON and qPCR.
R. Carvalho1 *, M. Henriques2, L. Esteves3, R. César1, H. Costa2. Results: The results show a lower diversity in fecal microbiota
1
Endocrinology and Nutrition Service, 2Intensive Care Service, composition, with a predominance of members of the Phylum
3
Genetics and Molecular Pathology Unit, Divino Espirito Santo Firmicutes and Proteobacteria. The value of total bacteria
Hospital, Ponta Delgada, Portugal found in those newborns was significant lower than those found
for healthy newborns, found in previous reports. The younger
Rationale: Critical illness is associated with a rapid deterior- the newborn, lower is the value of total bacteria in their
ation in nutritional status, even in patients admitted to the intestinal microbiota. The evaluation of the intestinal colon-
Intensive Care Unit (ICU) well nourished. Several tools assess ization shows an increase in diversity in the last weeks of
nutrition risk but most consider all ICU patients at high risk. permanence in the unit care. However, the newborns showed
Nutric score (NS) is a novel screening tool designed to better high relative abundance of Enterobacteria, Staphylococcus and
identify ICU patients at risk of developing malnutrition. The Streptococcus in the last weeks of permanence in the unit.
objective of the study was to compare the correlation of NS, Many of them are colonized by pathogenic bacteria, like
Malnutrition Universal Screening Tool (MUST) and serum Pseudomonas and Stenotrophomonas. There was a positive
albumin (SA) with the outcome, measured in ICU-LOS and 28 association between reduction of the diversity and occurrence
day mortality. of sepsis. The qPCR results showed a reduced colonization by
Methods: A retrospective, observational study, of all patients Lactobacillus and Bifidobacterium.
stayed in ICU >72 hours within a 6 month period. Data was Conclusion: Conclusion: These results suggested that the
collected for inclusion in the scores: age, baseline MUST, absence of feeding andTPN may disturb the establishment of
baseline APACHE II, baseline SOFA, number of comorbidities, intestinal microbiota, favoring pathogenic bacteria and conse-
days from hospital admission to ICU admission, Body Mass quent clinical intercurrents occurrence, such sepsis. These
Index <20 and SA. Outcomes were collected until day 28 findings may contribute to the understanding of how intestinal
and included ICU-LOS and 28-day mortality. Statistical analysis microbiota develops in critical newborn. Financial support:
was done with Studentst-test or Mann-Whitney test for FAPESP N. 2015/13–59–9.
continuous variables and Fisher’s exact tests for categorical Disclosure of Interest: None declared.
variables and considered to be significant for p-values less
than 0.05. All analysis were performed with SPSS 21.0
MON-P017
software.
THE IMPACT OF PERIOPERATIVE NUTRITIONAL SUPPORT
Results: 70 patients were eligible for the study, mean age
WITH THE USE OF NUTRIDRINK COMPACT WITH DIETARY
65.9 ± 9 y, males 55.7%, BMI 27.8 ± 6.6, LOS-ICU 12.1 ± 9.3 days.
FIBERS ON THE INCIDENCE OF INFECTIOUS COMPLICATIONS
At 28 day 11 patients (15.7%) died. In NS, 5 (7.1%) and 6 (8.5%)
AFTER PANCREATODUODENAL RESECTION
patients died in the low and high risk score respectively; in
MUST 1 (1.4%) and 10 (14.3%) patients died in the low and high S. Bobovnick1 *. 1ICU, Municipal Clinical Hospital named after
risk scores respectively and in SA 3 (4.3%) and 8 (11.4%) patients E.E.Volosevich, Arkhangelsk, Russian Federation
died in the moderate or severe depleted scores. The
Rationale: Perioperative nutritional support for patients after
differences were not statistically different for 28 day mortality
surgery for chronic pancreatitis is a difficult problem due to
or ICU-LOS in NS, MUST and SA scoring systems.
severity of desease and major intraabdominal trauma
Conclusion: We did not found a statistical difference between
Methods: 10 days before surgery patients in Group I received
survivors and non-survivors and between ICU-LOS in NS, MUST
daily 125 ml/day of Nutridrink Compact with dietary fibers.
and SA nutrition risk screening tools.
In the postoperative period they received the tube feeding
Disclosure of Interest: None declared. with Nutrisone at the rate of 25 kcal/kg/day and 1.5 g/kg/
day of protein in combination with Nutridrink Compact MF at
MON-P016 the rate of 125 ml/day 24 h after pancreatoduodenal
ESTABLISHMENT OF INTESTINAL MICROBIOTA IN SURGICAL resection. Patients in Group II received tube feeding with
NEWBORNS WITH INTESTINAL FAILURE Nutrisone at the rate of 25 kcal/kg/day and 1.5 g/kg/day of
R. Feferbaum1 *, on behalf of Luana Moreira2, A. M. Matuhara1, protein 24 h. Tubes were installed intraoperatively at the
M. E. J. Rivero1, C. R. Taddei2. 1Pediatrics, Instituto da Criança back of anastomosis zone. The period of duration of tube
do HC Faculdade De Medicina Da Universidade De São Paulo, feeding in both groups during the postoperative period was 7
Sao Paulo, Brazil days.
Results: Decrease in the number of infectious complications in
Rationale: Intestinal microbiota in the neonate is highly main group (2 patients, 9.5%) as compared to the control (6
susceptible to perturbations of the luminal environment. due patients, 28.6%, p = 0.02). Decrease in antibacterial therapy
to prolonged antibiotic treatments, delayed enteral feeding duration has been observed(only 2 patients from Group I
and TPN. underwent an average course of antibacterial therapy within
Methods: Analyse fecal microbiota of 20 surgical neonates with 9.2 days as compared to 6 patients from Group II within 13.7
intestinal wall failure due gastrosquisis and onphalocoele. days). Significant reduction in postoperative plenghts of stay
Fecal sample were collected from all newborns weekly since (Group I – 11.1 days, Group II 22.9 days, p = 0.01). In Group II, 2
S186 Poster
patients died from purulent-septic complications. More pro- MON-P019

nounced depletion of visceral pool of total protein, albumin THE EFFECT OF FLUID INTAKE ON FLUID BALANCE AND
and transferrin has been observed in Group II on the 10th day of PROGNOSIS IN POLYTRAUMA PATIENTS IN ICU
the postoperative period. V. Joskova1,2 *, A. Patkova1,2, E. Havel3, M. Kovarik1,2,
Conclusion: Nutritional support with the use Nutridrink Z. Zadak1, M. Hronek1,2. 1Department of Research and
Compact MF during the perioperative period leads to reduction Development, University Hospital in Hradec Kralove,
of complications, improvement of visceral protein status 2
Department of Biological and Medical Sciences, Faculty of
and a significant reduction of infectious complications in the Pharmacy in Hradec Kralove, Charles University, 3Department
postoperative period in patients undergoing surgery for chronic of Surgery, University Hospital in Hradec Kralove, Hradec
calculous pancreatitis. Kralove, Czech Republic
Rationale: The aim of this study was to evaluate the changes in
MON-P018 volume and distribution of body fluids with their effect on
JUSTIFICATION FOR INCLUSION OF SEMI-ELEMENTAL clinical outcomes in polytrauma patients, because it is not well
FEEDS INTO THE COMPOSITION OF EARLY ENTERAL known.
NUTRITION Methods: The study included 30 polytrauma patients (22 men
and 8 women) with mean age 43.33 ± 16.79 years. During the
V. Fisher1 *. 1Deputy Chief Regional Clinical Hospital, PhD, whole hospitalization fluid balances were recorded from
Ass Professor of the Department of Anesthesiology hospital documentation. On selected days (minimum day 2;
and Reanimation of the Stavropol Medical University, maximum day 65; in total 130 examinations), body fluids were
Stavropol Medical University, Stavropol, examined by bioelectrical impedance spectroscopy (BCM
Russian Federation monitor, Fresenius, Germany) and metabolism was character-
ized by the indirect calorimetry (Vmax Series, V6200 Autobox,
Rationale: Still some issues remain disputable concerning
SensorMedics Corporation, California, USA). Graph-Pad Prism6
the composition of the feeds for early EN and the periods for
(GraphPad Software, La Jolla, CA, USA) and Excel 2016
their prescription after surgery. This situation prompted the
(Microsoft, Redmont, WA, USA) were used for statistical
study as to the efficiency of the use of semi-elemental feeds for
analyses.
enteral nutrition during the first day after surgical
Results: According to patient’s fluid balances, examinations
interventions.
were divided into three periods of ICU hospitalization (day 1–
Methods: 20 patients after reconstructive surgeries related
3, day 4–10 and day 11 and more). Mean total body water
to elimination of operational stomas of the large intestine. 10
(TBW) (51.72; 50.40; 48.25 l) and extracellular water (ECW)
patients as a control group, 10 patients as a main group. During
(27.17; 26.67; 23.70 l) was decreasing, but mean intracellu-
the 24 h after the surgery the patients of the control group
lar water (ICW) remained unchanged (24.57; 24.70; 24.54 l).
received 1,000 ml of glucose-electrolyte solution, while the
In the period between day 4 and 10, higher fluid intake
patients of the main group received 500 ml of glucose-
correlated with higher excess fluid in extracellular water
electrolyte solution and 500 ml of semi-elemental tube feed
(OH) ( p = 7*10−5; r = 0.570), ECW ( p = 0,005; r = 0.424) and
(Nutrison Advanced Peptisorb). The groups were randomized as
ratio between ECW/ICW ( p = 9*10−5; r = 0.562). Patients with
to the volume of surgical intervention, the initial degree of
higher values of mentioned parameters showed longer
nutritional insufficiency. Significant comorbidity was the
duration of mechanical ventilation and length of ICU stay.
criterion for exclusion.
Fluid balance was influenced by fluid intake according to
Results: Anastomosis leakeage was observed in two patients of
derived equations.
the control group (20%) and only in one patient in main group
Conclusion: Changes in fluid volumes seem to be an indirect
(10%, p < 0.005). The number of postoperative wound abscesses
prognostic marker in polytrauma patients. Derived equations
was the same in both groups. By the 3rd day of the
can be applied in clinical practice for optimization of the
postoperative period the amount of albumin from the initial
appropriate fluid intake that can contribute to reduce the
level was 90% in the patients of control group and 93% in the
duration of mechanical ventilation and the length of ICU stay.
main group ( p < 0.005). It should be noted that by the third day
of the postoperative period the function of gastrointestinal Disclosure of Interest: None declared.
tract was restored, which allowed to perform complete enteral
nutrition in 70% of the persons in the control group and in 80% of MON-P020
the pts in main group ( p < 0.005). EARLY HIGH PROTEIN INTAKE WITHOUT ENERGY
Conclusion: Study demonstrate the benefits of semi-elemental OVERFEEDING IN CRITICALLY ILL PATIENTS
feeds for EN during the first 24 h after surgery on the large W. G. Looijaard1 *, N. Denneman1, B. Broens1, P. J. Weijs1,2,
intestine. it leads to earlier restoration of the intestinal tract H. M. Oudemans-van Straaten1. 1Department of Adult
function, normalizes protein metabolism, as well as reducing Intensive Care Medicine, 2Department of Nutrition and
the risk of infectious complications and frequency of anasto- Dietetics, VU University Medical Center, Amsterdam,
mosis leakeage. Netherlands
Rationale: Early high protein (≥1.2 g/kg/day) and no energy
overfeeding were associated with lower mortality in a
retrospective cohort of non-septic intensive care (ICU)
patients.1 Reaching protein targets without overfeeding
energy is challenging with traditional enteral formulas. This regression analysis was used to relate protein delivery (g/kg)
prospective pilot study aimed to determine the feasibility of during days 1–3, 4–7, and 8–14 of ICU admission to 6 m
reaching a protein target of ≥1.2 g/kg ideal body weight (IBW)/ mortality in sarcopenic patients, with adjustments for energy
day after 96 h of ICU admission using a new high protein-to- intake-expenditure ratio, and APACHE II score. A range of
energy ratio enteral nutrition (EN) formula. protein delivery levels was tested and the optimum level was
Methods: Adult non-septic, ventilated ICU patients were fed for selected based on HR and p-value. Protein target was >1.2 g/
96 h with the new formula (Fresubin® Intensive, Fresenius Kabi) kg/day.
containing 82 g hydrolysed whey protein/1,000 kcal. EN started Results: 199 sarcopenic patients (137 male) were included, age
<24 h of admission. Feeding target was 90% of energy 62 ± 17 y, APACHE II score 25 ± 8. Mean energy delivery was
expenditure measured daily by indirect calorimetry or VCO2.2 1,470 and 1,928 kcal/d in week 1 and 2, respectively. Mean
Primary endpoint was % of patients reaching the protein target protein delivery during the first 14 days in the ICU increased
(≥1.2 g/kg IBW) after 96 h. Secondary endpoints included from 0.5 to 1.2 g/kg. Cox regression indicated >0.8 g/kg on
protein intake after 48 h and GI tolerance. Data in median [IQR]. days 1–3, >1.3 g/kg on days 4–7, and >1.65 g/kg on days 8–14 as
Results: 26 patients were included (18M, 8F), age 60 [43–66], optimal. For days 8–14 higher levels were not available for
APACHE II 21 [19–23], BMI 26 [23–30] kg/m2. 20/26 patients evaluation.
received the study formula for 96 h (2 died, 4 started oral
intake). The protein target was reached by 22/26 patients Day 1–3 Day 4–7 Day 8–14
(85%) after 48 h and by 19/20 (95%) after 96 h. GI tolerance was
Protein delivery, g/kg/d 0.47 ± 0.32 1.11 ± 0.32 1.20 ± 0.28
good, no diarrhoea, 1 patient vomited once. In 1 patient plasma
Optimal protein delivery, >0.8 (42/199) >1.3 (55/199) >1.65 (8/199)
urea rose unrelated to renal failure (25 mmol/L). g/kg/d (# pats)
Adjusted mortality risk HR 0.43; CI HR 0.53; CI HR 0.12; CI
with optimal protein 0.21–0.86; 0.30–0.94; 0.03–1.52;
48 hours (n = 26) 96 hours (n = 20) delivery p = 0.016 p = 0.031 p = 0.118
Energy intake (% of 85 [75–92] 95 [79–99]
energy expenditure)
Patients receiving ≥1.2 g/ 22/26 (85%) 19/20 (95%) Conclusion: The optimal protein intake of sarcopenic ICU
kg IBW protein patients increased during admission from 0.8 g/kg/day during
Protein intake (g/kg IBW) 1.65 [1.28–1.82] 1.89 [1.56–2.33] days 1–3 to 1.3 g/kg/day during days 4–7, and higher than
Protein intake (g/kg 1.41 [1.26–1.57] 1.63 [1.41–1.86]
actual BW)
1.65 g/kg/day during the second week.
Conclusion: This high-protein EN formula containing hydro-
lysed whey protein is well tolerated and enables clinicians to MON-P022
achieve a high protein target early during ICU stay, without GUT MICROBIOTA TRAJECTORY IN PATIENTS WITH SEVERE
exceeding the defined energy target. BURN: A TIME SERIES STUDY
References X. Wang1 *, J. Yang1, F. Tian1, L. Zhang1, Q. Lei2, T. Jiang3,
1. PMID 25499096 J. Zhou4, S. Yuan4, J. Li1. 1Department of general sugery,
2. PMID 26494245 Jinling Hospital, Nanjing, 2Department of general sugery, The
Disclosure of Interest: W. Looijaard: None declared, N. Denneman:
First People’s Hospital of Foshan, Foshan, 3Department of
None declared, B. Broens: None declared, P. Weijs Speaker Bureau of: Gynecology, Obstetrics and Gynecology Hospital of Fudan
Fresenius Kabi, H. Oudemans-van Straaten Grant/Research Support University, Shanghai, 4Department of Burn, Jinling Hospital,
from: this investigator-initiated study was fully supported by Fresenius Nanjing, China
Kabi.
Rationale: Severe burn is a complicated lesion that greatly
impacts the physiological functionality of human body. Sepsis is
MON-P021
the leading cause of death in patients with severe burn due to
STEPWISE INCREASE IN PROTEIN DELIVERY IN THE FIRST 14
increased intestinal permeability, altered gut microbiomes and
DAYS OF ADMISSION IS ASSOCIATED WITH IMPROVED 6-MONTH
bacterial translocation. Recent studies have indicated that gut
OUTCOME IN SARCOPENIC CRITICALLY ILL PATIENTS
microbiota is closely associated with burn injury. However, few
W. G. Looijaard1 *, I. Dekker2, S. Stapel1, H. Oudemans1, time series experiments was designed to study the post-burn
P. J. Weijs1,2,3. 1Intensive Care Medicine, 2Nutrition and dynamic change of gut microbiome and its association with
Dietetics, VU University Medical Center, 3Nutrition and enteral nutrition.
Dietetics, Amsterdam University of Applied Sciences, Methods: Seven severely burned patients who suffered from a
Amsterdam, Netherlands severe metal dust explosion injury were recruited in this study.
The dynamic changes of gut microbiome of fecal samples at six
Rationale: There is no consensus on nutritional goals in critical time points (1–3 days, 2, 3, 4, 5 and 6 weeks after severe burn)
care. ESPEN and ASPEN guidelines agree that protein delivery were detected by using 16S ribosomal RNA pyrosequencing
should be >1.2 g/kg/d, however the trajectory is still unclear. technology.
Aim was to determine which protein trajectory was associated Results: Following the post-burn temporal order, gut micro-
with lowest 6-m mortality in sarcopenic ICU patients. biota dysbiosis was detected in the gut microbiome after severe
Methods: Sarcopenic ICU patients with abdominal CT-scan at burn, and then it was gradually resolved. The bio-diversity of
admission (+/−4 d) and with nutritional intake registered for gut bacteria was initially decreased, and then returned to
up to 14 d were retrospectively included. Sarcopenia was normal level. In addition, at the early stage (from 2 to 4 weeks),
defined as muscle area <110 m2 (F) and 170 m2 (M). Cox
S188 Poster
the majority of those patients’ gut microbiome was a pathogen for acute abdomen, in whom 98 patients needed to be admitted
genus, Enterococcus and Escherichia; while at the end of this to SICU due to immediate or potential life threatening
study, the majority was a beneficial genus, Bacteroides. conditions. There were 4 patients below 18 years of age, 12
Conclusion: Severe burn injury can cause a dramatic dysbiosis patients without PN administration and 13 patients with
of gut microbiota. A trend of enriched beneficial bacteria and transfer to ward within 3 days and 4 patients expired within
diminished pathogen bacteria may serve as prognosis micro- one week of admission. There were total 65 patients eligible for
biome biomarkers of severe burn patients. this study. There were 24 patients with early sPN and 41
Disclosure of Interest: None declared. patients with late sPN. The age, sex, SICU stay, ventilator days,
hospital stay, intra-abdominal abscess rate and mortality rate
were not statistically significant; however, the infection rate
MON-P023
for patients with early sPN was higher than that of late sPN (8/
FISH OIL-SUPPLEMENT PARENTERAL NUTRITION MODULATE
24 = 33% vs. 6/41 = 15%, p = 0.02).
IMMUNITY AND REDUCE INFLAMMATION VIA SUPPRESS THE
Conclusion: For critically ill patients with acute surgical
TLR-4 SIGNALING PATHWAYS IN RATS WITH ABDOMINAL SEPSIS
abdomen, early sPN is not recommended due to higher post-
Y. Zhou1 *, S. Cao1. 1General Surgery, Affiliated Hospital of operative wound infection rate.
Qingdao University, Qingdao, China
Reference
Rationale: The study researched the mechanisms of fish oil- Disclosure of Interest: None declared.
supplement parenteral nutrition modulate immunity and
reduce inflammation in rats with abdominal sepsis.
Methods: 36 adult male Sprague-Dawley rats were randomly MON-P025
assigned to receive standard chow and water (Sham group, ASSOCIATION BETWEEN HEART RATE VARIABILITY MEASURES
n = 9) or normal saline (NS group n = 9) or total parenteral AND ENERGY HOMEOSTASIS IN PATIENTS WITH VEGETATIVE
nutrition (TPN) containing a standard soybean oil emulsion (SO STATUS: A PROSPECTIVE CLINICAL COHORT PILOT STUDY
group n = 9) or FO-supplemented TPN (FO group n = 9) at the Y. Kiryachkov1 *, I. Shelkunova1 on behalf of I.G. Shelkunova, D.
onset of sepsis for 5 days. The dry/wet weight ratio of lung, L. Kolesov, V.V. Danilec. 1FSCC for Intensive Care Units and
intestinal mucosa scores, plasma cytokines and TLR-4, MYD88, Rehabilitation, Moscow, Russian Federation
phosphorylation NF-κB( p65), NF-κB ( p65) expression in spleen
mononuclear cells, occludin expression in intestinal tissue were Rationale: The aim of the study was to study the relationship
determined. between the parameters of the functional state of the
Results: Compared with the NS and SO group, Fish oil– autonomic nervous system and the nutritional status of
supplemented TPN can decrease the dry/wet weight ratio of patients.
lung; improve the intestinal mucosal damage score; suppressed Methods: 11 patients were examined. The average age of
TLR4 activation in spleen monocytes; up-regulate the expres- 46 ± 17.7, men – 6, women – 5. The reasons for the development
sion of the occludin mRNA and protein in intestinal tissue; of the vegetative state were: the consequences of traumatic
reduced proinflammatory cytokines production. brain injury in – 4 patients; Anoxic brain damage – 4 patients;
Conclusion: In this study, we observed that fish oil-supplement Consequences of development of acute cerebrovascular acci-
parenteral nutrition modulate immunity and reduce inflamma- dent – 3 patients. The Institutional Clinical Ethics Committee
tion via suppress the TLR-4 signaling pathways, namely has approved this study. Heart rate variability (Standard
alleviated ALI, protected the integrity of intestinal tissue, deviation of all NN Intervals – SDNN, pNN50% percentage of
reduce the production of proinflammatory cytokines. differences between adjacent NN intervals that are greater than
50 msec; square root of the mean of the squares of differences
Disclosure of Interest: None declared. between adjacent NN intervals – RMSSD) is analyzed a
computerized beat-to-beat heart rate. 5 minutes of cardio
MON-P024 intervals were used. 2. Plasma concentration of albumin,
THE EFFECT OF EARLY OR LATE PARENTERAL NUTRITION prealbumin, transferrin, is analyzed using routine
SUPPORT ON THE CLINICAL OUTCOME IN THE PATIENTS WITH technique. 3. The anthropometric measurements (BMI) and
ACUTE SURGICAL ABDOMEN total Lymphocyte count was also determined. All parameters
Y.-P. Hsu1 *. 1Trauma and Emergency Division, Surgical were registered at the time of admission of patients to the clinic.
Department, Chang-Gung Memorial Hospital, Linko Branch, Results: All patients in the vegetative state have a hyperadre-
Kaisan, Taiwan, Province of China nergic status: SDNN – 11,2 ± 2,81 msec; rMSSD – 2,45 ± 0,8 msec;
pNN50% – 0. In all patients in the hyperadrenergic status, the
Rationale: The early supplemented parenteral nutritional states of reduced nutrition: serum albumin 2,7 ± 0,08 mg/dl;
(sPN) for critically ill patients is still controversial (1). It is prealbumin 13 ± 1,7 mg/dl; transferrin 164,1 ± 10,6 mg/dl; total
wondering if the sPN is helpful for the critical patients with Lymphocyte count 1,430 ± 70/mm3; BMI 17,54 ± 1,27 kg/m2.
acute surgical abdomen. Conclusion: Between the parameters of reduced nutrition and
Methods: In this retrospective study, we reviewed the patients the parameters of functional activity of the autonomic nervous
who underwent operation due to acute surgical abdomen and system, a reliable interrelation. Imbalance of the autonomic
were admitted to surgical Intensive Care Unit (SICU). Early sPN nervous system leads to a deterioration in the status of
is defined as administration of sPN within 72 hours after SICU nutrition in patients with brain damage.
admission, and late sPN is beyond this time point.
Results: From January 1, 2016 to December 31, 2016, we
totally collected 887 patients undergoing emergent operation
Geriatrics 2 S189
MON-P026 Geriatrics 2
EARLY EVALUATION OF THE SWALLOWING FUNCTION CAN
SHORTEN HOSPITALISATION PERIOD FOR PATIENTS WITH MON-P027
ACUTE CEREBRAL INFARCTION: A HISTORICAL CONTROL THE DETERMINANTS OF MALNUTRITION IN THE IRISH
STUDY ELDERLY POPULATION BASED ON SEX: PRELIMINARY RESULTS
Y. Ogawa1 *, A. Naganuma1,2, M. Inagawa1, T. Iida3, M. Kimura4, FROM THE IRISH LONGITUDINAL STUDY ON AGEING (TILDA)
A. Kumakura1, T. Yoshida1, H. Nakamura1, A. Moroboshi1, L. A. Bardon1,2 *, M. Streicher3, C. A. Corish2,4, M. Clarke1,2,
R. Ueda1, Y. Kawahara1, S. Sekine1, Y. Shiozawa1, Y. Koyama1, L. C. Power2,4, D. Volkert3, E. R. Gibney1,2, on behalf of the
H. Funakoshi1, H. Tanaka1, M. Kanai1, K. Ishiguro1, T. Ogawa1, MaNuEL Consortium. 1School of Agriculture and Food Science,
2
H. Ishihara2. 1Nutrition Support Team, 2Department of UCD Institute of Food and Health, University College Dublin,
Gastroenterology, Takasaki General Medical Center, National Dublin, Ireland, 3Institute for Biomedicine of Aging, Friedrich-
Hospital Organization, Takasaki, Gunma, 3Department of Oral Alexander-Universität Erlangen-Nürnberg, Nuremberg,
Science, Graduate School of Dentistry, Kanagawa Dental Germany, 4School of Public Health, Physiotherapy and Sports
University, Yokosuka, Kanagawa, 4Department of Dysphagia Science, University College Dublin, Dublin, Ireland
Rehabilitation, Nihon University School of Dentistry, Chiyoda-
ku, Tokyo, Japan Rationale: Malnutrition detrimentally affects health, quality
of life and disease outcome; therefore, the determinants of
Rationale: Since April 2016, we evaluated the swallowing malnutrition should be established. The Malnutrition in the
function in patients with acute cerebral infarction (CI), Elderly (MaNuEL) project is conducting analysis of longitu-
using videoendoscopic examination (VE) within 48 hours of dinal European datasets to determine the predictors of
hospitalisation. Our aim was to verify whether early evalu- malnutrition in older, community-dwelling people. The aim
ation of the swallowing function by VE is useful in clinical of this research was to assess the factors associated with
practice. developing malnutrition from baseline to 2-y follow-up in
Methods: Two groups were included: a control (C) group of 35 males and females.
patients with CI who were treated with a conventional Methods: Data were analysed for a sub-cohort (n = 1,841) of
method from January to March 2016 and an early VE (V) TILDA participants using binary univariate regression analysis
group of 41 patients with CI who were evaluated using VE with malnutrition as the dependent variable (defined as
within 48 hours of hospitalisation from January to March BMI < 20 kg/m2/weight loss (WL) ≥10% over 2-y). Exclusion
2017. The following items were compared: the hospitalisation criteria included being <65 y, BMI/WL data unavailable at
period, the amount of energy administered 2 days after baseline and/or follow-up, and presence of malnutrition at
hospitalisation, and the improvement ratio of the dysphagia baseline (BMI < 20 or WL > 4.5 kg in the last year).
severity scale (DSS; DSS at discharge/DSS at hospitalisation). Results: Approximately half the cohort was female (50.2%).
To compare the characteristics of both the groups, Student t- The mean age was 71.7 ± 5.03 y in females and 71.7 ± 4.96 y in
test was performed. Pearson’s correlation coefficient was males. Factors associated ( p < 0.05) with malnutrition in both
performed to analyse the variables related to the hospital- genders were polypharmacy (≥5 drugs/day) [OR (95% CI) males,
isation period. females] [1.93 (1.25–2.97), 1.7 (1.13–2.56)], reported walking
Results: The patients characteristics (C vs. V group) were as difficulties [2.49 (1.29–4.78), 2.32 (1.3–4.15)] and problems
follows: mean age, 76.9 ± 10.1 vs. 76.4 ± 10.4 years; and mean climbing stairs [2.61 (1.7–4.0)]. Being unmarried, reporting low
body mass index, 21.5 ± 4.5 vs. 21.7 ± 3.9 kg/m2, respectively. physical activity, recent hospital admission, fair/poor self-rated
The results (C vs. V group) were as follows: the mean health and falling during the follow-up period were associated
hospitalisation period was 32.2 ± 17.2 vs. 22.4 ± 11.4 days (p = with nutritional risk at 2-y follow-up in males. For females, older
0.004), the amount of energy administered 2 days after age, receiving social support and cognitive impairment were
hospitalisation was 17.6 ± 12.9 vs. 23.1 ± 7.6 kcal/kg/day (p = associated with nutritional risk at 2-y follow-up.
0.025), and the improvement ratio of DSS was 1.37 ± 0.75 vs. Conclusion: Risk of malnutrition is influenced by a range of
1.64 ± 1.07 (p = 0.222). A negative correlation was observed determinants which differ according to sex. Future work will
between the hospitalisation period and amount of energy include multivariate regression analysis to establish the
administered 2 days after hospitalisation (r = −0.4295, p = 0.002). strongest independent determinants of malnutrition in older
Conclusion: To our knowledge, this is the first study that shows Irish people.
early nutritional intervention using VE within 48 hours of Disclosure of Interest: None declared.
hospitalisation shortens the hospitalisation period in patients
with acute CI. MON-P028
Disclosure of Interest: None declared. STAFF ATTITUDES TOWARDS NUTRITIONAL CARE FOR
ELDERLY IN NURSING HOMES IN ITALY: A MULTICENTER
SURVEY
A. Castaldo1, E. Zanetti2, M. Lusignani3, M. C. Gugiari1,
A. Nobili4, M. Zani5, A. Verardi6, M. Magri7, A. Ianes8,
G. Ardoino8, L. Bonetti9 *. 1Education, Provincia Religiosa di
S. Marziano di Don Orione, Piccolo Cottolengo, Milan,
2
Research, Gruppo di Ricerca Geriatrica, Brescia, 3Nursing
Bachelor, University of Milan, 4Quality, Mario Negri, Milan,
S190 Poster
5
Nursing home, Le Rondini, Brescia, 6Nutrition-Audit, Health Results: Total 3,731 people older than 60 years old were
Agency, 7Research, Nurse Council, 8Medical Direction, Korian analyzed and there were 94 GPT. Table 1 showed that GPTwere
Group, Milan, Italy, 9Istituto oncologico della Svizzera italiana, statistically associated with more hypercholesterolemia
Ente Ospedaliero Cantonale Canton Ticino, Bellinzona, (27.37% vs. 39.36%, p = 0.0372). Also GPT showed tendency to
Switzerland gain weight for a year less underweight, more obesity and higher
HbA1c. However they could not show statistical difference.
Rationale: Nutritional care is often neglected and under- Conclusion: GPT showed more incidence of hypercholesterol-
estimated by health professionals (HPs) and nurse aides. This emia. More attention might be required to yield better long-
can lead to malnourished patients or patients at risk of term prognosis and increase life quality of GPT. Further
malnutrition to not be identified and receive adequate care. evaluation to GPT is needed.
It was important to understand the areas of nutritional care in
Table 1: Analysis of nutritional parameters.
which HPs show negative attitudes to prevent malnutrition and
improve overall quality of care. The aim was to assess staff Non-GPT GPT P-value
attitudes towards nutritional care in Nursing Homes (NHs). HbA1c
Methods: This is a multicentre survey, involving physicians, ≥6.5 733 (20.99) 28 (28.08) 0.1681
<6.5 2,904 (79.01) 66 (71.92)
registered nurses and nurse aides, working in 29 NHs in Italy. We
Hypercholesterolemia
used ‘The Staff Attitudes to Nutritional Nurses Care Geriatric No 2,642 (72.63) 59 (60.64) 0.0372
Scale’ to assess attitudes (Bonetti et al. 2013). We compared Yes 995 (27.37) 35 (39.36)
attitudes between HPs and nurse aides using the Kruskal Wallis. Weight change (for a year)
None 2,628 (72.55) 56 (61.53) 0.0958
Results: 1,015 questionnaires were submitted, 204 were Decrease 588 (15.68) 22 (21.19)
nurses, 36 physicians and 712 nurse aides. 20% showed negative Increase 421 (11.77) 16 (17.28)
attitudes, 50% neutral and 30% positive. Nurse aides showed Obesity
Normal 2,205 (60.53) 57 (57.70) 0.5873
worse attitudes compared to health professionals. Differences Underweight 82 (2.16) 1 (0.91)
were found between those who attended education on Obesity 1350 (37.31) 36 (41.39)
nutritional care and those who didn’t. The areas in which HPs
showed the worst attitudes were ‘Norms’ and ‘Assessment’ and GPT geriatric patients after trauma associated admission.
Data are presented as number (percentage).
they showed the best attitudes in ‘Individualization’ and
‘Intervention’.
Conclusion: The study showed a low positive staff attitude Disclosure of Interest: M. Kim Grant/Research Support from: The
statistical consultation was supported by a grant of the Korea Health
towards nutritional care for the elderly. The fact that nurse
Technology R&D Project through the Korea Health Industry
aides showed the worse attitudes is important information as Development Institute (KHIDI), funded by the Ministry of Health &
they usually assist patients with meals and monitor food intake. Welfare, Republic of Korea (grant number : HI14C1062), H. J. Cho: None
It is therefore necessary to improve knowledge on the declared, T. H. Hong: None declared, J. I. Lee: None declared, J. Kim:
importance of nutritional care in HPs to prevent malnutrition None declared, S. Baek: None declared, A. Lee: None declared,
and its negative effects in elderly living in NH. S. Y. Kwon: None declared.
References
Bonetti L, Bagnasco A, Aleo G, Sasso L. Validation of the Staff MON-P030
Attitudes to Nutritional Nursing Care Geriatric scale in Italian. Int
RISK FACTORS OF REFEEDING SYNDROME AND MALNUTRITION
Nurs Rev. 2013;60(3):389–96.
SCREENING IN OLDER HOSPITALIZED PATIENTS
M. Pourhassan1 *, I. Cuvelier2, I. Gehrke3, C. Marburger4,
M. K. Modreker5, D. Volkert6, H.-P. Willschrei7, R. Wirth8.
MON-P029 1
Department of Geriatric Medicine, Marien Hospital Herne,
GERIATRIC PATIENTS AFTER TRAUMA ASSOCIATED ADMISSION Ruhr-University Bochum, Herne, 2Geriatric Center, Karlstruhe,
ARE EASY TO HAVE HYPERCHOLESTEROLEMIA 3
Department of Internal Medicine IV, Donaueschingen,
M. Kim1 *, H. J. Cho1, T. H. Hong1, J. I. Lee2, J. Kim3, S. Baek3, 4
Department of Geriatric Rehabilitation, Christophsbad Clinic,
A. Lee3, S. Y. Kwon4. 1Department of Trauma Surgery, Göppingen, 5Department of Geriatric, Sana Hanse-Clinic,
2
Department of Surgery, 3Nutritional Support Team, Wismar, 6Friedrich-Alexander-Universität Erlangen-Nürnberg,
Uijeongbu St. Mary’s Hospital, 4Nutritional Support Institute for Biomedicine of Aging, Nuremberg, 7Department
Team, Uijeongbu St.Mary’s Hospital, Uijeongbu-si, of Internal Medicine, Malteser Hospital St. Josefshospital,
Republic of Korea Uerdingen, 8Department of Geriatric Medicine, Marien
Hospital Herne, University Hospital Ruhr-University Bochum,
Rationale: There are many geriatric patients after trauma, Herne, Germany
however, analysis about their long-term prognosis is lacking.
This study was planned to analyze nutritional state in geriatric Rationale: The incidence of refeeding syndrome (RFS) in elderly
patients after trauma associated admission. (GPT) patients is not well-known. The aims of the study were (i) to
Methods: Data was collected from Korean national health and determine the prevalence of known risk factors for RFS and (ii)
nutrition examination survey conducted from 2013 to 2015. The to compare the prevalence and severity of malnutrition with the
elderly older than 60 years old were gathered and divided prevalence of known risk factors of RFS in older individuals.
according to trauma associated admission within a year. Their Methods: This cross-sectional multicenter-study investigated
nutritional parameters were analyzed. We performed Chi 342 older participants who were consecutively admitted to an
square for qualitative comparison and independent t-test for acute geriatric hospital ward. The National Institute for Health
quantitative comparison. and Clinical Excellence (NICE) criteria applied for determining
Geriatrics 2 S191
patients at risk of RFS. Malnutrition screening was conducted Conclusion: Protein consumption in hospitalized, malnour-
using Nutritional Risk Screening (NRS), Malnutrition Universal ished, older patients averages 0.62 g · kg−1 · d−1, remaining
Screening Tool (MUST) and Mini Nutritional Assessment-Short well below minimal protein intake requirements. Protein
Form (MNA-SF). Blood samples were analyzed according to supplementation increases daily protein intake towards
standard procedures. 0.8 g · kg−1 · d−1, but the protein content of the main meals
Results: Of 342 older participants (mean age 83.1 ± 6.8, BMI remains far less than 20 g. Provision of more protein-dense
ranged 14.7–43.6 kg/m2), 239 (69.9%) were considered to be at foods or protein supplementation is warranted to attenuate
risk of RFS. More participants were assessed at risk of skeletal muscle loss during hospitalization.
malnutrition using NRS (74.0%) compared to MUST (49.7%) Disclosure of Interest: None declared.
and MNA-SF (56.8%). Based on NRS, 75.9% of patients at risk of
malnutrition are at risk of RFS whereas according to MUST and
MON-P032
MNA-SF, 85.9% and 69.1% of patients at risk of malnutrition are
EATING DIFFICULTIES IN ACUTE GERIATRIC PATIENTS ARE
exposed to high risk of RFS, respectively. The prevalence of risk
ASSOCIATED WITH POOR NUTRITIONAL STATUS AND REDUCED
of RFS is increased with higher score of NRS and MUSTand lower
ACTIVITIES OF DAILY LIVING
score of MNA-SF.
Conclusion: Almost all geriatric hospitalized patients with risk M. M. Nielsen1 *, T. Maribo2,3, D. Melgaard4. 1Department of
of malnutrition demonstrated risk of RFS and should therefore Public Health, Aarhus University, Student cand.scient.san,
2
be regarded at risk for RFS. A special screening for risk factors Department of Public Health, Section of Clinical Social
of RFS in addition to malnutrition screening appears to be non- Medicine and Rehabilitation, Aarhus University, 3DEFAKTUM,
essential among this population. Nevertheless, in patients Central Denmark Region, Aarhus, 4Center for Clinical
undergoing nutritional therapy, monitoring and if necessary Research, North Denmark Regional Hospital, Hjørring,
supplementation of electrolytes is mandatory during the Denmark
refeeding period.
Rationale: Eating difficulties in acute geriatric patients are
Disclosure of Interest: None declared. associated with poor nutritional status and limitations in
activities of daily living. The aim of this study was to test the
MON-P031 association between eating difficulties and nutritional status
DISTRIBUTION OF PROTEIN CONSUMPTION IN HOSPITALIZED, and activity of daily living in a geriatric population.
MALNOURISHED, OLDER PATIENTS Methods: A cross-sectional study conducted between March
M. E. G. Weijzen1 *, I. W. K. Kouw1, P. Geerlings2, and September 2016. Eating difficulties were assessed using
L. J. C. van Loon1. 1NUTRIM School of Nutrition and the Minimal Eating Observational Form (MEOF-II), including
Translational Research in Metabolism, 2Department of observations related to ingestion, deglutition and energy/
Dietetics, Maastricht University Medical Centre, Maastricht, appetite. Eating difficulties were determined on the basis of
Netherlands one or more components of the MEOF-II. Poor nutritional status
was defined as age-specific low body mass index (BMI), <20 kg/
Rationale: Protein-dense foods and/or protein supplemen- m2 if <70 years, or <22 kg/m2 if ≥70 years. Activity of daily
tation are required to increase protein intake and, as such, living was assessed using the Barthel Index and defined as low
attenuate the loss of skeletal muscle mass during hospitali- (<50) or high (50–100).
zation in older patients. We recently showed that Results: 297 acute geriatric patients were included; mean age
patients admitted for elective surgery consumed 0.53 ± 0.02 g was 83.0 (±7.7) years and 56.2% were female. The prevalence
protein · kg−1 · d−1 during hospitalization. In the present study of eating difficulties was 54.9%. Mean BMI was 26.1 (±5.6) and
we assessed actual food and snack consumption and recorded median Barthel Index was 47 (30;58).
supplement use in a variety of malnourished patients during
hospitalization.
Methods: In this observational study, n = 100 patients will be No eating Eating
difficulties difficulties
monitored during hospitalization. Food provided by hospital
meals, snacks and supplements, and actual food consumed by Age* 82.4 (±7.5) 83.5 (±7.9) p = 0.871
patients was weighed and recorded. Data were analyzed using BMI* 27.6 (±5.3) 24.7 (±5.6) p < 0.001
Barthel-100** 51.0 (39;74) 42.5 (23;52) p < 0.001
paired Students t-tests and repeated measures ANOVA.
Results: Preliminary results (n = 46; age 72 ± 2 y; hospital stay *Mean (SD), **Median (IQR).
17 ± 2 d) show that malnourished patients consume 5.3 ± 0.3
MJ · d−1, with 15, 52, and 32 En% provided as protein, Patients with normal/high BMI had a risk reduction of 37% in
carbohydrate, and fat, respectively. The amount of protein eating difficulties, compared to patients with age-specific low
consumed (without supplementation) averaged 0.62 ± 0.04 g · BMI ( p = 0.003). Patients with a high activity of daily living had a
kg−1 · d−1. Protein supplementation was provided in 67% of the risk reduction of 39% in eating difficulties, compared to
patients (n = 31) and increased protein intake from 0.65 ± 0.05 patients with low activity of daily living ( p < 0.001).
to 0.82 ± 0.07 g · kg−1 · d−1. Protein intake was 12 ± 1, 12 ± 1, Conclusion: Eating difficulties are highly prevalent in geriatric
and 14 ± 1 g at breakfast, lunch, and dinner, respectively. patients and associated with poor nutritional status and
Protein supplementation, provided in between meals, reduced activities in daily living. Identification of eating
increased protein consumption with 4 ± 1 g in the morning, difficulties may be important to preserve nutritional status
3 ± 1 g in the afternoon, and 3 ± 1 g in the evening. and functioning in the geriatric population.
S192 Poster
MON-P033 Methods: A total of 75 elderly (men = 38, women = 37) who did
SIPPING IN PATIENTS OF ELDERLY AGE WITH HIP FRACTURE not diagnose with depression were included in this study. To
N. Andreeva1 *. 1Department of Resuscitation, Anesthesiology, calculate MDS, food frequency questionnaire were used which
Intensive Care and Emergency Medical Care, FGBOU VO includes 11 main components of the MD. According to the
TGMU (Pacific State Medical University), Vladivistok, Russian consumption frequency, (no consumption, rare, frequent, very
Federation frequent, weekly and daily) items are scored between 0 and
5. The total score was ranging from 0 to 55. MDS scores were
Rationale: 52% of patients admitted to in-patient departments divided into the tertiles, scores between 0 and 28 were
with cervical hip fractures have Nutritional deficiency (ND), considered as low, 29 to 30 as average and 31 to 55 as high.
which is left undetected in most cases. Moreover, delay in Depression was assessed with the Geriatric Depression Scale
surgery delay for up to 1.5 weeks, the presence of concomitant (GDS). According to GDS, a score of 0–10 is normal, 11–13
chronic diseases promotes deterioration of prognosis as to probable depression, ≥14 is depression.
successful osteosynthesis and rehabilitation in patients during Results: Mean age, MDS and GDS scores of individuals were
post-surgery period. Therefore, adding of enteral nutritional 68.7 ± 4.78, 29.9 ± 3.15 and, 11.5 ± 3.31, respectively.
mixtures (ENM) in the form of sipping to standard hospital diet Approximately half of the individuals (45.3%) were not in
is an important asset in terms of preparation of these patients depression while 21.3% were depressed. According to 1 to 3
for surgeries. tertiles, scores were 11.5 ± 3.92, 10.9 ± 3.03 and, 12.2 ± 3.16,
Methods: The efficiency of additional sipping nutrition by respectively. In addition, scores differences between groups
way of hyper caloric ENM in patients of elderly age with cervical were insignificant ( p > 0.05). Although statistically insignifi-
hip fractures was evaluated for 4 weeks during post-surgical cant, a negative relationship was found between MDS and GDS
period, with due regard to screening as to nutritional score (r = −0.16, p = 0.894).
deficiency. A nutritional mini-questionnaire was used to Conclusion: Depression was detected approximately one out of
reveal the degree of protein and energy deficiency, in which the four elderly. Although the protective effect of the MD on
general and subjective factors, BMI, anthropometric measure- depression is known, we thought that the lack of a relationship
ments, issues of dietary behavior, as well as biochemical between MDS and GDS in this study is due to the inadequate
markers, were reflected. sample size of the study.
Results: It was shown that the use of Forticare (hyper caloric Disclosure of Interest: None declared.
nutritional mixture) at a dose of 600 kcal a day helps to
normalize the indicators of absolute lymphocyte count and
MON-P035
albumin level, provide the average body mass gain of 700–800 g
FACTORS ASSOCIATED WITH SERUM 25-HYDROXYVITAMIND3
already by Day 7–8 after the beginning of treatment in 83.3%
LEVELS IN FREE-LIVING MODERATE ALZHEIMER’S DISEASE
patients with mild and moderate ND degree. It also allows to
PATIENTS
reduce the incidence of infectious complications by 16% and
minimize the development of multiple organ failure syndrome O. L. Vicente De Sousa1 *, R. S. Guerra2, A. S. Sousa3,
during post-surgery period. T. F. Amaral2. 1Geriatric Unit, Hospital Magalhães Lemos E.P.E.,
2
Conclusion: Sipping as an additional caloric and protein UISPA-LAETA/INEGI, Faculdade de Engenharia, Universidade
equivalent during post-surgical period leads to quicker do Porto, 3Faculdade de Ciências da Nutrição e Alimentação,
rehabilitation, increases the number of favorable treatment Universidade do Porto, Porto, Portugal
outcomes and helps to decrease mortality in patients of elderly
Rationale: Hypovitaminosis D has been associated with
age with cervical hip fractures.
cognitive decline among older adults. The relationship
Disclosure of Interest: None declared. between serum 25(OH)D3, functional status and caregivers
burden disease in free-living Alzheimer`s disease (AD) remains
MON-P034 to be studied. This study aims to explore the factors associated
ADHERENCE TO THE MEDITERRANEAN DIET AND RISK OF with 25(OH)D3 status among free-living moderate AD patients.
DEPRESSION IN ELDERLY Methods: A cross-sectional study was conducted in 79 free-
N. Seremet Kurklu1 *, G. Kaner2, H. Kamarli Altun1, living moderate AD patients [32 men/47 women; mean(SD)
E. Guven Sade3. 1Department of Nutrition and Dietetics, age = 78.2(6.6)years], not taking Vitamin D supplements.
Akdeniz University, Antalya School of Health, Antalya, Serum 25(OH)D3 was determined. MNA® score, bioimpedance
2
Department of Nutrition and Dietetics, İzmir Katip Çelebi analysis, functional status indicators, including gait speed,
University, Faculty of Health Sciences, İzmir, 3Family Medicine, handgrip strength (HGS), and Barthel index were evaluated.
Mersin, Turkey Cognitive function was assessed with MMSE score. Caregiver
burden disease was assessed using Zarit’s scale. Multivariable
Rationale: The Mediterranean diet (MD) is a dietary pattern linear regression analyses were conducted and b and 95%
characterized by high fruits, vegetables, legumes, cereals, confidence intervals (95%CI) were determined.
olive oil, and fish consumption, a low meat and dairy products Results: Fourteen patients (50.6%) were undernourished
consumption. Because of this, the adherence to a (MNA®≤17) and 39(49.3%) were nutritionally-at-risk
Mediterrnaean Dietary Pattern could prevent depression. We (MNA®score 17.1–23.4). Mean(SD) 25(OH)D3 levels were 15.8
aimed to assess the relationship between MD and the risk of (6.4) ng/mL. Among undernourished AD patients, 2 (50%) had
depression among elderly who live in the Mediterranean region severe 25(OH)D3 deficiency (≤10 ng/mL), 34 (52.3%) defi-
of Turkey. ciency (>10 ≤ 30 ng/mL) and 4(40%) normal levels. For the
patients at undernutrition risk, 2(50.0%) were classified as
Geriatrics 2 S193
presenting severe 25(OH)D3 deficiency, 31 (47.7%) deficiency MON-P037

and 6(60%) normal levels. Factors associated with serum 25 CAN FORTIFIED FOODS AND SNACKS INCREASE THE ENERGY
(OH)D3 were HGS(b = 0.319,95%CI 0.095–0.544), MMSE [b= AND PROTEIN INTAKE OF HOSPITALISED OLDER PATIENTS? A
−0.307,95%CI −0.528-(0.086)], Barthel index (b = 0.232,95%CI SYSTEMATIC REVIEW
0.005–0.459) and higher caregivers-Zarit burden disease score S. Mills1 *, C. R. Wilcox1, K. Ibrahim1,2, H. C. Roberts1,2.
(b = 0.250, 95%CI 0.045–0.456), R2 = 0.237. 1
Department of Academic Geriatric Medicine, University
Conclusion: A high proportion of free-living AD patients had 25 Hospital Southamption Mailpoint 807, 2National Institute for
(OH)D3 insufficiency. Higher HGS values, low MMSE score, Health Research Collaboration for Leadership in 13 Applied
independence and higher cargivers-Zarit burden disease score Health Research and Care (NIHR CLAHRC) Wessex, University of
were positively associated with 25(OH)D3. Southampton, Southampton, United Kingdom
Rationale: Malnutrition is a significant problem amongst
MON-P036 hospitalised older people. The purpose of this review was to
EVIDENCE ON HOME ENTERAL NUTRITION IN DEMENTIA summarise the evidence for the use of energy and protein
dense meals (via fortification) or snacks (supplementation) to
P. Orlandoni1 *, N. Jukic Peladic2, C. Venturini1, M. di Rosa3, increase the dietary energy and protein intake of older people
C. Cola2, D. Sparvoli2, N. Giorgini2, R. Basile3, D. Fagnani2. in hospital or rehabilitation facilities.
1
Nutrizione Clinica, 2Vivisol Srl, 3INRCA, Ancona, Italy Methods: A literature search was conducted through PubMed,
EMBASE, CINAHL and the Cochrane Database of Systematic
Rationale: There is a still open debate within the scientific
Reviews for studies published between May 1996 and May 2016
community about the advisability of artificial nutrition (AN) by
that assessed energy and/or protein intake of patients (mean
Percutaneous Endoscopic Gastrostomy (PEG) in elderly
age >60) in hospitals or rehabilitation centres.
patients ( pts) with advanced dementia (D). It is argues that
Results: Ten relevant articles were identified, containing 546
AN does not improve the outcomes of these pts when
patients (mean age 60–83 years). Four articles demonstrated
compared to orally fed pts. In Italy, the AN is administered
significantly increased energy intake, and five articles showed
only when pts cannot be fed by mouth. Therefore, we
significant increased protein intake. Fortification with dairy
compared the outcomes of pts with D, who were tube fed by
products was associated with a significantly increased energy
PEG and by nasogastric tube (NGT), with the outcomes of non
intake, whereas fortification involving mainly protein was
demented (ND) tube fed pts.
associated with improved protein intake. Two articles found
Methods: We performed a retrospective observational study on
ONS to be superior to fortification, however the quality of the
585 pts (85,6 ± 6,9 years), treated with Home Enteral Nutrition
comparisons was very poor. Four articles assessed compliance
(HEN) from 2010 to 2015 by Clinical Nutrition Unit of an Italian
with enriched products and reported good tolerance. Two
research geriatric hospital (INRCA, Ancona). Incidence rates of
articles performed cost-analysis and found that fortification
mechanical, gastrointestinal and metabolic complications and
was cost-effective.
survival – were compared between pts with severe D and ND
Conclusion: Despite a paucity of strong evidence, we suggest
pts. The mortality risk factors were evaluated by Cox
that an effective combination of energy and protein fortifica-
proportional hazards model.
tion may be a relatively simple, well-tolerated and economical
Results: The incidence rates of complications did not differ
approach to help older people meet their nutritional needs.
between D and ND pts (mechanical: 1,35/1000 days in ND vs.
Larger trials over longer periods are required to definitively
1,45/1000 days in D ( p = 0,270), gastrointestinal: 1,30/1000
establish the impact of fortified food on nutritional intake
days in ND vs. 1,35/1000 days in D ( p = 0,984), metabolic: 0,36/
and functional outcomes in comparison to ONS and usual
1000 days in ND vs. 0,35/1000 days in D ( p = 0,252)). Neither
nutritional care
the median survival differed significantly between D and ND
(193 days in ND vs. 192 days in D, ( p > 0.05). Female gender, Disclosure of Interest: None declared.
advanced age, NGT, Diabetes Mellitus and Chronic Renal failure
were identified as survival risk factors, high values of Geriatric MON-P038
Nutritional Risk Index as a protective factor. RELATIONSHIP BETWEEN THE RISK OF DYSPHAGIA AND
Conclusion: Given that there are no significant differences in FUNCTIONAL OUTCOMES IN OLDER COMMUNITY-DWELLERS
complications of the HEN therapy and survival among D and S. Tagliaferri1 *, L. Gionti2, F. Lauretani2, A. Ticinesi1,
ND pts, the AN shouldn’t be contraindicated a priori in pts T. Meschi1, M. G. Maggio1. 1Medicine and Surgery, University of
with severe D. Regular follow up is mandatory to guarantee Parma, 2Frailty and Multimorbity Lab Geriatric Clinic Unit,
the adherence of the therapy to its initial aims and to University Hospital of Parma, Parma, Italy
assure that a principle of beneficence and non-maleficence is
respected. Rationale: Oropharyngeal dysphagia (OD) is a swallowing
Disclosure of Interest: None declared. disorder highly prevalent in older community-dwellers,
increasing the risk of malnutrition and aspiration pneumonia.
However, it is frequently underdiagnosed and its association
with functional performance is still unclear.
Methods: With a cross-sectional study design, we enrolled 228
older (mean age 81) community-dwellers evaluated at the
Frailty-Multimorbidity Lab Geriatric Clinic Unit of Parma
University-Hospital. Subjective dysphagia was assessed with
S194 Poster
10-item Eating Assessment Tool (EAT-10). Nutritional screening positive association was observed ( p = 0.002, R2 = 44.7%). The
was performed calculating BMI and Mini-Nutritional mean difference was 1.24 g (limits of agreement -4.6–37.0),
Assessment-Short Form (MNA-SF) score. Physical and muscle with no proportional bias ( p = 0.61), also showing that mean
performance was assessed with Short-Physical Performance protein intake according to 24 h was slightly lower.
Battery (SPPB) test and handgrip strength. Cognitive perform- Conclusion: Our results showed that these two methods of
ance was screened with Mini-Mental State Examination (MMSE) dietary intake assessment provided similar results in elderly
test. The relationship between EAT-10 and nutritional, phys- people. The intake of energy and protein, assessed by 24-hour
ical, cognitive and motor performance was estimated through Dietary Recall was, as expected, slightly lower than assessed by
univariate analysis in sex- and age-adjusted and multivariate 3-day Food Diary.
linear regression model. A logistic regression analysis was run to Disclosure of Interest: None declared.
identify the most predictive factor of dysphagia risk.
Results: In the univariate models, EAT-10 score was sig-
MON-P040
nificantly and negatively correlated with SPPB score
ASSESSMENT OF BODY COMPOSITION IN ELDERLY PEOPLE. A
(β = −0.18 ± 0.04, p < 0.0001), handgrip strength (β = −0.35 ±
COMPARISON OF THREE METHODS
0.11, p = 0.001) and MNA-SF (β = −0.43 ± 0.07, p < 0.0001). In
the multivariate model, EAT-10 score confirmed as significantly S. Engelheart1 *, H. Bertéus Forslund2, O. Ljungqvist1,
associated with SPPB (β = −0.29 ± 0.10, p = 0.003) and handgrip R. Brummer1. 1School of Medical Sciences, Örebro University,
strength (β = −0.12 ± 0.05, p = 0.02), but not with MNA-SF. In Örebro, 2Institute of Medicine, Sahlgrenska Academy,
logistic regression analysis, SPPB was the only factor signifi- University of Gothenburg, Gothenburg, Sweden
cantly associated with EAT-10 score (OR = 0.82, 95%IC = 0.70–
0.96). Rationale: The importance of maintaining muscle mass in old
Conclusion: In older outpatients, the risk of dysphagia was age is well known, but the most adequate method to use,
significantly correlated with physical performance and muscle assessing body composition in elderly people in need of home
strength. The screening of OD should be implemented in the health care, is not. Dual-energy X-ray Absorptiometry (DXA) is
geriatric setting. considered a reference method, but has disadvantages that it
cannot be used at home or at local primary care centers. The
Disclosure of Interest: None declared. aim of the study was to compare DXA to two ambulatory
methods for assessment of the body composition and to study
MON-P039 the differences in outcome.
METHOD FOR ASSESSMENT OF DIETARY INTAKE IN ELDERLY Methods: Body composition was assessed in a 2-compartment-
PEOPLE. A COMPARISON OF 3-DAY FOOD DIARY AND 24-HOUR modell (body fat and fat-free mass): (1) DXA (n = 23), (2) BIA
DIETARY RECALL (n = 53), Bioelectrical Impedance assessment and (3) skinfold
S. Engelheart1 *, R. Brummer1, O. Ljungqvist1, measurement (n = 50) at four locations (biceps, triceps,
H. Bertéus Forslund2. 1School of Medical Sciences, Örebro subscapularis and crista iliaca). A sample of 58 elderly people
University, Örebro, 2Institute of Medicine, Sahlgrenska (20 females and 38 males), age 81.4 years (range 65–97), in
Academy, University of Gothenburg, Göteborg, Sweden need of home health care was included. Differences in methods
were assessed by parametric statistics, simple regression and
Rationale: Dietary assessment in elderly people in need of Bland-Altman plots.
home health care, is complicated by functional and cognitive Results: In men, mean body fat mass was 31.5 kg (DXA), 28.4 kg
disabilities. It is important to elaborate an accurate method, to (BIA) and 19.4 kg (skinfold), respectively. In women the body fat
be used as a base for nutritional treatment. The aim of the mass was 23.9 kg (DXA), 29.5 kg (BIA) and 21.7 kg (skinfold),
study was to compare two different methods for assessment of respectively. There was no significant differences according
dietary intake and to study the differences in outcome. to sex.
Methods: Dietary intake was assessed by 3-day Food Diary (FD) Results by DXA did not differ significantly from BIA (P = 0.05) or
and by 24-hour Dietary Recall (24 h) in elderly people in need of skinfolds ( p = 0.12), but the results by BIA differed significantly
home health care. A study population comprising 64 elderly ( p < 0.001) to skinfold. A positive association was observed in
people, and 42 (29 females and 13 males), age 82.2 years DXA vs. skinfold ( p = 0.001) and a non-significant ( p = 0.6)
(range 67–94), had assessed the dietary intake by both negative association was observed in DXA vs. BIA. For mean
methods, and was included. Differences between methods difference and limits of agreement, in the Bland Altman plot,
were assessed by parametric statistics, simple regression and see Table.
Bland-Altman plots.
Results: The mean energy intake according to FD (1,607 kcal/
day, SD 448 kcal, range 800–2,900 kcal) did not differ signifi- Mean Limits of
difference agreement
cantly ( p = 0.18) from 24 h (1,524 kcal/day, SD 394 kcal, range
800–2,500 kcal), and a positive association was observed ( p < Body fat mass DXA vs BIA −2.8 kg −15.1 to 9.48
0.001, R2 = 68.8%). The mean difference was 83 kcal (limits of DXA vs skinfold 1.8 kg −7,9 to 11.4
BIA vs skinfold 4.5 kg −4.5 to 13.6
agreement -655–821), with no proportional bias ( p = 0.34),
showing that mean energy intake according to 24 h was slightly
Conclusion: Our results showed that the two ambulatory
lower.
methods gave similar results as DXA in elderly people, but the
The mean protein intake according to FD (61.7 g/day, SD 17 g,
two ambulatory methods (BIA vs skinfold) did not.
range 28–116 g) did not differed significantly ( p = 0.68) from
24 h (59.9 g/day, SD 19 g, range 29–114 kcal). A possible Disclosure of Interest: None declared.
Geriatrics 2 S195
MON-P041 designed a study to show the association between frailty and

HANDGRIP STRENGTH IS LESS SIGNIFICANTLY ASSOCIATED osteosarcopenia in the elderly patients.
WITH GERIATRIC DOMAINS COMPARED TO QUADRICEPS Methods: One hundred elderly patients who had bone mineral
STRENGTH AMONG GERIATRIC OUTPATIENTS density available, performed as part of the routine geriatric
S. S. Y. Yeung1,2 *, E. M. Reijnierse1, M. C. Trappenburg3,4, assessment, were enrolled in the study. Osteosarcopenia was
C. G. M. Meskers2,5, A. B. Maier1,2. 1Medicine and Aged Care, considered when both sarcopenia and osteoporosis were
University of Melbourne, Melbourne, Australia, 2Human present. Frailty status of the patients were evaluated
Movement Sciences, MOVE Research Institute Amsterdam, according to the Fried’s Frailty Index, including five domains:
Vrije Universiteit, 3Internal Medicine, Section of Gerontology weight loss, weakness, exhaustion, low activity and slow
and Geriatrics, VU University Medical Center, Amsterdam, walking speed.
4
Internal Medicine, Amstelland Hospital, Amstelveen, Results: The median age of the one hundred patients was 75
5
Rehabilitation Medicine, VU University Medical Center, years (min-max: 65–90) and 51.0% were male. Frailty status of
Amsterdam, Netherlands the patients was as follows: 21% frail, 44% pre-frail and 35%
robust. Frailty was more common in osteosarcopenic patients
Rationale: Decline in muscle strength is a well-known compared to ‘sarcopenic and non-osteoporotic’ and non-
consequence of the ageing process and muscle strength sarcopenic groups (66.7%, 27.3% and 13.0%, respectively)
measurements are therefore usually part of a Comprehensive ( p < 0.001). Osteosarcopenia was found to be associated with
Geriatric Assessment (CGA). Whether handgrip strength frailty in univariate analysis (OR: 11.5, p < 0.001). Low handgrip
(HGS) as a proxy for overall muscle strength suffices, or strength and calf circumferences, higher age, slow walking
quadriceps strength (QS) should be measured in addition, is speed, lower body mass index (BMI), frailty, decreased scores of
unknown. The aim of this study was to examine the relation of basic and instrumental activities of daily living (ADL), clock
both HGS and QS to different domains of the CGA in geriatric drawing test, mini-mental state examination and mini-nutri-
outpatients. tional assessment-short from (MNA-SF) were shown to be
Methods: 163 older adults referred due to mobility problems to associated with osteosarcopenia ( p < 0.05, for all parameters).
a geriatric outpatient clinic in the Netherlands were included in In multivariate analysis, age (OR: 1,395, p = 0,023), instrumen-
the present study. CGA included questionnaires and measure- tal ADL (OR: 0.550, p = 0.042), female gender (OR: 43.203,
ments of physical (Timed Up & Go (TUG) and Short Physical p = 0.012) and BMI (OR: 0.507, p = 0.004) were detected to be
Performance Battery (SPPB)), functional (activities of daily independently associated factors with osteosarcopenia.
living (ADL)), psychological (Hospital Anxiety and Depression Conclusion: Our results suggest that frailty rate in osteosarco-
Scale (HADS)) and cognitive (Mini-mental state examination penic patients may be higher than those who are sarcopenic-
(MMSE)) domains. Standardized HGS and QS were defined as non-osteoporotic and non-sarcopenic
dependent variables and domains of CGA were defined as Disclosure of Interest: None declared.
independent variables. Linear regression analyses were applied
to examine the association of HGS and QS with different
MON-P043
domains of CGA adjusted for age and gender and presented as
THE SEVERITY OF COMMUNITY ACQUIRED PNEUMONIA IS
beta and 95% confidence interval (CI).
STRONGLY ASSOCATED WITH SERUM ALBUMIN
Results: HGS and QS were both significantly related to physical,
functional, psychological and cognitive domains of the CGA. T. Shimizu1 *, T. Namikawa2, K. Banba3, T. Nishikimi4.
1
However, HGS was less related to physical and psychological Department of Cerebrovascular Diseases, Wakakusa-Tatsuma
domains of the CGA compared to QS (TUG: −0.16 (−0.03; Rehabilitation Hospital, Daito, 2Department of Rehabilitation,
−0.01) vs. −0.37 (−0.06; −0.03); SPPB: 0.20 (0.03; 0.10) vs. Suita Tokushuen, Suita, 3Department of Rehabilitation,
0.38 (0.09; 0.17)); HADS depression: −0.18 (−0.08; −0.01 vs. Matsubara Tokushukai Hospital, Matsubara, 4Department of
−0.33 (−0.13; −0.05)). Medicine, Wakakusa-Tatsuma Rehabilitation Hospital,
Conclusion: In geriatric outpatients, both HGS and QS were Daito, Japan
associated with all domains of the CGA but HGS was less related
Rationale: Community acquired pneumonia (CAP) in the
to physical and psychological domains compared to QS.
elderly people may be occurred by the micro-aspiration of
Measuring QS in the Comprehensive Geriatric Assessment may
saliva. The reduction of immunity derived from the poor
be of additional value.
nutritional status may also be involved. Then in this study, the
Disclosure of Interest: None declared. association of CAP with nutritional status was investigated.
Methods: Twenty one cases with CAP were subjected (averaged
MON-P042 age was eighty four years). There were eight males and thirteen
THE RELATIONSHIP BETWEEN FRAILTY AND females. Their nutritional status was evaluated by serum
OSTEOSARCOPENIA IN GERIATRIC PATIENTS albumin, transferrin and transthyretin. The severity of CAP was
S. Kaya1, O. Deniz1 *, H. Dogan Varan1, M. C. Kizilarslanoğlu1, judged by the size of pneumonia lesion in the chest X-ray
B. Goker1. 1Department of Geriatrics, Gazi University, images. When the pneumonia lesion expands to less than one
Ankara, Turkey third of unilateral lung, the severity is low and to more than one
third of unilateral lung, it is high. The association between the
Rationale: Osteosarcopenia is defined as the presence of both severity and nutritional status was investigated. Nutritional
sarcopenia and osteoporosis in elderly patients and its status was evaluated by serum proteins such as albumin as a
association with frailty has not been well described. We static factor and rapid turnover proteins such as transferrin
(TRF) and transthyretin (TTR).
S196 Poster
Results: There were nine cases in low severity group (Group A) MON-P045
and twelve cases in high severity group (Group B). The mean FUNCTIONAL TEETH AMELIORATE NUTRITIONAL STATUS AND
age was 85 ± 8 years in Group A and 81 ± 12 years in Group B (ns), SELF-CARE ACTIVITY IN ELDERLY PEOPLE
the white blood cell counts (WBC) was 10,633 ± 5,407/mm3 and T. Namikawa1 *, T. Shimizu2. 1Department of Rehabilitation,
13,367 ± 7,211/mm3 (ns, not significant), and C-reactive Suita Tokushuen Geriatric Health Service Facility, Suita,
peptide (CRP) was 12.2 ± 11.3 mg/dl and 15.1 ± 9.0 mg/dl 2
Depart of Medicine, Maki Hospital, Osaka, Japan
(ns), respectively. In the investigation of association between
the pneumonia severity and nutrition, albumin was 3.61 ± 0.53 Rationale: Good oral function is essential to live in a healthy
g/dl in Group A and 3.12 ± 0.73 g/dl in Group B ( p = 0.0365), life especially for the old. The significance of residual teeth in
transferrin (TRF) was 167.4 ± 45.6 mg/dl and 171.9 ± 51.6 nutritional status and self-care activity in elderly people was
mg/dl (ns), transthyretin (TTR) was 10.54 ± 4.67 mg/dl and investigated. Then it was also investigated how the functional
10.49 ± 4.63 mg/dl (ns), respectively. teeth(FT) supported by denture, worked to ameliorate
Conclusion: The pneumonia severity in CAP was significantly nutritional status and self-care activity.
associated with albumin but TRF or TTR. Moreover it is not Methods: 89 elderly people (23 males, 66 females, mean age,
associated with WBC or CRP either. The pneumonia severity 84 ± 4 years) who are admitted to a geriatric health care
appears to depend on the usual nutritional status prior to services facility in a stable state were subjected. The
admission reflected by albumin. association of residual teeth and nutritional status evaluated
Disclosure of Interest: None declared. by albumin(alb) and self-care activity evaluated by Barthel
Index (BI) was investigated. Then the significance of FT
MON-P044 supported by denture was also examined.
EARLY RESUMPTION OF ORAL INTAKE AND ENTERAL Results: The subjects were classified into 2 groups according to
NUTRITION CONTRIBUTE TO THE CONTINUATION OF ORAL the number of residual teeth. The number of the teeth in Group
INTAKE IN PATIENTS WITH NURSING AND HEALTHCARE- A was 0–19 (n = 70), and that in Group B was more than 20
ASSOCIATED PNEUMONIA (n = 29). Alb was 3.45 ± 0.53 g/dl in Group A and 3.55 ± 0.55 g/
dl in Group B (ns). BI was 49.3 ± 29.5 in Group A and 45.0 ± 31.1
T. Ogasawara1 *, M. Oogiku2, Y. Ikematsu2. 1Respiratory in Group B (ns). In the investigation of effects of FT, the
Medicine, 2Surgery, Hamamatsu Medical Center, subjects were also divided into 3 groups according to the
Hamamatsu, Japan number of FT. The number of the FTwas 0–19 in Group C (n = 29),
more than 20 in Group D (n = 60) and 28 in Group E (n = 26). Alb
Rationale: Nursing and healthcare-associated pneumonia
was 3.36 ± 0.44 g/dl in Group C and 3.53 + 0.57 g/dl in Group D
(NHCAP), proposed by the Japan Respiratory Society, is made
(ns). BI was 36.6 ± 31.9 in Group C and 54.1 ± 27.2 in Group D
mostly of aspiration pneumonia in elderly patients. The aim
( p = 0.0084). In Group E, alb was 3.59 ± 0.56 and BI was
was to evaluate whether an early resumption of oral intake and
58.8 ± 27.2. These data in Group E were significantly bigger
aggressive enteral nutrition provide palliation of swallowing
than those of Group C ( p = 0.0398, p = 0.00223 respectively).
difficulty in patients with NHCAP.
Conclusion: The number of FTwas significantly associated with
Methods: In this retrospective study, 166 patients (median 85
BI. Especially the FT with 28 teeth showed a better nutritional
years old) with NHCAP, who participated in 2 prospective studies
status and BI. The study shows that the oral FT supported by
about a choice and duration of antibiotics therapy conducted in
twenty eight residual teeth or total denture works very well to
our hospital, were included. Early resumption of oral intake and
maintain good nutrition and self-care activity in the elderly
enteral nutrition (EOE) were defined as an initiation within 2
people.
days of hospitalization. The prognostic factor for the continu-
ation of oral intake was analyzed by logistic regression model. Disclosure of Interest: None declared.
Propensity scores were calculated from baseline data, risk
factors and comorbidities, resulting in 35 pairs. MON-P046
Results: Among the patients, 116 (69.9%) had aspiration DIFFERENCES IN HEIGHT- AND WEIGHT-ADJUSTED SKELETAL
pneumonia. Eighty one patients (48.8%) received EOE (oral MUSCLE MASS INDICES AS SARCOPENIA SCREENING TOOLS IN
intake = 68, enteral nutrition = 13) and 80 patients (48.2%) GERIATRIC POPULATIONS
could continue oral intake at the time of discharge. A V. Biesinger1, A. Hendricks1 *, A. Gonzalez Granda1, M. Basrai1,
univariate analysis showed a significant association between L. Stollhof2, U. C. Liener3, A. K. Nussler2, S. C. Bischoff1.
the continuation of oral intake and EOE (odds ratio [OR] = 5.1, 1
Nutritional Medicine, University of Hohenheim, Stuttgart,
95% confidence interval [CI]: 2.6–9.8), low body mass index 2
BG Trauma Center, Siegfried Weller Institut, Tübingen,
(<17 kg/m2) (OR = 0.38, 95%CI: 0.20–0.72) or severity of 3
Department of Orthopedics and Trauma Surgery, Vinzenz von
pneumonia (A-DROP <3) (OR = 4.2, 95%CI: 2.2–8.0) upon Paul Kliniken gGmbH Marienhospital, Stuttgart, Germany
admission. Among patients received enteral feeding as the
first nutritional therapy, early enteral nutrition slightly Rationale: Literature suggests different screening tools for
increased the number of patients who could be ingested sarcopenia in clinical practice, some include only bioimpe-
orally (15% vs. 0%, P = 0.09). After propensity adjustment, EOE dance analysis (BIA), others amend physical performance and
(OR = 3.24, 95%CI: 1.22–8.63, P = 0.02) was an independent muscle strength. We aim to find appropriate methods for a
prognostic factor for the continuation of oral intake. geriatric surgery population, since benchmarks are rare.
Conclusion: EOE strategy may provide palliation of swallowing Methods: Our cohort comprises 45.8% hospitalized and 54.2%
difficulty in elderly patients with NHCAP. obesity therapy patients (n = 2,864; 70% female; mean age 50
Disclosure of Interest: None declared. years; mean BMI 32 kg/m2), and a subgroup of geriatric surgery
Geriatrics 2 S197
patients (n = 44; mean age 82 years; BMI 24 kg/m2). We women and men measured with the Bio-Z® (both p < 0.001),
analysed height-adjusted (recommended in lean subjects) and 0.23 (0.14, 0.39) and 0.19 (0.10, 0.36) in women and men
and weight-adjusted (recommended in obesity) skeletal measured with the RJL-101® (both p < 0.001). The association
muscle mass indices hSMI and wSMI, derived from BIA data between phase angle and mortality persisted when adjusted
sets from clinical trials. If applicable the geriatric cohort was for age, body mass index or co-morbidities. The small number
categorized into EWGSOP criteria grades ‘presarcopenia’, of deaths in people who underwent a measurement by Eugedia®
‘sarcopenia’ and ‘severe sarcopenia’ (n = 30). (n = 93) or Xitron4000B® (n = 56) did not allow performing
Results: In total 7.6% are diagnosed sarcopenic by hSMI multivariate Cox regressions.
definition respectively 45.4% by wSMI, and only in 2.7% both Conclusion: Phase angle quartiles are associated with mortal-
indices are consistent. When adjusted for BMI, hSMI defines ity in people aged >65 years when using the RJL-101® or Bio-Z
7.3% lean and 0.3% obese subjects as sarcopenic. Contrary, device®.
wSMI attests sarcopenia in 4.4% and 41% of the lean and obese Disclosure of Interest: None declared.
subjects, respectively. In the geriatric subgroup the hSMI leads
to sarcopenia in 34.1% respectively 25% by wSMI, while 13.6%
MON-P048
match. According to EWGSOP criteria in the geriatric study
HYDRATION ON PATIENTS IN A HOME CARE PROGRAM (HCP)
group 30% show severe sarcopenia and 10% either impaired
WITH OROFARINGEA DYSPHAGIA
physical performance or reduced muscle strength (sarcopenia),
which resembles hSMI results. V. Aviles1 *, L. Andurell1, H. Segurola1, R. Lorite1, G. Cárdenas1,
Conclusion: Considerably divergent results are derived from A. Sancho1, N. Garcia1, M. Comas1, R. Burgos1. 1Nutritional
different sarcopenia screening tools. Adjustment by height and Support Unit, University Hospital Vall d’Hebron,
not weight seems reliable not only in lean but also in elderly Barcelona, Spain
subjects. In our geriatric population the BIA generated hSMI
Rationale: Patients suffering from oropharyngeal dysphagia
seems sufficient if physical performance and muscle strength
(OFD) often fail to achieve their nutritional and water
are not feasible. Further investigation with dual X-ray
requirements. Thickeners palatability is a factor that condi-
absorptiometry is needed.
tions the water intake, especially if the texture is very thick.
Disclosure of Interest: None declared. Dehydration can be a cause of hospitalization and confers a
worse prognosis.
MON-P047 Objectives: To rate the nutritional and hydration status of
ASSOCIATION OF MORTALITY AND PHASE ANGLE MEASURED patients in the HCP program affected by OFD that requires fluid
BY DIFFERENT BIOELECTRICAL IMPEDANCE ANALYSIS (BIA) thickening.
DEVICES Methods: A prospective, descriptive study of HCP patients
V. L. Karsegard1 *, C. E. Graf2, F. R. Herrmann3, A. Spörri4, included in a home nutrition program in the period of July 2015
L. Genton1. 1Clinical Nutrition, 2Dept. Internal Medicine, to September 2016. The tracing was carried out by telephone
Rehabilitation and Geriatrics, 3Rehabilitation and Palliative consultation, doing a 24 hour reminder, anthropometry and
Care, University Hospitals of Geneva, Geneva, 4Social and water records. Nutritional advice was offered in case of low
Preventive Medicine, University of Bern, Bern, Switzerland intake, as well as strategies to improve water intake.
Results: 66 patients, 39 women, age 84.2 ± 7.76 R(59–98). 28
Rationale: A high phase angle measured by the Nutriguard® patients with dementia (13 Alzheimer’s), 11 Parkinson’s, 15
bioelectrical impedance analysis device is associated with a cognitive and functional deterioration, 10 strokes, 1 neopla-
reduced mortality risk in older people. This retrospective study sia,1 COPD. BMI: 26.29 ± 5.26 R (14.84–42.43) 30% presented
aims to analyze whether this association persists with the other weight loss, of which 70% were dementias. In 41 patients (62%)
devices that have been used in our hospital. the diet was in pureé texture(TXT) and 25 (38%) in the form of
Methods: This study encompasses all people 65 yrs and older easy mastication (smooth and easy to chew)or regular texture.
who underwent a phase angle measurement between 1990 and All of them used thickeners for liquids: nectar texture 29%,
2011 at the Geneva University Hospitals, with the RJL-101® honey 41% and pudding 30%.
(RJL Systems), Xitron 4000B® (Xitron Technologies), Eugedia® Water registry: nectar texture 1,014.5 ml±441.8 R (425–2,125),
(Eugédia-Spengler) and Bio-Z® (Spengler). Diseases at the time honey 927.8 ml±380.3 R (425–2,000), pudding 781.3 ml±292.2 R
of phase angle measurement were reported in the form of the (200–1,500). P 0.025 between nectar and pudding, p 0.065
Cumulative Illness Rating Scale. Date of death was retrieved between honey and pudding. Patients with TXT diet had to
until December 2012. Phase angle values were categorized into thicken the liquids to honey texture by 49%, 39% to pudding and
sex- and device-specific quartiles, where quartile 1 represents to the non-TXT diet by 52% in nectar.
the lowest quartile and reference value. Cox regressions were Conclusion: Patients who need to thicken liquids have a lower
performed to evaluate the association between phase angle water intake when the liquid texture is pudding. The honey
quartiles and mortality. texture is the most used. It is necessary to determine the
Results: We considered 1,878 people (969 women), of whom minimum safe viscosity to favor ingestion and hydration, as well
1,151 had died. In univariate sex-specific Cox regressions, the as the use of more palatable thickeners.
death risk decreased progressively as the phase angle quartile Disclosure of Interest: None declared.
measured by the Bio-Z® or RJL-101® increased. The HR (95% CI)
in quartile 4 was 0.36 (0.26, 0.50) and 0.38 (0.29, 052) in
S198 Poster
MON-P049 Muscle mass is converted to the muscle mass index (SMI). For
A RANDOMIZED-CONTROLLED TRIAL OF LEUCINE-ENRICHED the lower limit value of reduced muscle mass the values
AMINO-ACID MIXTURES ON MUSCLE MASS, STRENGTH, AND indicated in the recommendations EWGSOP (media <8.87 and
PHYSICAL PERFORMANCE IN POST-STROKE PATIENTS WITH 6.42 kg/m2 in man and woman). Muscle strength is determined
SARCOPENIA by the power of distress using hand-held dynamometer.
Y. Yoshimura1 *, T. Bise2, S. Shimazu3, A. Shiraishi4. Decreased muscle strength is defined as less than 30 kg for
1
Rehabilitation Medicine, 2Rehabilitation, 3Nutritional men and 20 kg in women. Physical endurance test measured the
Management, 4Dental Office, Kumamoto Rehabilitation walking speed of a length of 4 m. The values of less than 0.8 m/
Hospital, Kumamoto, Japan s to identify persons with reduced physical endurance.
Results: One hundred participants (21 men and 79 women)
Rationale: Sarcopenia is associated with lower physical between the ages of 67 and 96 years (mean 80,7) was in a study
performance in stroke patients. The aim of the study is to of prevalence of sarcopenia. Mean Body Mass Index was
evaluate the effectiveness of nutritional intervention in 26,21 kg/m2 (BMI 20–25 kg/m2), 9.17 was index of muscle
improving physical function in stroke patients with sarcopenia, mass (SMI < 8.87 and 6.42 kg/m2, a man and a woman), 17/21
where the evidence is still limited. men and 73/79 had low muscle strength (less than 30 kg for
Methods: A total of twenty six post-stroke patients with men and 20 kg in women), 30/100 low usual gait speed (less than
sarcopenia were included and randomly allocated to either 0.8 m/s), 4/100 had sarcopenia and 1 of 4 had severe sarcopenia.
convalescent stroke rehabilitation with or without a blend of After 6 months follow-up examination 3/100 patients have died,
essential amino acids containing 40% leucine, AminoL40, to 18/100 patients had falls, 3/18 had fractures.
consume once daily for 2 months of intervention. Sarcopenia Conclusion: Sarcopenia is a common condition in older adults
was defined as a loss of skeletal muscle mass index (SMI) with that contributes to functional decline, disability, frailty, and
BIA and decreased muscle strength as measured by handgrip falls. The risk of identification sarcopenia will greatly facilitate
strength (HG); cut-off values were adopted from the AWGS. the intervention, any pharmaceutical agents that act on
Functional Independence Measure (FIM), SMI, and HG were different biological pathways, with adequate nutrition and
assessed at baseline, and after two months of intervention. targeted exercises remain the gold standard for therapy.
ANCOVAwith baseline values of age, sex and NIHSS as covariates Disclosure of Interest: None declared.
were used to analyze between-group differences.
Results: FIM improved in both groups without significant
between-group differences. The intervention group improved
Hormones, mediators and immunity
more in SMI and HG compared with the control group, between-
group effect of SMI (0.25 kg/m2, 95%CI: 0.11–0.40, p = 0.04) MON-P051
and HG (0.81 kg, 95%CI: 0.46–1.10, p = 0.03), respectively. ASSOCIATION OF TUMOR GROWTH FACTOR-Β AND
Conclusion: This two months intervention of leucine-enriched INTERFERON-Γ SERUM LEVELS WITH INSULIN RESISTANCE IN
amino-acid oral nutritional supplement added to convalescent NORMAL PREGNANCY
stroke rehabilitation resulted in improvements in muscle mass
A. Sotoodeh Jahromi1 *. 1Jahrom University of Medical
and strength among post-stroke patients with sarcopenia. This
Sciences, Jahrom, Islamic Republic of Iran
study shows proof-of-principle that specific nutritional supple-
mentation might benefit sarcopenic patients, especially Rationale: Pregnancy is related to change in glucose metab-
relevant for those with disabilities due to stroke. Further olism and insulin production. The aim of our study was to
trials are needed to investigate the role of a specific nutritional determine the association of serum IFN-γ and TGF-β levels with
supplement as part of a multimodal approach to improve insulin resistance during normal pregnancy.
physical performance among stroke patients with sarcopenia. Methods: This cross sectional study was carried out on 97
Disclosure of Interest: None declared. healthy pregnant (in different trimesters) and 28 healthy non-
pregnant women. Serum TGF-β and IFN-γ level were measured
MON-P050 by ELISA method.
THE PREVALENCE OF SARCOPENIA IN NURSING HOME FOR Results: Pregnant women had high level TGF-β and low level
THE ELDERLY IFN-γ as compared non-pregnant women. Maternal serum TGF-
Z. Sundov1 *, Z. Kolak2,3, A. Šundov4. 1Gastroenterology, β concentration significantly increased in third trimester as
Clinical Hospital Split, 2Home for the Retired and Elderly compared first and second trimester of pregnancy. Maternal
Persons, Split, Croatia, 3Gastroenterology, Home for the serum IFN-γ concentration significantly decreased in third
Retired and Elderly Persons, 4Hercegovačka 83, Community trimester as compared first and second trimester of pregnancy.
Health Center Split, Split, Croatia Pregnant women exhibited higher score of HOMA IR as
compared non-pregnant women. There were association
Rationale: Sarcopenia, or the decline of skeletal muscle tissue between gestational age with body mass index (r = 0.28,
with age, is one of the most important causes of functional P = 0.005), TGF-β (r = 0.45, P < 0.001) and IFN-γ (r = −0.50,
decline and loss of independence in older adults. Sarcopenia is P < 0.001). There was significant association between Insulin
defined by both loss of muscle mass and loss of muscle function resistance and TGF-β (r = 0.17, p = 0.05).
or strength. Conclusion: Our findings suggest that changes in maternal
Methods: The study on the prevalence of sarcopenia was cytokine level in healthy pregnant women were anti-inflam-
carried out in nursing home for the elderly in Split, Croatia. matory. Furthermore, Tumor Growth Factor-β appears has a
Muscle mass is measured by the bioelectrical impedance (BIA). role in induction insulin resistance in healthy pregnant women.
Hormones, mediators and immunity S199
However, further studies needed to evaluate role of different using maximum Sequential Organ Failure Assessment (max-
cytokines on insulin resistance in normal pregnancy. SOFA) and delta-SOFA score. Analysis was performed using
Disclosure of Interest: None declared. mixed linear regression.
Results: Concentration of 4 HDHA (0.01) and 17 HDHA (0.01)
was significantly higher in the FO group. Analysis demonstrated
MON-P052
that concentration of other anti-inflammatory markers i.e.
A RANDOMISED CONTROLLED TRIAL INVESTIGATING THE
LXA4, PGD2, Hipoxillin, 14 HDHA, 12 HEPE, 13 HODE, 15 HEPE,
EFFECTS OF PARENTERAL FISH OIL ON PRO-INFLAMMATORY
18 HEPE was higher in the FO group. Linear regression showed a
RESOLVIN & PROTECTIN PROFILE IN CRITICALLY ILL PATIENTS
significant association between FO, max-SOFA and delta-SOFA
WITH SEPSIS
scores in these patients. The max-SOFA and delta-SOFA scores
D. K. Bilku1 *, T. Hall1, D. Al-Leswas1, C. Horst1, J. Cooke1, in FO group were significantly lower than C-group.
M. Metcalfe1, A. Dennison1. 1University Hospitals of Leicester Conclusion: 4 HDHA and 17 HDHA were significantly higher in
NHS Trust, Leicester, United Kingdom the FO group. Fish oil improved organ dysfunction in these
critically ill septic patients.
Rationale: Severe sepsis in Intensive Care Unit (ICU) is
associated with high mortality (40%) due to inappropriate Disclosure of Interest: None declared.
inflammation and immunosuppression. Omega-3 (ω-3) has
shown to attenuate uncontrolled inflammation and produce MON-P054
clinical benefit. This trial explores the role of omega-3 in sepsis. EFFECT OF PARENTERAL OMEGA-3 ON MORTALITY AND
Methods: 20 patients with abdominal sepsis were selected COMPLEMENT-3 LEVELS IN SEPTIC PATIENTS
from a randomised trial of 60 consecutive septic patients in D. K. Bilku1,1 *, J. Zimmer1, C. M. Stover1, T. Hall1, W. Cheung1,
ICU. Of these 10 received parenteral ω-3 (Fish oil, FO group) C. Horst1, A. R. Dennison1. 1University Hospitals of Leicester
and 10 received standard medical therapy (control, C group). NHS Trust, Leicester, United Kingdom
The primary outcome was effect of ω-3 on pro-inflammatory
resolvins and protectins. The secondary outcome was to assess Rationale: To correlate mortality, the effect of parenteral
effect of omega-3 on organ dysfunction measured using omega-3 fish oil and serum complement 3 (C3) levels in septic
maximum Sequential Organ Failure Assessment (max-SOFA) patients on the Intensive Care Unit (ICU).
score and delta-SOFA score. Analysis was performed using Methods: As part of a randomised clinical trial investigating the
mixed linear regression. effects of parenteral omega-3, 20 septic patients were studied.
Results: Omega-3 significantly decreased PGE2 (0.001) and Levels of C3 were measured by ELISA and correlated with a
TXB2 (0.02) over time in the FO group. Also, the concentration number of important clinical parameters.
of other pro-inflammatory markers i.e. 5-HETE, 12-HETE, 15- Results: Levels of C3 were measured at two time points. Time
HETE, LTB4, PGF2α were higher in the C-group as compared to point 1 (t1) is day 0 and time point 2 (t2) is the last day of stay on
the FO-group. Linear regression showed a significant associ- ICU. All patients were found to be C3 depleted (<750 mcg/ml at
ation between FO, max-SOFA and delta-SOFA scores in these baseline). They were divided into two groups, group1 (N = 8)
patients. The max-SOFA and delta-SOFA scores in FO group were were patients with lower C3 at t2, group 2 (N = 12) were
significantly lower than C-group. patients with stable or higher C3 at t2. The two groups were
Conclusion: A significant decrease was detected in PGE2 and compared with regards to type of organism, mortality and
TXB2 concentration in the ω-3 group. Fish oil improved organ effect of omega-3 on mortality.
dysfunction in sepsis thus influencing clinical outcome. Conclusion: In group1, the majority of the sepsis was due to a
Disclosure of Interest: None declared. gram negative organism whereas in group 2 it was due to a gram
positive organism. In group 1, there were 3 deaths (50%) all of
which were controls and had progressive depletion of C3. There
MON-P053
were no deaths (0%) in the omega-3 sub-group. In group 2, 6/7
OMEGA-3 SIGNIFICANTLY IMPROVED ORGAN DYSFUNCTION IN
patients receiving omega-3 survived (12% mortality) while 3/4
CRITICALLY ILL SEPTIC PATIENTS – RESULTS OF A RANDOMISED
control patients survived (25% mortality). We conclude that
CONTROLLED TRIAL
parenteral omega-3 reduces mortality by up to 50%. Progressive
D. K. Bilku1,1 *, T. Hall1, D. Al-Leswas1, C. Horst1, J. Cooke1, depletion of C3 is associated with poor outcome and may be
M. Metcalfe1, A. Dennison1. 1University Hospitals of Leicester used as a marker for clinical outcome.
NHS Trust, Leicester, United Kingdom
Rationale: Inappropriate inflammation and immunosuppres-
sion causes high mortality (40%) in septic patients on Intensive MON-P055
Care Unit (ICU). Omega-3 (ω-3) has demonstrated to attenuate CORE TEMPERATURE AND DIETARY PATTERNS
uncontrolled inflammation and produce clinical benefit. This K. Kimura1 *, D. Akiyama1, G. Hagiwara2. 1Department of
trial explores the effect of omega-3 in sepsis. Health and Sports Management, Japan University of
Methods: A sub-group of 20 patients with abdominal sepsis Economics, Dazaifu-City, 2National Institute of Fitness and
were selected from a randomised trial of 60 consecutive septic Sports in Kanoya, Kanoya-City, Japan
patients in ICU. Of these 10 received parenteral ω-3 (Fish oil,
FO group) and 10 received standard medical therapy (control, C Rationale: For humans, maintaining a core temperature of
group). The primary outcome was effect of ω-3 on anti- 37.0°C is important, but reports in recent years show a
inflammatory resolvins and protectins. The secondary outcome declining trend in body temperature. The aim of this study
was to analyse the effect of ω-3 on organ dysfunction measured
S200 Poster
was to investigate the relationship between tympanic tem- were conducted with serum 25 hydroxy vitamin D and some
perature and dietary patterns. biochemical tests.
Methods: Subjects were 34 healthy female students (18.2 ± 0.4 Results: The body compositions and anthropometric measure-
years). The subjects measured their tympanic temperature ments were found to be significantly higher in obese children
upon waking using an infrared thermometer for two consecu- ( p < 0.05). The fasting blood glucose, insulin, HOMA-IR and
tive days. The dietary patterns survey used a questionnaire leptin levels in obese children and the HDL cholesterol and
format asking about the average meal content consumed per adiponectin levels in the non-obese children were found
week over the last 1–2 months, and the meal consumption, significantly higher ( p < 0.05). The serum vitamin D level of
including nutritional content and other factors, were analyzed both the obese children and non-obese children were
using analysis software. The Pearson correlation coefficient adequate, the leptin levels in the obese children were higher
was used for correlation relationships between items. Also, and the adiponectin levels were lower than non-obese children.
comparison of the two groups with tympanic temperature No significant differences were found in serum irisin level, the
readings of 36.5°C or more and less than 36.5°C was conducted, level of vitamin D, the insulin resistance, anthropometric and
and when there was no significant difference identified with biochemical measurements.
Levene testing for equal variances based on testing of Conclusion: Several studies conducted in adults linked the
applicable differences, t-test was implemented, while when irisin level to obesity. However, in this study no difference
significant differences were identified, Welch testing was between the results of irisin level of children was assumed due
implemented. A significance level of P < 0.05 was used. to the unmatured muscle tissue of the children compared with
Results: 17 subjects had waking tympanic temperature of 36.5° the adult muscle tissue.
C or more, and 17 subjects had temperatures of less than 36.5°C. Disclosure of Interest: None declared.
No correlation was identified between nutrition and tympanic
temperature in either group. Also, no significant differences
MON-P057
in diet were identified between the two groups. Among the
CORRELATION BETWEEN BMI AND TLR4 AND OB-R
subjects with temperatures of 36.5°C or more, the ratio of
EXPRESSION ON MONOCYTES IN PATIENTS WITH EATING
total caloric intake made up of fat was significantly higher
DISORDERS
(34 ± 5% and 31 ± 3%, P < 0.05), and the ratio of carbohydrate
was significantly lower (50 ± 7% and 54 ± 5%, P < 0.05). L. E. Belmonte1,2,3,4, M. P. Tavolacci4, M. Galmiche1,2,5,
Conclusion: We compared dietary content on either side of N. Achamrah1,2,3, A. Rimbert3, J. Delay3, C. Bole-Feysot1,2,
36.5°C, the ratio of total caloric intake made up of fat was C. Guérin1,2, S. Grigioni3, V. Folope3, A. Petit3, M. Coëffier1,2,3,
significantly higher for subjects with temperature of 36.5°C or P. Déchelotte1,2,3 *. 1Normandie Univ, URN, INSERM UMR 1073,
2
more, and the ratio of carbohydrate was significantly lower for Institut de Recherche et d’Innovation Biomédicale (IRIB),
these subjects as well. Universite de Rouen, 3Département de Nutrition, 4CIC-CRB
1404, CHU de Rouen, 5Societé TargEDys, Rouen, France
Rationale: Eating disorders like Anorexia Nervosa, Bulimia and
MON-P056 Binge Eating have been associated with low-grade inflamma-
THE RELATIONSHIP OF THE SERUM IRISIN LEVELS AND tion. TLRs and ObR activation on monocytes contribute to the
ANTHROPOMETRIC MEASUREMENTS OF OBESE AND NON- regulation of inflammatory mediators; however, there is a
OBESECHILDREN paucity of data examining its potential involvement in eating
K. Esin1 *, N. Şanlıer1, E. Adal2, S. Batırel3, G. Ülfer4, P. Yiğit5. disorders. We thus explored TLR2, TLR4 and Ob-R expression on
1
Nutrition and Dietetics, Gazi University, Ankara, 2Pediatric monocytes in a cohort of patients with disturbed eating
Endocrinology and Metabolism, Istanbul Medipol University, behavior.
3
Department of Biochemistry, Marmara University, Methods: Eighty seven patients fulfilling the DSM-V criteria
4
Department of Biochemistry, 5Department of Biostatistics and were included. Patients were classified into 5 groups according
Medical Informatics, Istanbul Medipol University, Istanbul, to baseline BMI: <18,5, n = 16; 18, 5–24,9, n = 10; 25–34,9,
Turkey n = 16; 35–39,9, n = 25 et ≥40, n = 20. Peripheral blood was
collected into EDTA tubes. TLR2, TLR4 and Ob-R expression
Rationale: Irisin is a newly discovered muscle derived hormone were assessed by flow cytometry. CD14 and CD11b antibodies
which has increasing effect on energy expenditure in the body. were used to identify peripheral monocytes. Results are
The aim of this study was to compare the serum irisin level and expressed as mean fluorescence intensity. Results (mean
the anthropometric measurements and biochemical para- ±SEM) were compared by ANOVA and correlations were
meters of the obese and non-obese children. Irisin is a newly analyzed by Spearman or Pearson tests.
discovered muscle derived hormone which has increasing Results: TLR4 expression in monocytes was significantly
effect on energy expenditure in the body. The aim of this different between the 5 groups BMI (*p = 0,008). In particular,
study was to compare the serum irisin level and the TLR4 was higher in patients with BMI < 18.5 than in patients
anthropometric measurements and biochemical parameters with BMI > 40 (36.9 ± 8 vs 14.9 ± 2, p < 0.05). Additionally, a
of the obese and non-obese children. negative correlation was observed between TLR4 expression
Methods: The study was conducted on a total number of 80 and BMI (*p = 0.0015). By contrast, TLR2 expression in
children, 44 of those were obese (Body Mass Index ≥ 97. peripheral monocytes was not different between groups
percentile) and 36 were non-obese. The anthropometric ( p > 0.05). Finally, Ob-R was also differentially expressed in
measurements and body compositions of the children were monocytes of patients according to their BMI. Specifically, Ob-R
recorded and hormone (irisin, leptin, adiponectin) analyses
Hormones, mediators and immunity S201
expression was greater in BMI < 18.5 than in BMI > 40 (49.6 ± 16 Table: Villous heights of jejunum and ileum, Intestinal IgA level.
vs 13.6 ± 1.7, p < 0.05). Jejunum Ileum IgA (μg/
Conclusion: These results show a differential expression of two (μm) (μm) ml)
receptors of inflammation, TLR4 and Ob-R, at cell surface of CHOW 436 ± 14* 220 ± 11 51.8 ± 12.3
monocytes according to BMI. Additional studies are necessary fat free PN 363 ± 9 200 ± 6 24.6 ± 3.7†
to determine both the molecular mechanisms responsible for 10%PN 452 ± 14* 235 ± 13 25.3 ± 2.6†
20%PN 452 ± 14* 229 ± 11 28.7 ± 4.6†
divergent expression and the role of these inflammatory 30%PN 443 ± 13* 216 ± 10 29.0 ± 6.2†
receptors in the regulation of eating disorders. 40%PN 441 ± 15* 225 ± 12 32.0 ± 4.5†
Disclosure of Interest: L. Belmonte: None declared, M. Tavolacci: None
means±SE, *p < 0.05 vs. Fat free PN, †p < 0.05 vs. CHOW, ANOVA.
declared, M. Galmiche Other: employee TarGEdys, N. Achamrah: None
declared, A. Rimbert: None declared, J. Delay: None declared, C. Bole-
Feysot: None declared, C. Guérin: None declared, S. Grigioni: None Disclosure of Interest: None declared.
declared, V. Folope: None declared, A. Petit: None declared,
M. Coëffier: None declared, P. Déchelotte: None declared.
MON-P059
INSULIN RESISTANCE AND SERUM LEVELS OF INTERLEUKIN-17
MON-P058 AND INTERLEUKIN-18 IN NORMAL PREGNANCY
DOES RESTORATION OF PEYER’S PATCH LYMPHOCYTE
S. Sobhanian1 *, A. Sotoodeh Jahromi1. 1Jahrom University of
NUMBER BY COMBINING FISH AND SOYBEAN OIL IN
Medical Sciences, Jahrom, Islamic Republic of Iran
PARENTERAL NUTRITION ALSO IMPROVE THE GUT
MORPHOLOGY AND IMMUNOGLOBULIN A LEVEL? Rationale: Pregnancy is associated with insulin resistance
M. Noguchi1 *, K. Fukatsu1, S. Murakoshi1, T. Watanabe2, M. Ri3, and glucose metabolism disorders. There is an oncoming
K. Higashizono3, A. Watokins4, T. Moriya2, H. Yasuhara1. augmentation in maternal insulin secretary response to
1
Surgical Center, The University of Tokyo Hospital, Tokyo, glucose and a variety of other stimuli during the course of
2
Department of Surgery, National Defense Medical College, gestation.
Tokorozawa, 3Department of Gastrointestinal Surgery, Methods: This descriptive cross sectional study was carried out
4
Department of Surgery, The University of Tokyo Hospital, on 97 healthy pregnant women including 32, 25, and 40
Tokyo, Japan individuals in the first, second, and third trimesters, respect-
ively, and on 28 healthy non pregnant women between the
Rationale: Lack of enteral nutrition causes atrophy of gut autumn of 2012 and the spring of 2013. We analyzed the serum
associated lymphoid tissue and gut morphology, and reduces concentrations of IL-17 and IL-18 by using the enzyme linked
mucosal IgA levels in small intestine. immunosorbent assay (ELISA). Insulin resistance was measured
Our previous study demonstrated parenteral nutrition (PN) by homeostasis model assessment of insulin resistance
containing both fish (FO) and soybean oil (SO) at a 1:2 ratio to equation.
restore Peyer’s patch (PP), an inductive site of gut mucosal Results: No significant differences between the demographic
immunity, lymphocyte numbers in mice. However, whether data of the pregnant and non pregnant groups were observed.
such PP recovery improves gut morphology and IgA levels Insulin resistant in pregnant women was significantly higher
remains unclear. than the controls ( p = 0.006). Serum IL-17 concentration was
Herein, we examined effects of the PN formula with various fat significantly different in non pregnant women and pregnant
to total energy ratio on intestinal morphology and IgA levels in women in all gestational ages ( p < 0.05). Serum IL-18 level was
mice. significantly lower in subjects with first, second, and third
Methods: Male ICR mice (n = 81) were randomized to chow, fat- trimesters of pregnancy in compared to non pregnant women
free, 10%, 20%, 30% and 40% PN groups. The latter 4 groups ( p < 0.05). No significant correlations were found between
received 33% of fat energy from FO and 67% from SO, but the fat serum IL-17 and IL-18 levels with insulin resistance (r = 0.08,
to total energy ratios differed (10–40%) among these groups. p = 0.34 vs. r = 0.01, p = 0.91, respectively).
After 5 days of feeding, the mice were killed and the entire Conclusion: Our data suggested that IL-17 and IL-18 do not
small intestine was harvested. Villous heights in the jejunum appear to attribute greatly to pregnancy deduced insulin
and ileum were evaluated with HE staining. IgA levels of small resistance during normal pregnancy.
intestinal washings were measured using ELISA.
Results: In the jejunum, villous height was lower in the fat-free
PN than in the chow group and 10–40%PN groups, without
significant differences among 10–40%PN and chow groups. The MON-P060
chow group showed higher gut IgA levels than any of the PN THE OPTIMAL TIME OF GLP-2 INTERVENE FOR EARLY
groups (Table). INTESTINAL REHABILITATION IN A RAT MODEL OF MASSIVE
Conclusion: Though PN containing FO and SO at a 1:2 ratio with BOWEL RESECTION
10–40% fat to total energy ratio equally improves PN-induced Y. Li1 *, Z. Cai2. 1Department of Surgery, Shanghai Ninth
mucosal atrophy in jejunum, this recovery apparently does not People’s Hospital, Shanghai Jiaotong Univesity School of
raise gut IgA levels. Medicine, Shanghai, 2Department of Surgery, Jinling Hospital,
Nanjing University School of Medicine, Nanjing, China
Rationale: To explore the optimal time of GLP-2 intervene for

early intestinal rehabilitation in a rat model of massive bowel
resection.
S202 Poster
Methods: The rats underwent massive bowel resection(80% Caspase 8 significantly increased after postoperative 72 hours,
small bowel resection) were divided into two groups: glucagon- while didn’t change much at postoperative 24 hours.
like peptide-2(GLP-2)and saline were given introperitoneal Conclusion: The expression of autophagy and apoptosis was
injection for 3 days at different time points following by MBR, presumed to be stabilized at a basal level after postoperative
respectively. The expression of apoptosis was detected by 72 hours. The increased apoptosis and decreased autophagy
Western Blotting by detecting the apoptosis-related protein may increase self-renewal of enterocytes and promote the
PARP and Caspase 8. process of intestinal adaptation
Results: The number of autophagic body was significantly Disclosure of Interest: None declared.
reduced after the treatment of GLP-2 at postoperative 24
hours. The expression of autophagy marker including LC3, Atg5
and Beclin-1 was heavily reduced after the treatment of GLP-2
at postoperative 24 hours on the level of mRNA. Among them,
Liver and gastrointestinal tract 2
the level of Beclin-1 was the most significantly reduced. While MON-P062
the expression of P62 significantly increased after the PREVALENCE OF INTESTINAL FAILURE ASSOCIATED LIVER
treatment at this time point. The rate of transition from LC3 I DISEASE (IFALD) IN ADULTS ACCORDING TO DIFFERENT
to LC3 II and the expression of LC3 II were reduced significantly INDICES
after the treatment of GLP-2 at postoperative 24 hours.
A. S. Sasdelli1, F. Agostini1, C. Pazzeschi1, M. Guidetti1,
Meanwhile, the levels of Atg5 and Beclin-1 were also reduced
L. Pironi1 *. 1Center for Chronic Intestinal Failure, University of
at this time point. However, the levels of P62 decreased
Bologna, Bologna, Italy
significantly after the treatment. The expression of autophagy
increased significantly after the treatment of GLP-2 at Rationale: A comprehensive and unique definition of IFALD is
postoperative 72 hours. not yet available. The aim of this study was to assess the
Conclusion: The intervene of GLP-2 initiated at postoperative prevalence of IFALD according to indirect biochemical and
24 hours is the optimal time for early intestinal rehabilitation a instrumental indices of liver disease.
rat model of massive bowel resection. Methods: Cross sectional study carried out in a single medical
Disclosure of Interest: None declared. center, on adult outpatients on Home Parenteral Nutrition
(HPN) for Chronic Intestinal failure (CIF) due to benign disease,
MON-P061 with no liver disease due to a known cause. The followings were
GLUCAGON-LIKE PEPTIDE-2 MODULATES THE EFFECTS OF collected: anagraphic and anthropometric data, CIF mechan-
AUTOPHAGY ON INTESTINAL ADAPTION IN A RAT MODEL OF ism, underlying disease, HPN characteristics, biochemistry and
SHORT BOWEL SYNDROME liver ultrasound (US). Criteria for IFALD diagnosis: ‘general
Y. Li1 *, Z. Cai2. 1Department of Surgery, Shanghai Ninth criteria’: alkaline phosphatase and gamma-glutamyl transfer-
People’s Hospital, Shanghai Jiaotong Univesity School of ase >1.5 ULN plus US signs of liver steatosis; cholestasis: direct
Medicine, Shanghai, 2Department of Surgery, Jinling Hospital, bilirubin >0.3 mg/dL; steatosis at biochemistry: AST/ALT ratio
Nanjing University School of Medicine, Nanjing, China (AAR) <1; steatosis at US; indices of fibrosis (APRI, Forns, NFS,
FIB-4). Statistic: median, chi-squared test.
Rationale: To explore the molecular mechamism of glucagon- Results: A total of 117 patients were included (M 44%, age
like peptide-2 modulating the effects of autophagy on 52 yrs). Prevalence (%) of IFALD according to the individual
intestinal adaption in a rat model of short bowel syndrome. index: ‘general criteria’, 7; cholestasis, 27; steatosis-AAR, 51;
Methods: The rats was underwent massive bowel resection steatosis-US, 44; fibrosis: APRI, 10; Forns, 24; NFS, 3; FIB-4, 20.
(80% small bowel resection) to imitate the clinical condition of Patients with all positive indices, 0; patients with no positive
SBS caused by IRI. The expression of autophagy at different index, 15. Prevalence of positive APRI (P < 0.01) or FIB-4
time points postoperatively through combined methods of (P < 0.03) was greater in females; positivity of Forns (P < 0.001),
electron microscopy (EM), polymerase chain reaction (PCR) NFS (P < 0.001) and FIB4 (P < 0.002) increased with age
and Western Blotting, and a variety of autophagy markers category; prevalence of cholestasis was greater in patients
including LC3, p62, Atg5 and Beclin-1 were observed, the with jejunostomy or entero-cutaneous fistulas (P < 0.05).
expression of apoptosis through the method of Western Blotting Conclusion: In adults, indirect indices of liver disease indicate
by detecting the apoptosis-related protein PARP and Caspase 8 that IFALD is mainly represented by liver steatosis, whereas
was analysed. cholestasis and hepatic fibrosis may affect about one fourth of
Results: The number of autophagic body within 24 hours after patients. Sex, age and CIF mechanism might play a role in the
MBR was greater than the sham-operated group, and the positivity of IFALD indices.
number decreased significantly at postoperative 72 hours. The Disclosure of Interest: None declared.
expression of autophagy marker including LC3, Atg5 and Beclin-
1 were significantly increased within postoperative 24 hours on MON-P063
the level of mRNA. Among them, the expression of Beclin-1 ASSOCIATION BETWEEN PRESARCOPENIA, SARCOPENIA AND
increased most significantly. These markers gradually BONE MINERAL DENSITY IN PATIENTS WITH CHRONIC
decreased at postoperative 72 hours. Besides, the expression HEPATITIS C
of P62 decreased within postoperative 24 hours, while
T. Bering1, K. G. D. Diniz1, M. P. P. Coelho1, D. A. Vieira1,
significantly increased at postoperative 72 hours in the
M. M. S. Soares2, A. M. Kakehasi3, M. I. T. D. Correia4,
experimental groups compared with the sham-operated
R. T. Teixeira1, D. M. M. Queiroz5, G. A. Rocha5, L. D. Silva1,2 *.
group. The expression of apoptosis related protein PARP and 1
Outpatient Clinic of Viral Hepatitis, Instituto Alfa de
Gastroenterologia, 2Internal Medicine, 3Locomotor System Methods: This is a multicenter observational study in patients
Department, 4Department of Surgery, 5Laboratory of Research with SBS >18 years. We studied microbiota at phylum-level by
in Bacteriology, Faculdade de Medicina, Universidade Federal 16S rRNA sequencing and hyperphagia (energy intake > 1,5
de Minas Gerais, Belo Horizonte, Brazil times the REE) measured by indirect calorimetry (Fitmate GS®,
COSMED®) and 7-day food record. Variables were expressed as
Rationale: Although low skeletal muscle mass (MM) has been frequencies and median [interquartile range]. Spearman
considered a predictor of bone mineral density (BMD), their correlation by IBM-SPSS Statistics21® was carried out.
association in chronic hepatitis C(CHC) is not fully understood. Results: Twenty patients were included (68 [59–76] years, 75%
Thus, we evaluated the prevalence of low BMD and sarcopenia women). The oral energy intake was 2,287 [1,643–2,887] kcal,
among CHC patients. The association between BMD, body 39 [24–49] kcal/kg/day, which were distributed as follows:
composition, muscle strength (MS) and nutritional status was 46 [39–52] % carbohydrates, 16 [14–18] % proteins (0,72
also investigated. [0,59–1,07] g/kg/day) and 35 [31–41] % lipids. 65% of the
Methods: 104 subjects [mean age, 50.5 ± 11.3 yrs.; 75.0% sample did not cover orally the minimum recommended
males; 67.3% non-cirrhotic and 32.7% with compensated amount of protein (0,8 g/kg/day), this patients having a
cirrhosis], prospectively, underwent scanning of the lean significant increase in Bacteroidetes ( p = 0,017). 50% of the
tissue, appendicular skeletal muscle mass (ASM), fat mass patients did not meet the recommended amount of dietary
(FM), lumbar spine, hip, femoral, neck and whole-body BMD by fibre (22,3 [8,3–32,4] g) (women: 22 g/day, men: 30 g/day).
dual-energy X-ray absorptiometry(DXA). MS was assessed by This was correlated with a lower presence of Actinobacteria
dynamometry. Sarcopenia was defined by the presence of both ( p = 0,03), but with an increase of Proteobacteria ( p = 0,011).
low ASM/height2 (ASMI) and low MS(EWGSOP criteria). Low BMD The presence of hyperphagia (57,9%) did not correlate with
and nutritional status were evaluated, respectively, according none of the phylums.
to WHO criteria and Controlling Nutritional Status score. Conclusion: The low protein intake appears to increase the
Results: Low BMD, low MS, presarcopenia (low MM) and Bacteroidetes and the insufficient fibre intake decreases the
sarcopenia were found in 34.6%, 27.9%, 14.4% and 8.7% Actinobacteria, while the Proteobacteria increases in patients
patients, respectively. In multivariate analysis, ASMI was an with SBS. The hyperphagia has not been linked to changes in
independent predictor of BMD. Neither FM nor body mass index the microbiota at the phylum-level.
(BMI) was associated with BMD. Sarcopenia was independently
associated with BMD and malnutrition. 88.9% of sarcopenic
individuals had normal BMI. Positive correlation was found
between mid-arm muscle circumference (MAMC) and ASMI. MON-P065
When ASMI was replaced by MAMC in the evaluation of MM, we STUDY OF INTESTINAL MICROBIOTA IN PATIENTS WITH SHORT
found a moderate and substantial agreement between MAMC BOWEL SYNDROME
and ASMI in the evaluation of presarcopenia and sarcopenia, I. Higuera Pulgar1, P. García Peris2, I. Bretón Lesmes2,
respectively. M. Camblor Álvarez2, M. C. Collado Amores3, C. Gil Martínez4,
Conclusion: To the best of our knowledge, this is the first study P. Matía Martin5, L. Arhip2, M. C. Cuerda Compés2 *.
1
to demonstrate that ASM is an independent predictor of BMD in Universidad Complutense de Madrid, 2Hospital General
CHC patients. MAMC coupled with handgrip strength testing Universitario Gregorio Marañón, Madrid, 3Instituto de
should be incorporated into routine clinical practice to detect Agroquímica y Tecnología de Alimentos de Valencia, Valencia,
4
presarcopenia and sarcopenia, which might go underdiagnosed Hospital Universitario de la Defensa Gómez Ulla, 5Hospital
when only BMI is used. Universitario Clínico San Carlos, Madrid, Spain
Rationale: The differences between patients with short bowel
syndrome (SBS) with and without colon, as well as with and
MON-P064 without intestinal failure (IF) have not yet been fully
DIET INFLUENCE ON THE INTESTINAL MICROBIOTA IN characterized.
PATIENTS WITH SHORT BOWEL SYNDROME Methods: This is a multicenter observational cross-sectional
I. Higuera Pulgar1, P. García Peris2, I. Bretón Lesmes2, study in patients >18 years, including 4 SBS groups (with and
M. Camblor Álvarez2, M. C. Collado Amores3, without IF, with and without colon) and 1 control group. We
M. L. Carrascal Fabián2, L. Arhip2, M. L. Motilla de la Cámara2, studied microbiota at phylum, family and genus level by 16S
M. C. Cuerda Compés2 *. 1Universidad Complutense de Madrid, rRNA sequencing. Variables were expressed as frequencies and
2
Hospital General Universitario Gregorio Marañón, Madrid, median [interquartile range]. Calypso 7.0 software (http://
3
Instituto de Agroquímica y Tecnología de Alimentos de cgenome.net/calypso/), T-test, one-way ANOVA, Bray-Curtis
Valencia, Valencia, Spain and Shannon Index were used used for statistical analysis.
Results: Twenty patients (age 68 [59–76] years, 75% women)
Rationale: In addition to developing different functions in the and 20 controls (age 44,5 [40–51] years, 55% women) were
body, intestinal microbiota could have a potential effect on included, with significant differences in age ( p < 0.0001). The
controlling food intake. Since the diet is a modifying factor of patients with SBS had a higher relative abundance of
the microbiota, the study of its influence on microbiota in Verrucomicrobia ( p = 0,024) and Fusobacteria ( p = 0,048) and
patients with short bowel syndrome (SBS) could make us a decrease in Bacteroidetes ( p = 0,019), compared to healthy
understand the dysbiosis and the development of hyperphagia subjects. In SBS patients, the absence of colon decreased
in these patients. Enterobacteriaceae ( p = 0,047) and Veillonela ( p = 0,047). The
presence of IF resulted in decreased bacterial diversity in
S204 Poster
patients with colon ( p = 0,015), with lessen Blautia ( p = 0,017), MON-P067

Veillonela ( p = 0,043) and Coprococcus ( p = 0,043). Bray-Curtis PARENTERAL NUTRITION WITH OMEGA-3 FATTY ACIDS
Index was 16% for the presence or absence of colon and 17% for RESULTS IN HIGH ENDOGENOUS EPA/DHA LEVELS IN SHORT
the presence or absence of IF. BOWEL SYNDROME PATIENTS
Conclusion: The microbiota of patients with SBS is different M. Karber1,2,3 *, S. Pevny1, D. Thurmann1, W.-H. Schunck2,
compared to healthy subjects. In addition, the dysbioses that K.-H. Weylandt1, U.-F. Pape1. 1Department of
are produced depend on the presence or not of colon in Gastroenterology, Hepatology and Endocrinology, Charité –
continuity, as well as the development or not of IF. Universitätsmedizin Berlin, 2Max Delbrück Center for
Disclosure of Interest: None declared. Molecular Medicine in the Helmholtz Association (MDC),
3
Berlin Institute of Health, Berlin, Germany
MON-P066
SMOF LIPID USE IN PATIENTS WITH INTRALIPID INTOLERANCE Rationale: Long-term parenteral nutrition (PN) of short bowel
syndrome patients (SBS-P) bears an increased risk of intestinal
M. Mundi1 *, J. Carnell2, M. McMahon2, R. Hurt2. 1Division of failure associated liver disease (IFALD). The antiinflammatory
Endocrinology, 2Mayo Clinic, Rochester, United States properties of long-chain omega-3 polyunsaturated fatty acids
(n-3 PUFA) attracted attention for preventing IFALD. However,
Rationale: Smoflipid has recently been approved for use in US
the relative impact and mechanisms of this approach have not
but literature has been limited to short term studies with
been fully established, as required for recommending general
duration of 14–28 days. Long-term studies are necessary in the
use of n-3 PUFA containing PN in SBS-P.
Home Parenteral Nutrition (HPN) population.
Methods: A prospective pilot study was performed in adult
Methods: Intralipid intolerant patients were transitioned to
IFALD-free SBS-P to investigate the effects of n-3 PUFAs on
Smoflipid with primary aim of increasing % calories from lipids
endogenous fatty acid (FA) profiles, inflammatory markers, and
without further elevation in liver function studies.
liver function tests. 8 SBS-P (mean age 50 ± 24 years;
Results: As of this analysis, 7 patients (3 female and 4 male)
pretreated with PN containing n-3 PUFA) received n-3 PUFA-
were placed on Smoflipid with duration of use of 83 ± 7.2 days.
free Lipovenös® MCT 20% during an 8- week washout, followed
Patients were on HPN for 10.9 ± 9.4 years with most common
by 8 weeks PN, wherein 25% of fat was replaced by n-3 PUFA-
indication of short bowel syndrome/malnutrition (n = 5) and
rich Omegaven®. 1,538 ± 275 kcal per infusion were applied on
motility disorder (n = 2). Most common reason for Intralipid
5.3 ± 1.4 days/week. Blood samples were taken every 4 weeks.
intolerance was IFALD (n = 7) with one patient also developing
The FA profile of erythrocytes yielded the HS-Omega-3 Index®
recurrent pancreatitis.
(n-3 index = (EPA + DHA)/total FA)).
Use of Smoflipid allowed an increase in total calories provided
Results: At baseline SBS-P demonstrated an n-3 index of
with an overall increase in the % calories from lipids from
12 ± 1.8, which declined continuously to 9 ± 0.8 during wash-
8.2 ± 7.2% to 12.4 ± 8.6%, while decreasing the % calories from
out. Subsequent re-supplementation resulted in significantly
dextrose from 64.8 ± 8.3% to 60.9 ± 7.2%. Despite increase in
increased n-3 PUFAs and decreased saturated and n-6 FA leading
lipid calories, liver studies revealed a trend towards improve-
to a raised the n-3 index of 13 ± 1.1. SBS-P simultaneously had
ment with total bilirubin decreasing from 1.3 ± 0.5 to 1.1 ± 0.6.
stable laboratory parameters and a clinically stable course.
Conclusion: A high baseline n-3-index did exclude n-3 PUFA
Baseline Week 8 P-value deficiency on pre-study PN; a specific reduction of n-3 PUFA on
wash-out and reversible increase on re-supplementation could
Age (years) 47.8 ± 13.9
Years on HPN 10.9 ± 9.4 be demonstrated and was associated with clinical and
BMI (kg/m2) 23.8 ± 4.8 paraclinical stability indicating exceptionally effective n-3
Total Calories per day 1,664.6 ± 516.3 1,702.5 ± 470.0 0.65 PUFA supplementation. Thus, n-3 PUFA-rich PN results in
% of Harris Benedict 108.3 ± 27.6 112.7 ± 34.7 0.40
Amino Acids (g/day) 112.3 ± 47.5 112.3 ± 47.5
extraordinarily high endogenous EPA/DHA levels compared to
Dextrose (g/day) 331.6 ± 83.7 298.7 ± 67.1 0.33 oral supplementation (n-3 indices 4 to 8).
Lipids (g/week) 109.3 ± 105.9 166.4 ± 145.3 0.13
% Calories from Amino 27 ± 5.2 26.7 ± 7.2 0.77
Acid
% Calories from Dextrose 64.8 ± 8.3 60.9 ± 7.2 0.017 MON-P068
% Calories from Lipids 8.2 ± 7.2 12.4 ± 8.6 0.05
Alk Phos 237.6 ± 266.9 211.7 ± 193 0.37 INDIVIDUALIZED 6-MONTHS CONTROLLED AND
AST 57.0 ± 30.1 39.8 ± 12.9 0.20 MOTIVATIONAL PROGRAM CHANGING EATING BEHAVIOR
ALT 66.9 ± 14.7 57.2 ± 17.9 0.47 REDUCE WEIGHT AND LEVELS OF NON-INVASIVE BIOMARKER
Total Bilirubin 1.3 ± 0.5 1.1 ± 0.6 0.02
OF LIVER APOPTOSIS IN PATIENTS WITH NONALCOHOLIC
FATTY LIVER DISEASE
Conclusion: Smoflipid is a viable alternative to Intralipid in
N. Dynnyk1 *. 1Internal Medicine 3, Bogomolets National
patients with IFALD allowing increase in calories provided from
Medical University, Kyiv, Ukraine
lipids with improvement in some LFTs.
Disclosure of Interest: M. Mundi: None declared, J. Carnell: None Rationale: Lifestyle modification and weight loss above 7–10%
declared, M. McMahon: None declared, R. Hurt Consultant for: Nestle. is the effectiveness treatment of NAFLD. But still there is a gap
how to increase patient adherence for changing eating
behavior and effect of weight loss. According to this we have
created motivational and controlled programm for changing
eating behavior and investigate it´s role in weight loss in
patients with NAFLD. Also we discover how this program can observed. Fetuin-A was highest in periportal fat-ladden
improve hepatic apoptosis as a main predictor of Nonalcoholic hepatocytes and next to inflammatory infiltrates. There was
fatty liver disease progression, which can be measured by a 4-fold F4/80 mRNA increased level upon VLHFD compared to
biomarker cytokeratin 18. ND. Interestingly, F4/80+ cells from lipogranuloma were
Methods: 58 patients with NAFLD were randomized in a two positive for fetuin-A protein staining.
groups. All of them had diagnosed NAFLD. We described Conclusion: Lipid deposition, macrophage infiltration and
importance of weight loss for the improving NAFLD. We gave fetuin-A production may be important factors in the liver
diet recommendations which consists of reducing portions of tissue remodeling observed during NASH development.
food, avoiding drinking soda water, reducing carbohydrates Disclosure of Interest: None declared.
intake and increasing fiber intake. For better diet adherence
every day first group were writing food diaries. Each person
MON-P070
from first group had 8 personalised sessions with doctor during
EFFECTS OF REDUCED SATURATED FATTY ACID ON BODY
6 months. On each sessions patients were measured of weight,
COMPOSITION IN PATIENTS WITH NON-ALCOHOLIC FATTY
waist circumference and fat percentage measured by bioelec-
LIVER DISEASE (NAFLD)
tric impedancemetry. To those from control group were just
given general recommendations of changing eating behavior N. B. Erdem1 *, Z. Goktas1. 1Nutrition and Dietetics, Hacettepe
without controlled sessions with doctor during 6 months. University, Ankara, Turkey
Results: We observed significant decreasing in weight loss
Rationale: Lifestyle changes including dietary patterns repre-
( p < 0,01), cytokeratin18 fragments M30 ( p < 0,01), Fatty liver
sents the main target for the prevention and treatment of
index, Visceral adiposity index and Fat contain measured by
nonalcoholic fatty liver disease (NAFLD). Saturated fatty acids
bioelectric impedancemetry.
(SFA) have unfavorable effects on lipid and glucose metabolism
Conclusion: Individualized controlled and motivational
which might worsen the progression of NAFLD. The aim of this
program of changing eating behavior leads to weight loss and
study to determine the effects of reduced saturated fatty acid
improves steatosis and Cytokeratin 18 levels in patients with
diet (7%) on anthropometric measurements of individuals with
NAFLD during 6 months.
non-alcoholic fatty liver disease.
Disclosure of Interest: None declared. Methods: A total of 23 adults aged between 19 and 65 years
participated in the study. Subjects were randomly divided into
MON-P069 two groups. Both groups followed a diet treatment for three
LIPID, FETUIN-A AND MACROPHAGE ZONATION IN HIGH FAT months; group 1 with 7% saturated fatty acid (n = 11) and group
DIET FOZ-FOZ MICE WITH NON-ALCOHOLIC STEATOHEPATITIS 2 with 12% saturated fatty acid (n = 12). Participants visited at
N. Lanthier1,2 *, Q. Etienne1, V. Lebrun1, L. Poekes1, baseline, 1st month and 3rd month. Data collected during each
Y. Horsmans1,2, I. A. Leclercq1. 1Laboratory of visit included height, weight, waist, hip, neck circumferences,
Gastroenterology and Hepatology, Institut de Recherche body fat composition, body muscle composition and intra
Expérimentale et Clinique, Université catholique de Louvain, abdominal fat. Body fat and muscle compositions were
2
Service d’Hépato-Gastro-Entérologie, Cliniques collected using bioelectrical impedance analysis. Intra abdom-
universitaires Saint-Luc, Brussels, Belgium inal fat was measured via VISCAN.
Results: A total of 12 female and 11 male subjects participated
Rationale: Innate immunity and insulin resistance constitute in the study. In both groups, weight significantly decreased;
potential mechanisms underlying non-alcoholic steatohepatitis from 86.1 to 81.2 in 7% SFA group and from 76.8 to 74.0 in 12%
(NASH) progression. Here, we explore the effect of a high fat SFA group ( p < 0.05). Moreover; waist circumferences, intra-
diet (HFD) on a liver-derived protein increased in diabetic abdominal fat and Body Mass Index (BMI) changes were
patients called fetuin-A and its relation with the development significant in both groups ( p < 0.05). For 7% SFA group waist
of steatosis, cell injury and liver macrophage activation in a hip ratio change wasn’t significant ( p > 0.05) however, it was
mouse model of obesity and NASH. significantly changed for 12% SFA group ( p < 0.05).
Methods: Male foz/foz mice were fed a normal diet (ND) or a Conclusion: Within each group there was significant decrease
HFD for 12 (long term HFD or LHFD) or 30 weeks (very long term in terms of anthropometric measurements such as weight, BMI,
HFD or VLHFD) to induce early or definite fibrosing NASH, waist circumference, intra abdominal fat. However there were
respectively. no significant differences in anthropometric measurements
Results: Compared to ND-fed foz/foz mice, HFD-fed foz/foz between different SFA groups.
mice developed obesity, insulin resistance and either steatosis Disclosure of Interest: None declared.
(LHFD) or steatohepatitis with steatosis, hepatocyte balloon-
ing, inflammation and fibrosis (VLHFD).
MON-P071
In ND fed mice, fetuin-A staining was positive in the cytoplasm of
INCREASE IN BMI AFTER INTESTINAL TRANSPLANTATION (ITX)
zone 3 centrilobular hepatocytes while F4/80+ Kupffer cells
IN ADULTS WITHOUT TOTAL PARENTERAL NUTRITION (TPN)
were located in the sinusoids of the intermediate lobular zone 2.
In LHFD fed mice, lipid deposition occurred in the zone 3 S. Tabak1 *, H. Noordhoff1, H. D. Bats1, F. V. D. Heide1,
centrilobular hepatocytes. Liver m-RNA expression showed a G. Dijkstra1. 1Gastroenterology and Hepatology, UMCG,
2-fold increased level of F4/80+ macrophage mRNA compared Groningen, Netherlands
to ND.
Rationale: Is intestinal transplantation (ITx) a succesful
In VLHD, a loss of zonation of liver steatosis with the presence
treatment of chronic intestinal failure to increase BMI
of fat loaded hepatocytes in all liver lobular zones was
S206 Poster
without TPN; results of 10 adult transplantations of the together with sarcopenic factors, OS and RFS rates of the
University Medical Centre Groningen. patients with sarcopenic obesity were significantly lower
Methods: Retrospective observational study from September compared with those of the others. Multivariate analyses
2001 to March 2017. revealed that high VSR (visceral adiposity) was an independent
Results: The University Medical Center Groningen (UMCG) is risk factor for mortality [Hazard ratio (HR) = 1.576, P = 0.009]
the only intestinal transplant (ITx) center in the Netherlands. and recurrence (HR = 1.405, P = 0.026) together with low SMI
In the last 15 years, only 11 intestinal transplants were needed (sarcopenia), low MA (muscle steatosis), high CA19–9, micro-
in adult patients with chronic intestinal failure. Ten patients (2 vascular invasion, and nodal metastasis.
male and 8 female, aged 24–55 years, median 42) were Conclusion: Visceral adiposity and sarcopenic obesity were
transplanted between September 2001 till March 2017, with a closely associated with mortality and recurrence after the
follow up period of 8–165 months (median 17). All patients had resection of pancreatic cancer.
a regular diet, before ITx. Indications for ITx were line Disclosure of Interest: None declared.
occlusion and infection (9), a perceived poor quality of life
(2). Patients were dependent of TPN before ITx during 9 and
MON-P073
164 months (median 74). Body weight before ITx was ranged
TREATMENT WITH TEDUGLUTIDE IN PATIENTS WITH SHORT
from 46 to 75 kg (median 57), the Body Mass Index (BMI) was
BOWEL SYNDROME: PARENTERAL SUPPORT AND
ranged from 15,5 to 23,1, median 20,7. Body weight after ITx at
BIOELECTRICAL IMPEDANCE ANALYSIS IN CLINICAL ROUTINE
the end of follow up was ranged from 49 to 98 kg (median 60,5)
and the BMI after ITx was ranged from 17,4 to 39,3 (median S. Pevny1, S. Maasberg1, M. Karber1 *, B. Knappe-Drzikova1,
21,5). In 4 patients bodyweight was increased with 6–41 kg D. Thurmann1, A. Pascher2, U.-F. Pape1. 1Department of
(median 16), the bodyweight of one patient remained the Gastroenterology, Hepatology and Endocrinology, 2Department
same, for one patient the bodyweight decreased with 15 kg of General, Visceral and Transplantation Surgery, Charité
(BMI 17,4). At the end of follow up, the graft of 6 patients was University Medicine Berlin, Berlin, Germany
intact, 2 patients died, in 2 patients the graft had to be
Rationale: Teduglutide (TED), an analogue of the gastrointes-
removed because of rejection. All patients were able to eat a
tinal hormone glucagon like peptide-2 (GLP-2) that promotes
regular diet at hospital discharge, only 1 of them needed
regeneration of the intestinal mucosa, is effective for
additionally TPN.
enhancing intestinal adaption in patients ( pts) with short
Conclusion: After intestinal transplantation, in 67% of the
bowel syndrome (SBS) and chronic intestinal failure. Data of
patients the BMI increases with a regular diet and without TPN.
clinical routine treatment are not available yet.
Disclosure of Interest: None declared. Methods: Center based prospectively collected clinical and
paraclinical data of pts with benign SBS were analyzed
MON-P072 retrospectively from a single university hospital. Within a
VISCERAL ADIPOSITY AND SARCOPENIC OBESITY ARE CLOSELY subcohort, nutritional status was assessed in clinical routine by
ASSOCIATED WITH MORTALITY AND RECURRENCE AFTER bioelectrical impedance analysis (BIA).
PANCREATIC CANCER RESECTION: USEFULNESS OF BODY Results: In total, 24 pts with heterogeneous bowel anatomy
COMPOSITION ANALYSIS were treated since Oct. 2014. Three month after initiation of
S. Okumura1 *, T. Kaido1, Y. Hamaguchi1, A. Kobayashi1, TED treatment pts showed a 2,679 ml (17%) reduction in
H. Shirai1, S. Yao1, S. Yagi1, N. Kamo1, K. Takaori1, S. Uemoto1. intravenous fluid (IVF) requirements (n = 17; p = 0.007) and a
1
Division of Hepato-Biliary-Pancreatic Surgery and 1,522 kcal (17%) reduction in intravenous energy requirement
Transplantation, Kyoto University, Kyoto, Japan (n = 17; p = 0.007) per week. After one year, the difference of
reduction approximately doubled (n = 9; p = 0,001 and p = 0,005
Rationale: Sarcopenia and muscle steatosis, characterized as resp.) accompanied by a significant reduction in parenteral
the decrease in muscle mass and function, have been identified nutrition (PN) of 1.9 days/week ( p = 0,01) and no reduction in
as poor prognostic factors for pancreatic cancer. However, the IVF days/week. Three out of 20 pts (15%) who are currently
significance of visceral adiposity and sarcopenic obesity on on TED were weaned off PN after a mean treatment of 25
outcomes after the resection of pancreatic cancer remains weeks (SD: 12 wks.), two continuing on IVF. Analysis of BIA
unclear. parameters revealed stability in body mass index, phase angle
Methods: A retrospective analysis of 301 patients who α, body cell mass, and intra- or extracellular water albeit
underwent resection for localized pancreatic cancer between reduction in parenteral support after 24 (n = 9) and 45 (n = 7)
2004 and 2015 was performed. Visceral adiposity [visceral to weeks on TED.
subcutaneous adipose tissue area ratio (VSR)] was measured on Conclusion: The gradual reduction of IVF and PN support
preoperative computed tomography images, together with in TED-treated SBS demonstrates a beneficial effect at no
visceral fat area (VFA), skeletal muscle index (SMI) and muscle cost of body composition suggesting stability of nutritional
attenuation (MA). The impacts of these body composition status with improved intestinal function. Applying BIA for
parameters on outcomes after pancreatic resection were monitoring body composition as a surrogate of nutritional
analyzed. status in clinical routine can guide decision making in IVF/PN
Results: The overall survival (OS) and recurrence-free survival management.
(RFS) rates were significantly lower in patients with high VSR Disclosure of Interest: S. Pevny: None declared, S. Maasberg: None
than those in patients with low VSR (P = 0.001, P = 0.007, declared, M. Karber: None declared, B. Knappe-Drzikova: None
respectively). There were no differences in OS and RFS declared, D. Thurmann: None declared, A. Pascher: None declared,
between high VFA and low VFA group, however, when analyzed U.-F. Pape Grant/Research Support from: Shire, Speaker Bureau of: Shire.
MON-P074 parameters (bilirubin, triglycerides, cholesterol, ALT, AST,

PARENTERAL OLIVE OIL IMPROVES LIVER FUNCTION IN GGT) were analysed before and after the change of LE.
INTESTINAL FAILURE PATIENTS: RANDOMIZED, CONTROLLED Statistical analysis was performed using Student’s t-test and
CLINICAL TRIAL Mann-Whitney test. A p-value <0.05 was considered to indicate
S. Klek1 *, K. Szczepanek2, L. Scislo3, E. Walewska4, M. Pietka2, statistical significance.
M. Pisarska5, M. Pedziwiatr6. 1General and Oncology Surgery Results: There were no statistically significant differences in
Unit with Intestinal Failure Center, 215 Tyniecka Street, any of the examined parameters before and after change of LE.
Stanley Dudrick’s Memorial Hospital, Skawina, 3Department of However, in both groups there were patients with a high level of
Clinical Nursing, 42Department of Clinical Nursing, 52nd Dept GGT at the beginning of the experiment (twice the norm and
of Surgery, 62nd Dept of Surgey, Jagiellonian University, above). In the IS group there were 6 such patients before
Krakow, Poland changing to Smoflipid and the change of LE from Intralipid to
Smoflipid resulted in the decrease of GGT in 5 patients. The
Rationale: Intravenous lipid emulsion (IVLE) is the essential decrease was up to 60%. In the IC group there were 10 patients
component of parenteral nutrition (PN), but also one the key with high GGT before changing to Clinoleic. The change from
risk factors for the intestinal failure related liver disease Intralipid to Clinoleic decreased GGT in 6 patients and
(IFALD). There is a variety of IVLE commercially available, of increased it in 4. Because of the small number of patients we
various generations, from long-chained triglycerides to multi- did not statistically analyse these data.
IVLE solution. A comprehensive research comparing long term Conclusion: A change of LE may influence patients with liver
hepatic effect of IVES, has never been done, hence it became problems, characterised by high GGT. Smoflipid seems to be
the aim of the study effective at improving GGT. A future study should focus on long-
Methods: A randomized, controlled clinical trial was per- term PN patients with liver problems.
formed at the Intestinal Failure Center, between January, the Disclosure of Interest: None declared.
1st 2010 and December, the 31st, 2015. Sixty-seven patients (37
F, 30 M, mean age 53.9) receiving home parenteral nutrition MON-P076
(HPN) due to stable chronic intestinal failure (CIF), were LOW FODMAP DIET IMPROVES SYMPTOMS AND QUALITY OF
randomized to receive one the following lipid emulsions for 12 LIFE IN PATIENTS WITH RADIATION INDUCED SMALL BOWEL
months: long-chained triglycerides (LCT), medium/long-
DISEASE: A PILOT STUDY
chained triglycerides (MCT/LCT), olive oil/LCT (OO/OCT) and
SMOFlipid. Liver function was assessed clinically and with T. Larsen1 *, T. Hausken1,2, S. O. Ystad1,3, N. Hovdenak1,2,
biochemical parameters: SGOT, SGTP, GGPT, serum bilirubin G. A. Lied1,2. 1Department of Clinical Medicine, Center for
Results: The most common reason for CIF was short bowel due Nutrition, University of Bergen, 2Section of Gastroenterology,
to mesenteric ischaemia, then Crohn’s disease, surgical Department of Medicine, 3National Centre of Functional
complications and radiation enteritis. The omega-9 based Gastrointestinal Disorders, Haukeland University Hospital,
lipid emulsion proved to be the only one capable of reducing Bergen, Norway
the bilirubin concentration (28.1 ± 25.3 at the beginning vs
Rationale: Patients suffering chronic radiation induced small
11.1 ± 4.5 at the end, p = 0.0023) as well as GGTP (222.5 ± 205.8
bowel disease (RISBD) after cancer treatment have similar
vs 146.6 ± 197.7, p = 0.0079). No other lipid emulsion exerted
symptoms as IBS (irritable bowel syndrome) patients despite
such an effect.
dissimilar pathological origin. The low FODMAP (fermentable
Conclusion: The omega-9-IVLE were the only emulsions, which
oligo-, di-, monosaccharides and polyols) diet (LFD) is a
demonstrated hepato-protective effect. It may suggest the it
widespread management strategy for IBS. The aim of this
should become an obligatory IVLE for long-term PN patients.
study was to investigate the effects of LFD on symptoms and
Disclosure of Interest: None declared. health related quality of life (HRQOL) for RISBD patients.
Methods: In an open pilot study, eleven patients with RISBD-
MON-P075 related IBS symptoms were instructed to follow LFD throughout
INFLUENCE OF DIFFERENT LIPID EMULSIONS ON LIVER a 4-week intervention period. IBS Severity Scoring System (IBS-
PARAMETERS IN PATIENTS ON LONG-TERM PARENTERAL SSS) and IBS Symptom Questionnaire (IBS-SQ) were used to
NUTRTION assess symptoms. An ad hoc questionnaire measured grade of
S. Osowska1 *, M. Kunecki2, M. Omidi1, J. Tokarczyk2, damage and typical RISBD complaints. Short Form Nepean
K. Majewska1, J. Sobocki1. 1Warsaw Medical University, Dyspepsia Index (SF-NDI) and 12-item Short Form Health Survey
Warsaw, 2Pirogow Hospital, Łódz,́ Poland (SF-12) were used to evaluate HRQOL. Baseline FODMAP intake,
additional dietary changes and adherence to the diet were
Rationale: The aim of this pilot study was to examine how a estimated from a 3-day food record. All forms were filled at
change of lipid emulsion (LE) influences liver parameters in baseline and at 4 weeks.
patients on long-term parenteral nutrition (PN). Results: FODMAP intake was successfully reduced, and add-
Methods: We obtained blood samples from 38 adult patients itional dietary changes were reduced intake of energy,
with intestinal failure on long-term (>2 years) PN from two PN carbohydrates and fiber. The adherence to the diet was high
centres in Poland (Warsaw and Łódz)́ . Patients with ongoing (mean 94.8%). IBS symptoms improved significantly based on
acute infections were excluded from the study. The PN regimen mean total score of IBS-SSS and IBS-SQ, which changed
of 15 patients changed from Intralipid to Smoflipid (IS group) respectively from 310.2 to 171.4 ( p = 0.001) and 27.4 to 15.7
and of 23 patients from Intralipid to Clinoleic (IC group). The ( p = 0.002). HRQOL improved based on SF-NDI (30.5 ± 9.4 to
patients were on the changed PN regimen for 2 months. Liver
S208 Poster
18.3 ± 8.2, p = 0.001) and based on the mental ( p = 0.047) and height were measured. BMI Z-scores were calculated.
the physical ( p = 0.134) component score of SF-12. Participants were classified as normal weight, overweight or
Conclusion: The low FODMAP diet seems effective in alleviat- obese at their last visit according to WHO BMI Z scores
ing IBS symptoms, and improving HRQOL in RISPBD patients. classification [normal: +1 to −1 standard deviation (SD),
High compliance to LFD is possible with adequate and overweight and obese: >1 SD]. Energy and macronutrients
continuous diet counseling. Further research should be intakes were analyzed from a parent-reported 3 days food
conducted to enable implementation of LFD as a future record. The percentage of energy intakes were expressed in
management strategy for RISBD. relative to the Turkey Dietary Guidelines. Mean percentage of
Disclosure of Interest: None declared. energy from protein, carbohydrate and fat was calculated.
Results: 52.9% of the survivors were overweight or obese.
The percentage of mean energy intake in relative to the
MON-P077
guideline was 103.9% ± 19.3% for normal BMI patients and
THE NEUTROPHIL-TO-LYMPHOCYTE RATIO PREDICTS
107.4% ± 26.9% for overweight-obese patients ( p > 0.05). Mean
MALIGNANT POTENTIAL IN PANCREATIC NEUROENDOCRINE
percentage of energy from protein were not different in
NEOPLASMS
overweight-obese patients (14.8% ± 1.7%) vs normal BMI
Y. Zhang1 *, H. Wu1. 1Pancreatic Surgery, Union Hospital, patients (14.9% ± 1.5%). Whereas mean percentage of energy
Wuhan, China from carbohydrates were higher in overweight-obese group
(48.1% ± 4.4% vs 43.3% ± 4.0%) ( p < 0.05), mean percentage of
Rationale: Accurately identifying malignant components in
energy from fats (42.3% ± 3.1% vs 36.8% ± 4.5%) ( p < 0.01) were
patients with pancreatic neuroendocrine neoplasms (PanNEN)
higher in normal BMI group.
remains challenging. Neutrophil-to-lymphocyte ratio (NLR) is a
Conclusion: The results of this study showed that eating habits
marker of poor prognosis in oncological patients. Our aim was
play an important role in obesity development in the survivors
to evaluate whether NLR was predictive of pancreatic
of pediatric ALL. Interventions are needed to address weight
neuroendocrine carcinoma (PanNEC) in PanNEN.
control after the treatment, particularly for patients who are
Methods: A total of 146 patients with PanNEN who underwent
overweight or obese.
surgery in Union Hospital (Wuhan, China) from 2005 to 2016
were included. The association between the presence of Disclosure of Interest: None declared.
malignant components and preoperative NLR was analyzed.
Results: Compared to patients with pancreatic neuroendocrine MON-P079
tumor (PanNET) (n = 119), patients with PanNEC (n = 27) IS OVERWEIGHT AND OBESITY HIGHER IN SURVIVORS OF
showed higher value of preoperative NLR (2.04 [1.50–2.79] vs. ACUTE LYMPHOBLASTIC LEUKEMIA CHILDREN?
2.92 [1.81–3.79]; P = 0.003). After multivariate analysis, NLR K. Tel Adıgüzel1 *, O. Gürsel2, H. Gokmen Ozel1. 1Nutrition and
value >2.47 (hazard ratio [HR] 4.45, 95% confident interval [CI]: Dietetics Department, Faculty of Health Sciences, Hacettepe
1.61–12.34; p = 0.004), CA19–9 > 37 IU/ml (HR 3.81, 95% CI: University, 2Pediatric Heamotology Department, Gülhane
1.01–14.43; p = 0.048), and tumor diameter > 3 cm (HR 7.35, Education and Research Hospital, Ankara, Turkey
95% CI: 2.45–11.95; p < 0.001) and were identified as an
independent prognostic factor. NLR > 2.47 shows a high Rationale: A high prevalence of obesity has been increased in
specificity of 71.4% and high negative predictive value of 91.4%. childhood cancers survivors. In particular, survivors of pediatric
Conclusion: Preoperative NLR is a useful predictor for acute lymphoblastic leukemia have been found to be at risk of
diagnosing PanNEC in patients with PanNEN. becoming overweight or obese. The aim of this study was to
Disclosure of Interest: None declared. evaluate overweight and obesity in acute lymphoblastic
leukemia (ALL) and survivors of leukemia children.
Methods: Nine children (5 boys, 4 girls) aged 4–12 years with
acute lymphoblastic leukemia (Group A) and 17 survivors of
Nutrition and cancer 2 leukemia (Group B) (10 boys, 7 girls, aged 4–13 years) were
MON-P078 included. Mean age of children (±SD) was 9.3 ± 2.7 years in
DO NUTRITIONAL INTAKES AFFECT ON BODY MASS INDEX IN Group A and 9.0 ± 3.1 years in Group B. The mean survival time
SURVIVORS OF ACUTE LYMPHOBLASTIC LEUKEMIA CHILDREN? after cancer treatment was 21.9 months (6–48 months) in Group
B. Body weight and height were measured. BMI Z-scores were
K. Tel Adıgüzel1 *, O. Gürsel2, H. Gokmen Ozel1. 1Nutrition and
calculated using WHO Anhtro Plus programme and compared
Dietetics, Facuty of Health Sciences, Hacettepe University,
2 between Group A and B. WHO BMIZ scores were used to classify
Pediatric Heamotology, Gülhane Education and Research
into: overweight and obese: >1 standard deviation (SD).
Hospital, Ankara, Turkey
Results: Types of leukemia were pre-B ALL (55.6%), B-ALL
Rationale: Survivors of pediatric acute lymphoblastic leukemia (44.4%) in Group A and pre-B ALL (82.4%), B-ALL (5.9%) and
(ALL) are at risk becoming overweight or obese after the T-ALL (11.8%) in Group B. Whereas there were no overweight
treatment. ALL survivors, may have a poor adherence to the and obese patients in Group A, 35.3% and 17.6% of children
dietary guildelines. The aim of this study was to evaluate were overweight and obese in Group B, respectively. BMI Z-
energy and macronutrient intakes in survivors of pediatric ALL. scores were significantly higher in Group B (1.01 ± 1.24) than
Methods: A total of 17 survivors of ALL aged 4–13 years (10 Group A (−0.24 ± 1.16) ( p < 0.01).
boys, 7 girls) were included. The mean age at enrollment (±SD) Conclusion: The results of this study showed that acute period
was 9.0 ± 3.1 yrs. The mean survival time after cancer of leukemia effects BMI negatively and survivors of acute
treatment was 21.9 months (6–48 months). Body weight and
lymphoblastic leukemia are at increased risk for several MON-P081

cardiometabolic complications such as overweight and PHASE ANGLE AND BODY COMPOSITION IN PATIENTS WITH
obesity. Since nutrition plays an important role in the etiology LOCALLY ADVANCED CERVICAL CANCER IB2-IVA WITH OR
of overweight and obesity, energy and nutreint intakes of these WITHOUT COMORBIDITIES
children should be evaluated regularly. Healthy dietary L. Flores-Cisneros1,2 *, V. Casique-Pérez1,
recommendations may decrease risk of weight gain and U. Velázquez-Morales1, L. Castillo-Martínez2, L. Cetina-Pérez1,
subsequent risk of cardiometabolic complications after R. Jiménez-Lima1, D. Castro-Eguiluz1, M. Sánchez-López1.
cancer treatment. 1
Instituto Nacional de Cancerología, 2Instituto Nacional de
Disclosure of Interest: None declared. Ciencias Medicas y Nutricion ‘Salvador Zubiran’, MEXICO CITY,
Mexico
MON-P080
IS ENERGY AND MACRONUTRIENTS INTAKE DIFFERENT Rationale: Patients with cancer have a greatest risk for
BETWEEN CHILDREN WITH ACUTE LYMPHOBLASTIC developing malnutrition. A clinical manifestation can include
LEUKEMIA AND SURVIVORS OF LEUKEMIA WHOSE BODY skeletal muscle wasting, anemia, anorexia and altered immune
WEIGHT NORMAL? function. Comorbidities can condition a worse malnutrition
status. The phase angle (PA) and body composition are
K. Tel Adıgüzel1 *, O. Gürsel2, H. Gokmen Ozel1. 1Nutrition and techniques which permit identify malnutrition. However PA it
Dietetics Department, Faculty of Health Sciences, Hacettepe has been associated as a good prognosis indicator in these
University, 2Pediatric Heamotology Department, Gülhane patients.
Education and Research Hospital, Ankara, Turkey Objective: To evaluate the body composition and phase angle
in patients with cervical cancer and comorbidities.
Rationale: Survivors of pediatric cancer have been found to
Methods: Cross-sectional study was performed in twenty
be at risk of becoming overweight or obese. Poor diet may
subjects with locally advanced cervical cancer IB2 – IVA older
increase the risk that childhood cancer survivors will suffer
than 18 years old were included. Chronic kidney disease, lupus,
from chronic disease. The aim of this study was to evaluate
HIV was excluded. Chi-square and t-test for independent
energy and macronutrient intakes in acute lymphoblastic
samples were performed in order to contrast the differences
leukemia (ALL) and survivors of leukemia whose body weight
between the groups without and with comorbidities (diabetes
normal.
type II, systemic hypertension and geriatrics). Lineal regression
Methods: Eight children (4 boys, 4 girls) aged 4–12 years with
was performed to evaluate the PA between groups adjusted by
ALL and 8 survivors of ALL (4 boys, 4 girls, aged 4–13 years)
confounding variables.
whose body weight normal were included. The mean survival
Results: 20 subjects were evaluated (10 without comorbidities
time after the treatment was 21.9 months (6–48 months). Body
and 10 with comorbidities). Patients with comorbidities
weight and height were measured. WHO BMIZ scores were used
presented higher age (62 ± 10.6 vs 38.5 ± 9.6, p < 0.001), less
to classify into: normal: +1 to −1 standard deviation (SD).
mid-upper arm circumference (27.7 ± 2.5 vs 30.7 ± 2.3, p =
Energy and macronutrients intakes were analyzed from a
0.08) lean body mass (54.2 ± 12.3 vs 63.7 ± 3.9%, p = 0.08), third
parent-reported 3 days food record. The percentage of energy
space (0.47 ± 0.5 vs −0.56 ± 0.64, p = 0.013) and phase angle
intakes were expressed in relative to the Turkey Dietary
(5.2 ± 0.96 vs 6.2 ± 0.85) p = 0.026 than subjects without
Guidelines. Mean percentage of energy from protein, carbo-
comorbidities. Patients with comorbidities had −1.10 less PA
hydrate and fat was calculated.
[β: −1.10; 95% CI: −2.173 to −0.0324, p = 0.044] compared with
Results: The mean energy intake percentage in relative to the
no comorbidities patients adjusted by age.
National Gudelines was higher in survivors of ALL (103.9% ±
Conclusion: Patients with cervical cancer and comorbidities
19.3%) than ALL patients (73.9% ± 21.9%) ( p < 0.05). Mean
present a deteriorated body composition and phase angle,
percentage of energy from protein were not different in ALL
which could have negative implications in diagnosis and
patients (15.5% ± 1.2%) compared to survivors (14.8% ± 1.7%).
clinical stage.
Mean percentage of energy from carbohydrates were higher in
ALL patients (51.4% ± 2.8% vs 43.3% ± 4.0%) ( p < 0.001) and Disclosure of Interest: None declared.
mean percentage of energy from fats were higher in survivors
of ALL (42.3% ± 3.1% vs 33.1% ± 2.6%) ( p < 0.001). MON-P082
Conclusion: The results of this study showed that energy and MUSCLE MASS LOSS (MML) ASSESSED BY ABDOMINAL CT
fat intakes were higher among survivors of ALL patients whose AFFECTS LONG-TERM SURVIVAL AFTER LIVER RESECTION FOR
body weight normal. Survivors of ALL may be more susceptible INTRA HEPATIC CHOLANGIOCARCINOMA (ICC)
to overweight and obesity caused by poor nutrition. L. Lacaze1 *, D. Bergeat2, E. Bardou-Jacquet3, A. Merdrignac1,
Prospective intervention trials are needed to establish P. Meurice4, D. Val-Laillet4, K. Boudjema1, R. Thibault5.
dietary guidelines for preventing obesity, among survivors of 1
Digestive and Hepatobiliary Surgery, University hospital,
childhood cancers. 2
Digestive and Hepatobiliary Surgery, University Hospital,
3
Disclosure of Interest: None declared. Hepatology, University Hospital, Rennes, 4INRA, Saint Gilles,
5
Nutrition, University Hospital, Rennes, France
Rationale: MML was identified to be independently associated

with poor prognosis in colorectal liver metastases and
hepatocellular carcinoma. This has never been studied after
S210 Poster
liver resection for ICC. Measuring the two psoas areas (PA) on swallowing problems followed by pain, fatigue, lack of
computed tomography (CT) is a simple tool to evaluate MML. appetite, constipation and dry mouth. Enteral/parenteral
Aim: To evaluate the prevalence of MML in patients who nutrition was received by 6% of patients within the last
underwent liver resection for ICC and to assess the prognostic month. More than 90% indicated that they were completely or
impact on patients’ survival. very satisfied with care they received.
Methods: All consecutive patients who underwent liver Conclusion: Patients with HN or E CA present to Canadian
resection for ICC between 2004 and 2016 and who had available cancer settings with weight loss and reduced oral intake
preoperative CT were included. PA measurement was per- however a minority receive artificial nutrition prior to
formed at the transversal level of the third lumbar vertebra by admission. Patients appear to be highly satisfied with the
one single non-radiologist operator with the ImageJ software quality of care they receive at the onset of diagnosis. Follow up
with a threshold range between −29 and +150 Hounsfield units data and inclusion of international settings will further
corresponding to muscle density. Univariate and multivariate illuminate nutrition practices, outcomes and experiences of
analysis for disease-free survival were realized using the Cox this high-risk population.
model. Disclosure of Interest: L. Gramlich Grant/Research Support from:
Results: 102 patients were included. 37% MML, 74% men, Fresenius-Kabi, Nutricia, Baxter, R. Dhaliwal Other: Nestle, Baxter.
median age 67 yrs, 82% ASA score greater than or equal to
2. Median PA was 1,166.2 mm2 in MML group and 2,132.7 mm2 in MON-P084
normal muscle mass group. The median body mass index (BMI) CLINICAL OUTCOME AND QUALITY OF LIFE IN PATIENTS WITH
was 25.3 kg/m2 (IQ = 23.5–28.4). On multivariate analysis, MML ADVANCED CANCER RECEIVING HOME PARENTERAL
was found to be an independent predictor of disease-free NUTRITION
survival (DFS) (Hazard ratio (HR) = 0.99 [95% confidence interval
(CI), 0.999–1.000], p = 0.038), metastatic lymph node (HR = L. C. Sun1,2 *, Y.-L. Shih1,2, J.-Y. Wang2,3,4. 1Division of Nursing,
2
2.359 [1.186–4.691], p = 0.021), chemotherapy (HR = 2.445 Nutrition Support Team, 3Division of Colorectal surgery,
[1.173–5.094], p = 0.017), tumor size (HR = 1.106 [1.024– Departments of Surgery, 4Department of Surgery, Faculty of
1.193], p = 0.01), BMI (HR = 1.093 [1.013–1.180], p = 0.021) Medicine, College of Medicine, Kaohsiung Medical University
were also found to be associated with a poor DFS. Hospital, Kaohsiung, Taiwan, Province of China
Conclusion: MML is an independent prognostic factor of poor
Rationale: Parenteral nutrition (PN) is indicated in advanced
DFS in European patients with resectable ICC. This could be
cancer patients with poor gastrointestinal function and
used to select patients and to implement adapted nutritional
inadequate enteral nutrition. When patients need PN supply
management before surgery.
outside the hospital, home PN (HPN) should be continued for
Disclosure of Interest: None declared. nutrition support. The study investigated the survival time,
quality of life (QoL), nutritional outcome of advanced cancer
MON-P083 patients receiving HPN.
INTERNATIONAL NUTRITION AUDIT IN FOREGUT TUMORS Methods: Fifty-four advanced cancer patients receiving HPN
(INFORM): A LOOK AT CANADIAN PATIENT EXPERIENCES were enrolled during December 2014 and January 2017. QoL
L. Gramlich1 *, R. Dhaliwal2, on behalf of the INFORM Study and nutritional status were measured at baseline and each
Investigators. 1Medicine, 2University of Alberta, Alberta month visit using EORTC QLQ-C 30 and laboratory data. Qol and
Health Services, Edmonton, Canada nutritional status were analyzed in five different time at after
1, 2, 3, 4 or 5 months. Overall survival (OS) was defined as the
Rationale: Patients with foregut tumors are at high risk of time interval between the dates of HPN start till the death or
malnutrition due to the complex nature of their disease and the last visit, and was also compared.
lengthy treatment. This paper describes nutrition practices and Results: There were 31 (57.4%) males and 23 (42.6%) females.
patient generated experiences in head/neck (HN) and esopha- Thirsty-one patients (57.4%) were stomach cancer and 20 (37%)
geal (E) cancer (CA) patients upon presentation to Canadian were colorectal cancer and 3 (5.6%) were other malignancy.
settings. After one month of HPN (n = 38) there was a significant worse in
Methods: In a multicenter prospective audit, consenting adult role of function (P = 0.002); while after 2 month of HPN (n = 21)
patients with curative HN or E CA were enrolled from 6 cancer there was a significant worse in physical function (P = 0.014).
care settings in Canada. Patients were followed by the However, after 4 and 5 months of HPN there was a significant
registered dietitian from presentation to the cancer care improvement in body weight (BW) and body mass index (BMI)
setting (baseline) to a maximum of 6 months. Baseline patient (both P < 0.05). After 5 months of HPN, there were a significant
characteristics, nutrition practices, patient generated subject- improvement in fatigue (P = 0.015). The median duration of
ive global assessment (PG-SGA) and satisfaction with care HPN was 3.9 months (range 1–23). Meanwhile, HPN patients
(CANHELP lite) are reported. administrated for at least 1 month had a significantly better OS
Results: Preliminary: A total of 71 patients were enrolled (42 than those with less than 1 month (P = 0.016).
HN, 29 E CA), average recruitment of 2.2 patients per week. Conclusion: HPN revealed the improvement in QoL, OS and
Average age was 62.3 yrs, BMI 28.4 and 77% were males. Thirty- nutritional status, and the obvious benefit was observed in
seven % patients were assessed by a dietitian within 1 month of patients after 4 months of HPN, although patients receiving
diagnosis. According to the baseline PGSGA, 34% patients HPN after 1 and 2 months revealed the prominent worse in role
reported a decrease in weight within the last 2 weeks and 46% and physical function, respectively.
reported a reduced oral intake within the last month. Disclosure of Interest: None declared.
Symptoms most likely to result in reduced intake were
MON-P085 different degrees. This study investigated incidence of muco-

NUTRITIONAL CHANGES IN PATIENTS WITH LOCALLY sitis, nutritional risk (NRS) and artificial nutritional therapy.
ADVANCED HEAD AND NECK CANCER DURING TREATMENT Methods: A retrospective observational cohort included all
L. Arribas1,2,3 *, L. Hurtós4, M. Taberna2,3,5,6, I. Peiró4, adult patients treated with HDT prior to stem cell transplant-
E. Vilajosana2,5, A. Lozano2,7, R. Mesia2,5, N. Virgili8. 1Clinical ation due to lymphoma or multiple myeloma at Aalborg
Nutrition Unit, Catalan Institute of Oncology (ICO), IDIBELL, University Hospital during 20 months. Data was extracted
L’Hospitalet de Llobregat, Barcelona, 2Head and Neck Unit, from patient records, and followed patients during the 21-day
Bellvitge University Hospital-, Catalan Institute of Oncology treatment. Statistics: Comparisons; student’s t-test, Mann-
(ICO), L’Hospitalet de Llobregat, Barcelona, 3University of Whitney, or X 2 test. Environmental risk factors by Cox
Barcelona, Barcelona, 4Clinical Nutrition Unit, 5Medical proportional hazards.
Oncology Department, 6Cancer Epidemiology Research Results: A high incidence of mucositis was seen, with highest
Program, 7Radiation Oncology Department, Catalan Institute occurrence in the BEAM population ( p = 0.02). The prevalence
of Oncology (ICO), IDIBELL, 8Nutrition and Dietetics Unit, of nutritional risk increased during treatment in both groups
Nutrition and Endocrinology Department, Bellvitge University ( p = 0.47), and 41% were treated with EN or PN. An elevation of
Hospital, L’Hospitalet de Llobregat, Barcelona, Spain sodium ( p = 0.00) as well as potassium (K) ( p = 0.02) before
upstart of treatment, increased duration of mucositis and
Rationale: The purpose of the study is to evaluate changes in elevation of sodium (Na) (=0.03) decrease in time to mucositis.
body composition and nutritional status that occur throughout
the oncological treatment. All HDT BEAM Melphalan
Methods: A prospective cohort observational study in patients population cohort cohort
diagnosed with head and neck squamous cell carcinoma N= (%Female) 66(35) 23(43) 43(30)
(HNSCC) that underwent treatment with induction chemother- Mucositis N(%) Yes 48(73) 21(91) 27(63)
apy (iCT) followed by chemoradiotherapy or bioradiotherapy NRS risk prior to 32(48) 9(39) 23(47)
treatment N(%)
were invited to participate. All patients had dietetic counseling NRS risk during 61(92) 22(96%) 39(91%)
from the diagnosis and a close monitoring throughout the treatment N(%)
treatment implementing nutritional support as needed.
Results: From June 2011 until October 2012, 20 patients were
Conclusion: Mucositis and nutritional risk is common in HDT,
included. Nutritional and anthropometric parameters were
with high prevalence of need for EN/PN. Attention should be
collected at diagnosis, post iCT, after RT, 1 and 3 months post
given to prevention and timing of nutritional therapy, as well as
radiotherapy. According to Patient Generated Subjective
studies looking into K and Na.
Global Assessment, 30% were malnourished at diagnosis.
After iCT there was an increase in weight, body mass index Disclosure of Interest: None declared.
(BMI) and fat free mass (FFM) with almost complete improve-
ment in dysphagia and odynophagia. Nevertheless a significant MON-P087
nutritional deterioration ( p = 0.0022) occurred at the end of HIGH-RADIODENSITY SKELETAL INDEX AS PREDICTOR OF
radiotherapy with 95% of patients becoming severe or EARLY MORTALITY IN OVARIAN ADENOCARCINOMA
moderate malnourished. Nutritional parameters such as K. D. A. Bruno1, N. S. de Paula1, M. A. Aredes1, G. V. Chaves1 *.
weight, BMI and hand grip strength also decrease significantly 1
Nutrition and Dietetics, Brazilian National Cancer Institute –
during treatment. INCA, Rio de Janeiro, Brazil
Conclusion: Despite an intensive nutritional support from the
diagnosis throughout the oncological treatment in advanced Rationale: This study aimed to determine the prognostic value
HNSCC cancer patients, nutritional status deteriorates during of the quantitative and qualitative parameters of the skeletal
RT. Our findings suggest that iCT may help improve nutritional muscle (SM) in patients with ovarian adenocarcinoma.
status by ameliorating the symptoms that limit the oral intake. Methods: In a retrospective cohort, we included patients with
This improvement in the nutritional status could contribute to ovarian adenocarcinoma, enrolled between 2008 and 2015,
minimize further deterioration. Further investigations are who had a CT scan (CT) available within 45 days before any
needed involving novel approaches to avoid nutritional cancer treatment. Sociodemographic and clinical data were
deterioration. collected, as well as one-year survival. CT images at the third
Disclosure of Interest: None declared. lumbar vertebra (L3) were used to assess overall skeletal
muscle index (SMI) using the standard range −29 to +150
Hounsfield Units (HU), which was afterwards divided into sub-
MON-P086
ranges of radiation attenuation: low-radiodensity skeletal
RISK OF MUCOSITIS IN HDT PRIOR TO STEM CELL
muscle index (LRSMI, in the range −29 to + 29 HU) representing
TRANSPLANTATION
SM area with increased intramyocellular triglycerides, and the
L. Drustrup1, M. Holst2 *. 1Department of Clinical Medicine, high-radiodensity skeletal muscle index (HRSMI, in the range
Aalborg University, 2Center for Nutrition and Bowel Disease, +30 to +150 HU), representing the area with low fat infiltration.
Aalborg University Hospital, Aalborg, Denmark Sarcopenia was defined when SMI was ≤38.9 cm2/m2. Kaplan-
Meier method and Cox Regression evaluated one-year survival.
Rationale: Mucositis is one of the most significant side effects
All statistical analysis were considered statistically significant
reported in patients receiving high-dose chemotherapy (HDT)
when p < 0.05.
prior to stem cell transplantation due to hematology disease.
Mucositis induces pain, diarrhea and reduced food intake in
S212 Poster
Results: Sarcopenia was found in 34.5% of the 139 eligible improvement in strength when evaluated by the 30 second
patients, although it was not associated to one-year mortality. chair test. Approximately 75% and 71% of the patients who
Patients in the lower quartile of the HRSMI had a shorter experienced moderated and severe SMI loss were allocated in
survival time, compared to patients in the upper quartiles CG. Conversely, 73.3% of the patients that experienced
( p = 0.014). In multiple cox regression, HRSMI was the only intramuscular fat gain (in terms of LRSMI) were in the CG.
independent predictor of shorter survival (HR: 2.852; CI: 1.17– Conclusion: Despite not having an effect on preventing SMI
6.95; p = 0.021). loss, omega-3 seems to prevent the intramuscular fat infiltra-
Conclusion: These results indicate that SM quality, specifically tion in the SM, resulting in preservation of SM quality after
the amount of HRSMI, directly implies in poor prognosis of cancer treatment.
patients with ovarian adenocarcinoma. More studies are Disclosure of Interest: None declared.
needed to understand the role of the HRSMI in cancer
outcomes. MON-P089
Disclosure of Interest: None declared. RESTING ENERGY EXPENDITURE IN ONCO-HEMATOLOGICAL
PATIENTS DURING HEMATOPOIETIC STEM CELL
MON-P088 TRANSPLANTATION
EFFECTS OF SUPPLEMENTATION WITH OMEGA-3 ON BODY M. Motilla De La Cámara1 *, L. Arhip1, I. Bretón Lesmes1,
COMPOSITION AND FUNCTIONAL CAPACITY IN PATIENTS WITH M. Camblor Alvarez1, V. Velasco Gimeno1,
CERVICAL CANCER IN CHEMORADIOTHERAPY: PRELIMINARY M. L. Carrascal Fabian1, A. Morales Cerchiaro1, G. Feo Ortega1,
RESULTS M. Kwon2, P. García Peris1, C. Cuerda Compés1. 1Nutrition Unit,
2
M. A. Aredes1, A. O. da Camara1, N. S. de Paula1, G. V. Chaves1 *. Hematology Service, Hospital General Universitario Gregorio
1
Nutrition and Dietetics, Brazilian National Cancer Institute – Marañón, Madrid, Spain
INCA, Rio de Janeiro, Brazil Rationale: There are few studies evaluating resting energy
Rationale: We aimed to evaluate the effect of omega-3 expenditure (REE) measured by indirect calorimetry (IC) in
supplementation on body composition, with emphasis on adult patients during hematopoietic stem cell transplantation
skeletal muscle quality, and functional capacity in cervical (HSCT). The aims of the study were: measure REE by IC and
cancer patients undergoing chemoradiotherapy. compare it with the Harris-Benedict Equation (HBE) and
Methods: Randomized controlled trial, triple blinded. contrast the individual energy requirements to ESPEN 2016
Patients were randomly assigned (2:1) at enrolment to the guidelines for cancer patients.
control group (CG) or intervention group (IG). CG received olive Methods: This is a prospective observational study in HSCT
oil and IG fish oil (2g eicoisapentaenoic acid). Data collection patients. Age, sex, and BMI were collected. REE was measured
occurred the day before the treatment and the other after 45 pre-HSCT, at D + 7 and D + 14, at discharge and post-discharge
days. Patients were assessed for weight, body composition, and after overnight fast by Fitmate®Cosmed and HBE. Results are
functional capacity by handgrip strength and 30 second chair expressed as median [interquartile range]. Non-parametric
test. CT images were used to assess skeletal muscle para- tests from IBM-SPSS Statistics21® and Bland-Altman were used.
meters. Skeletal muscle index (SMI) was calculated in the range Results: Twenty-five patients (10 men) aged 50[44–63] years
−29 + 150 Hounsfield Units (HU) and reduced muscle attenu- were studied. 64% of the patients had an allogeneic HSCT. The
ation area (range −29 + 29HU) was classified as low-radio- hospital stay was 33[30–44] days. The BMI decreased during
density skeletal muscle index (LRSMI), representing the SM area HSCT ( p < 0.001). Table 1 shows REE changes. There were no
with high intramuscular fat infiltration. A moderate and severe differences in measured REE according to the type of
loss was considered when a reduction of 5–9,9% and ≥10% transplant.
occurred, respectively. Conclusion: We did not find significant changes in measured
Results: We included 24 patients in this prelimiray results, 16 in REE during HSCT. There is a low concordance between
the GC and 8 in IG. All groups experienced median weight and measured REE and HBE in onco-hematologic patients during
SMI losses whereas with no statistical difference. The other HSCT. Individual energy requirements are lower than the ESPEN
parameters evaluated also did not present statistical differ- guidelines.
ence between the groups, although the IG showed a slight Disclosure of Interest: None declared.

Pre-HSCT D+7 D + 14 Discharge Post-Discharge p
HB(kcal) 1448[1288–1630] 1390[1277–1613] 1389[1271–1613] 1353[1270–1641] 1390[1278–1672] <0,001

IC(kcal) 1482[1349–1610] 1557[1344–1740] 1644[1412–1949] 1364[1228–1681] 1453[1122–1563] 0,471
IC(kcal/kg) 20,3[16,9–23,6] 21,2[19,4–25,3] 22,6[20,2–24] 21,9[19,2–22,7] 20,2[17,1–24,7] 0,376
Bland-Altman
Mean 7,1 −83,3 −163,5 −6,2 32,2
Mean±2SD (−397,3/411,5) (−481,3/314,7) (−541,4/214,4) (−256,9/244,5) (−300,7/397,3)
Confidence (−73,8/88) (−170,5/3,9) (−253,3/−73,7) (−77,1/64,8) (−52,2/116,5)
Interval95%
MON-P090 infection (n = 6). In pancreatic cancers, the most frequent

FTO GENE AFFECTS OBESITY AND BREAST CANCER THROUGH preoperative risk factors were pain (n = 8), diarrhea (n = 3), and
SIMILAR MECHANISMS: A NEW INSIGHT INTO THE MOLECULAR nausea (n = 3). Postoperatively, this group mainly suffered from
THERAPEUTIC TARGETS loss of appetite (n = 4), pain (n = 4), and nausea (n = 3). In gastric
M. Gholamalizadeh1 *, S. Doaei1. 1Medical University of Shahid cancer, frequent preoperative risk factors were nausea (n = 5),
Beheshti, Tehran, Islamic Republic of Iran pain (n = 4) and oral fungal infections (n = 3). Post surgery they
reported nausea (n = 5), pain (n = 5) and fatigue (n = 5).
Rationale: The fat mass and obesity-related (FTO) gene is Conclusion: Upper GI cancer patients receiving surgical
known to be associated with risk of obesity. Some recent studies treatment experience major weight loss due to substantial
have shown that the FTO polymorphisms are linked with breast and to some extent varying nutritional risk factors throughout
cancer. This review focused on the possible mechanisms of the the treatments.
effects of the FTO on obesity and breast cancer. Disclosure of Interest: None declared.
Methods: All articles published in English from June 1990 to
January 2017 were studied. The search terms used were FTO MON-P092
gene, FTO polymorphism, breast cancer and obesity. Inclusion CHANGES OF INTESTINAL PEPT1 EXPRESSION IN GASTRIC
criteria consisted of assessment of the relationship between CANCER PATIENTS UNDER MALNUTRITION CONDITIONS
FTO polymorphisms and/or FTO expression level with obesity
and/or breast cancer as a primary outcome. M. Wang1 *. 1Department of General Surgery, Nanjing Drum
Results: The risk of both obesity and breast cancer is affected Tower Hospital, Nanjing, China
by the FTO genotype. Some FTO polymorphisms exert their
Rationale: Malnutrition is common in gastric cancer patients.
effects through effect on IRX3 gene expression level. On the
The peptide transport and uptake processes depend on the
other hand, the FTO gene expression level is closely related to
intestinal peptide transporter 1(PEPT1). However, little is
mTOR signaling pathway activation and its ultimate effects on
known about the intestinal PEPT1 in gastric cancer patients.
obesity and breast cancer. Obesity and breast cancer might
Methods: Total 60 gastric cancer patients were included and
have similar genetics origins.
divided into two groups according to NRS2002 scores. group1:
Conclusion: The FTO gene is a possible mediator between
NRS score ≥ 3, group2: NRS score <3. Intestinal morphology in
obesity and breast cancer. If this result is correct then, it will be
two groups was observed. The expression of intestinal PEPT1
interesting to examine the FTO gene as a molecular therapeu-
protein was detected by western Blot. The concentration of
tics target.
serum cytokines in gastric cancer patients were determined by
Disclosure of Interest: None declared. ELISA. The expression of PEPT1 at different concentration of
cytokine treatment was detected in Caco-2 cell lines.
MON-P091 Results: The expression of intestinal PEPT1 in NRS score ≥ 3
LONG TERM WEIGHT LOSS AFTER ESOPHAGEAL, PANCREATIC, group was significantly higher than in NRS score <3 group
AND GASTRIC CANCER RESECTION (P < 0.05). Serum concentration of TNF-α in the NRS score ≥ 3
M. E. Cook1 *, L. B. Skadhauge1, A. E. Bilgrau2, M. Holst1, group was significantly higher than NRS score <3 group
H. H. Rasmussen1. 1Center for Nutrition and Bowel Diseases, (P < 0.05. With TNF-α (50 ng/ml) short treatment (24 h) for
Aalborg University Hospital, 2Department of Mathematical Caco-2 cells, PEPT1 expression increased significantly com-
Sciences, Aalborg University, Aalborg, Denmark pared with control.
Conclusion: Malnutrition high risk (NRS score ≥ 3) in gastric
Rationale: Malnutrition is a serious issue among patients with cancer patients was associated with increased expression of
esophageal, pancreatic, and gastric cancer in the pre- and intestinal PEPT1 protein, the mechanism was probably attrib-
postoperative period. The aim was to describe weight loss and uted to the regulation of TNF-α.
risk factors affecting nutritional intake during treatment. Disclosure of Interest: None declared.
Methods: All data relating to nutritional status were recorded,
including symptoms such as nausea, loss of appetite and other MON-P093
risk factors that could prevent a sufficient nutritional intake. PREOPERATIVE NUTRITION REGIME FOR PREVENTION OF
Data were collected by retrospectively reviewing 30 medical REFEEDING SYNDROME IN SURGICAL HEAD AND NECK CANCER
records in three upper gastrointestinal (GI) cancers (10 in each PATIENTS
group) and were obtained at time of diagnosis, preoperatively,
on discharge, and after 1, 3, and 6 months. M. O. Holm1 *, M. S. Abilashan1, I. Wessel2, J. R. Andersen1.
1
Results: The average weight loss was −11.0 kg (−13.8%, SD Department of Nutrition, Exercise and Sports, University of
7.7 kg) with pain, nausea, and dysphagia being the most Copenhagen, 2Department of Otorhinolaryngology, Head and
frequent preoperative risk factors. Postoperatively, nausea, Neck Surgery & Audiology, Rigshospitale 5t, Copenhagen,
loss of appetite, and pain were most frequent. The weight losses Denmark
were similar for each cancer site with an average of −12.1 kg
Rationale: Refeeding syndrome (RS) is observed in malnour-
(−14.6%, SD 5.7 kg), −10.7 kg (−13.5%, SD 10.0 kg), and
ished individuals who are refed after prolonged semi-starvation
−10.2 kg (−12.7%, SD 7.8 kg) for esophageal, pancreatic, and
experienced by 30–50% of head and neck cancer (HNC) patients
gastric cancer, respectively. The most frequent preoperative
most frequently caused by pain, dysphagia, tumour localiza-
risk factors for esophageal cancer were dysphagia (n = 6), pain
tion, and loss of appetite. A previous study in the same kind a of
(n = 5), and vomiting (n = 3). Postoperatively, this group suffered
patients resulted in a 20% incidence-rate of RS.
from loss of appetite (n = 6), early satiety (n = 6), and oral fungal
S214 Poster
Methods: A randomized, controlled, non-blinded study in HNC inflammatory markers. Those were higher in the 25(OH)D
patients recruited 5–14 days prior to surgery. Nineteen in the deficiency group (compared to the insufficiency group) but
intervention group, 20 in the control group. The intervention the results were no significant: CRP (0.75 ± 3.6 and 0.63 ± 2.90:
group received supplements to habitual dietary intake rich in p = 0,56); fibrinogen (606 ± 202.65 and 529.29 ± 115.147:
protein and low in sodium and had individual dietary advice p = 0.46).
with a goal of 1.5 g/kg protein and no additional sodium in the Conclusion: Our results show that low 25(OH)D (specially
food. The control group was treated according to the deficiency) is a frequent finding in head and neck cancer
department’s standard. Blood tests, weight, bio-impedance, patients. We also found non-significant higher levels of
hand grip strength, fitness tests and questionnaires about inflammatory markers in the deficient group. Based on these,
dysphagia, quality of life related to dysphagia, and Activities of we recommend screen and avoid 25(OH)D deficiency in head
Daily Living were collected pre and postoperatively. Patients and neck cancer patients with proper supplementation.
were followed-up daily for seven days, and 30 days’ Disclosure of Interest: None declared.
postoperatively.
Results: Seven percent of the intervention group and 40% of the
MON-P095
control group developed RS postoperatively. RF developed in
THE EFFECT OF FISH OIL-SUPPLEMENTED GEMCITABINE
86% of the intervention group and 93% in the control group. The
TREATMENT ON LEUKOTRIENE B4 LEVELS IN PANCREATIC
difference was not statistically significant. The intervention
CANCER
group had a significant increase in preoperative protein intake
compared to estimated needs (110%) compared to the control N. Martin1,2 *, J. Isherwood3, M. Madden2, V. Narayanan2,
group (71%). There was no significant difference in pre and N. Mustafa2, C. Bhangal2, S. Farah2, S. E. Jones2, F. Runau3,
postoperative sodium intake or postoperative energy intake A. Arshad3, W. Y. Chung3, A. R. Dennison3. 1Infection, Immunity
between groups. and Inflammation, University of Leicester, 2Health and Life
Conclusion: The compliance to advices on sodium reduction Sciences, De Montfort University, 3Hepato-Pancreato-Biliary
was poor in the intervention group, which is the probable Unit, University Hospitals of Leicester, Leicester,
explaination for the lack of a significant reduction in incidence United Kingdom
of RS between groups. Accordingly, it was not possible to
Rationale: Pancreatic cancer (PC) is the 5th leading cause of
conclude, whether such a preoperative dietary regime can be
cancer death in Western Europe. The immune-mediators such
recommended in HNC patients.
as Leukotriene B4 (LTB4) in the tumour microenvironment
Disclosure of Interest: None declared. might contribute to the growth and spread of PC. The aim of
this study is to determine the potential anti-inflammatory
MON-P094 effects of omega-3 fatty acids in patients being treated for PC.
HIGH PREVALENCE OF VITAMIN D DEFICIENCY IN HEAD AND Methods: Blood samples were taken from PC patients
NECK CANCER PATIENTS undergoing Gemcitabine treatment (n = 8, CON) and from
G. Allo Miguel1, A. Ruiz Alonso2, M. Sierra Bracamonte1, patients undergoing Gemcitabine treatment supplemented
M. León Sanz1 *. 1Endocrinology and Nutrition, 2Radiotherapy, (n = 17, O-3) with omega-3 fatty acids, for up to a maximum
12 de Octubre University Hospital, Madrid, Spain of 6 months where possible. Plasma was isolated from blood
and stored at −80°C until analysis for baseline LTB4 levels
Rationale: Vitamin D [25(OH)D] deficiency is a common finding (baseline). A further aliquot of blood was incubated with
in oncology patients. However, just one study has evaluated the Zymosan for 30 min at RT then 30 min at 37°C, plasma was
incidence of 25(OH)D deficiency in head and neck cancer collected and stored until analysis (stimulated). All samples
patients. So, the aim of this study is to evaluate 25(OH)D level were analysed using human LTB4 commercial ELISA kits
in a cohort of patients with head and neck cell cancer and its according to the manufacturers’ instructions (Invitrogen, USA
relation with inflammatory markers. and R&D Systems, UK).
Methods: 38 patients with new diagnosis of head and neck Results: There was a reduction in plasma LTB4 levels in O-3
cancer were included. None of the patients suffered of patients (CON 3.5 ± 0.3 (mean±SEM) ng/ml vs O-3 2.8 ± 0.1 ng/
metabolic bone diseases or were taking drugs (calcium and ml, p = 0.02), and the stimulated levels in O-3 patients were
vitamin D included) that interfere with bone metabolism. significantly reduced ( p < 0.05). There was a significant
Serum 25(OH)D, fibrinogen, C-reactive protein (CRP) were reduction in LTB4 levels of stimulated high Progression Free
measured. Statistical analysis: Data are presented as mean Survival (PFS) O-3 patients (O-3 low PFS 4.5 ± 0.3 ng/ml vs O-3
(std). Student t-test was used to compare inflammatory high PFS 3.6 ± 1.1 ng/ml, p = 0.01) and in patients at later TNM
markers between the groups with: 25(OH)D deficiency stage (O-3 stage 3 4.8 ± 0.2 ng/ml vs stage 4 2.9 ± 0.2 ng/ml,
(<20 ng/ml), insufficiency (≥20-<30 ng/ml) and sufficiency p < 0.0001).
(≥30 ng/ml). Significance level was 0.05. Conclusion: Our results show that although the baseline LTB4 is
Results: 34/4 (male/female) patients were included. Baseline unaffected by omega-3 supplementation, the stimulated
characteristics: age: 61.6 ± 10.4; IMC: 28.89 ± 6.23; 25(OH)D leukocyte response is reduced and is associated with increased
17.26 ± 8.19; CRP:1.45 ± 2.15; fibrinogen: 552.92 ± 159.02. patient PFS and later disease stage. These data indicate that
47,4% of the patients were at nutritional risk at diagnosis. 25 omega-3 supplementation affects an anti-inflammatory profile
(OH)D level was low in 94,4% of the patients: 27 patients showed in these patients, being more effective at later disease stages
25(OH)D deficiency (13.36 ± 3.67) and 9 patients insufficiency and may improve survival.
(23.66 ± 2.62). Only 2 patients showed 25(OH)D sufficiency. 25 Disclosure of Interest: None declared.
(OH)D showed no significant correlation with any of the
MON-P096 Univariate and multivariate analyses were performed including

BIOCHEMICAL MEASUREMENTS AS A PREDICTOR OF SURVIVAL Kaplan-Meier curves, Cox Regression and correlation analyses.
IN PATIENTS WITH INCURABLE CANCERS RECEIVING HOME Results: 71 HPN patients with incurable cancers (49
PARENTERAL NUTRITION (HPN) females, 22 males) with mean age 56.8 years (SD = 11.9). The
N. Keane1 *, K. Fragkos2, P. S. Patel1, K. Murray2, S. Obbard2, malignancy types were gynaecological (33.8%), upper gastro-
S. Ajibodu3, S. O’callaghan3, H. Kwok2, E. Paulon2, intestinal (25.4%), lower gastrointestinal (18.3%), hepato-
J. Barragry2, S. Mehta2, S. Di Caro2, F. Rahman2. 1Dietetics, pancreatic-biliary (7%), haematological (5.6%) and others
2
GI Services, 3Pharmacy, University College London Hospital, (9.9%). Most patients had metastatic disease (81.7%) and had
London, United Kingdom undergone prior surgery for their malignancy (74.3%), or
chemotherapy before and/or during PN administration
Rationale: To identify factors like biochemical measurements (88.6%). The majority of patients also had radiotherapy
that may affect prognosis in HPN patients with incurable (31.4%). The mean BMI upon starting HPN was 19.9 kg/m2
cancer. (SD = 4.13), with 58.1% of patients presenting with a weight loss
Methods: Data was collected retrospectively for all patients of more than 10%, and, 11.3% with more than 30%. Therefore,
receiving HPN between 01/01/2006 and 15/10/2016. 87% patients were in a state of cancer cachexia. The mean
Demographic, biochemical and medical factors, Karnofsky weight upon starting HPN was 55.3 kg (SD = 11.5), while in the
Performance Status (KPS) and Glasgow Prognostic Score (GPS) outpatient setting between 0–3 months and 3–6 months, mean
were recorded. Univariate and multivariate analyses were weight was 54.5 kg (SD = 9) and 58.6 kg (SD = 11.3) respectively,
performed including Kaplan-Meier curves, Cox Regression and indicating a relative increase. None of the weight, height, BMI
correlation analyses. and presence of cancer cachexia variables significantly
Results: 66 HPN patients (43 female, mean age 57 years) with predicted survival.
incurable cancers were identified. On discharge, mean CRP was Conclusion: Several studies1 have examined anthropometrics
high at 46 mg/L (SD = 48.3) and albumin borderline low at as predictors of survival in patients with advanced cancer on
32.2 g/L (SD = 6). Mean haemoglobin was slightly below normal HPN, although this study failed to observe any associations
(101.6 g/L, SD = 15) and mean values of electrolytes were amongst BMI, height and weight with survival.
within normal values. The only significant predictors of survival Reference
were CRP [(HR = 1.01 (95% CI 1.004–1.015, p = 0.001)] and WCC
1. Bozzetti F, Santarpia L, Pironi L, et al. The prognosis of incurable
[HR = 1.06 (95% CI 1.01–1.10, p = 0.011)], with higher levels of
cachectic cancer patients on home parenteral nutrition: A multi-
markers of inflammation being correlated with higher inci- centre observational study with prospective follow-up of 414
dence of deaths. Sodium predicted survival (overall and 6- patients. Annals of Oncology 25:487–493, 2014.
month) with borderline significance [those with sodium
≥ 135 mmol/L showing 38% less incidence of deaths compared
to sodium <135 mmol/L]. Higher levels of albumin were
associated with an improved survival [HR = 0.96 (95% CI 0.91– MON-P098
1.00, p = 0.052)] with a borderline statistical significance. RISK OF MALNUTRITION ASSOCIATED WITH
These results are aligned with the findings of the correlation GASTROINTESTINAL SIGNS AND SYMPTOMS AND THE
between survival and GPS which encompass both CRP and LOCATION OF THE DISEASE: RESULTS OF BRAZILIAN
albumin. RESEARCH ON NUTRITION ONCOLOGY
Conclusion: Our study supports that a systemic inflammatory N. B. de Pinho1 *, C. Saunders2, R. B. Martucci1,3,
status, as assessed with higher GPS, CRP, and WCC is associated V. D. Rodrigues1, C. A. D’almeida1, L. C. S. Thuler4,
with a worse performance status (i.e. lower KPS and prognosis). W. A. F. Peres2. 1Nutrition and Dietetic Service, National
Possible timely referral for nutrition support may be required as Cancer Institute, 2Nutrition and Dietetic, Universidade
patients with earlier stage disease will likely have better GPS Federal do Rio de Janeiro, 3Applied Nutrition, Universidade do
and KPS scores which is associated with improved overall Estado do Rio de Janeiro, 4Research Center, National Cancer
survival. Institute, Rio de Janeiro, Brazil
Rationale: Nutritional Patient-Generated Subjective Global
Assessment (PG-SGA) plays an important role in the diagnosis of
MON-P097 malnutrition in cancer patients. The objective was to evaluate
ANTHROPOMETRIC MEASUREMENTS AS A PREDICTOR OF the prevalence of malnutrition and its association with tumor
SURVIVAL IN PATIENTS WITH INCURABLE CANCERS RECEIVING location and nutritional impact signs and symptoms at the time
HOME PARENTERAL NUTRITION (HPN) of hospital admission in all regions of Brazil.
N. Keane1 *, K. Fragkos2, P. S. Patel1, K. Murray2, S. Obbard2, Methods: Multicenter, cross-sectional study, included 45
S. Ajibodu3, S. O’callaghan3, H. Kwok2, E. Paulon2, hospitals. 4,783 nutritional status of adult and elderly patients,
J. Barragry2, S. Mehta2, S. Di Caro2, F. Rahman2. 1Dietetics, 2GI of both genders, was assessed at the time of hospital admission
Services, 3Pharmacy, University College London Hospital, using PG-SGA. The association between the independent
London, United Kingdom variables (signs and symptoms of nutritional impact and
tumor location) and the nutritional status classification was
Rationale: To identify factors like anthropometry that may evaluated in three levels: A (well nourished), B (moderately
affect prognosis in HPN patients with incurable cancer. malnourished or nutritional risk) and C (severe malnourished),
Methods: Data was collected retrospectively for all patients using the ordinal polytomic regression with proportional odds
receiving HPN between 01/01/2006 and 15/10/2016. model.
S216 Poster
Results: The overall prevalence of malnutrition (B (n = 1,601) MON-P100

= 33.5% + C (n = 564) = 11.8%) was 45.3%. The prevalence of METABOLIC DISORDERS IN PATIENTS WITH ADVANCED
malnutrition was 74.5% (B = 44.3% and C = 31.2%) in patients GASTRIC CANCER BEFORE ANTITUMOR CHEMOTHERAPY
with upper abdominal tract tumors and 64.0% (B = 39.7% and O. Obukhova1 *, S. Kashiya1, I. Kurmukov1. 1Medical ICU, N.N.
C = 24.1%) in patients with head and neck tumors. The presence Blokhin Russian Cancer Research Center, Moscow, Russian
of more than 3 symptoms considerably increased the odds ratio Federation
for malnutrition (OR = 27.3, 95% CI: 22.9–32.6; p < 0.001).
Dysphagia (OR = 4.05, 95%: 3.25–5.05; <0.001) and anorexia Rationale: Gastric cancer is associated with the development
(OR = 3.38, 95% CI: 2.91–3.93; p <0.001), among the signs and of cachexia, which can affect survival in chemotherapy. We
symptoms, were those with the highest risk for malnutrition. diagnosed cancer cachexia in the presence of two factors: the
Conclusion: Nutritional impact signs and symptoms, such as body weight loss ≥10% and the level of C-reactive protein (CRP)
anorexia and dysphagia, and upper abdominal tract (OR: 5,53, ≥10 mg/l. Our goal was to study the consumption of protein and
IC: 4,09–7,5; p < 0,001) and head and neck tumors (OR: 4,54, IC: energy, as well as assess water/electrolyte disorders in patients
3,29–6,26; p < 0,001) presented the highest risk for malnutri- with advanced or metastatic gastric cancer before the onset of
tion in oncology patients at the time of hospital admission. antitumor chemotherapy.
Disclosure of Interest: None declared. Methods: 56 patients with locally advanced or metastatic
gastric cancer (30 males, age 33–76 years) were consecutively
MON-P099 enrolled. Patients were questioned about their diet (data on all
PREDICTING ENERGY EXPENDITURE IN CANCER: IMPACT OF food and drink consumed over 3 days was recorded). Energy,
BODY COMPOSITION, TUMOUR STAGE AND INFLAMMATION protein and fluid intake was calculated. Body mass index (BMI),
azotemia, serum glucose, total protein, albumin, liver function
O. Wallengren1 *, I. Bosaeus1. 1Clinical Nutrition Unit, tests, electrolytes, CRP were measured. The data were
Sahlgrenska University Hospital, Gothenburg, Sweden analyzed by SPSS13.0 software. The results were expressed as
mean ± SD.
Rationale: Resting energy expenditure (REE) tends to be higher
Results: The energy intake made 23.4 ± 3.1 kcal/kg, the
in cancer patients but variation is considerable. We explored if
protein intake was 0.74 ± 0.17 g/kg per day, the liquid intake
REE prediction in cancer patients could be improved compared
equaled 17.4 ± 1.7 ml/kg per day. The weight loss over last six
to the Harris-Benedict equation (HB) with a cancer specific
months was 15.1 ± 3.3%. The BMI was 19.3 ± 1.2 kg/m2, the CRP
prediction using sex, age, height and body weight, also
was 20.1 ± 2.2 mg/l. The concentrations of sodium, potassium,
considering body composition (BC), tumour stage and levels
ionized calcium were decreased (128.1 ± 2.2 mmol/l, 3.2 ± 0.4
of inflammation.
mmol/l, 1.09 ± 0.5 mmol/l, respectively).
Methods: REE was measured by indirect calorimetry in 390
Conclusion: Thus, in patients with inoperable gastric cancer
patients with advanced cancer (stage III and IV). Body
against the background of cachexia, the intake of energy,
composition was measured by DXA (fat free mass; FFM and
protein and liquid with food is significantly reduced, which
fat mass; FM) and inflammation by 4-levels of C-reactive
leads to the development of electrolyte disorders (in particu-
protein (CRP <10, 10–24, 25–100 and >100 mg/L). Regression
lar, severe hyponatremia, hypocalcemia) requiring medical
with leave-one-out cross-validation was used and prediction
correction.
accuracy are expressed as coefficient of variation of root mean
squared prediction error, (CV(RMSE); %). Disclosure of Interest: None declared.
Results: The HB equation explained 62% of the variance (R 2,
P < 0.001) with mean bias of –156 ± 167 kcal (P < 0.001) and CV MON-P101
(RMSE) of 15%. The sex, age, height and weight model had CANCER CACHEXIA: HOW ACCURATE IS THE ONCOLOGISTS’
R 2 = 64% and CV(RMSE) of 11%. With addition of CRP and stage CLINICAL ASSESSMENT?
R 2 was 70% and CV(RMSE) 10%. The BC model (age, FFM and FM) Q. van Bokhorst1, A. Van Der Werf1 *, H. Verheul2,
had R 2 = 66% and CV(RMSE) of 11%. With addition of CRP and M. de van der Schueren1, J. Langius1. 1Nutrition and Dietetics,
stage R 2 was 72% and CV(RMSE) 10% (P for all models <0.001). 2
Oncology, VUmc, Amsterdam, Netherlands
There was no difference in REE between sexes when adjusting
for BC (P = 0.3). REE was increased with inflammation by 3, 6 Rationale: Despite its high prevalence, cancer cachexia
and 15% (52, 95 and 218 kcal respectively, P < 0.01) for each often remains under-recognized in clinical practice. In this
level of CRP > 10 mg/L. There was a difference in REE of 2% study, we aimed to investigate cancer cachexia proportions
(37 kcal, P = 0.02) between tumour stages. according to both the judgement of the treating oncologists
Conclusion: Prediction of REE from sex, age, height and weight and objective assessment methods by body composition
improved prediction compared to the Harris-Benedict equa- analyses.
tion. Considering body composition added little improvement. Methods: Patients with metastasized colorectal cancer (n = 47)
Tumour stage and inflammation was associated with increased were clinically and objectively assessed for cancer cachexia
REE and should be considered when developing REE estimation before the start of first line chemotherapy. Assessment on the
equations for cancer patients. basis of clinical presentation was performed by the treating
Disclosure of Interest: None declared. oncologists. For objective assessment, the international
diagnostic criteria by Fearon et al. (2011]) were used: weight
loss >5% or weight loss >2% combined with BMI < 20 or (CT
determined) low muscle mass. A McNemar’s test was
performed to examine whether proportions of cancer cachexia disease progression, whereas chemotherapy was stopped and
were similar according to the two diagnostic approaches. patients received home palliative care.
Results: Proportions of cancer cachexia differed significantly Disclosure of Interest: None declared.
between the two assessment methods ( p < 0.001). Cachexia
was present in 3 patients (6%) according to the oncologists
MON-P103
and in 22 patients (47%) according to objective assessment. Of
CHARACTERISTICS OF HOME ENTERALLY TUBE FED PATIENTS
the 22 objectively cachectic patients, 1 was also clinically
WITH HEAD AND NECK CANCER IN THE UK
recognized, while the other 21 cachectic patients were non-
cachectic according to the oncologists (false negative rate of R. H. Evill1 *, T. R. Smith2, R. J. Stratton2, on behalf of the BANS
95%). The small number of clinically cachectic patients Committee, British Association for Parenteral and Enteral
hindered further statistical analyses. Nutrition (BAPEN). 1on behalf of BANS, 2BANS, BAPEN,
Conclusion: Cancer cachexia is severely under-recognized by Redditch, United Kingdom
the oncologists. Although there are indications of factors
Rationale: The use of home enteral tube feeding (HETF) in
contributing to this under-recognition (e.g. high BMI masking
patients with head and neck cancer is growing1 but there has
low muscle mass), further research should be done to
been little recent exploration nationally of this patient group
investigate whether accuracy of clinical assessment can be
and their outcomes in the UK.
improved. Furthermore, it should be studied which of the
Methods: The British Artificial Nutrition Survey (BANS) of
assessment methods is most predictive for clinical outcomes
BAPEN investigated the use of HETF in head and neck cancer
and whether cachexia treatment is effective in these patients.
patients, to assess patient characteristics and outcomes. As
For now, objective approach is recommended in cancer
part of the ongoing survey (www.e-bans.com), 117 reporting
cachexia assessment.
centres from across the UK (6,270 adult patients; point
Disclosure of Interest: None declared. prevalence December 2015) provided fully anonymised data
for head and neck cancer patients on: age; ability to manage;
MON-P102 activity level; reason, route and location for feeding. Patient
DIETETIC COUNSELING IN A NUTRITION TEAM IMPROVES outcomes after 1 year of HETF were reported.
NUTRITIONAL STATUS FOR PATIENTS WITH UPPER Results: The proportion of adult patients receiving HETF with
GASTROINTESTINAL CANCER DURING PALLIATIVE cancer was 26% (1638/6270) and most (83%, n 1353) had head
CHEMOTHERAPY and neck cancer (an increase of 12% since 2010). Most (70%)
R. E. Nielsen1 *, T. Beermann1, A. Carus2, M. E. Cook1. patients receiving HETF with head and neck cancer were aged
1
Department of Gastroenterology, 2Department of Oncology, ≤70 y and were tube fed primarily because of a swallowing
Aalbrog University Hospital, Aalborg, Denmark disorder (69%), disease-related malnutrition (19%) or GI
obstruction (3%), typically (85%) by gastrostomy. Most patients
Rationale: Patients with upper gastrointestinal cancer (UGIC) lived in their own home (96%) and were independent (75%),
in palliative care often suffer from unintended weight loss. The with only 4% requiring total help to manage and 20% some help.
aim of this study is to evaluate the effect of dietetic counseling The majority of patients had full normal activity (73%), 25% had
by a registered dietitian and care by a nurse specialized in limited activity, and <2% were housebound or bedbound. After
unintended weight loss. 1 year, 61% continued with HETF, almost a quarter (24%)
Methods: Patients with UGIC receiving palliative chemother- returned to oral feeding alone, 14% had died, 0% were
apy at Aalborg University Hospital and considered of nutritional hospitalised and <1% withdrew or refused HETF.
risk by NRS-2002, were during medical counseling screened for Conclusion: This survey suggests patients with head and neck
nutritional problems using a modified PG-SGA questionnaire. A cancer receiving HETF are a relatively independent and active
patient with a score ≥7 on a scale from zero to 10 was referred patient group living at home. Further work is required to assess
to the nutrition team. Patients received dietetic advice on how the optimal way of providing HETF to support this patient
to obtain the required amount of energy and protein, using group.
regular foods, enteral and/or parenteral nutrition as required. Reference
The nursing counseling included advice for gastro-intestinal
1. Smith T. et al. Annual BANS report 2011. Artificial nutrition support
problems, fatigue and nausea.
in the UK 2000–2010. BAPEN, 2011 (www.BAPEN.org.uk)
Results: 32 patients (17 M/15 W, average BMI: 21,7 and age:
65.9 years) with UGIC (16 pancreatic, 10 cardia, 3 oesophagus, Disclosure of Interest: None declared.
2 ventricular and 1 appendix) were referred to the nutrition
team during a period of 6 months. 30 patients had weight loss MON-P104
before referral to the nutrition team (average −13.9 kg, range: DEVELOPMENT OF ORAL MUCOSITIS AFFECTS ENERGY AND
−3 to −31.4). At the following counseling weight loss had MACRONUTRIENT INTAKES IN HOSPITALIZED PEDIATRIC
diminished significantly (−0.5 kg (n = 22) p < 0.001), was almost ONCOLOGY PATIENTS
unchanged for the 2nd follow-up (−0.8 kg, n = 17) and S. Öztürk1 *, H. Susam Şen2, C. Akyüz2, H. Gokmen Ozel1.
stabilized at 3rd follow-up (0.0 kg, n = 9). 1
Nutrition and Dietetics, Faculty of Health Sciences, 2Pediatric
Conclusion: Dietetic counseling as part of a specialized Oncology Department, Faculty of Medicine, Hacettepe
nutrition team stopped unintended weight loss for patients University, Ankara, Turkey
with upper gastrointestinal cancer receiving palliative chemo-
therapy during active treatment period. However, more and Rationale: Oral mucositis (OM) is a very common, potentially
more patients were lost to follow-up counseling caused by severe side effect, caused by treatment with radiotherapy or
S218 Poster
chemotherapy (CT) for cancer. Patients with OM often Results: Mean BMI Z score was significantly lower on the last day
experience intense pain, leading to difficulty with eating and of CT (−0.20 ± 2.09) than before CT (0.05 ± 1.99) ( p < 0.001).
speech. The aim of this study was to evaluate the effects of OM The mean energy intake percentage in relative to the National
development on energy and macronutrient intakes in hospita- Gudelines was lower in the last day of CT (46.4%±25.3%) than
lized pediatric oncology patients treated with CT. before CT (85.5%±29.5%) ( p < 0.001). It was found that
Methods: Thirteen hospitalized pediatric oncology patients (8 two patients (3.3%) did not consume any food or drink on the
boys, 5 girls) aged between 3 and 15 years developed OM were dietary recall day during the last day of CT. Mean percentage of
included. Five patients had lymphomas and eight patients had energy from protein (before CT = 14.3 ± 2.67% vs last day
solid tumors. Mean age of children (±SD) at enrollment was CT = 13.6 ± 3.5%), carbohydrate (before CT = 42.0 ± 7.7% vs last
7.5 ± 4.1 years. Mean cycles of chemotherapy was 5.0 ± 4.1 day CT = 44.6 ± 9.7%) and fats (before CT = 42.5 ± 7.3% vs last
(between 1 and 12). Energy and macronutrient intakes were day CT = 40.7 ± 8.6%) did not change significantly during the
analyzed from a 24-hour dietary recall before CT, on the last course of CT.
day of CTand after OM development. The percentage of energy Conclusion: Energy intakes and BMI Z scores varied in the cycle
intakes were expressed in relative to the Turkey Dietary of chemotherapy, with the lowest intake and BMI Z scores on
Guidelines. Mean percentage of energy from protein, carbo- the last day of CT. Further studies evaluating dietary intake and
hydrate and fat was calculated. antropometrc measurements in patients undergoing CT should
Results: The mean energy intake percentage in relative to include in the protocol the exact time point of dietary
the National Gudelines was higher before CT (88.7% ± 33.6%) assessment.
and on the last day of CT (59.2% ± 30.8%) than after OM Disclosure of Interest: None declared.
development (17.2% ± 22.6%) ( p < 0.001). It was found that
five patients (38.5%) did not consume any food or drink on the
MON-P107
dietary recall day after the development of OM period. Mean
THE IMPACT OF PREOPERATIVE NUTRITIONAL RISK
percentage of energy from protein (before CT = 14 ± 2.7%, last
SCREENING 2002 SCORE ON SURVIVAL IN PATIENTS
day CT = 12.2 ± 3.4%, OM = 12.1 ± 3.1%), carbohydrate (before
UNDERGOING CYTOREDUCTICE SURGERY AND HYPERTERMIC
CT = 43.9 ± 7.0%, last day CT = 46.2 ± 6.8%, OM = 44.7 ±
INTRAPERITONEAL CHEMOTHERAPY
5.2%) and fats (before CT = 41.0 ± 5.6%, last day CT = 40.5 ±
5.9%, OM = 43.2 ± 8.2%) did not change significantly during the S. Demiral Sezer1 *, T. Ö. Sezer2, O. Firat2, S. Ersin2. 1Internal
course of OM. Medicine, Tepecik Training and Research Hospital, 2General
Conclusion: It was found that energy intake of the patients was Surgery, Ege University School of Medicine, Izmır, Turkey
the lowest after OM development. Regular dietary counseling
Rationale:
during the course of OM appears to maintain or to improve
The Nutritional Risk Screening 2002 (NRS 2002) defines
nutritional status.
nutritional and functional status of patients with the aim of
Disclosure of Interest: None declared. identifying who could benefit from a nutritional intervention.
However impact of NRS 2002 scores after Cytoreductice Surgery
MON-P105 and hypertermic intraperitoneal chemotherapy is unclear
CHANGES IN NUTRITION STATUS DURING THE COURSE OF (CRS + HIPEC).
CHEMOTHERAPY IN HOSPITALIZED PEDIATRIC ONCOLOGY Methods: This study evaluated preoperative NRS 2002 score in
PATIENTS 30 patients undergoing CRS+ HIPEC at our institution between
S. Öztürk1 *, H. Susam Şen2, C. Akyüz2, H. Gokmen Ozel1. March 2016 and January 2017 retrospectively. Patients demo-
1
Nutrition and Dietetics, Faculty of Health Sciences, 2Pediatric grafic data, postoperative complications, lenght of hospital
Oncology Department, Faculty of Medicine, Hacettepe stay, shortterm survival were analyzed.
University, Ankara, Turkey Results: Weight loss in last 3 months had a longer postoperative
hospital stay. A statistically significant relationship with NRS
Rationale: Deterioration in nutritional status during cancer 2002 score higher than 3 had a longer hospital stay and
treatment has been increasingly noted. The aim of this study postoperative complications ( p < 0.01). Shortterm survival was
was to evaluate changes in energy and macronutrients intakes higher at NRS2002 score higher than 3 but not significant.
and anthropometric measurements during chemotherapy (CT) Conclusion: Malnutrition is highly prevalent among patients
in pediatric oncology patients. hospitalized in advanced cancer patients, and it affects the
Methods: Sixty hospitalized pediatric oncology patients (33 length of hospitalization, postoperative complications and
boys, 27 girls) aged between 2 and 17 years treated with CT early survival. NRS 2002 score was easy to predict postoperative
were included. Thirteen patients had lymphomas and 47 morbidity.
patients had solid tumors. Mean age of children (±SD) at Disclosure of Interest: None declared.
enrollment was 8.8 ± 5.1 years. Mean cycles of chemotherapy
was 4.1 ± 3.2 (between 1 and 13). Body mass index (BMI) Z
scores were calculated using WHO Standards. Energy and
macronutrient intakes were analyzed from a 24-hour dietary
recall before and on the last day of CT. The percentage of
energy intakes were expressed in relative to the Turkey Dietary
Guidelines. Mean percentage of energy from protein, carbo-
hydrate and fat was calculated.
MON-P108 complications were classified according to Clavien Dindo [Minor

NUTRITIONAL PREDICTORS FOR POSTOPERATIVE LONG-TERM (grade I–IIIa) and Major(grade IIIb–V)].
OUTCOME OF GASTRIC CANCER PATIENTS TREATED WITH Results: 59 pts were enrolled, 11 were excluded due to
POSTOPERATIVE CHEMOTHERAPY unavailable CT scan. 48 pts were included, mean age of
S. Y. Yu1 *, T. S. Sohn2, J. M. Bae2, S. Kim2, Y. J. Kim1, Y. Y. Cho1, 70,9 ± 8,5 years, 28 males. 25% of pts had major post-op
M. Y. Rha1, M. G. Choi2. 1Department of Dietetics, 2Department complications and 90 day mortality was 8,3%. On simple logistic
of Surgery, Samsung Medcal Center, Seoul, Republic of Korea regression skeletal muscle area (OR 0,97; P = 0,09) and index
(OR 0,91; P = 0,09) had a trend for a protective effect of major
Rationale: The impact of pre- and post-operative nutritional complications. On multiple logistic regression both skeletal
status on long term outcomes for gastric cancer patients muscle index (OR 0,89; P = 0,05) and surgery duration (OR 1,01;
treated with postoperative chemotherapy was investigated. P = 0,07) were associated with major complications. ROC curve
Methods: We retrospectively reviewed 293 gastric cancer analysis of the later model showed an adequate ability of major
patients who underwent surgical resection treated with post-op complications discrimination (AUC = 0,736). On simple
postoperative chemotherapy from January 2008 to October logistic regression surgery duration (OR 1,02; P = 0,05), visceral
2008. Median follow-up duration was 67.2 months (range 6–84). fat area and index were associated with a higher 90 d mortality
At admission, and one month after surgery, the patients were (OR 1.02; P = 0,02 and OR 1,05; P = 0,04, respectively), whereas
assessed on nutritional risk index (NRI), anthropometric muscle radiation attenuation had a protective effect (OR 0,88;
measurement and laboratory data. The NRI was calculated as P = 0,05).
follows: NRI = [1.519 × serum albumin (g/L) + 0.417 − ( present Conclusion: Lower skeletal muscle and muscle radiation
weight/usual weight × 100). Nutritional risk was defined as attenuation, as well as higher visceral fat and surgery duration
three grades: (1) severely malnourished (NRI ≤ 83.5); (2) are associated with worse clinical outcomes namely major post
moderately malnourished (NRI 83.5–97.5), or (3) well nourished op complications and 90 day mortality.
(NRI ≥ 97.5). Disclosure of Interest: None declared.
Results: The 5-year survival rates in patients with preoperative
NRI score 1, 2, and 3 were 33.3%, 73.8% and 79.5%. Overall MON-P110
survival rates were significantly lower in preoperative severely THE IMPACT OF PROGNOSTIC NUTRITIONAL INDEX (PNI) ON
malnourished patients (NRI ≤ 83.5) (P = 0.018) and patients
THE SURVIVAL OF PATIENTS WITH ADVANCED
whose preoperative body weight loss was ≥5% (P < 0.001).
HEPATOCELLULAR CARCINOMA TREATED WITH SORAFENIB: A
Multivariate analysis of overall survival indicated that TNM
MULTICENTER STUDY
stage (P = 0.001), venous invasion (P = 0.003), preoperative
bodyweight loss (P = 0.002), and preoperative NRI score T. Hatanaka1,2 *, A. Naganuma1, D. Uehara3, T. Nagashima4,
(P = 0.025) were independent prognostic factors. The post- T. Ueno5, M. Namikawa6, S. Saito7, K. Hosonuma8, T. Ohyama2,
operative nutritional status (nutritional status at one month H. Suzuki9, H. Takagi10, K. Sato11, S. Kakizaki11. 1Department of
after surgery) was not independent prognostic factor. Gastroenterology, Takasaki General Medical Center, National
Conclusion: The preoperative NRI score and preoperative body Hospital Organization, Takasaki, 2Department of
weight loss were a useful predictor for the long-term outcome Gastroenterology, Saiseikai Maebashi Hospital, 3Department
of gastric cancer patients treated with postoperative of Medicine and Molecular Science, Gunma University
chemotherapy. Graduate School of Medicine, Maebashi, 4Department of
Gastroenterology, Shibukawa Medical Center, National
Hospital Organization, Shibukawa, 5Department of Internal
Medicine, Isesaki Municipal Hospital, Isesaki, 6Department of
MON-P109 Internal Medicine, Kiryu Kosei General Hospital, Kiryu,
BODY COMPOSITION AS A PREDICTOR OF MORBIDITY AND 7
Department of Gastroenterology, Tomioka General Hospital,
MORTALITY IN SURGICAL PATIENTS WITH BILE DUCT AND Tomioka, 8Department of Internal Medicine, Toho Hospital,
PANCREATIC CARCINOMA Midori, 9Department of Internal Medicine, Haramachi Red
S. Velho1 *, M. C. Santos2, C. Cunha3, F. Costa4, L. Agostinho5, Cross Hospital, Agatsuma, 10Department of Gastroenterology
R. Cruz5, R. Roque3, P. Oliveira3, J. R. D. Andrade6, C. Ferreira6, and Hepatology, Kusunoki Hospital, Fujioka, 11Department of
R. Maio3, V. Baracos7, M. Cravo2. 1Dietetics and Nutrition, Gastroenterology and Hepatology, Gunma University Hospital,
2
Gastroenterology, 3Surgery, Hospital Beatriz Ângelo, Maebashi, Japan
4
Oncology Manager, Luz Saúde, 5Radiology, Hospital Beatriz
Ângelo, Loures, 6Surgery, Hospital da Luz, Lisboa, Portugal, Rationale: This study aimed to investigate the impact of
7
Oncology, University of Alberta, Alberta, Canada prognostic nutritional index (PNI) on the survival of patients
with advanced hepatocellular carcinoma (HCC) treated with
Rationale: To assess the association between body composition sorafenib.
measurements and post-op complications and 90 days Methods: A total of 110 advanced HCC patients from May 2009
mortality. to December 2015 at Takasaki General Medical Center and our
Methods: Retrospective study in patients ( pts) with pancre- affiliated hospitals were included in this retrospective multi-
atic, ampullary or bile duct carcinoma that underwent surgery center cohort study. PNI was calculated as follows: 10 × serum
between March 2012 and October 2016. Body composition albumin (g/dl) + 0.005 × total lymphocyte count ( per mm3).
(skeletal muscle, visceral fat and subcutaneous fat area) was The patients were divided into two groups according to the cut
assessed with routine diagnostic Computed Tomography scan; off value of PNI that was calculated by a ROC curve analysis.
images were acquired at the 3rd lumbar vertebrae. Post-op
S220 Poster
Results: The optimal cut off value of PNI was set at 46.5. The muscle depletion is a powerful prognostic factor, independent of
patients’ characteristics between PNI-high group (>46.5, body mass index. J Clin Oncol. 2013;31(12):1539–47.
n = 26) and PNI-low group (<46.5, n = 84) were not statistically Disclosure of Interest: None declared.
significant. The median age was 71 (interquartile range [IQR];
64–76) years in PNI-high group and 71 (IQR: 64–76) years in PNI- MON-P112
low group. Child-Pugh Class (A/B) in PNI-high group and PNI-low CUT-OFF VALUES FOR THE FAACT-A/CS AND THE VAS FOR
group were 25 (96.2%)/1 (3.8%) and 76 (90.5%)/8 (9.5%), APPETITE FOR THE ASSESSMENT OF ANOREXIA IN CANCER
respectively. Barcelona Clinic Liver Cancer (BCLC) stage (B/C) PATIENTS
was 9 (34.6%)/17 (65.4%) in PNI-high group and 28 (33.3%)/56
(66.7%) in PNI-low group. α-fetoprotein (AFP) were 45 (IQR; 10– T. J. E. van Elsacker1, S. Van Den Berghe1, M. De Groot1,
1703) ng/ml in PNI-high group and 137 (IQR; 17–798) ng/ml in J. A. E. Langius1 *. 1Nutrition and Dietetics, The Hague
PNI-low group. One-year survival rates were 80.0(CI: 64.3–95.7) University of Applied Sciences, The Hague, Netherlands
% in PNI-high group and 48.7(CI: 37.7–59.7) % in PNI-low group,
Rationale: The Anorexia/Cachexia Subscale of the Functional
respectively. Cumulative survival rate in PNI-high group was
Assessment of Anorexia/Cachexia Therapy questionnaire
significantly better than that in PNI-low group (P = 0.023). A
(FAACT) and the visual analog scale for appetite (VAS) are
multivariate analysis showed that an AFP > 120 ng/ml (Hazard
diagnostic tools used to assess anorexia in cancer patients.
ratio [HR] 2.04; 95%CI 1.32–3.05, P < 0.001) and PNI-high group
Several different cut-off values for anorexia are proposed for
(HR 0.59; 95%CI 0.35–0.995, P < 0.048) were independent
the FAACT (≤24, ≤30 and ≤37) and the VAS (<50 and <70). As no
factors associated with overall survival.
normative data in a healthy population currently exist, this
Conclusion: PNI is a simple and useful marker to predict the
study aimed to obtain cut-off values for the FAACT and the VAS
survival of patients with HCC treated with sorafenib.
for the assessment of anorexia in patients with cancer, based on
Disclosure of Interest: None declared. the scores of the healthy adult Dutch population.
Methods: The FAACT and the VAS were both assessed among
MON-P111 healthy, independent living men and women aged 18–75 years.
SARCOPENIA IS ASSOCIATED WITH POORER COMPLIANCE Participants were excluded when using any medication affect-
WITH ADJUVANT CHEMOTHERAPY IN GASTRIC CANCER ing appetite. To examine if age- or gender-specific reference
PATIENTS values were required, the correlation between age and
T. Nishigori1 *, S. Tsunoda1, K. Obama1, T. Watanabe1, appetite and between sex and appetite was investigated by,
S. Hisamori1, K. Hashimoto1, Y. Sakai1. 1Department of Surgery, respectively, the Spearman’s correlation coefficient rho and
Kyoto University, Kyoto, Japan Eta. The cut-off values for the FAACTand the VAS were based on
the 10th percentile of the scores of the healthy population.
Rationale: S-1 Adjuvant chemotherapy (AC) has been shown to Results: A total of 280 participants (38.6 ± 17.4 years; 44%
improve the prognosis after the curative resection of advanced male) were included for data analyses. The median anorexia
gastric cancer (GC), but it is associated with poor compliance. score was 40 (IQR 36–42) points on the FAACTand 83 (IQR 69–92)
Recently, sarcopenia has been reported to be associated with points on the VAS. No correlation was found between age and
higher chemotherapy toxicity in several types of cancers. The sex and the scores on the FAACT (rho = 0.029; p = 0.624 and
aim of this study was to investigate the impact of sarcopenia on Eta = 0.231) and the VAS (rho = 0.117; p = 0.051 and
the continuation of AC after gastrectomy. Eta = 0.106). Based on the 10th percentile of the total
Methods: Patients who received S-1 AC following curative population, the optimal cut-off value for the FAACT was ≤33
gastrectomy for Stage II/III GC at Kyoto University Hospital and for the VAS ≤ 54.
between 2005 and 2015 were retrospectively investigated. Conclusion: For the assessment of anorexia in cancer patients,
Imaging at L3 level of preoperative CT scan was used to analyze cut-off values of ≤33 for the FAACT and ≤54 for the VAS are
skeletal muscle mass. Sarcopenia was defined based on the cut- suggested. These cut-off values differ from previously pro-
off values reported by Martin et al.1 The proportions of patients posed cut-off values. Further research is needed to validate
who discontinued AC within one year (except for recurrence) these cut-off values in cancer patients.
were compared between patients with and without sarcopenia. Disclosure of Interest: None declared.
Results: Among 149 eligible patients, 60 (40%) had sarcopenia.
In patients with and without sarcopenia, 21 (35%) and 13 (15%)
MON-P113
discontinued S-1 AC within one year, respectively (P = 0.004).
EGCG INDUCED MIRNA-MEDIATED REGULATION IN NON-SMALL
Multivariate logistic regression analysis, adjusting for age,
CELL LUNG CANCERS (NSCLCS)-NGS APPROACH
stage, creatinine clearance, and body weight loss after surgery,
demonstrated that sarcopenia (OR 2.91, 95% CI 1.26–6.70, V. Bhardwaj1 *, N. Ramesh1, A. K. A. Mandal1. 1Biotechnology,
P = 0.012) and age ≥ 65 (OR 3.58, 95% CI 1.29–9.95, P = 0.015) VIT University, Vellore, India
were independent predictors of poorer compliance with AC.
Rationale: Non-small cell lung cancers (NSCLCs) is a group of
Conclusion: In patients with GC, sarcopenia is associated with
distinct diseases with cellular and genetic heterogeneity with
poorer compliance with S-1 AC. Further studies are needed to
three known forms adenocarcinoma, squamous cell carcinoma
elucidate the effect of perioperative nutrition and physical
and large cell carcinoma. Modulation of miRNAs expression
activity programs on AC compliance after gastrectomy.
profiles are known to be predictor in NSCLCs. Hence, the
Reference current study was undertaken to investigate the modulatory
1. Martin L, Birdsell L, Macdonald N, Reiman T, Clandinin MT, effect of EGCG on cellular miRNA expression and cell cycle
McCargar LJ, et al. Cancer cachexia in the age of obesity: skeletal proliferation in NSCLCs (A549).
Methods: A549 cells were treated with 40 and 100 μM EGCG. Conclusion: We believe introducing EEN as suggested by ESPEN
Next generation sequencing technology (NGS) was employed to guidelines is advantageous. In our 198 GC patients, EEN was
study the differential expression of novel and known miRNAs. successfully implemented via FJ. Enteral therapy via feeding
The data generated was analysed with computational approach jejunal tube is highly feasible and thereby may be routinely
to study and correlate the expression profiles of both known and performed in GC patients for early enteral feeding.
novel miRNAs. Flow cytometry analysis was also carried out to Disclosure of Interest: None declared.
better understand the role of EGCG in cell cycle proliferation.
Results: Studies with significantly expressed known miRNAs
MON-P115
showed noteworthy difference in control and EGCG treated
COULD SARCOPENIC OBESITY SERVE AS AN INDEPENDENT
samples, which was evident from the generated heat maps. In
RISK FACTOR FOR POSTOPERATIVE SHORT-TERM OUTCOMES
case of novel miRNAs, the differential expression levels were
AFTER RADICAL RESECTION FOR GASTRIC CANCER? A SINGLE
estimated by counting the number of times the miRNA
TEACHING HOSPITAL PILOT RETROSPECTIVE STUDY
sequences are repeated in the given dataset. Together the
analysis of these microRNA profiles revealed log 2 fold Y. Zhou1 *, L. Wang2, S. cao1. 1General Surgery, 2Affiliated
modulation in expression levels. 667 (control), 661 (40 μM Hospital of Qingdao University, Qingdao, China
EGCG) and 663 (100 μM EGCG) known mature miRNAs and 157
Rationale: The aim of this study was to investigate the impact
(control), 282 (40 μM EGCG) and 165 (100 μM EGCG) novel
of CT-assessed SO on short-term outcomes after radical
mature miRNAs were reported. Gene-annotation analysis
resection for gastric cancer.
(DAVID and PANTHER) of the top 50 miRNAs treated with
Methods: We retrospectively analyzed a consecutive patient
EGCG showed to regulate networks associated with WNT, AKT/
who underwent radical gastrectomy for gastric cancer. Skeletal
PI3K pathways and cell cycle. Flow cytometric analysis further
muscle area and adipose tissue area were measured using CT
confirmed EGCG’s role in cell cycle proliferation.
scan at the level of the third lumbar vertebra (L3) where both
Conclusion: In conclusion, the analysis demonstrates that
transverse processes were visible within 1 week before surgery.
EGCG is actively involved in miRNA modulation in NSCLCs,
Perioperative data, and short-term outcomes were recorded
which further attests to its chemoprotective role.
prospectively.
Disclosure of Interest: None declared. Results: When compared with patients in non-SO group,
patients in SO group had higher perinephric fat thickness
MON-P114 (1.41 vs. 0.86, p < 0.001), subcutaneous adipose tissue area
EARLY ENTERAL FEEDING VIA FEEDING JEJUNOSTOMY IN (156.16 vs. 111.95, p < 0.001), inter-muscle adipose tissue area
GASTRIC CANCER PATIENTS AFTER RADICAL RESECTION (13.40 vs. 8.03, p < 0.001), visceral adipose tissue area (162.20
W.-C. Su1 *, H.-L. Tsai1, J.-Y. Wang1. 1Division of Colorectal vs. 109.82, p < 0.001) and total adipose tissue area (331.76 vs.
Surgery (Department of Surgery), Kaohsiung Medical 226.65, p < 0.001). Comparing with non-SO patients, SO
University Hospital, Kaohsiung, Taiwan, Province of China patients had a higher risk in major postoperative complications
(42.2% vs. 16.8%, p < 0.001), longer postoperative hospital stay
Rationale: Introducing early enteral nutrition (EEN) in gastric (9.00 vs. 8.00, p = 0.007), and higher hospital costs (14688 vs.
cancer (GC) patients has conventionally been challenging by 13693, p = 0.011). Multivariable analysis after controlling for
oral feeding. The aim of this study was to assess the clinical potential confounders revealed that sarcopenic obesity (OR
outcomes of feeding jejunostomy (FJ) in GC patients undergo- 2.935, 95% CI 1.121–7.682, p = 0.028), diabetes (OR 4.146, 95%
ing radical resection in one single institution in Taiwan. CI 1.033–16.639, p = 0.045) and hypoalbuminemia (OR 2.030,
Methods: This study recruited 198 patients diagnosed with GC 95% CI 0.985–4.181, p = 0.055) were independent risk factors
who had radical resection and FJ from May 2010 to January for major postoperative complications.
2017. All medical records from 198 GC patients were Conclusion: This study suggests that sarcopenic obesity could
retrospectively analysed. Early enteral feeding was admini- serve as an independent risk factor for postoperative short-
strated within 48 hours after radical resection. The outcome term outcomes, at least in patients with gastric cancer who
was evaluated based on postoperative complications, anasto- undergo radical gastrectomy.
motic leak rate, and length of hospitalization. Disclosure of Interest: None declared.
Results: FJ was performed in 118 males (59.6%) and 80 females
(40.4%) operated for GC with a mean age of 66.2 (28–92) years. MON-P116
Among 198 patients, 38.9% were stage I, 21.2% were stage II, PI3KINASE-AKT-MTOR PATHWAYAND GLUTAMINE METABOLISM
33.9% were stage III and 6.0% were stage IV in 6.0%. Total IN OVARIAN CANCER
gastrectomy (TG) was performed in 33 (16.7%) patients and 165
Z. Ajgal1,2 *, S. Le Plenier2, S. Ricci3, N. Neveu2,3,
(83.3%) underwent subtotal gastrectomy (STG). The mean
J. Alexandre1, F. Goldwasser1, J.-P. De Bandt2,3, L. Cynober2,3,
operative time for TG and STG were 305.4 ± 64.3 (min) and
M.-C. Blanc2,3. 1Medical Oncology, Hôpital Cochin, 2EA4466,
248.5 ± 69.8 (min) respectively. In terms of operative blood
Université Paris Descartes, 3Biochemistry, Hôpital Cochin,
loss, the mean TG and STG were 173.6 ± 262.2 (mL) and
Paris, France
107.3 ± 114.2 (mL) accordingly. Mean postoperative hospital
stay for TG patients was 14.9 ± 9.2 days whereas for STG Rationale: PI3Kinase-AKT-mTOR is a frequently mutated
patients was 14.4 ± 12.7 days. The incidence of postoperative signaling pathway in ovarian cancer and can be activated by
complications was 24.2% but none of these cases were due to FJ glutamine (Gln) and its metabolites. Conversely mTORC1
itself. Prolong ileus incidence was merely 2.5% and this further regulates glutaminolysis. Combining inhibition of mTORC1 and
supports feasibility of FJ.
S222 Poster
glutaminolysis could have a synergistic effect on the inhibition had been successfully removed the PEG/J and completely
of tumor growth. weaned off enteral nutrition. 4 cases of gastroptosis were
Methods: Three human ovarian cancer cell lines, OVCAR3 (high successfully treated. The enteral nutrition duration was
grade serous), ES2 and TOV21G (clear cells), were cultured in (158.57 ± 19.36) days and the cost of hospitalization was
RPMI-15% FBS with 0, 2 or 4 mM Gln. Cells were incubated with 1 (47.0 ± 16.0) thousand yuan. As for the patients’ nutritional
to 10 nM Rapamycin (Rapa), a selective mTORC1 inhibitor, for 24 index, mean BMI, body weight gain, blood hemoglobin,
or 4 8h. Cell proliferation was assessed by BrdU incorporation serum albumin level and serum prealbumin level were
(ELISA). Expression and activation of signaling proteins (S6K1, (19.70 ± 1.50) kg/m2, (9.54 ± 5.08) kg, (129.14 ± 14.94) g/L,
Akt, Erk, c-myc, HIF1α IκB) was measured by western blot. (43.96 ± 2.56) g/L, (279.38 ± 78.20) g/L respectively.
Results as mean ± SD; Mann Withney test was used for comparison Conclusion: Enteral nutrition through PEG/J is a clinical valid
Results: Rapa 10 nM had a moderate antiproliferative effect treatment in gastroptosis patients with severely malnutrition
after a 24 or 48 h incubation. No synergistic effect with Gln and could significantly improve the nutritional status and
deprivation was found. abdominal distension symptoms.
Cell proliferation (Optic Density) Disclosure of Interest: None declared.
48 h Rapa 0nM 48 H Rapa 10 nM MON-P119

COEXISTENCE OF MALNUTRITION, FRAILTY, PHYSICAL
Gln 0 mM Gln 2 mM p Gln 0 mM Gln 2 mM p
FRAILTY, AND DISABILITY IN PATIENTS WITH COPD AT THE
TOV21 G 1,13 ± 0,09 1,20 ± 0,12 0,1 0,86 ± 0,04 0,80 ± 0,08 0,3 START OF A PULMONARY REHABILITATION PROGRAM
OVCAR3 0,59 ± 0,05 0,66 ± 0,05 0,7 0,65 ± 0,04 0,48 ± 0,08 0,03
ES2 0,79 ± 0,06 0,55 ± 0,08 1 0,60 ± 0,1 0,32 ± 0,03 0,03 L. ter Beek1,2,3 *, H. van der Vaart2, J. B. Wempe2,
F. D. Ottery1,4, J. L. Roodenburg3, C. P. van der Schans1,5,6,
H. Jager-Wittenaar1,3. 1Research Group Healthy Ageing, Allied
Phospho-AKT is detected in all experimental conditions Health Care and Nursing, Hanze University of Applied Sciences,
indicating upstream activation of the pathway despite S6K1 Groningen, 2Department of Pulmonary Diseases and
inhibition by Rapa. Phospho-Erk increased in OVCAR3 after Tuberculosis, Center for Rehabilitation, University of
addition of Rapa but was constitutively present in TOV21G and Groningen, University Medical Center Groningen, Haren,
ES2: activation of MAPKinase signaling could be another Groningen, 3Department of Maxillofacial Surgery, University of
pathway of resistance. Depletion of Gln inhibited expression Groningen, University Medical Center Groningen, Groningen,
of HIF1α. HIF1α/GAPDH ratio was 0 (TOV21G), 0.3 (OVCAR3) and Netherlands, 4Ottery & Associates, Vernon Hills (Chicago),
0.07 (ES2) in 0mM Gln condition versus 1.5 (TOV21G), 3.8 United States, 5Department of Rehabilitation Medicine,
6
(OVCAR3) and 2.2 (ES2) in standard condition. Department of Health Psychology Research, University of
Conclusion: Gln depletion alone or in combination with Rapa Groningen, University Medical Center Groningen, Groningen,
has a moderate impact on proliferation but contributes to the Netherlands
regulation of signaling pathway like HIF1α known to be involved
in VEGF production, invasiveness and chemoresistance. Rationale: Malnutrition, frailty, physical frailty, and disability
seem to be ‘overlapping’ conditions, since all are to a certain
extent defined by a decrease in muscle mass and/or strength,
level of activity, and functional performance. However, it is
unclear to what extent these conditions coexist in patients with
Nutrition and chronic diseases 2 chronic disease. We therefore aimed to determine the
coexistence of malnutrition, frailty, physical frailty and
MON-P118
disability in patients with chronic obstructive pulmonary
THE EFFECT OF ENTERAL NUTRITION SUPPORT THERAPY
disease (COPD) that started a pulmonary rehabilitation
THROUGH PEG/J IN PATIENTS WITH GASTROPTOSIS AND
program.
SEVERELY MALNUTRITION
Methods: In 47 patients with COPD (47% male, mean age
L. Zhang1 *, X. Gao1, X. Wang1, J. Li1. 1Research Institute of 60.2 ± 9.6 years, mean BMI 24.0 ± 4.6, median FEV1% pred 33
General Surgery, Jinling Hospital, Medical School of Nanjing [IQR: 25–43]), malnutrition was assessed by the Scored Patient-
University, Nanjing, China Generated Subjective Global Assessment. Patients were cate-
gorized as well nourished (PG-SGA A), moderate/suspected
Rationale: To investigate the significance, effects and precau-
malnutrition (PG-SGA B), or severe malnutrition (PG-SGA C).
tions of enteral nutrition support therapy through PEG/J in
Frailty was assessed by the Evaluative Frailty Index for Physical
patients with gastroptosis and severely malnutrition.
activity, and physical frailty was assessed by Fried’s criteria.
Methods: Clinical date of 11 gastroptosis patients with severely
Disability was measured by the WHO Disability Assessment
malnutrition who were treated with enteral nutrition support
Schedule 2.0.
therapy through PEG/J were retrospectively summarized. They
Results: Of all patients, 40% percent (19/47) were categorized
were followed up more than 6monthes and all the patients are
as malnourished (B or C). Eighty-five percent (40/47) were
alive till now. The cost of hospitalization, the enteral nutrition
frail, 17% (8/47) were physically frail, 75% (35/47) were
duration and de current nutritional status of these patients
physically pre-frail, and 30% (14/47) were disabled. The
were analyzed.
coexistence of malnutrition and disability is limited (15%). Of
Results: After treatment, the nutrition status of all the 11
physically frail patients, 75% were malnourished and 44% of
patients were improved. The body weight of 7 cases returned to
frail patients were malnourished. In three patients all four
normal and abdominal distension symptoms disappeared, who
conditions coexisted. Six patients were neither malnourished, received noninvasive mechanical ventilation. The indication
frail, physically frail or disabled. was 73.6% for dysphagia and 26.4% for respiratory. The weight
Conclusion: Most COPD patients starting pulmonary rehabili- evolution from the first visit to the RPG indication was
tation are frail, but only a minority is physically frail. Almost all distributed into 4 groups, depending on weight loss: (a)
malnourished patients are frail (95%) but not all frail patients 39.1%, no weight loss, (b) 29.9%, weight loss <5%, (c) 24.1%,
are malnourished (45%). weight loss 5–10% and (d) 6.9%, weight loss > 10%. There is a
Disclosure of Interest: L. ter Beek: None declared, H. van der Vaart significant positive correlation between placement acceptance
Other: Personal fee from Vertex, outside the submitted work, delay and weight loss ( p = 0.003) with an average delay of 5.4,
J. Wempe: None declared, F. Ottery Other: Developer of the PG-SGA, 1.9, 5.09 and 5.9 months respectively. During the follow-up, 36
co-developer of the PG-SGA based Pt-Global app, J. Roodenburg: None (41%) patients died. The weight remained stable in all groups
declared, C. van der Schans: None declared, H. Jager-Wittenaar Other: during the 6 months after RPG.
Co-developer of the PG-SGA based Pt-Global app. Conclusion: The most common indication for RPG in ALS
patients is dysphagia, and its placement helps to maintain
MON-P120 nutritional status, avoiding weight loss. Further delay in
RADIOLOGICAL PERCUTANEOUS GASTROSTOMY (GRP) AND gastrostomy placement is associated with increased weight
ITS IMPACT ON NUTRITIONAL STATUS IN PATIENTS WITH loss. More studies are needed to give greater robustness to the
AMYOTROPHIC LATERAL SCLEROSIS (ALS). results obtained.
M. Virgili-Casas1 *, A. Prats2, I. Jimenez3, E. Romero4, Disclosure of Interest: None declared.
V. Herrera5, B. Andres6, M. Montserrat7, R. Lopez-Urdiales8,
M. Povedano9. 1Clinical Nutrition and Dietetics Unit, MON-P121
Endocrinology and Nutrition Department, Multidiscilplinary ASSOCIATION OF THE DIETARY AND LIFESTYLE FACTORS WITH
Unit Motor Neuron Disease, Hospital Universitari Bellvitge, THE LONG-TERM CARDIOVASCULAR RISK IN THE URBAN SAUDI
IDIBELL, L’Hospitalet de Llobregat, Barcelona, 2Clinical POPULATION DURING EARLY ADULTHOOD
Nutrition and Dietetics, Endocrinology and Nutrition
A. M. Almajwal1, M. M. A. Abulmeaty1,2 *, M. F. Elsadek1,
Department, Multidisciplinary Unit Motor Neuron Disease,
D. Aldisi1, M. Alquraishii1, S. Razak1, N. K. Almadani1,
Hospital Universitari Bellvitge, IDIBELL, L’Hospitalet de
H. M. Hassan1, on behalf of the Deanship of Scientific Research
Llobregat, 3Clinical Nutrition and Dietetics Unit,
at King Saudi University, the research group project no RGP-
Endocrinology and Nutrition Department, Multidisciplinary
VPP-193. 1Clinical Nutrition Program, Community Health
Unit Motor Neuron Disease, Hospital Universitari de Bellvitge,
Sciences, King Saud University, Riyadh, Saudi Arabia, 2Medical
IDIBELL, L’Hopsitalet de Llobregat, Barcelona, 4Clinical
Physiology, Obesity Research and Management Unit, Zagazig
Nutrition and Dietetics Unit. Endocrinology and Nutrition
University, Zagazig, Egypt
Department, Multidisciplinary Unit Motor Neuron Disease,
Hospital Universitari Bellvitge. IDIBELL, L’Hospitalet de Rationale: Is the long-term risk of the cardiovascular
Llobregat, Barcelona, 5Clinical Nutrition and Dietetics Unit, disease (CVD) among urban Saudi population during the early
Endocrinology and Nutrition Department.Multidisciplinary adulthood determined by certain dietary and lifestyle
Unit Motor Neuron Disease, 6Multidisciplinary Unit Motor parameters?
Neuron Disease, 7Clinical Nutrition and Dietetics Unit, Methods: A total of 371 subjects (163 men), 18–46 y old were
Endocrinology and Nutrition Department, 8Clinical Nutritition enrolled in a cross-sectional study. The simple lifestyle
and Dietetics Unit, Hospital Universitari Bellvitge, indicator questionnaire1 was used and we investigated certain
9
Multidisciplinary Unit of Motor Neuron Disease, Hospital factors such as consumption of vegetables, fruits & fishes,
Universitari Bellvitge, IDIBELL, L’Hospitalet de following a dietary regimen (which included variety & calorie
Llobregat, Spain control), salt addition, physical activity, smoking, and cola
drinking. Fasting glucose and lipid panel were analyzed, and
Rationale: ALS is a neurodegenerative disease that leads to a
blood pressure was recorded in the sitting position. Lifelong
state of malnutrition. It is associated with hypermetabolism
American college of cardiology/American heart association
and/or dysphagia, so the placement of a Percutaneous
(lifetime ASCVD)2 was calculated. Multiple logistic regression
Gastrostomy (PG) is indicated to correct this situation. To
was used to test determinants of lifetime ASCVD.
describe the therapeutic indication of RPG, and to monitor
Results: Among Saudi young women, following a dietary regimen
weight evolution and the impact of the delay between indica-
and having no family history of cardiovascular disease reduce the
tion and RPG placement on the nutritional status of the patient.
risk of lifetime ASCVD by about 89% and 80% {odds ratio (95%
Methods: A retrospective and descriptive study has been
CI) = 0.11 (0.02–0.52) and 0.20 (0.05–0.82), respectively,
held in the Multidisciplinary Motor Neuron Disease Unit
P < 0.05}. Among men group no significant predictors were
(MMNDU) of Bellvitge University Hospital with ALS patients
found, however, the high-risk quartile was more smoker
who underwent RPG between Jan 2012 and Dec 2015. Six
(X 2 = 5.76, df 1 & P < 0.05), more cola drinker, added more table
months after RPG placement, clinical and nutritional follow up
salt, and had a family history of cardiovascular disease (P > 0.05).
is described.
Conclusion: In women, following a dietary regimen is the main
Results: 87 patients (54% men), age at diagnosis 63 years.
protector of ASCVD. In men, no determinants were significantly
Spinal onset 57%, bulbar onset 41%, respiratory onset 1%. The
reported however, smoking and salt addition were associated
mean vital capacity (FVC) at the time of diagnosis was
with the high-risk quartile.
73% ± 19% decreasing to 55% ± 18% at the RPG placement. 61%
S224 Poster
References MON-P123
1. Godwin et al. Testing the Simple Lifestyle Indicator Questionnaire STUDY OF THE DIAGNOSTIC VALUE OF THE GERIATRIC
Initial psychometric study. Can Fam Physician 2008;54:76–77. NUTRITIONAL RISK INDEX (GNRI) IN PATIENTS ON
2. Goff et al. 2013 ACC/AHA guideline on the assessment of HEMODIALYSIS: INFLUENCE OF AGE
cardiovascular risk: a report of the American College of
M. C. Terroba Larumbe1 *, C. Crespo Soto1,
Cardiology/American Heart Association Task Force on Practice
M. Gonzalez Sagrado2, J. M. Monfá Bosch3, G. Cabezas García1,
Guidelines. Circulation. 2014;129 (25 suppl 2):S49–S73.
M. Ventosa Viña1, L. Cuellar Olmedo1, M. Chimeno Viñas1,
Disclosure of Interest: None declared. G. Gallego Herreros1. 1Endocrinology and Nutrition, 2Research
Support Unit, 3Nephrology, Hospital Universitario Río Hortega,
MON-P122 Valladolid, Spain
DOCOHEXANOIC ACID IMPROVES INFLAMMATORY PROFILE
AND ANEMIA IN HEMODIALYSIS PATIENTS Rationale: To determine the sensitivity and specificity of
M. Ruperto1 *, M. Fernández-Lucas2, L. Blanco2, E. Casillas2, the GNRI, proposed as a nutritional screening method in
J. L. Teruel2, F. Liaño2. 1Human Nutrition and Dietetics, patients on hemodialysis, applying different cutoff points, and
Universidad Alfonso X el Sabio, 2Nephrology, Hospital Ramon y taking as reference the protein energy wasting (PEW)
Cajal, Madrid, Spain syndrome.
Methods: 53 patients were evaluated (35 men, 18 women),
Rationale: Docohexanoic acid (DHA), a dietary n-3 polyunsat- mean age 68.3+/−13.5 years, 28 under 70 and 25 over 70 years
urated fatty acid(PUFA n-3), have shown reduce all-cause old, median time on hemodialysis 34 months (range 7.4–80.9).
mortality in hemodialysis patients (HD). This study aimed The prevalence of malnutrition was established according
to evaluate whether DHA-supplementation modified inflam- to the International Society of Renal Nutrition and Metabolism
matory profile and modulated response to erythropoiesis- (ISRNM) criteria to diagnose PEW syndrome and with the
stimulating-agents in HD. formula: IRNG = [14.89 × albumin (g/dl)] + [41.7 × (weight/
Methods: Parallel-controlled clinical trial in 42 HD patients ideal weight)], applying different cutoff points. The analysis
(men: 69%; aged:66.7 ± 15.5;DM:19%), randomized into 2 was performed globally and separating patients according
groups: intervention group (DHA, n = 21) and, control group to age.
(Control, n = 21). Administration of DHA supplementation Results: The table includes the prevalence of malnutrition in
(645 mg DHA/3 times per week, post-HD) for 2 months of frequency and percentage, applying PEW and GNRI, and the
follow-up. Assessment intra and inter-groups at baseline(0) and sensitivity and specificity of GNRI. 19 patients (35.8%) were
post-intervention(1) of clinical, biochemical and nutrition- diagnosed as PEW; 11 (39.3%) of them < 70 and 8 (32%) > 70.
inflammatory parameters. Inflammation measured by C-react- Considering the GNRI < 92 diagnosis overall, sensitivity (S) was
ive protein(CRP), anemia control through weekly dose of 42.1 and specificity (Sp) 85.3, being 50 and 70.6 respectively in
erythropoietin (Epo) and erythropoiesis -responsiveness those aged >70. Applying GNRI < 100 overall, sensitivity was 84.2
index (ERI). and specificity 55.9 [ positive predictive value (PPV) 51.6,
Results: The DHA supplemented group(0–1), significantly negative predictive value (NPV) 86.4]; in those aged > 70
improved hemoglobin concentrations (Hb) (Hb0: 10.87 ± 1.65 the sensitivity was 100 and the specificity was 41.2 [PPV 44.4,
vs. Hb1: 11.7 ± 1.15; p = 0.019), associated with lower Epo NPV 100].
doses (Epo0: 13312.5 ± 8.219,6 vs. Epo1: 8687.5 ± 6680.5;
p = 0.022) and ERI (IRE0: 22.25 ± 13.77 vs. IRE1:12.28.±8.96; Group PEW GNRI < 92 GNRI < 100
p = 0.005); whereas in the control group there were not found Global 19 (35,8%) 13 (24,5%) S42.1 Sp85.3 31 (58,5%) S84.2 Sp55.9
differences in the Epo requirements(Epo0:7850 ± 6002.4 vs. Age < 70 11 (39,3%) 4 (14,3%) S36.4 Sp100 13 (46,4%) S72.7 Sp70.6
Epo1: 9000. ± 7732; p = 0.22) and ERI (ERI0:14.7 ± 13.7 vs. Age > 70 8 (32%) 9 (36%) S50 Sp70.6 18 (72%) S100 Sp41.2
ERI1:16.4. ± 14.9;p = 0.32) in the control group. High mean
values of CRP (inter and intra-groups) in the control group Conclusion: Although the GNRI < 92 has been postulated as a
(Control, CRP(0–1):18.79 ± 4.4–28.23 ± 15.4; p = 0,018), com- simple and valid marker of malnutrition in hemodialysis
pared with DHA group (DHA, PCR(0–1):18.79 ± 4.4–13.15 ± 3.5; patients, in our study it showed a low sensitivity in the global
p = 0,018) were found. No significant changes in lipid profile patient population. Applying the GNRI < 100 could be useful for
were observed. Adverse effects with DHA supplementation those over 70 years old.
were not found. Disclosure of Interest: None declared.
Conclusion: DHA supplementation post-HD enhances the
inflammation and the control of anemia in HD patients.
Further studies are required to evaluate longitudinally the
effect of DHA in inflammatory biomarkers for the control of
anemia.
MON-P124 many studies that analyze separately the effect on the

VALUE OF THE PROTEIN CATABOLIC RATE (PCR) AS AN malnourished. Furthermore the definition of malnutrition
INDICATOR OF PROTEIN INTAKE IN HEMODIALYSIS PATIENTS varies widely among them so there is little data regarding OS
(HDP) AND ITS ASSOCIATION WITH ANTHROPOMETRIC AND use in patients with PEW syndrome.
BIOCHEMICAL PARAMETERS. INFLUENCE OF INFLAMMATION. Methods: 43 patients were evaluated (31 men, 12 women),
M. C. Terroba Larumbe1 *, C. Crespo Soto1, mean age 68.2+/−13.7 years, carrying out food survey,
M. Gonzalez Sagrado2, R. Conde Vicente2, G. Cabezas Garcia1, anthropometry, bioimpedance and biochemistry at the base-
A. Quintano Pindado3, M. Ventosa Viña1, G. Gallego Herreros1, line and after 7.6+/−0.4 months. The presence of PEW was
L. Cuellar Olmedo1. 1Endocrinology and Nutrition, 2Research defined according to the International Renal Society of
Support Unit, 3Nephrology, Hospital Universitario Río Hortega, Nutrition and Metabolism (ISRNM) criteria. PEW patients at
Valladolid, Spain baseline took a specific OS (Nepro® HP), 1 bottle daily (220 ml,
396 kcal, 17.8 g of protein with lower concentrations of
Rationale: Low protein intake is associated with higher carbohydrates, sodium, potassium and phosphorus than stand-
mortality in HDP and should be monitored by a dietary survey ard OS). Non-PEW patients received routine care.
or by measuring the PCR adjusted for body weight (nPCR) Results: 16 patients were diagnosed as PEW at baseline and
expressed in g/kg/day, indicative of protein intake in stable received OS. After follow-up, non-PEW patients who did not
patients. The aim of this study is to evaluate the achievement take the supplement had a significant decrease in mid arm
of the objective of protein intake > 1.2 g/kg/d in our patients muscle circumference (MAMC) ( p = 0.001) and body mass index
using both methods and the correlation between nPCR, (BMI) ( p = 0.033) while PEW patients did not show significant
nutritional and inflammatory parameters. changes. Analyzing the percentage of patients who met the
Methods: 29 patients were evaluated (21 men, 8 women), dietary intake goals: in non-PEW patients, caloric intake
mean age 68.7+/−12.9 years, applying a food survey, mid arm dropped from 46.2% to 40.7% and protein intake increased
muscle circumference (MAMC), body mass index (BMI), albumin from 84.6% to 92.6% while in PEW patients, caloric intake
and C-reactive protein (CRP). Presence of inflammation is increased significantly from 37.5% to 87.5% ( p = 0.003) and
recognized if CRP > 3 mg/L. protein intake increased from 81.2% to 100%.
Results: Mean nPCR:1.2 g/kg/d; Median:1.13 (Q1 0.96 Q3 Conclusion: The use of specific OS in our PEW patients
1.35); 14 of the 29 patients (48.3%) showed inflammation. The favored the achievement of the dietary intake goals, signifi-
protein intake objective was reached in 12 cases (41.4%) cantly in the case of energy, although significant improvements
according to nPCR and in 17(58,7%) according to the survey. were not produce in the anthropometric parameters. The use
Overall nPCR was not associated with protein intake according of OS in non-PEW patients could prevent nutritional
to the survey or with CRP but we found a significant association deterioration.
between nPCR and albumin(r = 0.479; p = 0.009). When inflam- Disclosure of Interest: None declared.
mation is not present nPCR was not correlated with the survey
but the mean value was higher in patients who met survey
MON-P126
targets than those who did not (1.15 versus 0.8 mg/kg/d). nPCR
CONTROLLED RANDOMIZED STUDY IN ANOREXIC
was not associated with albumin, MAMC or BMI. When
HEMODIALYSIS PATIENTS TREATED WITH MEGESTROL ACETATE
inflammation is present, nPCR showed a non-significant
COMPARED WITH PLACEBO.
negative association with the protein intake surveys, signifi-
cant correlation with albumin(r = 0.566, p = 0.035) and non- M. Fernández-Lucas1, M. D. M. Ruperto Lope2 *, M. Diaz1,
significant association with MACM and BMI. N. Rodríguez-Mendiola1, G. Ruíz-Roso1, J. L. Teruel1, F. Liaño1.
1
Conclusion: In our study, nPCR was associated with albumin, a Nephrology, Hospital Ramon y Cajal, 2Human Nutrition and
marker of mortality in HDP but it was not useful as an indicator Dietetics, Universidad Alfonso X EL Sabio, Madrid, Spain
of protein intake, especially in hypercatabolic patients. Rationale: Uremic anorexia is a frequent nutritional disorder in
Despite nutritional intervention it is difficult to meet the hemodialysis patients (HD). This study aimed to analyse the
intake goals. effect of megestrol acetate on uremic anorexia vs. placebo in
Disclosure of Interest: None declared. HD patients.
Methods: A sample of 19 HD patients (men: 44,4%, age: r: 40–80
MON-P125 years) were enrolled in a randomized –controlled study for 1
CHANGES IN THE NUTRITIONAL PARAMETERS OF PATIENTS IN year follow–up in a HD unit. Uremic anorexia by Likert scale was
MAINTENANCE HEMODIALYSIS (MHD) DIAGNOSED WITH evaluated. The sample was randomized into two groups: G1,
PROTEIN ENERGY WASTING (PEW) SYNDROME WITH A intervention group: 160 mg/ day of megestrol acetate (n = 10)
SPECIFIC ORAL SUPPLEMENT (OS) and placebo group (n = 9). A dose of 160 mg/day of megestrol
M. C. Terroba Larumbe1 *, C. Crespo Soto1, acetate was provided during 3 months of follow-up.
M. Gonzalez Sagrado2, B. Gomez Giralda3, L. Cuellar Olmedo1, Anthropometric measures, biochemical parameters and body
M. Ventosa Viña1, F. Nuñez Ortega1, A. Barrera Rebollo4, composition analysis by bioelectrical bioimpedance (EFG,
G. Gallego Herreros1. 1Endocrinology and Nutrition, 2Research Akern, SRL), on baseline (V0) and post-intervention period
Support Unit, 3Nephrology, 4Surgery, Hospital Universitario Río (V1) were performed.
Hortega, Valladolid, Spain Results: At baseline, no differences between groups on age,
time on HD, serum albumin and Kt/Vsp were found. At 3
Rationale: Oral supplements improve nutritional parameters months, 90% of intervention group vs. 44.4% of placebo group
and reduce mortality in MHD patients. However, there are not had better perception of appetite. Higher significant body
S226 Poster
weight, serum creatinine and serum albumin were only found in higher BMI, Fat-Free mass, Total Fat mass, and Total muscle
intervention group (at least, p < 0.05). No adverse effects were mass are associated with slight decrease in the risk of
found with administration of megestrol acetate. osteoporosis.
Conclusion: The administration of megestrol acetate improve Conclusion: BMI and Fat Free Mass evaluated by by bioelec-
nutritional status being associated significantly with weight trical impedance analysis are associated with osteoporosis risk,
gained and higher serum albumin and creatinine concentra- which is in line with previous studies.
tions in anorexic HD patients. Further longitudinal studies are Disclosure of Interest: None declared.
required to evaluate uremic anorexia in HD patients.
Disclosure of Interest: None declared. MON-P128
A PILOT STUDY: THE DIFFERENCE OF BODY FAT COMPOSTION
MON-P127 IN CHRONIC KIDNEY DISEASE PATIENT ON HEMODIALYSIS WITH
ANTHROPOMETRIC AND BIOIMPEDANCE PARAMETERS AND AND WITHOUT TYPE 2 DIABETES MELLITUS IN ATMA JAYA
THEIR ASSOCIATION WITH OSTEOPOROSIS. A CASE CONTROL HOSPITAL
STUDY M. R. Iryaningrum1 *, L. Luse1, V. Visakha1, F. Chriestya1,
M. J. Martínez-Ramírez1*, C. Montes Castillo2, Y. Maslim1. 1Internal Medicine, School of Medicine Atma Jaya
C. Tenorio Jiménez3, M. Garrido Martínez3, Catholic University of Indonesia, Jakarta, Indonesia
A. D. Delgado-Martínez4, M. de Damas Medina3,
M. Serrano Quero3, M. Delgado-Rodríguez5. 1Endocrinology and Rationale: Chronic kidney disease (CKD) is a common
Nutrition, Hospital of Jaén. University of Jaén, Jaén, comorbidity in patients with type 2 Diabetes Mellitus (T2DM).
2
Endocrinology and Nutrition, La Paz Hospital, Madrid, About 50% patients with T2DM globally estimated have CKD.
3
Endocrinology and Nutrition, Hospital of Jaén, 4Traumatology Visceral or central obesity, as evidenced by waist-hip ratio
and Orthopaedic Surgery, Hospital of Jaén. University of Jaén, (WHR), is very common in T2DM and increase cardiovascular
5
Public Health and Epidemiology, University of Jaén, Jaén, Spain morbidity and mortality. WHR is used as an indirect measure of
body fat composition. The aim of the study is to know body fat
Rationale: Low body weight is one of the main factors for composition in CKD patient on hemodialysis (HD) with and
osteoporosis. Specifically loss of muscle has been associated without T2DM.
with an increase in fracture risk. Our aim was to assess the Methods: A pilot study that using simple random sampling was
association between anthropometric and bioimpedance ana- done to CKD patients on HD who came to HD unit in Atma Jaya
lysis parameters and the presence of osteoporosis. Hospital from January to March 2017. We made two group of
Methods: Case-control study. Fifty eight cases and 58 controls patients consisted of 12 patients with T2DM and 29 patients
matched for age (±1 year) and sex. Cases were patients without T2DM. Those patients underwent anthropometric
diagnosed with osteoporosis using Dual-energy X-ray absorpti- measurement, such as body mass index (BMI), WHR, and skin-
ometry (DXA). Controls were healthy individuals without fold test, to assess body fat composition.
osteoporosis (DXA performed) and no history of fractures. Results: There were 23 (56,1%) male and 18 (43,9%) female
Anthropometric parameters (weight, height, BMI) and evalu- patients participated in this study. The median age among
ation of body compartments by bioelectrical impedance patients was 50 (25–68) years. BMI, WHR, and skin-fold calipers
analysis were performed in both groups. Statistical analysis: in CKD patients on HD with and without T2DM, sequentially, was
T-test for comparison of means and Multivariate linear 24,87 ± 4,5 and 21,51 ± 3,07; 0,97 ± 0,07 and 0,91 ± 0,07;
regression models. 2,23 ± 1 and 1,31 ± 0,65. There are significant differences in
body fat composition between diabetic and non-diabetic
Table 1: Mean Differences between Cases and Controls.
patients in all of the anthropometric measurement.
Anthropometric parameters Conclusion: There are differences of body fat composition in
Variable p-value
CKD patient on HD with and without type 2 DM. Future research
Weight (Kg) Controls 74.88 (1.72) 0.00 with larger sample and laboratory measurement is needed to
Cases 64.01 (1.65) determine the significant differences.
Height (cm) Controls 157.98 (0.76) 0.15
Cases 156.18 (0.99) Disclosure of Interest: None declared.
BMI (Kg/m2) Controls 30.05 (0.70) 0.00
Cases 26.26 (0.61)
MON-P129
Bioelectrical impedance analysis
Variable Mean (±EEM) p-value RELATION BETWEEN OMEGA-6 INTAKE AND CYTOKINES
Fat (%) Controls 35.40 (1.15) 0.07
CONCENTRATION IN WOMEN WITH RHEUMATOID ARTHRITIS.
Cases 32.53 (1.10) M. Lozada-Mellado1 *, M. Ogata-Medel1, L. Llorente2,
Total Body water (Kg) Controls 45.55 (0.73) 0.08
A. Hinojosa-Azaola2, J. A. Pineda-Juárez1,
Cases 47.37 (0.72)
Fat Free Mass (Kg) Controls 47,30 (1.14) 0.01 J. M. García-Morales1, A. Rojas-Mandujano1,
Cases 43.26 (1.10) L. Castillo-Martínez1, J. Alcocer-Varela2. 1Nutrición clínica,
Total Muscle Mass (Kg) Controls 44.84 (1.03) 0.01 2
Reumatología, Instituto Nacional De Ciencias Médicas Y
Cases 40.28 (1.38)
Total Fat Mass (Kg) Controls 27.18 (1.58) 0.00 Nutrición Salvador Zubiran, Ciudad de México, Mexico
Cases 21.60 (1.26)
Rationale: Polyunsaturated Fatty Acids (PUFAs) are associated
Results: We observed a significant difference between cases with inflammation. While Omega-3 PUFAs have emerged as
and controls in weight, BMI, Fat Free mass, Total Fat mass, and anti-inflammatory, the role of Omega-6 PUFAs is yet to be
Total Muscle mass (Table 1). Multivariate analysis showed that established in rheumatoid arthritis (RA).
Methods: Women with RA global functional status I-III were handgrip strength (r:0.62, p < 0.01), leg strength (r:0.66,
included, cytokines levels were determined by the Luminex p < 0.01), inspiratory- (r:0.52, p < 0.05) and expiratory mouth
method, the intake of Omega-6 PUFAs was obtained by 24-hour pressures (r:0.64, p < 0.01). ASR LEU > HMB was correlated with
dietary recall which was divided in terciles of consumption (low plasma HMB (r:0.53, p < 0.05) and BCKA concentrations (r:0.51,
<4.1 gr, intermediate 4.1–14.0 gr, and high intake ≤ 15.0 gr), p < 0.05), and handgrip strength (r:0.73, p < 0.001).
and the difference between terciles was obtained by ANOVA. Conclusion: Muscle weakness is associated with reduced HMB
Results: Fifty women were included with median age of 47 concentration and production in patients with COPD.
(P25th 37.5 – P75th 55) years, mean DAS28 score 2.5 ± 1.1, and Disclosure of Interest: None declared.
median disease duration 9 (P25th 5 – P75th 19) years. It was
observed that the group of lower intake of Omega-6 PUFAs had
MON-P131
higher concentration of proinflammatory cytokines compared
TASTE RECEPTOR POLYMORPHISMS AND OBESITY: IS THERE
with intermediate and high intake, independently of other
A LINK?
variables associated with inflammation: EGF p= 0.003 151.96
(P25th 54.15- Pth75 202.22) vs 60.93 (P25th 30.4 - P75th M. Taus1 *, A. Vignini2, F. Borroni2, S. Pugnaloni2,
119.8), IL12 p= 0.05 76.84 (P25th 2.1 - P75th356.7) vs 20.17 J. Sabbatinelli2, M. Fabri3, M. Emanuelli2, D. Fumelli1,
(P25th 0 P75th 67.25), IL13 p= 0.001 91.98 (P25th 0 – P75th M. Cecati2, G. Nicolai1, D. Busni1, A. Nicolai1, L. Mazzanti2.
1
319.8) vs 0.28 (P25th 0 – P75th 6.5), IL5 p= 0.014 11.98 (P25th Unità di Dietetica e Nutrizione Clinica, Azienda Ospedaliera
0.1 – P75th 72.0) vs 3.29 (P25th 0.62 – P75th 9.0), IL8 p = 0.002 Universitaria di Ancona, 2Dipartimento di Scienze Cliniche
40.31 (P25th 40.31 – P75th 138.32) vs 15.84 (P25th 9.7 – P75th Specialistiche ed Odontostomatologiche-Sezione di
23.6), TNFβ p= 0.001 278.11 (P25th 16.3 – P75th 706.49) vs Biochimica, Biologia e Fisica, Facoltà di Medicina e Chirurgia,
3
12.45 (P25th 0 – P75th 98.69). Dipartimento di Medicina Sperimentale e Clinica, Sezione di
Conclusion: The high intake of Omega-6 PUFAs was associated Neuroscienze e Biologia Cellulare, Facoltà di Medicina e
with the decrease serum levels of proinflammatory cytokines. Chirurgia, Università Politecnica delle Marche, Ancona, Italy
Disclosure of Interest: None declared. Rationale: Taste sensitivity plays an important role in
individual food preferences and dietary habits and its
MON-P130 changes is positively correlated with Body Mass Index (BMI)
Β-HYDROXY-Β-METHYLBUTYRATE (HMB) PLASMA LEVELS increase. The aim of this study was to investigate the genetic
ARE STRONGLY RELATED TO MUSCLE MASS AND STRENGTH IN polymorphisms of taste receptors in obese and control patients
PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE since their modifications could lead to prefere high-calorie
M. P. Engelen1 *, D. K. Walker1, A. Wierzchowska-Mcnew1, foods that promote the onset of obesity.
M. S. Jeon1, N. E. Deutz1. 1Center for Translational Research in Methods: In 78 overweight-obese patients (BMI ≥ 25 kg/m2)
Aging and Longevity, Dept. Health and Kinesiology, Texas A&M and 31 normoweight healty patients (BMI < 25 kg/m2), we
University, College Station, United States investigated 4 different polymorphisms: TAS2R38 A49P
(rs713598) and TASR38 V462A (rs1726866) located at TAS2R38
Rationale: β-hydroxy-β-methylbutyrate (HMB), a product of gene (NM_176817.4) which codifies for the bitter taste
leucine (LEU) oxidation, is known for its anti-catabolic receptor; and TAS1R3 C-1572T (rs307355) and TAS1R3 G-
properties. Chronic Obstructive Pulmonary Disease (COPD) is 1266A (rs35744813) located at TAS1R3 gene (NM_152228.2)
often associated with muscle loss and dysfunction but the role which codifies for the sweet taste receptor. These 4 investi-
of HMB remains unclear. This study investigates the relationship gated polymorphisms differ at three nucleotide positions
between HMB metabolism, muscle strength and mass in normal resulting in amino acid changes in the protein.
weight COPD patients. Results: The frequency of the mutations for TAS1R3 C-1572T
Methods: In 22 patients with moderate to severe COPD (GOLD and TAS1R3 G-1266A is extremely low in pathological and
II-IV) and 13 age-matched healthy control subjects, fasted control samples; thus we aren′t able to formulate any
plasma HMB, branched chain amino acid (BCAA) and keto acid suggestion relative to alleles distribution. On the contrary,
(BCKA) concentrations, and rate of appearance (Ra) of LEU preliminary data seem to show a different distribution for two
were measured after pulse IV administration of 2H3-LEU, and alleles involved in both of two polymorphisms TAS2R38 A49P
absolute synthesis rate of HMB from Leucine (ASR LEU > HMB) and TAS2R38 V462A between pathological and control groups.
was calculated. Appendicular skeletal muscle mass index Conclusion: Our data could support recent scientific advances
(ASMI) was measured by Dual-energy X-ray absorptiometry, showing that single nucleotide polymorphisms are linked to
and respiratory-, handgrip-, and leg muscle strength by mouth differences in taste perception and food preference. The
pressures, handgrip- and one leg dynamometry, respectively. importance of genetic chemosensory variation and the
We measured plasma concentrations and enrichments by GC- influence of gustatory functioning on eating behavior should
and LC-MS/MS. Statistics by unpaired t-tests and spearman be investigated in each person since individual genotypic
correlation tests. variations results in specific phenotypes of food preference and
Results: The COPD patients were characterized by reduced nutrient intake. In conclusion, our findings could provide
(upper and lower) limb and inspiratory mouth pressure important insights for the design of new therapies for weight
( p < 0.01), and increased Ra LEU ( p < 0.001) as compared to loss and long-term weight maintenance.
the healthy control group, and comparable values for ASMI, Disclosure of Interest: None declared.
plasma HMB, BCAA and BCKA concentrations, and ASR
LEU > HMB. Significant relationships were found in COPD
patients between plasma HMB and ASMI (r:0.77, p < 0.001),
S228 Poster
MON-P132 correlation was found between VD and psychological status in

EQ5D-3L INCLUDING VAS FOR MEASURING QUALITY OF LIFE dialysis patients ( p < 0.05). There was statistically significant
IN HPN PATIENTS relation between VD and obsessive compulsive disorder,
M. Holst1,2 *, L. Ryttergaard3, L. S. Frandsen2, depression, paranoid ideation scores ( p < 0.05). Patients who
L. Vinter-Jensen2, H. H. Rasmussen1,2. 1Department of Health low VD level has had high scores.
Sciences, Aalborg University, 2Center for Nutrition and Bowel Conclusion: VD levels can be effective on psychological status
Disease, Aalborg University Hospital, Aalborg, in dialysis patients. Vitamin D is essential for not only bone
3
Gastroenterology, Herlev Hospital, Copenhagen, Denmark health but also psychological wellness in these patients. While
clinicians will asses and therapy of dialysis patient’s psycho-
Rationale: According to literature, HPN patients experience logical status should take into account patient’s vitamin D
reduced quality of life (QOL). This study aimed to explore the status.
internal validity for measuring quality of life by EQ5D-3L Disclosure of Interest: None declared.
including VAS in a Danish population of HPN patients.
Methods: All patients receiving HPN for > one year (N = 88) at MON-P134
Center for Nutrition and Bowel Disease, Aalborg University MEGESTROL ACETATE INCREASE MUSCLE MASS IN
Hospital, were included in the investigation of EQ-5D-3L HEMODIALYSIS PATIENTS
including the EQ VAS (visual analogue scale), which was sent
to patients by mail, with a reply envelope. M. Fernandez-Lucas1, M. D. M. Ruperto2 *, M. Díaz1,
Results: A total of 50 (57%) patients mean age 63(SD 12.4) N. Rodríguez-Mendiola1, G. Ruíz-Roso1, J. L. Teruel1, F. Liaño1.
1
responded. Of these, 68% were female. The majority were Nephrolgy, Hospital Ramón Y Cajal, 2Nutrition, U. Alfonso X el
cohabiting 31 (62%), 40% had a medium high education, and 53% Sabio, Madrid, Spain
retired. Home care nurse was involved in 26 (53%) care around
Rationale: Megestrol acetate is a stimulant-appetite with
HPN. Overall EQ5D VAS score for QOL was 58.73. a numerically
potential effects in uremic anorexia in hemodialysis patients
lower score was found in Female (56.44) than male (63.59).
(HD). The study aimed to assess the effect of megestrol acetate
Lowest VAS-QOL was found in patients aged 30–50 years
on nutritional status and the body composition changes in
(Female: 48 and Male: 55). For the EQ5D dimensions, most
HD patients.
patients indicated ‘no problems’ to mobility, personal care and
Methods: Descriptive-longitudinal-intervention study in 9
anxiety/depression, while for usual activities 30% and pain/
anorexic HD patients (men: 44,4%, age: r: 40–80 yr) assessed
discomfort, 36% reported ‘difficulties’. The mean value of EQ-
by Likert scale. A dose of 160 mg/day of megestrol acetate was
5D index score (0.694) was higher than the mean VAS score
provided during follow-up (2–12 months). Anthropometric
(0.587); T = 5.172 and p < 0.001. Further studies may explain
measures, biochemical parameters and body composition
the difference between the two parts of EQ5D-3L.
analysis by bioelectrical bioimpedance (EFG, Akern, SRL), on
Conclusion: A significant difference was seen between the
baseline (V0) and post-intervention period (V1) were
EQ5D-QOL-measures, by index score and VAS. Decreased QOL in
performed.
HPN patients is seen especially in age below 50, and in
Results: Mean time of follow-up was 6.5 ± 3.8 months. Data
dimensions of usual activities and pain/discomfort.
post-intervention compared with baseline showed significant
Disclosure of Interest: None declared. differences with dry weight (V1: 61.7 ± 13.7 vs. V0: 56.7 ± 11.2;
p= 0.009), intracellular body water (V1: 56.5 ± 5 vs. V0:
MON-P133 49.9 ± 5; p = 0.01), body cell mass (kg) (V1: 25 ± 7.5 vs. V0:
VİTAMİN D AND PSYCHOLOGİCAL STATUS İN DİALYSİS PATİENT 21.3 ± 6.1; p= 0.025), and muscle mass (V1: 30.8 ± 8.9 vs. V0:
M. Aydin Cil1 *, K. Gokalp2, A. Yayla3. 1Nutrition and Dietetic, 26.7 ± 7.6; p= 0.033). No significant changes on fat mass were
Health Science Faculty, Ataturk University, 2Psychological, found. Higher normalized nitrogen appearance (V1: 1.5 vs. V0:
3
Surgery, Nursing Faculty, Ataturk University, Erzurum, Turkey 0.97 g/kg /day; p < 0.05), as well as higher level of serum
albumin and s-creatinine (both, p < 0.05), were found in post-
Rationale: Psychological disorders are common problems intervention state. No changes in phosphatemia and dialysis
among end-stage renal disease patients. Vitamin D (VD) can dose (sp Kt/Vurea) or adverse effects of megestrol acetate
be essential for congitive functions. Especially depression is were observed.
associated with VD deficiency. The aims of this study was to Conclusion: The administration of megestrol acetate improve
elucidate association between serum VD level and psycho- nutritional-hydration being associated significantly with
logical status in dialyzed patients. weight gained and higher body cell mass, muscle mass and
Methods: The study was carried out in a university hospital serum albumin in anorexic HD patients. Further longitudinal
dialysis center in Eastern Turkey. 25(OH) D levels measured in a studies are required to evaluate uremic anorexia in HD
university hospital biochemical laboratuary. Psychological patients.
status was evaluated by Brief Symptom Invantory. Disclosure of Interest: None declared.
Results: The study was conducted with 90 dialysis patient (59
hemodialysis, 31 continuous ambulatory peritoneal dialysis).
Mean age was 53.74 ± 14.83 (18–81) years, 61.6% of patients
were female, 38.4% of patients were male. Mean VD was
23.51 ± 29.50 ng/mL (3–118) and 63.2% of patients were levels
of VD<20 ng/mL, 8.9% of patients were levels of VD 20–30 ng/
mL, %27.8 of patients were levels of VD >30 ng/mL. Negatif
MON-P135 Methods: The protocol contemplates to review home medica-

MONITORING OF NUTRITIONAL STATUS IN PATIENTS WITH A tion in all patients that at discharged incorporate a feeding
PSYCHIATRIC DIAGNOSIS, COMPARED PARAMETER VALUES IN tube. Pharmacists list all medication by reconciliation protocol
THE GROUP OF PATIENTS WITH EATING DISORDERS and record it in patient history. These report includes
(ANOREXIA NERVOSA AND BULIMIA NERVOSA) AND WITHOUT medication recommendation for feeding tube according to
EATING DISORDERS bibliography. During 2016 for each patient was recorded:
M. Navratilova1 *, J. Tůmová2, J. Jarkovský3. 1Department of demographic variables, type of feeding tube, conciliation to
Psychiatry, 2Department of Clinical biochemistry, Medical hospital discharge or replacement of the device, causes of
Faculty of Masaryk University and University Hospital Brno, feeding tube establishment, number of patients who needed
3
Institute of Biostatistics and Analyses, Medical Faculty of pharmacists’ intervention, and patient with pharmacists
Masaryk University Brno, Brno, Czech Republic intervention whose physician adapted treatment to their
recommendations.
Rationale: The aim of our study was to monitor the nutritional Results: 116 patients were recruited, 61.8% women, mean age
status and laboratory parameters in patients with a psychiatric 76 ± 18 years. 62.9% PEG, 36.2% NGT, 0.86% nasojejunal tube.
diagnosis and compare parameter values in the group of 58.6% was performed at the time of device placement, and
patients with eating disorders and without eating 41.4% at subsequent insertions. [U1] [I2] Causes of feeding
disorders (ED) tube: Dementia 18.96%; Ictus 29.31%; Neoplasms 18.11%,
Methods: We observed a total of 338 patients with a psychiatric Alzheimer’s 16.37%; Parkinson’s disease 5.18%; Other 12.06%.
dg 217 women, 121 men over a period of 1y from January to After reviewing patient’s medication at discharged, 75% of
December 2014. The average length of follow-up was them required a reconciliation report. After physicians
3.5 months, 122 patients with ED-32 with bulimia nervosa, 62 prescriptions analysis, 45.9% of pharmacist’s recommendations
with anorexia nervosa, 28 with mixed form and 216 with other were accepted
psych. diagnoses:128 women, 88 men. The average age of Conclusion: Three quarters of patients require medication
patients with ED was 26 y, women accounted 90.2%, males 9.8% modifications according to feeding tube characteristics. The
of the dataset, aged 14–38 y, average age with other psychiatric implementation of the protocol allows an early adaptation of
diagnoses was 36 y, women 59%, men 41% of the dataset, aged the medication and a periodic monitoring of the use of the
15–87 y. Patients were observed in long-term study. medication in half of patients
We investigated the biochemical prm a total of 36 prm in serum Disclosure of Interest: None declared.
and 10 prm in urine for 24 hrs under metabolic screening.
The dataset were statistically evaluated.
MON-P137
Results: Statistically significant differences were found for
EFFECT OF CITRULLINE SUPPLEMENTATION COMBINED TO
total bilirubin, GGT, ALP, total protein, glucose, albumin,
HIGH INTENSITY INTERVAL TRAINING ON FUNCTIONAL
phosphorus, sodium, potassium, magnesium, iron, pancreatic
CAPACITIES AND BODY COMPOSITION IN NON-OBESE OLDER
amylase, HDL-cholesterol, total T3, prealbumin, transferrin
ADULTS.
and ferritin, but it did not response the severity of the clinical
condition. For the assessment of the clinical status these M. Aubertin-Leheudre1,2 *, M. C. Dulac1, G. El Hajj Boutros3,
differences between the two groups are insignificant. L. P. Carvalho3, V. Marcangeli3, P. Gaudreau4, J. A. Morais5,
Conclusion: We reaffirmed that it cannot reveal the dg of ED G. Gouspillou3, P. Noirez6. 1Sciences of Physical Activity, UQAM,
2
using biochemical parameters, we observed small differences Centre de Recherche de l’Institut Universitaire de Geriatrie
in contrast to significant weight loss and very serious clinical de Montreal (CRIUGM), 3UQAM, 4U de Montreal, 5McGill
conditions (bradycardia, arrhythmia, hypotension, amenor- University, Montreal, Canada, 6Paris Descartes University,
rhea, osteopenia to osteoporosis, lanugo, impaired thermo- Paris, France
regulation, trophic changes, changes in GIT, peripheral
Rationale: Aging is associated with an increase in fat mass
cyanosis, colaps conditions, epiparoxysmy, immune
(FM), a decrease in muscle mass (LBM) and strength leading to a
deficiencies).
decline in functional capacity. In animal studies, citrulline
Disclosure of Interest: None declared. supplementation (CIT) induces an increase of LBM, a decrease
of FM and stimulates lipolysis. Our aim was to evaluate the
MON-P136 effect of CIT combined to high intensity interval training (HIIT)
A PROTOCOL FOR MEDICATION RECONCILIATION IN PATIENTS on functional capacities and body composition in non-obese
WITH FEEDING TUBE older adults.
M. G.-M. G.-M. Isabel1, M. Moreno Santa Maria1, E. Alvaro1, Methods: 44 non-obese (BMI < 30 kg/m2) and sedentary (<2 h of
L. Rey1, J. Abiés1 *, J. Arenas1. 1Hospital Costa Del Sol, structured exercise/week) older adults (>60 yrs) have been
Marbella, Spain recruited and double-blinded randomly assigned to 2 groups:
Placebo (PLA; n = 21) and CIT (n = 23).
Rationale: To describe the characteristics of a population of All participants received 10 g of CIT supplementation/day and
patients with feeding tube who have been included in a followed a HIIT (30 min/session; cycle: 30 sec > 80% heart rate
program for medication reconciliation and drug management (HR)+ 1:30 min at 65%HR) on elliptical during 12 weeks.
education provided by pharmacist. Secondarily, to analyze if Body composition (LBM, FM: DXA); functional capacities
the recommendations are accepted by the doctor and the (unipodal balance; normal and fast timed up & go (nTUG;
medication is modified according to our indication fTUG); chair and step tests);handgrip stenght (HS) & aerobic
S230 Poster
capacities (6min-walk test; VO2 max) were measured pre and MON-P139
post-intervention. PATIENTS WITH SHORT BOWEL SYNDROME STRATIFIED BY
Results: At baseline, no difference was observed for age DIAGNOSIS: POST HOC ANALYSIS OF TEDUGLUTIDE ON FLUID
(67.9 ± 3.3 vs 67.5 ± 5.0 yrs), BMI (26.1 ± 2.2 vs 25.5 ± 2.4 kg/ COMPOSITE EFFECT
m2), total FM (24.04 ± 5.04 vs. 24.14 ± 5.28 kg) and LBM P. B. Jeppesen1 *, S. M. Gabe2, K. Iyer3, U.-F. Pape4,
(47.6 ± 9.9 vs. 44.1 ± 8.8 kg) or HS/body weight (0.46 ± 0.08 D. L. Seidner5, H.-M. Lee6, C. Olivier7. 1Rigshospitalet,
vs. 0.44 ± 0.010 kg/kg) between the PLA and CIT groups. Copenhagen, Denmark, 2St Mark’s Hospital, Northwick Park,
Using a General Linear Model repeated measured, we observed United Kingdom, 3Mount Sinai Medical Center, New York,
that the CIT group improved significantly more unipodal United States, 4Charité University Medicine, Berlin, Germany,
balance ( p = 0.020), nTUG ( p = 0.033), fTUG ( p = 0.0016), and 5
Vanderbilt University Medical Center, Nashville, 6Shire Human
total ( p = 0.033), trunk ( p = 0.042) and android ( p = 0.017) FM. Genetic Therapies, Inc., Lexington, United States, 7Shire
Conclusion: CIT supplementation combined to HIIT improves International GmbH, Zug, Switzerland
more efficiently functional capacities and body composition in
non-obese older adults. Further studies will be necessary to Rationale: Inflammatory bowel disease (IBD) and mesenteric
decipher the underlying mechanism of action of CIT in vascular (Vasc) disease are underlying conditions for short
association with exercise. bowel syndrome−intestinal failure (SBS−IF). Fluid balance,
Disclosure of Interest: None declared. urine production, and parenteral support (PS) volume are
variable among SBS−IF patients ( pts). This is a post hoc analysis
MON-P138 of teduglutide (TED) on fluid composite effect (FCE = sum of
PREVALANCE OF MALNUTRITION IN HOSPITALIZED CHILDREN urine volume output increase, oral fluid intake reduction, and
PS volume reduction) in pts stratified by diagnosis.
N. Urganci1 *. 1Pediatry, Nutricia, Istanbul, Turkey Methods: STEPS (NCT00798967; EudraCT2008-006193-15) was
a 24-wk, placebo (PBO)−controlled study of TED 0.05 mg/kg/
Rationale: This study aims to investigate the distribution of
day in SBS−IF pts. Three groups were evaluated: SBS−IBD, SBS
malnutrition and disease, detection of malnutrition preva-
−Vasc, and Other.
lance, effects of hospitalization on nutritional status.
Results: The SBS−IBD group included more pts with stoma (95%;
Methods: Four hundred children at the age of 1 month to 18
SBS−Vasc, 19%; Other, 41%) and fewer with colon-in-continuity
years who were hospitalized and followed at the inpatient
(11%; SBS−Vasc, 78%; Other, 62%). At Wk24 (Table), PS volume
pediatric clinics of Şişli Hamidiye Etfal Training and Research
reductions were significantly higher in SBS−IBD pts treated
Hospital in the period between August 2014 and May 2015, were
with TED vs PBO (P = 0.02) and vs TED pts in SBS−Vasc (P = 0.04)
included in the study. Within the first 48 hours after
and Other (P = 0.02) groups. Change in FCE was greater in SBS
hospitalization and discharged at the last 24 hours, body
−IBD pts treated with TED vs PBO (P < 0.02) and vs TED pts in SBS
weight, height was measured. The prevalence of malnutrition
−Vasc (P < 0.01) and Other (P = 0.05) groups.
during hospital admission and discharge of patients was
determined Table:
Results: Malnutrition was observed at 56.2%, 38.4%, 30%, 28.9% SBS–IBD SBS–Vasc Other
rates, in children having malignancy, neurological diseases,
Mean (SD), TED, PBO, TED, PBO, TED, PBO,
infection diseases, gastroenterological system diseases,
mL/day n = 11 n=8 n = 15 n = 17 n = 16 n = 18
respectively. 31.5% of all the subjects had acute malnutrition
at discharge. It is found an increased prevalance of malnutri- Baseline
PS 2268 (1480) 3088 (1156) 1827 (982) 1338 (731) 1399 (811) 1928 (855)
tion 2–6 years of age and 10–18 years of age at discharge. The Oral intake 2456 (1176) 1521 (532) 1780 (761) 1634 (536) 1600 (575) 1692 (708)
prevalance of malnutrition decreased in the 1 month-2 age Urine 1160 (160) 1302 (243) 1385 (252) 1389 (327) 1448 (114) 1387 (226)
group and 6–10 age group between admission and discharge. Change at Wk24
PS –1102 (654)* –357 (453)‡ –513 (539) –277 (428)§ –450 (280)# –363 (345)
Among the groups with high number of patients when evaluated Oral intake –220 (338)† 246 (608)‡ –24 (500) 188 (531)# 79 (611)# 254 (470)
according to hospitalization criteria, the highest malnutrition Urine 191 (180)† –138 (239)‡ 52 (286) 31 (243)# 222 (341)# 128 (466)
rate was found in malignity (56.2%), neurology (38.4%) and FCE –1437 (900)† 27 (818)‡ –588 (995) –147 (575)# –593 (444)# –237 (588)
infection (30%) groups. The lowest rate of malnutrition was
*n = 9; †n = 8; ‡n = 7; §n = 16; #n = 15.
found in allergy (0.002%), endocrine (0.002%), heart diseases
(0.002%) and metabolic diseases (0.002%) groups. Diseases with Conclusion: TED had the largest absolute effect on FCE in the
more patients in the group when assessed according to system SBS−IBD group; TED effect on FCE was not as major in SBS−Vasc
only the prevalence of malnutrition were decreased in the or Other pts at Wk24.
infection group at discharge.
Disclosure of Interest: P. Jeppesen Consultant for: Shire, Speaker
Conclusion: Hospitalization of children affects the nutritional Bureau of: Shire, S. Gabe Consultant for: Shire, K. Iyer Consultant for:
status adversely in general, and increases the high frequency of Shire, U.-F. Pape Grant / Research Support from: Shire, Consultant for:
malnutrition. That’s why calori calculation according to Shire, Speaker Bureau of: Shire, D. Seidner Consultant for: Shire, H.-M.
childrens’ age, diagnosis and needs should be evoluated and Lee Other: Employee for Shire, C. Olivier Other: Employee for Shire.
it’s important to prevent them from starving.
MON-P140 Australian hospital. Electronic hospital records and coding

PREVALENCE AND ASSOCIATED FACTORS OF LOW BONE were used to explore the influence of malnutrition on
MINERAL DENSITY AND FRACTURES IN A LARGE COHORT OF healthcare use (length of hospital stay (LOS)), admission type
SEVERELY UNDERNOURISHED INPATIENTS WITH ANOREXIA (respiratory or non-respiratory related) and costs (Australian
NERVOSA (AN) dollars (AUD$)).
P. Bemer1 *, H. Ohanyan1, N. Kayser1, M. Hanachi1,2, Results: Of the 834 COPD patients observed, 286 were
J.-C. Melchior1,2. 1Clinical Nutrition Unit, Hôpital Raymond hospitalised during follow-up (16% coded for malnutrition).
Poincaré (APHP), Garches, 2Faculté de médecine, Université de Malnourished patients hospitalised for non-respiratory related
Versailles, Saint-Quentin-en-Yvelines, INSERM U1179, reasons had significantly longer mean LOS (22.1 SD 21.1 d vs 9.8
Montigny-le-Bretonneux, France SD 13.9 d; p < 0.001) at more than double the cost ($39,209 SD
$40,525 vs $18,857 SD $25,333; p < 0.001). Malnutrition in
Rationale: Anorexia nervosa (AN) is a psychiatric disorder with respiratory-related admissions was related to significantly
potentially serious somatic consequences. Reduced bone longer mean LOS (14.0 SD 11.4 d vs 7.3 SD 8.9 d; p = 0.003) and
mineral density (BMD) is frequently observed in patients with a trend for increased costs ($22,366 SD $17,544 vs $13,791 SD
AN which expose them to high risk of fractures. $21,273; p = 0.083). This was similar at the respiratory ward
Methods: We aimed to study the prevalences of low BMD level with malnourished patients staying significantly longer
and fractures in severely malnourished inpatients with AN (15.3 SD 10.4 d vs 8.3 SD 9.1 d; p = 0.006). Importantly, 35% of
and their associations with clinical and biological parameters. malnourished patients on the respiratory ward had an admission
BMD was evaluated by using dual energy X-ray absorptiometry. ≤1 week compared to 25.5% of the malnourished cohort as a
Results: We included 109 patients (105 F/4 M), age 30.8 ± 12.4, whole. This rose to 41% (LOS ≤ 1wk) of malnourished COPD
BMI 12.9 ± 2, 67.9% AN restrictive type, 32.1% purging type. patients admitted for respiratory-related reasons across all
Duration of illness and amenorrhea were respectively wards.
11.4 ± 10.8 and 8.9 ± 9.4. Prevalence of reduced spine Zscore Conclusion: Malnutrition was associated with increased
under -2 SD was observed in 57 patients (52.3%). Eleven healthcare use and costs but this varied considerably depend-
patients (10.1%) had one or more fractures, including 8% of ing on the admission type and ward. While the acute setting is
vertebral fractures. Higher age and lower BMI were significantly an opportune time to identify malnutrition and start nutrition
associated with lower spine Zscore (respectively p = 0.005, support, the limited LOS highlights the need for robust
p = 0.0003). Higher age was also associated with lower femoral coordinated nutritional care post-discharge.
neck Zscore ( p = 0.0002), as well as alkaline phosphatase Disclosure of Interest: None declared.
( p = 0.04), duration of illness ( p = 0.003) and undergoing
neuroleptic treatment ( p = 0.001). Bone mineral density for
MON-P142
all body was significantly associated with an undergoing
VALIDATION OF PREDICTIVE EQUATIONS FOR RESTING
treatment by proton pump inhibitors ( p = 0.01) and fractures
ENERGY EXPENDITURE IN ADULTS AND ELDERY NON-
( p = 0.03). Fractures were significantly more frequent in older
CRITICALLY ILL PORTUGUESE PATIENTS
patients ( p = 0.009) and associated with the duration of disease
( p = 0.02). P. S. Barcellos1,2 *, N. Borges3, D. Torres2. 1Departamento de
Conclusion: More than half of severely AN malnourished Ciências Fisiológicas, UFMA, São Luís-MA, Brazil, 2Fcnaup,
inpatients have low BMD with high rate of fractures. Severity Universidade Do Porto, Porto, Portugal, 3Fcnaup, Universidade
of undernutrition and duration of disease are the most Do Porto, Porto
important associated factors. These results highlight the
Rationale: Compare resting energy expenditure (REE) mea-
importance of rapid weight gain in this population. More
sured by indirect calorimetry (IC) and predicted by equation
prospectives studies are needed to identifie patient profiles at
values in adults and elderly non-critically ill patients and
high risk of osteoporosis and fractures and to test preventive
analyze which was the best alternative.
and curative treatments.
Methods: Non-critical ill patients (180), with non-critically ill
Disclosure of Interest: None declared. diagnosis from Surgery unit at portuguese hospital were
evaluated from June 2015 to December 2016. Indirect
MON-P141 calorimeter was used to measure REE (Cosmed k4 b2) and
TREATMENT OF MALNUTRITION IN HOSPITALISED PATIENTS compared with energy expenditure formulas.
WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD): Results: Table 1. Resting energy expenditure mean measured
IS THERE OPPORTUNITY? by indirect calorimetry and estimated by formulas in non-
P. F. Collins1,2 *, A. S. Lackoff1, C. Hukins3. 1School of Exercise critical ill patients in a Portuguese Hospital, 2016.
and Nutrition Sciences, Faculty of Health, QUT, 2Department of Conclusion: Resting energy expenditure measuared by iC shows
Nutrition and Dietetics, 3Department of Respiratory & Sleep weak correlation with estimated energy by formulas (Harris-
Medicine, Princess Alexandra Hospital, Brisbane, Australia Benedict, Ireton-Jones and MifflinSt. Jeor, 1991). Mean of
difference were differents both in adults and elderly people.
Rationale: Malnutrition in COPD presents both an economic Results suggests these formulas there′s not accurate for this
and operational burden to hospitals. This study aimed to population.
explore patterns of healthcare use and costs in relation to
malnutrition and admission type.
Methods: A prospective cohort observational study was
conducted in outpatients with COPD attending a large tertiary
S232 Poster
Table 1: those without DM2. Females with DM2 showed lower energy
GLOBAL (n = 180) ADULTS (n = 102) ELDERLY (n = 78) intake. On average, subjects seem to have a negative energy
balance, which is probably due to a combination of under-
REE (kcal) Mean SD r Mean SD r Mean SD r
reporting of intake and over-reporting of activity.
Indirect 1891,53 ±723,58 1 1928,33 ±661,76 1 1843,40 ±799,12 1
Calorimetry Disclosure of Interest: R. Memelink Grant / Research Support from:
Harris- 1414,38* ±229,12 0,33** 1501,44* ±237,79 0,35** 1300,53* ±157,16 0,35** Baseline data obtained from Nutricia Research co-funded trials,
Benedict A. Verreijen: None declared, J. De Vogel-Van den Bosch Other:
Ireton-Jones 1535,98* ±378,02 0,23** 1747,29* ±316,28 0,21* 1259,64* ±253,91 0,32** Employee Nutricia Research, P. Weijs: None declared.
MifflinStJeor 1339,39* ±239,65 0,40** 1419,46* ±234,55 0,42** 1234,68* ±204,33 0,40**
1990
MON-P145
Friedman Test *p-value <0,05 r- Pearson correlation * < 0,05 and ** <0,01. THE EFFECT OF DIETARY NITRATE SUPPLEMENTATION ON
MECHANICAL EFFICIENCY AND CARDIOMETABOLIC RISK
References
PROFILE IN PATIENTS WITH CHRONIC OBSTRUCTIVE
Harris JA. and Benedict FG. A biometric study of human basal PULMONARY DISEASE
metabolism. Proceedings of the National Academy of Sciences of the
United States of America 1918;4: 370–373. R. J. H. C. G. Beijers1 *, S. Huysmans1, C. van de Bool1,
Ireton-Jones C, Jones JD. Improved equations for predicting energy B. R. M. Kingma2, L. B. Verdijk2, L. J. C. van Loon2, S. J. Meex3,
expenditure in patients: The Ireton-Jones equations. Nutr Clin Pract. H. R. Gosker1, A. M. W. J. Schols1. 1Department of Respiratory
2002;17:29–31. Medicine, 2Department of Human Biology and Movement
Mifflin MD, Stjeor ST and cols. A New Predictive Equation for Resting Sciences, NUTRIM School of Nutrition and Translational
Energy-Expenditure in Healthy-Individuals. AJCN. 1990;51(2):241–7. Research in Metabolism, Maastricht University Medical Centre+,
3
Disclosure of Interest: None declared. Department of Clinical Chemistry, Cardiovascular Research
Institue Maastricht (CARIM), Maastricht, Netherlands
MON-P144 Rationale: Many patients with COPD have a decreased
ENERGY INTAKE AND EXPENDITURE IN OBESE OLDER ADULTS mechanical efficiency during exercise and are at increased
WITH AND WITHOUT TYPE 2 DIABETES cardiometabolic risk. Dietary nitrate supplementation may
R. G. Memelink1 *, A. M. Verreijen1, J. De Vogel-Van den Bosch2, reduce oxygen requirements during submaximal exercise,
P. J. Weijs1. 1Department of Nutrition and Dietetics, School of improve exercise performance and lower blood pressure. This
Sports and Nutrition, Amsterdam University of Applied study determines the impact of acute and 7-days dietary
Sciences, Amsterdam, 2Nutricia Advanced Medical Nutrition, nitrate supplementation on mechanical efficiency and cardio-
Nutricia Research, Utrecht, Netherlands metabolic risk profile in patients with COPD.
Methods: In a double-blind, randomized cross-over placebo-
Rationale: Obesity is a risk factor for type 2 diabetes (DM2), controlled trial 18 COPD patients were included with moderate
however not all obese people develop DM2. We explored airflow obstruction and exercise impairment, normal BMI
differences in energy intake and expenditure between obese (25.9 ± 3.4 kg/m²) but high prevalence of abdominal obesity
older adults with and without DM2. (77.8%) and moderately decreased mechanical efficiency.
Methods: Baseline data from 2 lifestyle interventions with a Subjects were randomly allocated to the treatment order of 7
total of 202 obese older adults were included in the analyses. days sodium nitrate ingestion (∼8 mmol per day) and 7 days
Obesity was defined as BMI > 30.0, or >27.0 with waist placebo (NaCl solution), separated by one week washout.
circumference >88 (women) or >102 cm (men). DM2 was Before (day 1) and after (day 7) both intervention periods
confirmed by use of diabetes medication. Subjects were mechanical efficiency during submaximal cycle ergometry,
between 55 and 85 years old and 45% was female. Energy plasma nitrate and nitrite levels, cardiac plasma markers (e.g.
intake (EI) was measured by 3-day food diary and physical high-sensitive troponin T (Hs-TNT), Nt-proBNP and creatinine
activity level (PAL) by 3-day movement diary. Resting energy kinase (CK)) and blood pressure were measured.
expenditure (REE) was measured using indirect calorimetry and Results: Plasma nitrate and nitrite concentrations increased
total energy expenditure (TEE) was calculated as REE x PAL. at day 1 (7-fold and 2-fold, respectively) and day 7 (8-fold and
Between group differences were analysed with independent 2-fold, respectively) after sodium nitrate compared with
samples T-tests. placebo ingestion. Systolic and diastolic blood pressure did
Results: The obese group with DM2 (n = 117) had more males not change following nitrate ingestion. Furthermore, no
(67.5% vs 37.6% p < 0.001) and similar BMI (33.3 vs 33.0 kg/m2) differences were observed in mechanical efficiency during
compared to the group without DM2 (n = 85). Analyses of males submaximal exercise and no changes were observed in Hs-TNT,
and females separately showed lower PAL in males with DM2 (vs CK and Nt-proBNP concentrations between the nitrate and
without DM2; 1.37 vs 1.45, p = 0.015), without differences in EI placebo treatment.
(2055 vs 1953 kcal/d), REE (1970 vs 1929 kcal/d), and TEE Conclusion: Acute as well as 7-days of dietary nitrate
(2699 vs 2830 kcal/d). In females with DM2, both PAL (1.38 vs supplementation does not increase mechanical efficiency or
1.47, p = 0.014) and EI (1543 vs 1839 kcal/d, p = 0.008) were improve cardiometabolic risk profile in mild-to-moderate COPD
significantly lower, whereas REE (1592 vs 1598 kcal/d) and TEE patients.
(2220 vs 2318 kcal/d) did not differ significantly from obese
females without DM2.
Conclusion: In both males and females, obese older adults with
type 2 diabetes showed similar resting and total energy
expenditure but lower physical activity level compared to
MON-P146 respiratory disease other than COPD, those having a disease

A POOR MUSCLE FUNCTION STATUS IS ASSOCIATED TO that would lead to malnutrition, pregnant women, and those
MALNUTRITION RISK IN A COHORT OF CHRONIC HEART who gave birth in the last 3 months were excluded. Body mass
FAILURE PATIENTS index (BMI), fat-free body mass, findings of respiratory function
S. Molinero Abad1, A. Mijan de la Torre1, M. Soto Celix2, and handgrip strength tests, the Modified Medical Research
A. Riego Valledor1 *. 1Internal Medicine, Hospital Universitario Council dyspnea score, and the GOLD 2015 stage were
De Burgos, Burgos, Spain, 2Nutrition, Universidad Pontificia recorded.
Católica de Chile, Santiago de Chile, Chile Results: The study included 241 COPD patients who had a GOLD
stage A (n = 54), B (n = 32), C (n = 61), or D (n = 94) COPD. There
Rationale: Our previous studies have shown how Sarcopenia is a was no difference among the stage groups regarding gender and
prevalent syndrome in CHF patients with a lower survival. Now fat-free body mass. The BMI of the patients with stage D was
we wanted to check if a malnutrition risk modifies survival in significantly lower than that of those with stage A. The rate of
this setting and his association with a poor muscle function. weak patients (a BMI of <18.5) was 0% in the patients with stage
Methods: Prospective cohort study (n = 103) patients with CHF A and 5.3% in those with stage D. A decrease was observed in the
(NYHA III-IV) were consecutively selected. Nutrition risk forced expiratory volume in one second (FEV1), which reflects
screening (NRS-2002), Mini-Nutritional assesment (MNA) and the respiratory muscle strength, with increasing disease stage.
Subjective global assessment (VGS) were performed. Muscle The value of the handgrip test, which reflects the peripheral
function was measured by hand-grip dynamometry (kg) - lower muscle strength, was lower in the patients with stage D than in
limit <20(f ); <30(m)-. Patients were followed-up and survival those with stage A (Table 1).
rate (months) registered. Data (mean, IC 95%) were stat
Table 1: Findings of the patients with GOLD stage A and D COPD.
analyzed by Kaplan-Meier and Log-Rank Tests. Statistical
Stage A Median Stage D Median
significance was reached at p < 0.05.
(Q1-Q3) (Q1-Q3)
Results: One-hundred three patients (50 f-82.5y; 53 m-82.5y)
were selected. Global prevalence of malnutrition was 69,9% BMI, kg/m2 28.02 (24.8–32.31) 25.97 (22.30–29.79)
FEV1, % 61 (57–74) 33 (23–41)
NRS-2002 (67,3% females/71,7% males); 83,3% MNA (83,7% Handgrip strength test, kg 29.92 (25.2–38.63) 24.58 (19.23–29.87)
females/83%males) and 58,8% VGS (59,2% females/ 58,5%
males). Low muscle strength (Kg) was detected in 77,1% (37) of Conclusion: The BMI was observed to be lower in the advanced
women and 79,2% (42) of men with a mean of 14,9 ± 2,5 and stage COPD patients, which resulted in a decrease in the muscle
24.5 ± 5,5 respectively. Survival rate was not influenced by strength.
gender ( p = 0.56), but was influenced by risk of malnutrition
( p= 0,017 NRS; p= 0.08 MNA; P= 0.005 VGS). An association Disclosure of Interest: S. Arinc Grant / Research Support from: Nutricia
Medical Nutrition, Turkey, M. Agca Grant / Research Support from:
between muscle function and risk of malnutrition using the T-
Nutricia Medical Nutrition, Turkey, F. Yaman Grant/Research Support
Test (mean difference 3,45 Kg NRS ( p = 0.039); mean differ- from: Nutricia Medical Nutrition, Turkey.
ence 5,33 Kg MNA ( p = 0.00,9); mean difference 4,085 Kg in
VGS ( p = 0,009)).
MON-P148
Conclusion:
DIETARY INTAKE OF PATIENTS WITH INFLAMMATORY BOWEL
1. A high prevalence of malnutrition has been shown in our
DISEASE
cohort of Severe CHF patients.
2. The risk of malnutrition is statistically associated with a S. Maissen1 *, D. Caviezel2, P. Hruz2, C. Kiss1. 1Dietetic Service;,
lower survival. Endocrinology, Diabetology & Metabolism, 2Gastroenterology
3. Muscle function decreases at risk of malnutrition & Hepatology, University Hospital Basel, Basel, Switzerland
4. Further analysis to check if low muscle strength may
isolately influence to survival Rationale: Inflammatory bowel disease (IBD) is a chronic
inflammatory condition of the gastro-intestinal tract which
may have a relevant impact on the dietary intake and
Disclosure of Interest: None declared. nutritional status of affected patients. Observations suggest
that the increased prevalence of malnutrition and nutritional
MON-P147 deficiencies have an unfavourable effect on disease outcome
NUTRITIONAL STATUS IN COPD PATIENTS STAGED ACCORDING (1). In the past few years biological therapies have been
TO THE 2015 GOLD STANDARDS: AN OBSERVATIONAL STUDY introduced in the treatment of IBD. Since then only a few
studies report about the diet and nutritional status of these
S. Arinc1 *, M. Agca1, F. Yaman1. 1Department of Chest Disease,
patients.
Sureyyapasa Chest Disease and Thoracic Surgery Training and
To assess the nutritional status of IBD patients treated with
Research Hospital, Istanbul, Turkey
biologicals a comprehensive assessment was undertaken. In a
Rationale: Nutritional status is one of the factors affecting part of this study we assessed for eating habits.
prognosis in chronic diseases. Nutrition support is an important Methods: In this descriptive, prospective single center study
component of patient care. This study aimed to evaluate the 156 adults with IBD were included. The IBD patients were
nutritional status of patients with the diagnosis of chronic between 18–83 years (mean 41) and 50% were women. The
obstructive pulmonary disease (COPD). dietitian assessed dietary intake with a modified food
Methods: This observational study included consecutive frequency questionnaire (2). The questionnaire contains 10
patients who were admitted to the hospital and followed-up components and each component has a score ranging from 0 to
with the diagnosis of COPD for at least 1 year. Patients having a
S234 Poster
2 with a max of 20. Higher values in the score indicate better to CVC management at first CRBSI we did not find significantly
the adherence to the healthy eating guidelines. increased risk of future CRBSIs.
Results: The mean score of the food questionnaire was 14.3 Disclosure of Interest: None declared.
(range 9–18). Three quarters of IBD patients showed an
insufficient intake of vegetables and 35% eat only 0–1 fruit
MON-P150
portions. Only one of five uses recommended oils and more
NUTRITIONAL SUPPORT IN MELAS SYNDROME. NOT ONLY
than one third have a dietary calcium intake below 750 mg per
SCIENCE BUT ALSO ART.
day. The majority has not been referred to a dietitian, although
more than half of them would be interested in dietary V. Garcia Zafra1 *, P. Sanchez Sequero1, R. Cañas Angulo1,
counselling. A. Rubio Gambin1, A. M. García Cayuela1, M. Chiang Alvarez1,
Conclusion: The results may provide a basis for an improved T. Bernal Canales2, J. F. Sánchez Romera3, M. Ferrer Gomez3.
1
dietary management of patients with IBD by a specialised Endocrinology and Nutrition, Hospital General Universitario
dietitian. Santa Lucia, Cartagena, 2Psychiatry, Hospital General
Universitario Reina Sofia, 3Endocrinology and Nutrition,
References Hospital Clinico Universitario Virgen de la Arrixaca,
1. Forbes A, et al. Clinical Nutrition 2017;36:321–347. Murcia, Spain
2. Russell J, et al. Brit J Nutr. 2013;109:547–555.
Disclosure of Interest: None declared. Rationale: MELAS syndrome (MS) is a rare mythocondrial
disease, maybe due to an heterogeneous phenotype under-
diagnosed. Its complexity is related with the multiple organ
MON-P149
dysfunction. Most prevalent symptoms are lactic acidosis (97%),
PATIENTS WITH INTESTINAL FAILURE (IF) RECEIVING HOME
seizures and stroke-like episodes (>90%), but also diabetes
PARENTERAL SUPPORT (HPS): EVALUATION OF A CATHETER-
mellitus (DM) (33%) and gastrointestinal manifestations (77%)
SALVAGE-STRATEGY IN CASE OF CATHETER-RELATED
like gastric dismotility. The only available treatment is arginine
BLOODSTREAM INFECTIONS (CRBSIS)
supplements (ARG) but vomits determine its bad accomplish-
S. Tribler1 *, C. F. Brandt1, K. A. Fuglsang1, M. Staun1, ment. Related with DM, first line treatment is diet and
P. Broebech1, C. E. Moser2, T. Scheike3, P. B. Jeppesen1. exercise, metformin is contraindicated for lactic acidosis risk.
1
Department of Medical Gastroenterology, 2Department of There is a lack of evidence concerning the complex manage-
Clinical Microbiology, Copenhagen University Hospital, ment of nutritional support in these patients.
Rigshospitalet, 3Department of Biostatistics, Copenhagen Methods: Here we report the case of a 29-year-old woman with
University, Copenhagen, Denmark severe caloric undernutrition hospitalized for seizures, nausea
and vomits that debuted with DM after nutritional support.
Rationale: Facing CRBSIs IF patients may require repetitive
Results: The patient had cognitive impairment due to a stroke-
replacement of their tunneled central venous catheter (CVC).
like episode and could not eat or receive ARG. Enteral nutrition
The catheter-salvage-strategy recommended by ESPEN is
(EN) was administrated throw nasogastric tube with continuous
evaluated.
regimen and a standard formula. This tube was also used to
Methods: In a retrospective analysis, based on the Copenhagen
administrate ARG. After one week on EN, glycemia was 401 mg/
IF database and the Microbiological Database, Rigshospitalet,
dl. Lab test showed: insulin 252 mcUI/ml (2–25), C-peptide 7.1
Denmark, we evaluated all CRBSIs from 2002–2016. Catheter
ng/ml (1.1–4.4), HbA1c 7.8% and negative autoimmunity for
salvage was defined by successful antimicrobial treatment with
DM. Later, EN was changed to a specific diabetes formula and
the CVC retained at discharge. CRBSI recurrence was defined by
the insulin needs were reduced and simplified. Finally the
the finding of the same microbial species and identical
patient was discharged with nocturnal EN cycle throw
antibiogram within 100 days. Hazard ratio was analysed with
gastrostomy, specific DM formula and 6 units of glargine insulin.
Cox proportional hazard model.
Conclusion: MS is a rare but also underdiagnosed disease.
Results: In 715 adult HPS patients, 2006 CVCs were inserted
Gastrointestinal symptons are frequent and determine nutri-
covering 2014.3 CVC years with 1350 CRBSIs (1.83/1000 CVC
tional status as well as DM in which MET is contraindicated. In
days) occurring in 357 patients (49.9%). CRBSI-related mortal-
this case nocturnal EN cycle provides a safe way to administrate
ity (n = 5) was 0.007/1000 CVC days. The hazard risk ratio for a
ARG, improve nutritional status and control hyperglycemia.
new CRBSI was 0.82 (95% CI; 0.57–1.17) (P = .28) in a replaced
versus retained CVC when analysed on patients first CRBSI. In Disclosure of Interest: None declared.
744/1350 of CRBSIs (55.1%) the CVC was salvaged; Mono-
infections 577/913 (63.2%) and poly-infections 154/296 MON-P151
(52.0%). Salvage rates for Coagulase-negative staphylococci EXAMINATION OF GLYCEMIC CONTROL INDEX IN DIABETIC
(CNS) were 68.4% (350/512); Enterobacteriaceae 49% (269/ DIALYSIS PATIENTS UNDER ON-LINE HEMODIAFILTRATION
549) and Staphylococcus aureus 40.7% (46/113). The median Y. Kitajima1 *, T. Hyodo2, Y. Sato3. 1Tokyo Healthcare University,
time to a CRBSI in a new CVC was 105 days (25–75th percentiles; Tokyo, 2Eijin Clinic, Hiratsuka, 3Sato Junkankika Hospital,
44–265) and 76 days (38–171) to next CRBSI in a previously Matsuyama, Japan
salvaged CVC (PWilcoxon=.004). Risk of CRBSI recurrence after a
CNS was 12.9%, for S. aureus 8.7% and for Enterobacteriaceae Rationale: Glycohemoglobin (HbA1c) of diabetic dialysis
16.7%. patients has been reported to underestimate diurnal blood
Conclusion: A catheter-salvage-strategy in HPS patients is sugar fluctuations as it is affected by red cell survival,
safe, however it carries a risk of CRBSI recurrence. New CRBSIs erythropoietin, etc. Therefore, it is recommended in Japan
occur earlier in a salvaged CVC, but when evaluated according that glycoalbumin (GA) should be used for glycemic control
index of diabetic dialysis patients. However, recently in Japan, Conclusion: The WHO/FAO (Food and Agriculture organisation
on-line hemodiafiltration (o-HDF) with high albumin (Alb) of the UN) and some health agencies in Europe, Canada, and
leakage has been widely used in dialysis treatment methods Australia advocate consumption of a low-GI diet. Since low GI
due to the reimbursement in the national insurance system breads may control postprandial BG and insulin responses
since 2012. As GA is affected by albumin metabolism, better, GI can be used to guide bread choices in both heathy
evaluation of GA values needs to be reexamined for diabetic subjects and patients with chronic diseases.
dialysis patients under o-HDF. In this study, we examined GA Disclosure of Interest: None declared.
values for different dialysis treatment methods.
Methods: The subjects were divided according to treatment
MON-P153
types: a hemodialysis (HD) group (23 diabetic dialysis patients)
DOES DIFFERENT PREPERATION AND COOKING METHODS
and an o-HDF group (133 diabetic dialysis patients). We
IMPACT ON THE GLYCEMIC INDEX OF THE POTATO?
examined the correlation of GA and HbA1c in comparison
with known correlation, and the amount of Alb removed in the S. Çiftçi1, Z. Büyüktuncer Demirel1 *, H. Köksel2,
o-HDF group. H. Gokmen Ozel1. 1Nutrition and Dietetics, Faculty of Health
Results: A significant positive correlation was observed Sciences, 2Food Engineering, Hacettepe University, Ankara,
between GA and HbA1c in the HD group (R2 = 0.809 and Turkey
p < 0.0001). Inaba et al. reported a similar result (r = 0.777 and
Rationale: Potato, staple food, is widely consumed in most
p < 0.001: J Am Soc Nephrol, 2007). However, the correlation in
countries. Potato has a high glycemic index (GI) and the
the o-HDF group was lower than in the HD group (R2 = 0.316 and
preparation and cooking methods affect the GI of the potato.
p < 0.0001). In the o-HDF group, average of GA, HbAlc and Hb is
The aim of this study was to determine the effect of different
20.4 ± 4.7%, 6.0 ± 0.9% and 10.6 ± 1.0 g/dl.
preparation and cooking methods on GI of potato.
Conclusion: It is possible that GAvalue is underestimated in the
Methods: Ten healthy volunteers aged 19–35 yrs were included.
o-HDF group due to the effect of Alb leakage. If Hb value is
Each of the 10 subjects consumed potatoes which were
stable by the therapy, HbA1c may be the golden standard of the
prepared and cooked using different 8 methods [boiled for
diabetic estimation even also in dialysis patients. For glycemic
35 min (B35), boiled for 50 min (B50), boiled for 35 min and
control index of diabetic dialysis patients, GA and HbA1c need
then cooled for 24 hrs (B35C), boiled for 50 min and then
to be used along with the dialysis treatment method.
cooled for 24 hrs (B50C), peeled and fried for 8 min (PF),
Disclosure of Interest: None declared. unpeeled and fried for 8 min(UPF), peeled and baked for
30 min (PB) and unpeeled and baked for 30 min (UPB)]. The
MON-P152 reference foods (glucose powder and white bread) and
GLYCEMIC INDEX OF FREQUENTLY CONSUMED BREAD TYPES potatoes were consumed containing 25 g of available carbohy-
USED FOR HEALTHY SUBJECTS AND PATIENTS WITH CHRONIC drate on separate mornings over a-10-week period. Capillary
DISEASES duplicate blood glucose (BG) levels were measured after 12
Z. Büyüktuncer Demirel1 *, R. Ergun1, H. Köksel2, hours starvation and at 15, 30, 45, 60, 90 and 120 minutes
H. Gokmen Ozel1. 1Nutrition and Dietetics, Faculty of Health after test and reference foods consumption. GI were calculated
Sciences, 2Food Engineering, Hacettepe University, Ankara, using WHO incremental area under the BG response curve.
Turkey Results: The lowest GI were found in potatoes which were B35C
relative to glucose (65 ± 37) and white bread (83 ± 50). The GI
Rationale: There is growing evidence that the type of values of other preperation and cooking methods were as
carbohydrate consumed is important in relation to chronic follows relative to glucose: PF (76 ± 32), UPF (77 ± 31), B50C
diseases risk, and there is currently particular interest in the (81 ± 51), UPB (91 ± 48), B35 (101 ± 32), B50 (100 ± 43) and
role of low-glycaemic index (GI) foods. Bread is the staple food relative to white bread: PF (97 ± 35), UPF (101 ± 45), B50C
in Turkish population. The aim of this study was to assess GI of (102 ± 54), UPB (115 ± 52), B50 (131 ± 59) and B35 (133 ± 43).
frequently consumed bread types used for both healthy The lowest GI were found in potatoes which were PB relative to
subjects and patients with chronic diseases. glucose (115 ± 56) and white bread (148 ± 63).
Methods: Ten healthy volunteers aged 19–35 years were Conclusion: It has been suggested that foods with a GI are
included. Capillary blood glucose (BG) were measured after detrimental to health. Frying method had relatively low GI
12 hours starvation and at 15, 30, 45, 60, 90 and 120 minutes. values, but it does not appear to be particularly healthy. Beside
Each of the 10 subjects consumed portions of the ten types of of the GI knowledge, healthy eating habits should be taught to
breads and the reference food (glucose powder), containing the individuals by dietitians.
50 g of available carbohydrate on separate mornings over a- Disclosure of Interest: None declared.
11-week period. GI were calculated using WHO incremental
area under the BG response curve.
Results: The lowest GI were found in village bread (VB) rich in
whole wheat (42 ± 4). The GI values of other bread types were
as follows: Stone mill (46 ± 5), wheat bran (51 ± 3), rye (52 ± 7),
ciabatta (54 ± 6), germ (54 ± 6), bagel (60.0 ± 3), white (65 ± 7),
pita (70 ± 8) and hazelnut (75 ± 9). BG after VB consumption
was significantly less than after hazelnut ( p < 0.01), pita and
white breads at 90 minutes ( p < 0.05).
S236 Poster
MON-P154 scarce. Our aims are to describe the prevalence of these co-
PHOSPHORUS NUTRITIONAL KNOWLEDGE IN DIALYSIS UNITS morbid conditions and their impact on patients with AN.
IN GREECE Methods: We conducted an observational, retrospective study
Z. Pafili1,2 *, M. Maridaki2. 1Department of Dietetics, Volos including patients with AN followed by our Nutrition Unit. Data
General Hospital, Volos, 2School of Physical Education and related to mental status and its treatment as well as data
Sport Science, National and Kapodistrian University of Athens, related to medical conditions and admissions to conventional
Athens, Greece medical wards were collected.
Results: Data from 50 patients were available for analysis. 58%
Rationale: In hemodialysis patients dietary phosphorus restric- of the cohort suffered from other co-morbid conditions. 18% had
tion is an essential component of the effort to control serum allergic diseases, 14% gastritis or gastroesophageal reflux
phosphorus. Despite dietary counceling, nutritional knowledge disease, 10% neurological diseases and 4% celiac disease. 18%
of phosphorus has been found to be low in this population. Our were admitted in a medical ward of our hospital. Electrolyte
aim was to assess phosphorus nutritional knowledge in Greek imbalances followed by infectious diseases were the most
hemodialysis patients, renal nurses and nephrologists. common causes of admission (55.5%, 22.2%, respectively).
Methods: Phosphorus nutritional knowledge was evaluated Patients who required admission were more likely to have non-
using the CKDKAT-N questionnaire in three hemodialysis units. classical co-morbidities (88.9% vs 11.1%; p = 0.04), longer time
Sixty eight patients, 19 renal nurses and 11 nephrologists of evolution of AN (16.1 ± 6.9 vs 4.7 ± 0.9 years; p = 0.01), higher
completed the questionnaire which consisted of a phosphorus age at diagnosis (19.1 ± 5.2 vs 16.7 ± 5.5; p < 0.001) and were
section (15 questions) and a rest nutrient section (10 questions taking a higher number of psychiatric drugs (3 ± 0.5 vs 1.2 ± 0.9;
for protein, sodium and potassium). Test questions assesed p < 0.001). Body mass index was not significantly tied to a higher
knowledge of food nutrient content, nutrient health effects rate of admissions.
and intake recommendations. To calculate total and partial Conclusion: Non-classical co-morbidities are frequent in
scores each correct answer got 1 point. patients with AN. Thought we found that severity of mental
Results: Nephrologists had higher CKDKAT–N total and phos- status has a strong influence on probability to be admitted by
phorus knowledge scores compared with renal nurses and clinical condition, some common clinical conditions in these
patients (total: 19.1 ± 3.6 vs 14.1 ± 2.8 and 13.2 ± 2.8 respect- patients, such as gastrointestinal disorders, can promote that
ively, P < 0.01), ( phosphorus: 10.6 ± 2.7 vs 7.6 ± 2.2 P and probability irrespective of body mass index.
7.3 ± 2.0 respectively, P < 0.01). There were no differences in Disclosure of Interest: None declared.
total and phosphorus scores between nurses and patients.
Patients and nurses answered correctly a higher percentage of
MON-P156
phosphorus section questions compared with the rest section
INFLUENCE OF A NUTRITION SUPPORT TEAM IN NUTRITIONAL
questions (P < 0.001), whereas no such difference was found for
CLINICAL PRACTICE: A SINGLE-CENTER DESCRIPTIVE
doctors.
ANALYSYS.
Conclusion: Our results confirm those of previous studies that
hemodialysis patients as well as renal nurses have a low M. Cayón-Blanco1 *, C. Garcia-Figueras Mateos2,
knowledge level of phosphorus. Nutritional training of patients L. Garcia Garcia-Doncel1. 1Endocrinology and Nutrition Unit,
2
and health professionals could increase knowledge and possibly Internal Medicine Unit, Hospital Sas De Jerez De La Frontera,
contribute to better biochemical profile of phosphorus in Jerez De La Frontera, Spain
patients. Rationale: With the development of specialized nutrition
Reference support, an interdisciplinary approach was essential to
translating this medical breakthrough from the laboratory to
1. Pollock JB, Jaffery JB. Knowledge of phosphorus compared with
the bedside. Nutrition support teams (NST) were created to
other nutrients in maintenance dialysis patients. J Ren Nutr. 2007
Sep;17(5):323–8. optimize the effectiveness and safety of this therapy. In
hospitals that have incorporated NST to routine clinical
practice, patterns of nutritional support can change after its
incorporation. This study aims to analyze the interventions of a
NST over 2 years after its setting-up in our hospital.
Nutritional assessment 2 Methods: Descriptive and prospective study including all
patients which nutrition support were directly supervised by
MON-P155
NST. To test potential changes in nutrition support patterns,
INFLUENCE OF NON-CLASSICAL MEDICAL CONDITIONS ON
characteristics of the activity and prescriptions performed
CLINICAL COURSE OF PATIENTS WITH ANOREXIA NERVOSA
by NST during first and second year were compared.
M. Cayon-Blanco1 *, C. Garcia-Figueras-Mateos2. 1Endocrinology Patients were followed-up from first day of assesment to
and Nutrition Unit, 2Internal Medicine, Hospital Sas De Jerez discharge.
De La Frontera, Jerez De La Frontera, Spain Results: During the second year after its implementation, NST
Rationale: Anorexia nervosa (AN) is associated with numerous increased its activity by 13% (first year consultations: 10.7/
and well-known concurrent medical complications. In addition month; second year: 13.9/month). Most of requirements for
to these classical medical complications, other co-morbid nutrition approach were made by medical departments (51.8%
conditions are common. Also, patients with AN often require at first year and 53.3% during second year; p > 0.05). During the
admissions to non-psychiatric hospital wards due to medical second year, parenteral nutrition use decreased by 9%
complications. Published data focused on both issues are and enteral nutrition using feeding lines increased by 8.5%
( p < 0.05). Mean follow-up days during hospital stay decreased MON-P159
significantly in the second year (14.1 ± 1.9 vs 10.3 ± 4.9; VALUATION OF MEDICAL NUTRITION
p = 0.02) due to shorter lengh of stay. M. Nuijten1 *. 1Nutritioneconomics, A2M – Minerva, Jisp,
Conclusion: Implementation of NST in our hospital resulted in a Netherlands
reduction of use of parenteral nutrition, increase of use of
enteral nutrition and a shorter lengh of hospital stay. Rationale: Disease related malnutrition is a worldwide problem
Disclosure of Interest: None declared. in all health care settings with potentially serious clinical and
economic consequences. Many studies show that the use of
MON-P158 medical nutrition is a cost-effective treatment leading to cost
IMPACT IN NUTRITIONAL STATUS AND DIET PROGRESSION savings and a higher effectiveness. Therefore the price setting
OF A NUTRITIONAL CONSULTATION AFTER STOMA of medical nutrition may be questioned.
CONSTRUCTION Methods: We calculated the break-even price for medical
nutrition from various perspectives: (1) The incremental cost-
M. Moreno Santa Maria1,2, J. Abilés Osinaga1,2 *, effectiveness threshold from the payer’s perspective based on
L. Rey Fernández1, C. Pérez Jiménez3, P. Utrilla Navarro2,4, health economic concepts; (2) The Discounted Cash Flow
C. López Rodriguez1, L. Visiedo Rodas1, threshold from the perspective of the financial investor based
J. J. Arenas Villafranca1,2. 1Pharmacy and Nutrition on business valuation theory. These methods are commonly
Department, Hospital Costa del Sol, Marbella, 2Doctoral applied to pharmaceuticals for price setting and price
Programme in Pharmacy, University of Granada, Granada, justification.
3
Surgery Department, Hospital Costa del Sol, Marbella, Results: The break-even price was at least 10 times higher than
4
Pharmacology Department, University of Granada, the actual price of 2 euro per day in the most conservative
Granada, Spain analysis. There was a huge variance in the outcomes based on
the underlying assumptions of the calculations in both the cost-
Rationale: In ostomized patients the oral diet reintroduction
effectiveness and business valuation model. The incremental
should be performed progressively. In addition, malnutrition is
cost-effectiveness ratio and cost of capital were the most
a long-term complication. Our objective is to evaluate the
sensitive parameters in respectively the cost-effectiveness and
impact of a nutritional consultation at dischargein theses
business valuation model.
patiens.
Conclusion: The break-even price analyses show that the
Methods: A prospective study was performed. At discharge, the
prices for medical nutrition do not reflect the full value
patient has two appointment with dieticians for assessment
from a society perspective, consisting of the payer and
and diagnosis, a review of diet progression and nutritional
financial investors. The willingness to pay for medical
treatment. The patient’s weight was recorded and nutritional
nutrition seems inappropriately lower compared with phar-
profile was requested (albumin, prealbumin, transferrin,
maceuticals, which may question the use of different pricing
cholesterol) at 7–10 days (visit1) and a month later (visit2).
and reimbursement policies for medical nutrition and
Statistical analysis was performed.
pharmaceuticals.
Results: 37 patients were recruited, 66.9 ± 13.3years, 81%men.
Nutritional diagnosis at Visit1 was 37.8% good nutritional Disclosure of Interest: None declared.
status, 18.9% nutritional risk, 13.5% mild malnutrition*, 27%
moderate* and 2.7% severe*; At Visit2 was 64.3% good MON-P160
nutritional status, 32.1% nutritional risk and 3.6 mild malnu- NUTRITIONAL RISK IS A UNKNOWN CONDITION IN
trition* (*All protein-calorie). Weight’s difference between INSTITUTIONALIZED ELDERLY PEOPLE WITHOUT
Visit1 and Visit2 was + 2.4 ± 3.6 kg ( p = 0.001). The mean FUNCTIONAL LIMITATIONS AND COGNITIVE IMPAIRMENT. ARE
nutritional parameters measured between Visit1 and Visit2 REQUIRED PREVENTIVE STRATEGIES?
were respectively: Albumin 3.5 g/dL and 4.0 g/dL (+0.6 ± 0.5, M. D. M. Ruperto Lopez1 *, C. Iglesias1. 1Human Nutrition and
p = 0.001), PreAlbumin 20.0 mg/dL and 25 mg/dL (+4.9 ± 7.3, Dietetics, Universidad Alfonso X el Sabio, Madrid, Spain
p = 0.003), Cholesterol 155.9 mg/dL and 181.2 mg/dL
(+25.3 ± 36.0, p = 0.002), Transferrin 200.7 mg/dL and Rationale: Disease-related malnutrition (DRM) is a multifac-
254.9 mg/dL (+54.2 ± 39.6, p = 0.001), CRP 45.3 mg/L and torial condition in institutionalized eldest population. The aim
14.9 mg/L (-30.3 ± 41.0, p = 0.002). At Visit1 72.2% of the of the study was to analyse the nutritional risk and DRM in
patients tolerated soft diet, 22.2% complete, 2.8% astringent elderly people without functional limitations and cognitive
and 2.8% low-residues; 40.5% required oral supplementation impairment living in nursing homes.
(mean extra 870 kcal/patient). At Visit2 100% tolerated normal Methods: Cross-sectional study in 189 elders (60% men, aged:
diet requiring supplementation 29.7% (mean extra 440 kcal/ 87.9 ± 9.2 years, and time of institutionalization: 20.1 ± 10.2
patient) months). Demographic, clinical and nutritional indicators were
Conclusion: The nutritional consultation for ostomized recorded. Nutritional screening by Mini-Nutritional Assessment
patients has allowed us to reach a good nutritional status in (MNA) and, anthropometric, biochemical parameters were
the majority of the patients with a correct diet transition and performed. Analysis of body composition by bioelectrical
an optimization in the use of oral supplementation. impedance was used. Subjects were classified into three
Disclosure of Interest: None declared. groups (G): Well-nourished (MNA ≥ 24 points); At nutritional
risk (MNA 23,5–17 points) and DRE (<17 points). Statistical
analysis by SPSS v.20.
S238 Poster
Results: Nutritional risk and DRE were 52.9% and 10%, mortality rates, compared to their counterparts with normal
respectively. MNA score showed significant differences FFMI
between groups with BMI, mid-arm muscle and calf circumfer- Disclosure of Interest: None declared.
ences, lean body mass and serum prealbumin (at least,
P < 0.05). MNA was directly correlated with % fat mass (r = 0.34;
MON-P162
p < 0.001), mid-arm muscle circumference (r = 0.28; p = 0.003)
COMPARATIVE ANALYSIS OF THE PREVALENCE OF IN-
and %lymphocytes (r = 0.31; p = 0.002), whereas an inverse
HOSPITAL MALNUTRITION ACCORDING TO ASPEN-ADA 2010
significant correlation with hand-grip strength (right hand)
AND ESPEN 2015 CONSENSUS
(r = 0.84; p = 0.017) were found.
Conclusion: Elderly people without functional limitations and M. Millan-Lopez1 *, M. A. Reyes Lopez2. 1Nutrition, Instituto de
cognitive impairment have also higher nutritional risk and/or Salud del Estado de Mexico, Tenancingo, 2Nutrition, Instituto
DRE. Periodic screening and assessment of nutritional status Nacional de Perinatología, Mexico, Mexico
prevents malnutrition and improve quality of live in elder
Rationale: In-hospital malnutrition is a problem that prevails.
people. Further studies and new preventive strategies too
In developed the prevalence of in-hospital malnutrition ranges
promove healthy ageing are required.
widely due to the absence of standardized diagnostic tools. In
Disclosure of Interest: None declared. the field of clinical nutrition, as far as we know, no existent
data compares the diagnosis potential of the ASPEN-ADA 2010
MON-P161 and ESPEN 2015 tools
ARE PATIENTS WITH NORMAL WEIGHT OR OVERWEIGHT AND This study is aimed to evaluate in-hospital malnutrition
CONCOMITANT WEIGHT LOSS MISSED IN THE NEW ESPEN prevalence by employing the underlying rationale of the
DEFINITION FOR MALNUTRITION? ASPEN-ADA-2010 and ESPEN-2015 tools.
M. A. De Van Der Schueren1 *, M. de Smoker1, E. Leistra2, Methods: A transversal study was conducted at the General
H. M. Kruizenga1. 1Nutrition and Dietetics, Vu University Hospital located at Tenancingo, Mexico, and divided into two
Medical Center, 2Health Sciences, Vrije Universiteit, time periods; August 15th-26th of 2016 and March 6th–22th of
Amsterdam, Netherlands 2017. To some extent, patients from the areas of internal
medicine, surgery, and traumatology were included to conduct
Rationale: Concerns have been raised whether the new this study.
ESPEN definition for malnutrition correctly classifies malnutri- Results: The population sample comprehends one hundred
tion in patients with normal weight or overweight and patients, with a mean age of 48 years. The in-hospital
concomitant weight loss, as they do not necessarily meet malnutrition prevalence, rises higher with to ASPEN-ADA 2010
the criteria for low FFMI. The aim of this study is to assess tool in comparison to the ESPEN 2015 tool (65% vs 22%, p
the association between critical weight loss and one-year <0.001). Both tools, showed that the greatest frequency of In-
mortality in hospitalized patients, stratified by BMI and FFMI hospital malnutrition prevalence was present in internal
subgroups medicine patients (80% ASPEN-ADA 2010 and 25% ESPEN
Methods: Included were 769 patients admitted to the VU 2015). Consequently, the stratified analysis demonstrated
University Medical Center. Critical weight loss (CWL) was that in adults, (young 16–40 y, middle 41–60 y and older
defined as >5% weight loss in the previous month or >10% weight >61 y), the in-hospital malnutrition prevalence was higher
loss in the previous six months. The association between CWL according to the ASPEN-ADA 2010 tool than to ESPEN 2015 (50%
and one-year mortality was analyzed with a priori stratification vs23%, 74%vs35%, and 77%vs7%, respectively).
by the ESPEN definition cut-off values: BMI ≥ 20.0 kg/m2 for Conclusion: The In-hospital malnutrition prevalence varia-
patients <70 years and ≥ 22.0 kg/m2 for patients ≥70 years, tions, highly depends on the tool used employed. ESPEN 2015
FFMI ≥ 15 kg/m2 for females and ≥ 17 kg/m2 for males. tool tends to underestimate the diagnosis. We consider that the
Mortality risks were calculated (HR, 95% CI) advantages of having an early diagnosis, favourably outweighs
Results: Overall, CWL was associated with an increased one- the inconveniences of a higher In-hospital malnutrition
year mortality rate compared to no-CWL. In BMI and FFMI prevalence. We suggest the use of the ASPEN-ADA 2010 tool
subcategories, CWL was predictive for mortality only in as a means of monitoring and identifying in-hospital patients
patients with low FFMI (Table). with malnutrition.
HR for one-year mortality
compared to patients with no CWL
MON-P163
CWL (all patients) 1.76 (1.26–2.45) IN-HOSPITAL DESNUTRITION PREVALENCE AT GENERAL
CWL + FFMI ≥ 15/17 1.37 (0.85–2.21)
HOSPITAL OF TENANCINGO, (MEXICO) ACCORDING ESPEN
CWL + FFMI <15/17 1.95 (1.20–3.17)
CWL + BMI ≥ 20 /22 1.75 (1.17–2.61) 2015 CONSENSUS
CWL + BMI ≥ 20 /22 + FFMI ≥ 15/17 1.38 (0.84–2.27) M. Millan-Lopez1 *, M. A. Reyes Lopez2. 1Nutrition, Instituto de
CWL + BMI ≥ 20 /22 + FFMI <15/17 2.69 (1.29–5.65)
Salud del Estado de Mexico, Tenancingo, 2Nutrition, Instituto
Nacional de Perinatología, Mexico, Mexico
Conclusion: Patients with critical weight loss have a higher
one-year mortality risk compared to patients with no critical Rationale: Although in-Hospital malnutrition is a widely known
weight loss. FFMI seems to play a crucial role in this association, problem, its prevalence varies according the studied group and
as only patients with a FFMI below cut-off points had increased the employed tool. The consequences of In-hospital malnutri-
tion ranges from a worst clinic prognosis until economics
concerns, so its identification and treatment must be a priority. period (median 24.3 months). The cumulative mortality rate
The study aim was to identify the In-hospital malnutrition was 14.3% after two years. Fat free mass index (FFMI) below
prevalence according ESPEN 2015 tool. normal (Hazard Ratio 3.9 [95% CI; 1.1–14.1]; P = 0.04) and
Methods: A transversal study was conducted at the General phase angle below normal (Hazard Ratio 5.3 [95% CI; 1.6–17.5];
Hospital located at Tenancingo, Mexico in two periods; August P = 0.007) were identified as independent risk factors for
15th–26th of 2016 and March 6th–22th of 2017. To some extent, mortality
patients from the areas of internal medicine, surgery and Conclusion: In this study, we found that phase angle (PA) and
traumatology were included to conduct this study. fat free mass index (FFMI) predicted mortality in a cohort of
Results: The population sample comprehends one hundred patients with intestinal failure on long-term parenteral
patients, with a mean age of 48 years. According body mass nutrition. We found a fourfold increased mortality in patients
index (BMI) 52% had normal weight, 33% overweight, 8% with a low FFMI and a fivefold increased mortality in patients
obesity and 7% underweight. The In-hospital malnutrition with a low PA
prevalence was 22%. The internal medicine group was the Disclosure of Interest: None declared.
patients group with the highest In-hospital malnutrition
prevalence (25%), in contrast with the surgery and orthope-
MON-P165
dics and traumatology groups (19.4% and 12.5%, respect-
MALNUTRITION PREVALENCE IN PATIENTS ADMITTED IN A
ively). The stratified analysis showed an In-hospital
GENERAL PSYCHIATRY WARD OF AN ACUTE CARE HOSPITAL
malnutrition prevalence of 35% for adults, 23% for young
adults and 6.7% for older adults. M. Comas1 *, H. Segurola1, V. Avilés1, M. Guerrero1, A. Sancho1,
Conclusion: We found an in-hospital malnutrition prevalence G. Cárdenas1, M. Giribés1, B. Sarto1, C. Puiggrós1, R. Burgos1.
1
to similar reported for others authors. The In-hospital Nutritional Support Unit, University Hospital Vall d’Hebron,
malnutrition problem varies according de group of age and Barcelona, Spain
the kind of pathology. It seems that ESPEN 2015 tool has a
Rationale: Disease-related malnutrition (DRM) is highly preva-
diagnosis potential for identify malnutrition among internal
lent at hospital admission, and impacts negatively in the
medicine patients and those between 41 and 59 years, although
evolution of the patient. There is not enough information
it is necessary more studies for evaluate the confiability of
regarding the malnutrition prevalence in patients admitted for
this diagnosis The In-hospital malnutrition consequences
psychiatric pathology, with the exception of units specialized in
impact clinical and economic fields, so its identification is a
eating disorders.
priority.
To determine the malnutrition prevalence in patients admitted
Disclosure of Interest: None declared. in a general psychiatry ward of an acute care hospital, which is
not a reference center for eating disorders.
MON-P164 Methods: Patients admitted in a psychiatric ward between
BODY COMPOSITION IS ASSOCIATED WITH MORTALITY IN 2013–2016 were included in the study. Nutritional risk (NR) was
PATIENTS WITH INTESTINAL FAILURE ON LONG-TERM HOME evaluated by Nutritional Risk Screening 2002 (NRS-2002),
PARENTERAL NUTRITION followed by full nutritional assessment (NA) of positive
M. Køhler1 *, H. H. Rasmussen1,2, S. S. Olesen2,3. 1Center for screened patients.
Nutrition and Bowel Disease, Aalborg University Hospital, Results: 216 psychiatric patients were screened with NRS-
2
Clinical Institute, Aalborg University, 3Center for Pancreatic 2002, of which 31(14.4%) were detected as NR. Average age:
Diseases, Aalborg University Hospital, Aalborg, Denmark 45 ± 15 years. Only 2 malnourished patients had eating disorder
among other diagnoses, and 7 had dependence on toxic
Rationale: Patients with intestinal failure type 3 (IF) are at risk substances.
of altered body composition and impaired muscle function due After NA 18(58%) were confirmed as malnourished. The mean
to malnutrition, malabsorption and immobilization, which may hospital stay was 13 ± 8.3 days, without any difference
negatively influence survival. The aim of this study was to according to nutritional status.
investigate the association between body composition, muscle As a main dietary intervention, a personalized diet was
strength and mortality in IF patients on long-term parenteral designed in 78% of the patients, and 17% needed an oral
nutrition (HPN) nutritional supplementation. Only one case required enteral
Methods: This was a prospective cohort study comprising 77 nutrition.
patients with IF on long-term HPN (>12 months). The primary 71% of malnourished patients were discharged home, 23% to a
outcome was all-cause mortality. We recorded gender, age, psychiatric convalescent facility. The mortality rate was 3%. Of
body mass index (BMI, kg/m2) and handgrip strength (HGS, kg). the patients screened as negative NR, 20% required a stay in the
Further, we recorded fat mass index (FMI, kg/m2), fat free mass convalescent center.
index (FFMI, kg/m2) and phase angle (PA, degrees) measured by Conclusion: The DRM prevalence in a psychiatric ward is lower
bioelectrical impedance analysis (BIA). HGS and BIA para- than those described for the general hospital population,
meters were analysed for their association with mortality; probably related to the youngest and the lower comorbidities of
assessments variables were compared to normative data and this group of patients. Among malnourished patients, the group
categorised into normal or abnormal. of patients with addictions to various substances is the most
Statistics: Kaplan-Meier curves and Cox proportional hazards prominent (22%).
models. Significance level: p < 0.05 Disclosure of Interest: None declared.
Results: Of the 77 patients (age 59 ± 15 years, BMI 20.0 ± 4.2
kg/m2, female 73%), 16 (20.8%) died during the follow-up
S240 Poster
MON-P166 Results: Malnourished patients showed a significantly higher

DISEASE-RELATED MALNUTRITION AT ADMISSION IN A THIRD mortality risk. Compared to 31 well nourished patients (SGA A)
LEVEL HOSPITAL: BEYOND 10000 SCREENED PATIENTS 119 malnourished patients (SGA B and C) showed a fourfold
M. Comas Martínez1 *, H. Segurola1, V. Avilés1, A. Sancho1, higher 30-day mortality risk (9.4 8.7% vs. 2.3 2.3%; p < 0.001).
G. Cárdenas1, B. Sarto1, M. Giribés1, M. Guerrero1, Using PA <5th percentile as criterion for malnutrition the
C. Puiggrós1, R. Burgos1. 1Nutritional Support Unit, University mortality risk was of the same magnitude in 103 patients and
Hospital Vall d’Hebron, Barcelona, Spain significantly higher than in the well nourished group (9.8 9.1%
vs 3.8 3.9%; p < 0.001). Using either NRS ≥ 3 and SGA B and C or
Rationale: Disease-related malnutrition (DRM) is highly preva- NRS ≥ 3 and PA <5th percentile as criterion the prevalence of
lent at hospital admission, and impacts negatively in the malnutrition was 33% and 29% in excellent agreement with
outcome of the patient. published data.
To analyze the impact of malnutrition in the outcome of Conclusion: SGA as a subjective and PA as an objective method
patients admitted to a third level hospital after implementing a are equally well suited to identify patients at increased risk of
nutritional risk screening method at hospital admission. malnutrition related mortality.
Methods: In 2013, a nutritional intervention protocol was Disclosure of Interest: None declared.
started, including detection of nutritional risk through
Nutritional Risk Screening 2002 (NRS-2002), followed by MON-P168
nutritional evaluation and nutritional plan. THE RELATIONSHIP BETWEEN DIET QUALITY AND LIFE
Results: Since 2013, 10089 patients have been screened, of QUALITY IN ADULTS
whom 23.8% presents risk of malnutrition at admission. After
nutritional assessment, 52% of the patients were identified as M. A. Sahin1 *, Z. Buyuktuncer1. 1Nutrition and Dietetics,
malnourished and required nutritional intervention: diet Hacettepe University, Ankara, Turkey
adaptation in 54.2%, 36.7% also needed oral nutritional
Rationale: Diet quality has a potential to influence the quality
supplementation, 3.8% required enteral nutrition and 5.3%
of life. However, little is known about the relationship between
parenteral nutrition.
diet quality and life quality. This study aimed to determine the
The mean hospital stay was 16.64 days in malnourished
relationship between diet quality and life quality in an adult
patients. Patients without nutritional risk had an average
population.
hospital stay of 10.97 days. ( p < 0.0001)
Methods: The study was conducted on 1,181 individuals, aged
Malnourished patients presented a high mortality rate (8.2% VS
19 to 65 years who were admitted to 19 Family Health Centers
2.7% in non-malnourished patients), and also a high need for a
in Edirne, Turkey. General characteristics, anthropometrical
convalescent center (13.45% VS 7.26% ( p < 0.0001))
measurements and physical activity data of individuals were
Conclusion: The DRM prevalence is very similar to that
recorded. Food frequency questionnaire was used to determine
reported in literature, highlighting a greater mortality rate
diet quality; and Short Form-36 life quality questionnaire was
and a higher need for a convalescent center. We need to
used to determine the life quality. Healthy Eating Index-2005
implement nutritional strategies to address DRM in the
(HEI-2005) scores of individuals were calculated, and then
community setting.
classified into three groups: good (over 80 points), moderate
Disclosure of Interest: None declared. (between 51 and 80 points), and poor (50 and under points).
Short Form-36 life quality questionnaire was used to calculate
MON-P167 mental components score and physical components score.
INFLUENCE OF MALNUTRITION ON MORTALITY IN Results: The mean of Healthy Eating Score was 58.3 for males,
HOSPITALIZED PATIENTS 63.8 for females. A strong relationship between diet quality
M. Wäsch1, M. Plauth1 *. 1Dessau Community Hospital, Dessau- and life quality was shown in this study. The diet quality score
Roßlau, Germany was significantly associated with mental components score
( p < 0.01). Moreover, individuals had low scores for consump-
Rationale: Hospital malnutrition is an often underestimated tion of total vegetables, whole grains and dairy products, and
problem in the Industrial countries causing increased morbidity intake of sodium whereas high scores for consumption of total
and mortality for patients as well as considerable additional grains, meats and legumes and intake of saturated fat.
cost for the health care system. For the detection of the Conclusion: Improving the life quality of populations is one of
malnutrition, various screening and assessment tools are the main goals of public health strategies. This study showed
recommended. The aim of this study was to examine whether that improving diet quality can help improving society’s life
hospital patients classified as malnourished according to either quality. Encouraging people for increasing their vegetable,
SGA category B and C or phase angle (PA) <5th percentile had an grain and dairy consumption, and decreasing salt intake should
increased mortality risk according to the Pandora score. be prior foresight to improve diet quality of people living in
Methods: Of 353/358 consecutive patients admitted to the Edirne.
gastroenterology ward of Dessau community hospital in the References:
period 15.02–24.04.2016 were screened for malnutrition using
NRS-2002. 191/353 patients had a score of ≥ 3. In 150/191 Disclosure of Interest: None declared.
patients the full data set including Pandora score, SGA
classification, PA from bioelectric impedance analysis was
available for analysis.
MON-P169 depression was determined by Beck Depression Scale. Beck

VALIDATION OF THE MALNUTRITION UNIVERSAL SCREENING depression scores were classified as minimal, mild, moderate,
TOOL (MUST) FOR THE MALNUTRITION IN TURKISH HOSPITAL and several depression. The differences of caffeine intake and
SETTINGS Beck Depression Score in non-examination and examination
F. Sümer1, B. Bolayır2, C. Balcı1, R. T. Doğrul1, G. S. Ayçiçek1, period were examined by paired t test
C. Özsürekçi1, H. Çalışkan1, B. B. Yavuz1, M. Cankurtaran1, Results: Our subjects consisted of a total of 68.8% females and
M. Halil1 *. 1Department of Internal Medicine Division of 31.2% males. The mean beck depression score of female and
Geriatrics, Hacettepe University, 2Department of Internal male were found 12.0 ± 10.0, 8.6 ± 8.9 in the examination
Medicine Division of Endocrinology and Metabolism, Gazi period and were found 6.4 ± 6.4, 5.3 ± 5.1 in non-examination
University, Ankara, Turkey period, respectively ( p < 0.01). For female and male, the
quantity of daily caffeine consumption was found 323.1 and
Rationale: A variety of screening tools are used for the 307.2 mg in examination period, respectively, however,
determination of malnutrition, one of the most one is the average daily caffeine consumption was found as 186.8 and
Malnutrition Universal Screening Tool (MUST). In this study, we 242.2 mg, respectively ( p < 0.05). Major contributors to
have investigated the validation of the MUST test in hospital caffeine intake among students were black tea, Nescafe,
settings. herbal tea, green tea, Turkish coffee, ice tea and milk with
Methods: A total of 252 patients hospitalized in medical or chocolate, respectively. Caffeine consumption was shown to
surgical wards were included for the study. All the patients have a positive relationship with beck depression score and
underwent comprehensive geriatric assessment. Nutritional beck depression score was found to be higher in those with a
status of the patients was evaluated by two geriatricians higher caffeine intake ( p < 0.01).
experienced in malnutrition. There was very good agreement Conclusion: In examination period, university students tend to
between them (kappa = 0.85). The patients were also eval- increase their caffeine consumption in order to manage
uated by using MUST test for nutritional status by a different academic stress.
clinician blinded to the decisions of the geriatricians for the Disclosure of Interest: None declared.
nutritional status of the patients. Nutritional status of the
patients according to the MUST and the geriatrician decision MON-P171
was compared with Cohen’s kappa analysis. Also, the sensitivity
CHANGES IN SLEEP DURATION ASSOCIATED WITH
and specificity results of the MUST test for the malnutrition
NUTRITIONAL STATUS AND APPETITE IN ELDERLY
were evaluated.
Results: The mean age of the patients was 59,55 ± 15,93 years N. Acar Tek1, M. S. Karacil Ermumcu1 *. 1Nutrition and
and 56% of them were female. The sensitivity, specificity, Dietetics, Gazi University Faculty of Health Sciences, Ankara,
positive predictive and negative predictive values of the MUST Turkey
test for detecting malnutrition in hospital settings were 73%,
Rationale: The aim of the present study was to examine the
92%, 85% and 85%, respectively. Test results were more sensitive
association between nutritional status with appetite and
in patients under 65 age, but more specific in geriatric
changes in sleep duration in older adults.
population. When compared between medical and surgery
Methods: This is a cross-sectional population-based study was
wards, test was both more sensitive (77%) and specific(96%) in
conducted at 142 men and 265 women totally 407 elderly
surgery ward.
aged ≥ 60 years. Questionnaire including the demographic
Conclusion: This study showed that the Turkish version of the
characteristics, health information, sleep duration, Mini
MUST test is validated for inpatients.
Nutrition Assessment (MNA), Mini Nutrition Assessment-Short
Disclosure of Interest: None declared. Form (MNA-SF) and Simplified Nutritional Appetite
Questionnaire (SNAQ) was performed by face-to-face inter-
MON-P170 views. Statistical analysis was performed with version 16 SPSS.
IS EXAMINATION PERIOD RELATED WITH INCREASED Results: A total of 407 home dwelling elderly individuals were
CAFFEINE INTAKE AMONG UNIVERSITY STUDENTS? A CROSS interviewed (142 men and 265 women) with a mean age of men
SECTIONAL STUDY and women 72.8 ± 6.67 years; 71.1 ± 6.41 years respectively
M. M. Tengilimoglu Metin1 *, D. Gumus1, S. Sevim1, G. G. Topal1, ( p < 0.05). The mean night sleep duration (hour/day) of women
M. Kizil1. 1Hacettepe University, Ankara, Turkey and men 7.9 ± 1.72 and 7.9 ± 1.72 hours respectively and the
mean daytime sleep duration (hour/day) of women and men
Rationale: University students are exposed to stress due to 1.0 ± 1.19 and 0.9 ± 1.18 hours respectively. There isn’t any
their daily academic load. Due to work and projects, university significant differences between daytime and night sleep
students commonly have academic stress. Caffeinated stimu- duration between groups ( p > 0.05). When we determinated
lants are broadly regarded as helping students stay focused and the association between sleep duration with nutritional status
alert to improve their academic performance, especially and appetite we found that there is negative correlation
examination period. Hence, the aim of this study was to between daytime sleep duration with MNA-SF (r:−0.236;
compare the non-examination and examination period caffeine p:0.000), MNA (r:−0.250; p:0.000), and SNAQ (r:−0.133;
intake and depression p:0.000), scores. But there is a positive association between
Methods: A cross-sectional study was conducted on 103 male night sleep duration and MNA-SF (r:0.098; p:0.048) scores.
and 227 female university students aged 18–30 years. In non- Conclusion: Better nutritional status and appetite was
examination and examination period, caffeine intake data was associated with changes in sleep duration.
collected using caffeine consumption questionnaire and Disclosure of Interest: None declared.
S242 Poster
MON-P172 Results: The mean age of the patients was 47.17 ± 10.61 years.
DETERMINANTS OF QUALITY OF LIFE IN FREE-LIVING And 48.8% of the patients were men and 51.2% were females.
ELDERLY POPULATION: NUTRITIONAL STATUS AND APPETITE Prevalence of malnutrition was 8.5% according to body weight (<
N. Acar Tek1, M. S. Karacil Ermumcu1 *. 1Nutrition and %85 ideal body weight) and 92.7% with regard to energy intake
Dietetics, Gazi University Faculty of Health Sciences, Ankara, (<35 kkal/kg for <60 years and <30–35 kkal/kg for ≥60 years) and
Turkey 54.90% for BMI (<23 kg/m2) and 46.3% according to creatine
(<10 mg/dL) and 35.4% with regard to cholesterol (<150 mg/dL).
Rationale: The aim of the present study was to examine There was not any malnourished individual according to BUN
nutritional risk factors such as poor appetite and malnutrition (<60 mg/dL) and only one patient was malnutrition accordingly
affecting quality of life in elderly. nPNA (<1 g/kg/day) and two patients were malnutrition accord-
Methods: This is a cross-sectional population-based study ing to albumin (<3.5 g/dL). And 20.7% of patients were
consisted of 407 (142 men and 265 women) elderly mean malnourished according to 4 or more of the malnutrition criteria.
aged 71.7 ± 6.54. Questionnaire including the demographic and Conclusion: The malnutrition prevalence of patients was found
general characteristics, health information, nutrition beha- very different according to the parameters related to malnu-
viours, health related life quality scale (The Health Survey trition. Therefore it should be necessary to evaluate these
Short Form-SF36), Mini Nutrition Assessment (MNA), Mini parameters together.
Nutrition Assessment-Short Form (MNA-SF) and Simplified Disclosure of Interest: None declared.
Nutritional Appetite Questionnaire (SNAQ) was performed by
face-to-face interviews. Anthropometric measurements were MON-P174
measured by well-trained investigators, using standard meas- RELATIONSHIP BETWEEN NUTRITION AND PSYCHOLOGICAL
urement protocols. Daily food consumption was assessed using STATUS İN DIALYSIS PATIENT
24 hour dietary recall.
Results: Women obtained lower scores in the physical function- M. Aydin Cil1 *, K. Gokalp2, A. Yayla3, M. Tan4. 1Nutrition and
ing, bodily pain, general health, vitality, role-emotional, Dietetic, Health Science Faculty, Ataturk University,
2
physical and mental component summary scales ( p < 0.05). Psychology, 3Surgery, 4Internal Medicine, Nursing Faculty,
There isn’t any significant association between anthropometric Ataturk University, Erzurum, Turkey
measurements, number of main meal/snack and consumption
Rationale: Psychological disorders like depression and anxiety
of nutrients (except energy and fiber intake) with life quality of
are most commonly comorbid diseases to end-stage renal
elderly. But night sleep duration negatively correlated with
disease patients. Due to poor oral consumption depression is a
mental component summary scale scores and BMI negatively
risk factor for malnutrition. The study aim was to asses the
correlated with physical component summary scale scores. A
relationship between nutritional and psychological status in
one unit increase in the elderly’s SNAQ score caused a two unit
hemodialysis (HD) and continuous ambulatory peritoneal
increase in the physical component summary scale And also a
dialysis (CAPD) patient.
one unit increase in the elderly’s SNAQ and MNA-SF score
Methods: This study was conducted in dialysis centers in
caused 1.4 unit increase in the mental component summary
Erzurum in Turkey. We evaluated the nutrition status of dialysis
scale score.
patient by antropometric measuruments (body mass index
Conclusion: Factors such as nutritional status and appetite
(BMI), waist/hip ratio, triceps skinfold thickness (TSF)), serum
which affect life quality of elderly have to improve so these
albumin and subjective global assesment (SGA). Brief Symptom
factors will increase the quality of life in this group.
Inventory (BSI) was used to asses psychological status.
Disclosure of Interest: None declared. Results: Totally 177 patients (HD, CAPD) who fit inclusion
criteria were enrolled. Mean age was 51.70 ± 16.75 years and
MON-P173 47.5% of patients were male, 52.5% of patients were female.
EVALUATION OF MALNUTRITION ACCORDING TO DIFFERENT While there was no statistically difference between psycho-
CRITERIA IN HEMODIALYSIS PATIENTS logical status and SGA in CAPD ( p > 0.05), statistical signifi-
E. Koksal1, M. S. Karacil Ermumcu1 *, O. Kucukerdonmez2, cant difference between phobia, psychoticism scores and SGA
E. Karabudak1. 1Nutrition and Dietetics, Gazi University was observed in HD ( p < 0.05). Well- nourished patients had
Faculty of Health Sciences, Ankara, 2Nutrition and Dietetics, lower scores than malnourished (SGA B-C). Negatif correl-
Ege University Faculty of Health Sciences, İzmir, Turkey ation were found between TSF and psychological status both
two groups. In BSI, interpersonal sensitivity, depression,
Rationale: The aim of this study to evaluate malnutrition anxiety, paranoid thought, hostility, psychoticism scores for
according to malnutrition related parameters in hemodialysis CAPD patients; obsessive compulsive disorder, anxiety and
patients. phobia scores for HD was found higher in malnourished
Methods: This cross-sectional clinical study was conducted on patients ( p > 0.05). There was no statistically significant
eighty two patients applied to a special dialysis center. The relation between BKI, serum albumin, waist/hip ratio and
demographic parameters, antropometric measurements and psychological status.
biochemical findings were taken for all participants. Body Conclusion: Psychological status was found independent
weight, body mass index (BMI), energy intake (kkal/kg), predictors of malnutrition in dialysis patients. Clinicians
normalized protein nitrogen appearance (nPNA (g/kg/day)), should be evaluating patient′s psychological status while
albumin (g/dL), blood urea nitrogen (BUN (mg/dL)), creatine assessing nutritional status of dialysis patients.
(mg/dL) and serum cholesterol (mg/dL) was used to determine Disclosure of Interest: None declared.
malnutrition in patients with their spesific cut off values.
MON-P175 Methods: A qualitative multi-criteria method Decision Expert

EFFECT OF ORAL NUTRITIONAL SUPPLEMENTATION ON THE (DEXi) was applied to create the model, tested on 20 women
NUTRITIONAL STATUS AND QUALITY OF LIFE OF PATIENTS and 13 men. Average women body mass index was 29,1 ± 2,7,
WITH GASTROINTESTINAL CANCER AFTER SURGERY: A MULTI- with 38,2% ± 3,1 of body fat; average men body mass index was
CENTER STUDY 29,8 ± 2,8, with 24,2% ± 3,5 of body fat.
X. Yang1, M. Zhu2 *, D. Xiu3, Y. Yang4, G. Yang5, W. Hu6, Z. Wang7, Results: We designed a multi-criteria decision model that
H. Cui1, J. Wei1. 1Beijing Hospital, 2Beijing Hospital, 3Peking can be used as a decision support in selecting assessment
University Third Hospital, Beijing, 4Xinhua Hospital Affiliated frequency, data collection with monitoring and evaluation. The
to Shanghai Jiaotong University School of Medicine, Shanghai, main criteria that is put on the top of DEXi model, tells us when
5
Nanfang Hospital Affiliated to Southern Medicine University, reassessment is required: in 1 week (very high health risk), in 2
Guangzhou, 6Ruijin Hospital Shanghai Jiaotong University weeks (high health risk), in 3 weeks (low health risk), 4 weeks
School of Medicine, 7Shanghai Sixth Hospital Affiliated to (very low health risk) or reassessment is not required (no risk).
Shanghai Jiaotong University School of Medicine, Shanghai, The selected criteria that contribute to the value of the main
China criteria are: energy intake, the adequacy of nutrients, dietary
habits, physical activity and health (e.g. biochemical determi-
Rationale: This study aims to evaluate the effect of oral nations: glucose, insulin, lipids and inflammatory markers). We
nutritional supplementation on the nutritional status and identified nine subjects with very high health risk, sixteen with
quality of life of patients with gastrointestinal cancer. high health risk, seven with a low health risk, one with very
Methods: A multi-center study was conducted on gastrointes- small health risk.
tinal cancer patients who received surgical treatment from Conclusion: The decision-model, created according DEXi
2013 to 2015. All patients were screened using the Nutrition method, was developed as a uniform system of decision-
Risk Screening 2002 (NRS 2002) to assess for nutritional risk. making in the process of nutritional treatment in obesity
Patients with nutritional risk were randomly divided into two prevention. Using this model, we can reduce the time to make
groups upon discharge: patients in study group, were given decisions, evaluate the variants, understand the decisions, and
dietary guidance and oral nutritional supplements (500 Kcal/ allow equal treatment of all subjects.
d, whole protein enteral nutrition); patients in control group Disclosure of Interest: None declared.
only received dietary guidance. Anthropometric measure-
ments, nutrition-related laboratory tests and gastrointestinal
MON-P177
function scores were also collected and compared.
VALIDATION AND RELIABILITY OF THE TURKISH VERSION OF
Results: 55 in study group and 59 patients in control group
SUBJECTIVE GLOBAL ASSESSMENT TEST IN HOSPITALIZED
completed this study. Compared with baseline, the body weight
PATIENTS
of patients in study group increased by 1.345 ± 0.531 Kg and
1.352 ± 0.729 Kg at 60 days and 90 days respectively, which was C. Balci1, B. Bolayır2, F. Sümer1, R. T. Doğrul1, G. S. Ayçiçek1,
significantly higher than control group (−1.012 ± 0.543 Kg, and C. Özsürekci1, H. Çalışkan1, B. B. Yavuz1, M. Cankurtaran1 *,
−1.597 ± 0.811 Kg at 60 days and 90 days after discharge; M. Halil1. 1Department of Internal Medicine Division of
P = 0.003 and 0.008). A similar situation was also observed for Geriatrics, Hacettepe University, 2Department of Internal
BMI, which increased in patients in study group (60 days: Medicine Division of Endocrinology and Metabolism, Gazi
0.486 ± 0.215, 90 days: 0.539 ± 0.218), but decreased in control University, Ankara, Turkey
group (60 days: −0.428 ± 0.221, 90 days: −0.44 ± 0.231)
Rationale: Malnutrition is a frequent occurrence in hospita-
(P < 0.01). There were no differences between groups for
lized patients. Although there are numureous screening tools
other indicators between two groups.
for malnutrition most of them has not been validated in our
Conclusion: Oral nutritional supplements might improve the
country. In this study, the validity and reliability of the Turkish
weight and BMI of patients with gastrointestinal cancer after
version of the Subjective Global Assessment (SGA) test used to
surgery. However, this has less impact on improving their
assess malnutrition in hospitalized patients was evaluated.
quality of life.
Methods: A total of 231 patients 131 women (56.7%) and 100
Disclosure of Interest: None declared. men (43.3%) with an average age of 58,8 ± 16.2 were included in
the study. 109 (47.2%) and 122 (52.8%) of the patients were
MON-P176 followed at the medical and surgical wards, respectively. Two
NUTRITIONAL ASSESSMENT IN OBESITY PREVENTION geriatricians experienced in the field of malnutrition who were
M. Stubelj1 *, M. Černelič Bizjak1, A. Petelin1, unaware of the SGA results, interpreted the patients nutri-
Z. Jenko Pražnikar1. 1University of Primorska, Faculty of tional status after the evaluation of several parameters such as
Health Sciences, Izola, Slovenia medical history including weight loss, appetite, anthropomet-
ric measurements, biochemical markers, bioimpedance ana-
Rationale: Nutrition care process in obesity prevention is a lysis, hand grip strength and 3-day dietary records. Based on
problem-solving method composed of assessments, diagnosis, these, the patients were divided into ‘at nutritional risk’ and
interventions, monitoring and evaluations. Nutrition assess- ‘not at nutritional risk’ groups by specialists. Concordance
ment is a systematic process of obtaining and interpreting data between the two clinicians’ clinical assessment was analyzed
in order to make decisions about the nature of nutritional by kappa statistics and excellent concordance was found
treating. It depends on practice settings and is an on-going, (kappa = 0.861), therefore the more experienced specialist’s
dynamic process. Due to the large amount of data, it is difficult decisions was accepted as gold-standard. A third physician
to control. performed SGA within 48 h of admission. At the end of the SGA
S244 Poster
evaluation patients with a category ‘A’ were classified as ‘non- MON-P179

malnourished’ and those with categories ‘B and C’ were THE RESEARCH BETWEEN THE DATA OF CALF
classified as ‘malnourished’. CIRCUMFERENTIAL MEASUREMENT IN MINI NUTRITIONAL
Results: In general, SGA was found to be 83% sensitive and 92% ASSESSMENT SHORT FORM (MNA-SF) AND THE DATA OF PHASE
specific compared to the clinician’s assessment of malnutri- ANGLE FOR BED BOUNDED PATIENTS―THE 7TH REPORT
tion. The positive predictive value and the negative predictive AFTER COPENHAGEN
value were 86% and 90%, respectively. N. Katsura1 *. 1Surgery, Miyazu Takeda Hospital, Kyoto, Japan
Conclusion: The Turkish version of the SGA test in hospitalized
patients is a valid and reliable method for evaluating Rationale: One of the advantage of Mini Nutritional
malnutrition. Assessment-Short Form (MNA-SF) is that it does not need to
Disclosure of Interest: None declared. measure body weight of patients. Body mass index(BMI) can be
exchanged to calf Circumference (CC) measurement. However,
MON-P178 current cut off point, 31 cm is adequate for standing or sitting
LOW BIOIMPEDANCE PHASE ANGLE INDICATES MUSCLE position. In the ESPEN in Leipzig, we reported the new cut-off
CATABOLISM AND LOSS OF MUSCLE AND COGNITIVE point, 29 cm for supine position. This time we examined the
FUNCTION IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE relevance between the discrepancy of CC at supine position and
sitting position with phase angle measurment to check
N. Rotovnik Kozjek1,2 *, C. Lieben1, N. Deutz1, M. Engelen1. nutritional situation of bed-bounded patients.
1
Center for Translational Research in Aging & Longevity, Dept. Methods: 45 patients, 21 male, 24 female, mean age 83.1
Health and Kinesiology, Texas A&M University, College Station, (70–98 years old), were examined with both 29 cm and 31 cm of
United States, 2Clinical Nutrition Unit, Institute of Oncology, CC measurement of MNA-SF and phase angle data with Bio
Ljubljana, Slovenia Impedance Analyzer (BIA). As the results, a coefficient of
correlation was calculated.
Rationale: Phase angle (PA) is a parameter of bioelectrical
Results: A coefficient of correlation of 45 patients between the
impedance analysis (BIA) and a low value has been used as an
gap of the data of supine position and sitting position and phase
indirect marker of fat-free mass loss, impaired cell function
angle is 0.7506, showing strong coefficient.
and poor disease prognosis in chronic obstructive pulmonary
Conclusion: Strong correlation between the gap of CC and
disease (COPD). We examined whether low PA in COPD is
phase angle was admitted. We should use our new cut-off point,
associated with skeletal muscle and cognitive dysfunction,
29 cm, with MNA-SF to the patients who show the normal phase
muscle loss, and enhanced muscle myofibrillar protein break-
angle data.
down (MPB) rate.
References: no reference
Methods: In 21 normal weight COPD patients (GOLD II-IV, 10
with normal PA (≥5) (NPA) and 11 with low PA (<5) (LPA)) and 13 Disclosure of Interest: None declared.
healthy age-matched controls, body composition, and inspira-
tory, hand, and leg muscle strength were assessed by dual- MON-P180
energy X-ray absorptiometry, mouth pressure, handgrip and COMPARISON OF BODY COMPOSITION ASSESSMENT BY BIA
one leg dynamometry, respectively. Physical activity was AND DEXA ACCORDING TO THE BODY MASS INDEX: A
assessed by PASE Questionnaire, and PA at 50 Hz by BIA. RETROSPECTIVE STUDY ON 3655 MEASURES
Cognitive function was measured with Trail Making Test (TMT), N. Achamrah1,2, G. Colange2, J. Delay2, A. Rimbert1,2,
and whole body MPB by pulse iv administration of L-(2H3)tau- V. Folope1,2, A. Petit1,2, S. Grigioni1,2, P. Déchelotte1,2 *,
methylhistidine stable tracer. Statistics by one-way analysis of M. Coëffier1,2. 1INSERM UMR 1073, Normandie Univ, 2Nutrition,
variance and significance was set at p < 0.05. Rouen Hospital Center, Rouen, France
Results: Body composition was not different between the 3
groups, and severity of airflow obstruction comparable in Rationale: Body composition (BC) assessment is used in clinical
the COPD subgroups. The LPA COPD group had lower values practice for nutritional evaluation and monitoring. The
for inspiratory, handgrip and leg strength, and physical standard method, dual-energy X-ray absorptiometry (DEXA),
activity ( p < 0.01), higher TMT response and interference is hardly feasible in routine clinical practice contrary to
time ( p < 0.05) than the control group. Furthermore, the LPA Bioelectrical Impedance Analysis (BIA) method. We aimed to
COPD had lower values for handgrip and leg strength, and compare BC assessment by DEXA and BIA according to the body
higher TMT interference ( p < 0.05) than the NPA group. MPB mass index (BMI) in a large cohort.
was higher in the LPA COPD group compared to the control Methods: We analysed DEXA and BIA measures in patients
group (0.48 ± 0.33 vs 0.20 ± 0.09 μmol/kg ffm/h, p < 0.01) but followed in a Nutrition Unit from 2010 to 2016. BC was assessed
not to the NPA group (0.32 ± 0.21 umol/kg ffm/h, p = 0.11). under standardized conditions by DEXA (Lunar Prodigy
Conclusion: Low phase angle reflects presence of muscle Advance) and BIA (Bodystat QuadScan 4000, Manufacturer’s
weakness, deficits in psychomotor speed and cognitive equation). Bland-Altman test was performed for each class of
flexibility, and myofibrillar protein breakdown in normal BMI. Fat mass (FM) and fat free mass (FFM) values were
weight COPD patients. compared using Kruskal-Wallis test.
Disclosure of Interest: None declared. Results: FM and FFM differences are indicated in Table 1. BC
values were very closed for BMI between 16 and 18,5
(difference <1 kg). For BMI >18,5 and BMI <40, BIA over-
estimated FFM from 2,51 to 5,67 kg, and underestimated FM
from 3,38 to 8,28 kg compared with DEXA method. For
Table 1: (abstract: MON-P180). Values without a common letter differ significantly (p < 0.05).
BMI < 16 16 ≤ BMI < 18.5 18.5 ≤ BMI < 25 25 ≤ BMI < 30 30 ≤ BMI < 35 35 ≤ BMI < 40 BMI > 40
2 a b c d e f g
BMI(kg/m ) 14,67 ± 0,09 17,17 ± 0,05 21,26 ± 0,12 28,03 ± 0,08 32,69 ± 0,05 37,44 ± 0,05 44,25 ± 0,12
a a b c d c c
Age 32,0 ± 1.1 32,5 ± 1,0 33,4 ± 0,98 45,1 ± 0,8 48,5 ± 0,5 45,9 ± 0,5 45,1 ± 0,5
a a b c c d d
Δ FM(BIA-DEXA; kg) −2,57 ± 0,26 −0,86 ± 0,22 2,51 ± 0,23 5,67 ± 0,21 5,42 ± 0,14 4,02 ± 0,15 0,62 ± 0,18
a a b c c c d
Δ FFM (BIA-DEXA; kg) 2,25 ± 0,27 0,64 ± 0,22 −3,38 ± 0,26 −7,18 ± 0,23 −7,74 ± 0,15 −8,28 ± 0,17 −5,87 ± 0,18
BMI ≥ 40, differences vary with BMI. For BMI <16, BIA under- MON-P182
estimated FFM by 2,25 kg, and overestimated FM by 2,57 kg. THE DIFFERENCE RELIABILITY BETWEEN NUTRITIONAL
Conclusion: BIA provides a suitable assessment of BC for BMI ASSESSMENT PARAMETERS FOR DETECTING MALNUTRITION
between 16 and 18,5. For BMI <16, further analyses are needed, IN TYPE 2 DIABETES MELLITUS OUTPATIENTS WITH ACTIVE
in a larger number of patients. For BMI >18,5 and BMI <40, TUBERCULOSIS
adjustments have to be made according to the BMI class. N. N. M. Soetedjo1 *, D. F. Abdullah2, P. Santoso3, H. Permana1.
1
Disclosure of Interest: None declared. Endocrinology and Metabolism DIvision, Internal Medicine
Department, 2Internal Medicine Department, 3Pulmonology
MON-P181 Division, Internal Medicine Department, Padjadjaran
NUTRITIONAL RISK ASSESSMENT OF THE PATİENTS WITH University, Bandung, Indonesia
INFLAMMATORY BOWEL DİSEASE
Rationale: Diabetes Mellitus (DM) and Tuberculosis (TB) are
N. G. Ünal1 *, N. ORUÇ1, A. Ö. Özütemiz1. 1Gastroenterology, both have strong correlations with malnutrition, but there is no
Ege University Faculty of Medicine, İzmir, Turkey currently simple, easy and inexpensive method for assessment
of nutritional status in detecting malnutrition especially in
Rationale: Inflammatory bowel disease (IBD) is chronic
type 2 diabetes mellitus (T2DM) outpatients with active TB.
inflammatory disease of the digestive tract. IBD patients tend
The aim of this study is to evaluate the difference agreement
to have nutritional deficiency cause of active course of disease
between malnutrition parameters based on Body Mass
and also to avoid nutrition-releated bowel symptoms.
Index (BMI), Subjective Global Assessment (SGA), and Total
Nutritional factors play a key role fort the patients outcome.
Lymphocyte Count (TLC) with serum albumin as gold standard
This study aimed to determine nutritional ris assessment of the
in T2DM with active TB.
IBD patients.
Methods: This study was a cross-sectional study in type 2
Methods: A total 318 IBD outpatients were enrolled to the
Diabetes Mellitus outpatients with active Tuberculosis between
study between december 2015-december 2016. Data of the
February 2014 until November 2015 who come to Endocrinology
patients and mini nutritional assessment form (MNA)1 were
and Pulmonology Outpatient Clinics, Hasan Sadikin General
evaluated retrospectively. According to the MNA form, the
Hospital, Bandung, Indonesia. Non Parametric Kappa Formula
total scores of the patients were classified into 3 groups;<17 is
were using to measure the difference reliability between BMI,
defined as malnutrition, 17–23,5 at the risk of malnutrition and
SGA and TLC with serum albumin as gold standard.
24–30 as normal nutritional status. BMI were calculated
Results: At the end of this study there were 64 T2DM
according to WHO criteria as followed; <18,5 kg/m2 under-
outpatients with active TB, 34 (53,1%) were male. The mean
weight, 18,5–25 normal range, 25–30 overweight and ≥ 30
aged was 52 ± 11 years old. Malnutrition prevalence was 31,3%
obese.2
based on serum albumin; 39,1% based on SGA; 29,7% based on
Results: A total 200(63%) of the patients were ulcerative
TLC and 21,9% based on BMI. The reability test showed that BMI
colitis, 118(37%) were Crohn’s disease. Mean age was 45,7 years
and TLC had slight reliability (k = 0,208, p 0,087; k = 0,078,
(18–83), 174(55%) of the patients were men, 25(8%) of the
p = 0,531) while SGA has good reliability with serum albumin as
patients were underweight, 146(46,4%) normal, 110(34,6)
gold standard (k= 0,830, p < 0,001).
overweight and 37(%12) obese. MNA score showed 59(18,5%)
Conclusion: As conclusion SGA compared to BMI and TLC
were malnourished, 105(33%) were at risk of malnutrition and
showed good reliability with albumin value in detecting
154(48,5) were normal nutritional status.
malnutrition in type 2 diabetes mellitus outpatients with
Conclusion: Data of this study showed that 8% of IBD patients
active tuberculosis.
are underweight according to the BMI. But MNA scores revealed
that at least 50% of patients are malnourished or at the risk of Disclosure of Interest: None declared.
malnutrition. MNA can be used as a tool for the assessment of
the nutritional risk in IBD outpatient. MON-P183
References EVALUATION OF NUTRITIONAL STATUS AND SOCIAL
1. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening CONDITIONS OF STREET CHILDREN: KAYSERI PROVINCE FROM
for Undernutrition in Geriatric Practice: Developing the Short-Form TURKEY
Mini Nutritional Assessment (MNA-SF). J. Geront. 2001; 56A: G. Kaner1, N. İnanç2 *, G. Ünal2, E. Sivri2, N. Seremet Kürklü3.
M366–377 1
Faculty of Health Sciences, Department of Nutrition and
2. WHO expert consultation. Appropriate body-mass index for Asian
populations and its implications for policy and intervention
Dietetics, Izmir Katip Celebi University, Izmir, 2Faculty of
strategies. The Lancet, 2004; 157–163.
S246 Poster
Health Sciences, Department of Nutrition and Dietetics, Nuh Results: Physical characteristics of the players were: age
Naci Yazgan University, Kayseri, 3Department of Nutrition and 15 ± 1.2 years, height 175.2 ± 6.8 cm, weight 67.3 ± 5.9 kg, BMI
Dietetics, Akdeniz University, Antalya School of Health, 21.9 ± 1.3 kg/m2 and body fat percentages % 6.2 ± 1.7. When
Antalya, Turkey their food consumption is examined, it’s seen that their daily
energy intake is 3225 ± 692 kcal and their energy consumption
Rationale: The number of children who work on the streets of is 3322 ± 240 kcal. Carbohydrate, protein, fat percentage of
Turkey has prominently increased. They become vulnerable to the energy intake was found as %53,6, %16,2 and %30.2
malnutrition. We aimed to evaluate the nutritional status and respectively. Daily fluid consumption of athletes found to be
social conditions of a group of street children in Central 2780 ± 567 mL. During the training, athletes only consumed
Anatolia. water and amount of water consumed is 908.6 ± 332.7 mL.
Methods: A general questionnaire was applied to 75 children When nutrient intake of players are examined based on RDA
via a face-to-face interview. Body weight and height were (Recommended Daily Allowance), it has been seen that %92,3
measured and BMI was calculated. Children were distributed of them do not consume D vitamin adequately and %50 of them
according to the height for age and weight for height by using do not consume calcium adequately.
WHO 2007 references. Conclusion: To summarize, inadequacies are determined in
Results: The majority of the children were boys. Approximately food and fluid intakes of adolescent athletes. As they are in
half of the children were attending primary school and also developmental period, they must increase their calcium intake.
working on the street whereas 29.3% dropped out of school. The Considering that fact that the adolescent athletes may transfer
incidence of working on the street was higher in 7–9 and 10–12 their wrong nutrition habits to their professional life, they need
age groups and that half of the children were selling tissues, professional assistance in nutrition and hydration status.
gums and flowers on the street. It was seen that 37.3% of the
children working on the street were having 2 main meals, while
56.0% were having 3; that the majority of them were skipping
meals. Majority of boys (87.3%) and girls (75.0%) cannot receive MON-P185
the daily energy they need. One fourth of the boys (25.4%) and ASSESSMENT OF NUTRITION KNOWLEDGE AND FOOD INTAKES
one third of the girls (33.3%) cannot intake enough protein. OF WHEELCHAIR WOMAN NATIONAL BASKETBALL TEAM
Most of the boys cannot consume sufficient fiber (79.4%), N. Ersoy1 *, G. Ersoy2. 1Nutrition and Dietetic, Hacettepe
vitamin C (69.8%) and phosphor (65.1%). Almost all the boys University, Ankara, 2Nutrition and Dietetic, İstanbul Aydın
(98.4%) and all of the girls (100.0%) can not receive enough University, İstanbul, Turkey
calcium. Almost half of the boys (47.6%) and the majority of the
girls (75.0%) cannot gain enough iron. More than half of the Rationale: In this study, determination of nutrition knowledge
children (54.7%) were normal weight; while 36.0% of them were and food intakes of disabled athletes are aimed.
overweight according to their body mass index for age. Methods: This study was made by 22 players of Wheelchair
According to their height for age, 70.7% of children were Woman National Basketball Team between 14–17 January 2013
normal and 12.0% were stunted. (during camp period) in Ankara. Players voluntarily partici-
Conclusion: The children who are put to work in the streets do pated to the study and nutrition knowledge level questionnaire
not have a balanced diet. This subject is in need of extensive and food intake records of the players for the past 24 hours have
studies with control groups including all the cities in Turkey. been taken. All subjects gave their written informed consent to
participation. Descriptive statistics on personal character-
istics, and food consumption variables was calculated.
Results: Average age of the basketball players were 25,5 ± 7,2
MON-P184 years and daily energy intake was 2868 ± 524 kcal, energy
ASSESSMENT OF NUTRITION STATUS OF ELITE TURKISH consumption is 3407 ± 662 kcal. Carbohydrate, protein, fat
ADOLESCENT FOOTBALL PLAYERS percentage of the energy was found as %42.7 ± 8.84, %
N. Ersoy1 *, G. Ersoy2. 1Nutrition and Dietetic, Hacettepe 13.3 ± 1.96, %44.0 ± 8.07 respectively. %72.7 of the participants
University, Ankara, 2Nutrition and Dietetic, İstanbul Aydın had stated that their nutrition knowledge level was good but
Üniversitesi, İstanbul, Turkey they only answered %29 of the questions correctly. It has been
seen that the players are commonly uninformed about
Rationale: Meeting energy and nutrient requirements of nutrients, fluid intake and principals of sports nutrition. %
adolescent athletes is not only important for sports perform- 18,2 of the players with healthy nutrition information said that
ance but also for their health. By considering that they are on they gained the source of these information from dieticians.
the way of starting professional life, determination of their When nutrient intake of players are examined based on RDA
nutrition status is very important. (Recommended Daily Allowance), it has been seen that intake
Methods: 26 young athletes, who are on the way of becoming of vitamin B1, folic acid, iron, magnesium and fibre are
professional athletes, are participated to this study. All inadequate.
measurements (anthropometric measurements, food consump- Conclusion: Nutrition information (especially in the field of
tion records and fluid consumption amount) were taken during sports nutrition) of disables athletes is inadequate. Reference
three consecutive days before an important competitive soccer values have to be created for putting emphasis on nutrition
match. The study was approved by the Clinical Research Ethical status of disabled athletes, for developing strategies for
Advisory Committee No. 1 in Ankara. Descriptive statistics on nutrition status and food consumption requirements.
personal characteristics, and food consumption variables was
calculated.
Reference Group Healthy Ageing, Allied Health Care and Nursing, Hanze
Guidetti L, Franciosi E, Emerenziani GP, Gallotta MC, Baldari C. University of Applied Sciences, Groningen, Netherlands,
7
(2009) Assessing Basketball Ability in Players with Mental Ottery & Associates, LLC., Oncology Care Consultants, Vernon
Retardation. Br J Sports Med;43:208–212. Hills (Chicago area), United States
Rationale: The Scored Patient-Generated Subjective Global
Assessment (PG-SGA) is a multidimensional tool to assess
MON-P186
malnutrition and risk factors. We aimed to translate and cross-
ASSESSMENT OF ADOLESCENCE SWIMMERS’ NUTRITION
culturally adapt the original PG-SGA for the Thai setting and
STATUS
test its linguistic validity and intra-rater reliability in cancer
N. Ersoy1 *, T. Özgürtaş2. 1Nutrition and Dietetic, Hacettepe patients.
University, 2Medicine, Sağlık Bilimleri University, Ankara, Methods: The Thai version of the PG-SGA was developed
Turkey according to the Principles of Good Practice for the Translation
and Cultural Adaptation Process for the Patient Reported
Rationale: To assess nutrition status in adolescence swimmers Outcomes by the International Society for Pharmacoeconomics
and to evaluate food consumption. At the same time, and Outcomes Research (ISPOR). In 50 cancer patients and 50
anthropometric measurements of adolescence swimmers healthcare professionals, linguistic validity of the Thai PG-SGA
were got and this measurements were evaluated according to was assessed by Scale Comprehensibility Index (S-CI) and Scale
reference data. Difficulty Index (S-DI)), using a 4-point scale. Relevance was
Methods: In total 19 swimmers aged 11–13 years, were included assessed in professionals only, by Scale Content Validity Index
in this study. Three days food consumption records and some (S-CVI). In addition, intra-rater reliability (test-retest within 72
anthropometric measurement (weight and height) were hours of admission; Intraclass Correlation Coefficient (ICC) and
assessed. The study was approved by the Clinical Research weighted kappa (κ)) were assessed.
Ethical Advisory Committee in Ankara (with the resolution Results: The Thai PG-SGA showed excellent comprehensi-
dated 24.07.2013 and numbered B.10.4.İSM.4.06.68.49), and bility (S-CI = 0.99) and difficulty (S-DI = 0.95) as perceived by
all subjects gave their written informed consent to participa- patients. It also showed excellent comprehensibility
tion. Descriptive statistics on personal characteristics, and (S-CI= 0.92) and borderline acceptable difficulty (S-DI = 0.79)
food consumption variables was calculated. as perceived by professionals. Relevance of the Thai PG-SGA in
Results: The mean weight and height of swimmers were assessing malnutrition was considered excellent (S-CVI = 0.95).
45.3 ± 8.7 kg and 153.0 ± 6.3 cm, respectively. Carbohydrate, Agreement between numerical scores was good to excellent
protein, fat percentage of the daily energy intake was found as (ICC = 0.95) and agreement between PG-SGA categories was
38.6 ± 5.3%, 16.8 ± 2.8% and 44.7 ± 5.0 respectively. Daily very good (weighted κ=0.95).
calcium intake was 801.3 ± 241.0 mg and only 7 swimmers Conclusion: The Thai version of the PG-SGA was considered
(37%) met the daily calcium requirement. very easy to complete by patients. Professionals evaluated it as
Conclusion: Carbohydrate and fat intake of swimmers were very comprehensible, relevant, and borderline acceptable in
unbalanced. Carbohydrate intake was below the recommended difficulty to complete. It is a reliable tool for assessment of
value, and fat intake was over the recommended value. At the malnutrition and risk factors in cancer patients.
same time, calcium intake is also very low. It should not be
forgotten that swimming sports can be risky in terms of vitamin Disclosure of Interest: N. Nitichai Grant/Research Support from:
The 90th Anniversary of Chulalongkorn University Scholarship, J.
D deficiency because they are made in closed area in Turkey. It
Angkatavanich Grant/Research Support from: The 90th Anniversary of
should be noted that these athletes may be at risk for Chulalongkorn University Scholarship, N. Somlaw: None declared,
developing some diseases, especially bone health, if their B. Sirichindakul: None declared, K. Chittawatanarat: None declared,
calcium and vitamin D needs cannot be met due to their age of N. Voravud: None declared, H. Jager-Wittenaar Other: Co-developer of
development. the PG-SGA based Pt-Global app, F. Ottery Other: Copyright holder of
Disclosure of Interest: None declared. the Patient-Generated Subjective Global Assessment (PG-SGA), co-
owner and co-developer of the PG-SGA based Pt-Global app.
MON-P187
TRANSLATION AND CROSS-CULTURAL ADAPTATION OF THE MON-P188
SCORED PATIENT-GENERATED SUBJECTIVE GLOBAL RELATIONSHIP BETWEEN SKELETAL MUSCLE MASS AND EACH
ASSESSMENT (PG-SGA) TO THE THAI SETTING NUTRITIONAL INDEX OF HEART FAILURE PATIENTS: DOES BMI
AND BIOCHEMICAL INDICATORS REFLECT SKELETAL
N. Nitichai1 *, J. Angkatavanich1, N. Somlaw2, B. Sirichindakul3,
MUSCLE MASS?
K. Chittawatanarat4, N. Voravud2, H. Jager-Wittenaar5,6,
F. D. Ottery6,7, on behalf of PG-SGA/Pt-Global Platform Team. N. Suzuki1 *, K. Kida2, S. Doi1, C. Ito2, K. Ashikaga2, H. Matsuda1,
1
Department of Nutrition and Dietetics, Faculty of Allied K. Suzuki2, T. Harada2, Y. J. Akashi2. 1Division of Cardiology,
Health Sciences, Chulalongkorn University, 2Department of Department of Internal Medicine, ST. Marianna University
Medicine, 3Department of Surgery, Faculty of Medicine, School of Medicine Yokohama City Seibu Hospital, Yokohama,
2
Chulalongkorn University and King Chulalongkorn Memorial Division of Cardiology, Department of Internal Medicine, ST.
Hospital, Bangkok, 4Department of Surgery, Faculty of Marianna University School of Medicine, Kawasaki, Japan
Medicine, Chiangmai University, Chiangmai, Thailand,
5 Rationale: The European Society of Clinical Nutrition and
Department of Oral and Maxillofacial Surgery, University of
Metabolism (ESPEN) Consensus Statement recommends diag-
Groningen, University Medical Center Groningen, 6Research
nosis of malnutrition using several malnutrition screening tools
S248 Poster
and physical measurement, other than biochemical indicators. Results: A total of 81 patients (53% male; mean age 59 (±13)
Also, body mass index is cited as an index to recognize years) were included. At baseline, mean body mass index was
significant correlation with skeletal muscle mass. However, 21.5 (±17.3) kg/m2, mean WL prior to admission was 8 kg
body weight changes due to edema are often observed in (10%). In 23 (51%) patients the HGS and in 30 (76%) patients
chronic heart failure (CHF) patients. the FFMI were below the 10th percentile of the reference
Methods: Totally 45 outpatients with CHF were enrolled. Total values at baseline. Mean HGS at admission was 26 (±9.4) kg
skeletal muscle mass was measured at the level of the third and mean FFM was 46.5 (±9.4) kg. During follow-up there
lumbar vertebra using available preoperative computed tom- were no significant changes in HGS (P = 0.36) and FFM
ography images (Cutoff value: male 36.2 cm2/m2, female (P = 0.88).
29.6 cm2/m2). It was investigated on the relationship Conclusion: In this study there were no changes observed in
between skeletal muscle mass and each nutritional indicator. HGS and FFM during nutritional intervention and follow-up in
Results: The mean age was 75.6 ± 6.4 years old and left newly admitted malnourished hospitalized patients. The
ventricular ejection fraction was 44.3 ± 18.9%. Of the study added value of HGS and FFM measurements in nutritional
patients, 53.3% patients were male, 26.7% patients had intervention and follow-up needs to be assessed in further
ischemic heart failure, 57.8% patients had New York Heart studies.
Association (NYHA) classification ≥2, and 68.9% patients had Disclosure of Interest: None declared.
Mini Nutritional Assessment Short Form (MNA-SF) score ≤11.
Correlation between skeletal muscle mass and each index was
MON-P190
body mass index (BMI; r = 0.63, p < 0.01), Geriatric Nutritional
REFERENCE VALUES FOR HANDGRIP STRENGTH CORRECTED
Risk Index (GNRI; r = 0.51, p < 0.01), MNA-SF (r = 0.37, p = 0.03)
FOR ARM MUSCLE AREA DIFFER BETWEEN GENDERS.
and serum albumin value (Alb; r = −0.10, p = 0.59). In addition,
the predictive ability of skeletal muscle mass reduction by area P. Reijven1 *, P. Geerlings1. 1Dietetics, Mumc Maastricht,
under the receiver operating characteristic Curve (AUC) was Maastricht, Netherlands
BMI: 0.79, MNA-SF: 0.74, GNRI: 0.70, and Alb: 0.59.
Rationale: A low handgrip strength (HGS) is an indication for
Conclusion: Because Alb was affected by inflammation and
loss of skeletal muscle and/or overall physical condition of
body congestion, there was no correlation between skeletal
patients and is an independent predictor for complications and
muscle mass. On the other hand, BMI and MNA – SF, GMRI
mortality. Reference values are not specified for frame size,
including BMI in the evaluation items also showed correlation
height or muscle mass. This might lead to misinterpretations of
with skeletal muscle mass in CHF, and these possibilities may
measured values. We therefore constructed reference values
reflect skeletal muscle mass.
corrected for mid arm muscle area (MAMA).
Disclosure of Interest: None declared. Methods: In 1273 (913 females; 360 males) healthy volunteers
(age 20–80 years) HGS, midarm circumference and triceps
MON-P189 skinfold were measured. MAMA was calculated and HGS was
CHANGE IN HANDGRIP STRENGTH AND FAT-FREE MASS corrected for MAMA. Age and gender specific percentiles were
DURING NUTRITIONAL INTERVENTION AND FOLLOW-UP IN calculated. Data of men and women were compared by
MALNOURISHED HOSPITALIZED PATIENTS student T-tests.
P. L. M. Lakenman1, C. Oudshoorn2 *. 1Department Nutrition Results: In all age categories absolute HGS was higher in males
and Dietetics, Internal Medicine, 2Department Internal than in females (P < 0,001). However, HGS/cm2 MAMA was not
Medicine, Erasmus MC, University Medical Center, Rotterdam, different between genders and stable until the age of 50 years.
Netherlands In females the P50 percentile showed a decline of 30% from age
30 to 70 years, while in males this decline was only 18%.
Rationale: Malnutrition is frequently observed in Dutch
Table 1: P50 values HGS/MAMA (kg/cm2) from age 40 to 79 years.
Hospitals. According to the Dutch Dietetic Guidelines, mea-
surements of handgrip strength (HGS) and fat-free mass (FFM) Age (years) 40–49 50–59 60–69 70–79
should be part of assessment of the nutritional status. It Males 0,922 0,901 0,846* 0,755*
remains unknown how often HGS and FFM should be measured Females 0,913 0,800 0,696 0,677
during follow-up. The aim of this study was to examine the *significantly different from females (P < 0,001).
change in HGS and FFM during nutritional intervention and
follow-up in hospitalized patients. Conclusion: in healthy persons the HGS corrected for MAMA is
Methods: All patients admitted to the departments of internal constant until the age of 50 years and not different between
medicine and surgery who were diagnosed as malnourished genders. Above 50 years the corrected HGS declines gradually,
according to the Malnutrition Universal Screening Tool (MUST, especially in women. HGS/MAMA might be a simple screening
score ≥ 2) in the period January-March 2017 in the Erasmus MC tool for muscle quality and/or overall physical capacity. The
were included. Nutritional assessment (NA) took place at difference between genders during ageing might indicate
admission, 5 days after the day of admission and after longer differences in muscle metabolism.
follow-up period on indication. NA was assessed by: body Disclosure of Interest: None declared.
weight (kg), weight loss prior to admission (WL, kg), FFM (kg/
m2), fat-free mass index (FFMI, kg/m2), HGS (kg) and protein
intake (weight X 1.2–1.5 g, as percentage of requirement).
Non-parametric tests were performed to examine the differ-
ences of HGS and FFM during follow-up.
MON-P191 We proposed using Quality Improvement Methodologies to

A SHORT NUTRITIONAL ASSESSMENT PROCEDURE (SNAP) improve the standard of nutritional care being provided to all
IDENTIFIES PATIENTS WITH NORMAL BMI AS MALNOURISHED. patients admitted to an acute Neurosurgical Ward.
P. Reijven1 *, L. Sundaram1, A. Vroomen1, J. Brouns1, Methods: The Model for Improvement (MFI) framework2 was
P. Geerlings1. 1Dietetics, MUMC Maastricht, Maastricht, used in conjunction with the “Plan, Do, Study, Act (PDSA)
Netherlands cycle”. A number of baseline audits were completed (rates of
screening, weight on admission audit, mealtime audits). A
Rationale: In a recent ESPEN consensus statement disease number of PDSA cycles were completed including:
related malnutrition (DRM) was defined as a low BMI (<18,5) or • Nutrition education
a substantial weight loss combined with a low BMI or low FFMI. • Admission Pack Flowsheets
This definition excludes the need for body composition and • Self Auditing process
function measurements. Especially in patients with liver or • Using red mats to highlight patients requiring assistance
renal disease this might lead to wrong conclusions. Aim of the
study was to compare BMI with mid arm muscle and fat area and Results: Over an eight week period, the team achieved a
handgrip strength (HGS) in patients with renal or liver disease. sustained compliance rate of 80% for malnutrition screening
Methods: in 32 patients with liver disease (15 males, 17 (from baseline of 0%). There was also an improvement with
females, mean age 58 years (SD = 9))and 44 patients on renal mealtime assistance observed, with 100% of patients receiving
dialysis (30 males, 14 females, mean age 70 years (SD 12)) we timely assistance post intervention (compared to 72% at
measured weight, height, midarm circumference, triceps baseline).
skinfold and HGS and calculated BMI, mid arm muscle area Conclusion: A significant improvement in optimising the
(MAMA) and mid arm fat area (MAFA). Values were compared nutritional care for patients was achieved using the MFI and
with gender and age specific reference values ( percentiles). PDSA cycles. Patients at risk of malnutrition were identified at
Results: BMI below 18,5 kg/m2 was measured in two dialysis an earlier stage of their admission journey resulting in earlier
patients, both patients scored below P5 for MAMA, MAFA and dietary intervention. A secondary outcome of this project has
HGS. All other patients had BMI values above 20. Despite the been the change in mindset and culture within the
absence of underweight a substantial numbers of patients organisation.
scored low for MAMA, MAFA and HGS (see Table 1). References
Table 1: Percentage of patients with values < P5 or between P5 and P15 for MAMA, 1. http://www.bapen.org.uk/pdfs/nsw/nsw-2011-report.pdf
MAFA and HGS. 2. Langley et al. 2009. The Improvement guide. Jossey-Bass: A Wiley
Patients MAMA MAFA HGS imprint (USA)
<P5 P5-P15 <P5 P5-P15 <P5 P5-P15
Liver dis.(N = 32) 9 22 12 12 28 31

Dialysis (N = 44) 20 11 14 7 45 9 MON-P193
MALNUTRITION HAS NEGATIVE EFFECTS ON POSTOPERATIVE
Conclusion: BMI is unable to identify malnourished patients COMPLICATIONS, LENGTH OF STAY AND READMISSIONS AT
with compromised body composition and low muscle strength. SURGICAL PATIENTS
Overhydration, ascites and (abdominal) fat mass can mask the P. Sarkut1 *, S. Kilicturgay2, E. S. Kerim3, O. Sütcüoglu4,
loss of skeletal muscle mass. Simple anthropometric measures G. Dundar5, I. Tirnova1. 1Department of General Surgery,
might be useful in daily practice to monitor nutritional status of Uludag University, 2Department of General Surgery, WM
chronically ill patients when a detailed nutritional assessment Medical Park Hospital, Bursa, 3Department of General Surgery,
is not possible. Tepecik Training and Research Hospital, Izmir, 4Department of
Internal Medicine, Gazi University, 5Department of
Otolaryngology, Hacettepe University, ankara, Turkey
MON-P192 Rationale: We investigated the effects of malnutrition and

USING QUALITY IMPROVEMENT METHODOLOGIES TO nutritional supporting on postoperative complications, length
OPTIMISE NUTRITION CARE FOR ALL PATIENTS ADMITTED TO of hospitalisation and readmissions of postoperative 30th and
AN ACUTE NEUROSURGICAL WARD IN BEAUMONT HOSPITAL 90th days in this trial.
P. O’connor1, K. Cullen1 *, E. Bradley2. 1Department of Methods: The data is collected from the surgical patients as
Nutrition & Dietetics, 2Department of Nursing, Beaumont prospectively between March 2013 and March 2014. Patients’
Hospital, Dublin 9, Ireland data as age, gender, body mass index (BMI), loss of wiegth (%10
in 6 months), nutritonal support status, nutritonal support
Rationale: Malnutrition can be both a cause and a conse- timing, lenght of stay (LOS), postoperative complications and
quence of disease, and can lead to worse health and clinical readmissions of postoperative 30th and 90th days. Patients with
outcomes in all social and healthcare settings. Previous audits BMI < 18.5 and/or weigth loss are assumed as malnourished
showed that on average 28% of patients admitted to our patient. Malnourished patients are divided in four groups; no
hospital are at risk of malnutrition1. To ensure patients receive malnutrition support (N), preoperative nutritional support
the right intervention at the right time we need systems in (PrN), postoperative support (PsN)and both preoperative and
place to firstly identify patients at risk of malnutrition and also postoperative nutritional support (PerN).
prevent patients from becoming malnourished during Results: 1,325 women (%58,2) and 951 men (%41,8), 2,276
admission. patients evaluated totally. Malnutrition was detected at 185
S250 Poster
patients (%8,1). İnfectious complications had seen in %4,9 of MON-P195

malnutriated patient while others suffered from infectious DIAGNOSTIC ACCURACY OF ESPEN DIAGNOSTIC CRITERIA FOR
complications at %2,2 rate ( p = 0,037). Similarly malnourished MALNUTRITION IN SELECTED CLINICAL POPULATIONS
patients had significantly longer hospital stay ( p < 0,005). The P. Dewansingh1,2 *, L. ter Beek1,3,4, M. Euwes5, G. van der Sluis6,
readmission rate was %13 at malnourished patients, while F. D. Ottery1,7, C. P. van der Schans1,8,9,10,
others’ rate was %6,5 at postoperative 30th day ( p = 0,001). H. Jager-Wittenaar1,11. 1Research Group Healthy Ageing,
Postoperative 90th day readmission rates were %4,9 and %1,4 Allied Health Care and Nursing, Hanze University of Applied
respectively( p = 0,002). By the way there were no significant Sciences, Groningen, 2Nutrition and Dietetics, Nij Smellinghe
difference between the groups on gastrointestinal complica- Hospital, Drachten, 3Department of Pulmonary Diseases and
tions ( p = 0,197) and other complications ( p = 0,045). Tuberculosis, Center for Rehabilitation, 4Department of
Conclusion: BMI is detected as unsatisyfing on evaluation of Maxillofacial Surgery, University of Groningen, University
malnutrition. Malnutrition is a significant risk factor of LOS, Medical Center Groningen, Groningen, 5General Health Care,
infectous complications and readmissions. It seems to nutri- 6
Department of Physical Therapy, Nij Smellinghe Hospital,
tional supporting has an impact on infectious complications on Drachten, Netherlands, 7Ottery & Associates, Vernon Hills
readmission althougt it has no effect at early stage. (Chicago), United States, 8Faculty of Medical Sciences, 9Dept.
Disclosure of Interest: None declared. of Rehabilitation Medicine, 10Dept. of Health Psychology
Research, 11Dept. of Maxillofacial Surgery, University of
MON-P194 Groningen, University Medical Center Groningen, Groningen,
A SHORT NUTRITIONAL ASSESSMENT PROCEDURE (SNAP) Netherlands
FOR ROUTINE DIETETIC PRACTICE.
Rationale: We aimed to assess diagnostic accuracy of ESPEN’s
P. Reijven1 *, L. Sundaram1, A. Vroomen1, J. Brouns1, Diagnostic Criteria for malnutrition (EDC), as compared to the
P. Geerlings1. 1Dietetics, MUMC Maastricht, Maastricht, Patient-Generated Subjective Global Assessment (PG-SGA) in
Netherlands selected clinical populations.
Methods: In two hospitals, in 174 patients (67.5 ± 10.3 yrs;
Rationale: Screening for malnutrition is introduced in most
COPD: n = 116; colon/rectum cancer: n = 21; orthopedic:
hospitals. However a full nutritional assessment in positively
n = 37) malnutrition was assessed by EDC and PG–SGA.
screened patients is not a routine procedure. We propose a
According to EDC, malnutrition was defined as having at least
simple, quick and cheap method that can be used in health
one of the following criteria: 1) BMI < 18.5 kg/m2; 2)
care centers. Aim of the study was to compare SNAP outcomes
combination of unintentional weight loss (>10% of habitual
with body composition measured by bioelectrical impedance
weight indefinite of time, or >5% over 3 months) and low BMI
analysis (BIA).
(<20 or <22 kg/m2 in subjects younger and older than 70 yrs,
Methods: In patients referred by medical specialists for a full
respectively) and/or a low fat-free mass index (FFMI) by
nutritional assessment, fat free mass index (FFMI) and fat mass
bio-electrical impedance (<15 [female] and <17 kg/m2
index (FMI) measured with BIA (using the Geneva equation)
[male]). As reference, malnutrition was defined as PG-SGA
were compared with SNAP outcomes of mid arm muscle area
Stage B (moderately/suspected malnutrition) or Stage C
(MAMA), mid arm fat area (MAFA) and handgrip strength (HGS).
(severely malnourished). Diagnostic accuracy was assessed by
Patients with neurological or muscular diseases were excluded.
sensitivity, specificity, positive and negative predictive value,
The SNAP consists of anthropometric measurements: height,
and ROC curve.
weight, circumference of mid upper arm, triceps skin fold and
Results: According to EDC and PG-SGA, 6.9% and 31% were
HGS. Together with date of birth, gender and usual weight
malnourished, respectively. For COPD, colon/rectum cancer,
these data are used in a spreadsheet. The patients age, weight,
and orthopedic patients, prevalence was 9.5% and 39.7%, 4.8%
weight loss, MAMA, MAFA are calculated and results of BMI,
and 19%, and 0% and 10.8% respectively. Overall sensitivity,
frame size, MAC, MAMA, MAFA and HGS are immediately
specificity, positive and negative predictive value were 0.15,
available. Gender and age specific reference values are used
0.97, 0.85 and 0.03, respectively. The area under the ROC curve
for presenting results in percentiles categories.
(AUC) was 0.56 ( p = 0.23) for the total population. For COPD,
Results: 42 patients were included (mean age 50 years, SD = 18
colon/rectum cancer, and orthopedic patients AUC was 0.55
years). Mean BMI was 23,2 kg/m2 (SD = 6,3), 13 patients (31%)
( p = 0.39), 0.63 ( p = 0.45), and 0.50 ( p = 1.00), respectively.
had BMI < 18,5 kg/m2. HGS was below P15 is 29 (69%) patients.
Conclusion: In COPD, rectum-/colon cancer, and orthopedic
Of the patients with normal BMI (>18,5) (n = 29) 41% had MAMA
patients, diagnostic accuracy of EDC as compared to the PG-
below P15 and 72% had HGS below P15. VVMbia correlated with
SGA is low, especially sensitivity and negative predictive value.
MAMA (R = 0,73, P < 0,01), VMbia correlated with MAFA
Consequently, using EDC in these populations is likely to result
(R = 0,73, P < 0,01). The sensitivity and specificity of MAMA
in underrecognition of malnutrition, which may hinder timely
for identifying patients with a low FFMI (males: < 17,4 kg/m2;
and adequate treatment of malnutrition.
females: <15,0 kg/m2) were 64% and 75% respectively.
Conclusion: When a full nutritional assessment is not possible, Disclosure of Interest: P. Dewansingh: None declared, L. ter Beek:
SNAP can help dieticians to identify and monitor patients with a None declared, M. Euwes: None declared, G. van der Sluis: None
low FFMI and low muscle strength. declared, F. Ottery Other: Developer of the PG-SGA, co-developer of
the PG-SGA based Pt-Global app, C. van der Schans: None
Disclosure of Interest: None declared. declared, H. Jager-Wittenaar Other: Co-developer of the PG-SGA
based Pt-Global app.
MON-P196 MUST in comparison with subjective global assessment (SGA),

‘lET THEM EAT CAKE’: A RETROSPECTIVE SERVICE as the reference standard of nutritional status.
EVALUATION OF FOCUS ON UNDERNUTRITION IN CARE HOMES Methods: Inpatient admissions to the HF Unit were nutrition-
R. Masters1 *. 1Nutrition and Dietetics, County Durham and ally screened using the MUSTand HFiNUT. A SGA was completed
Darlington NHS Trust, NHS, Bishop Auckland, United Kingdom by an experienced dietitian, blinded to the NST results. Each
NST was used to categorise patients by malnutrition risk and
Rationale: Undernutrition is a cause of poor health in older compared with nutritional status indicated by SGA.
people, affecting 35% of residents in care homes1. Focus on Results: 40 inpatients (23 male), average age 73 years (28–95
Undernutrition (FoU), delivered by dietetic assistants (DA) uses years) were assessed. Ethnicity in 63% of the participants was
multifaceted approaches to undernutrition management. The White, 23% were Asian and 5% Black.
study aims to evaluate FoU’s impact on undernutrition outcome 68% of the participants were malnourished by SGA. 15% were at
measures in care homes; including weight change in residents nutritional risk using MUST (Score ≥1) and using HFiNUT 90%
‘at risk’ of undernutrition, prevalence of undernutrition and (Score ≥1). MUST identified 8% for dietetic referral and
pressure ulcers (PU). HFiNUT 70%.
Methods: A retrospective pragmatic service evaluation using The sensitivity of HFiNUT was 85% and MUST was 11% when
pseudonymised data collected over 13 years on weight, identifying patients for referral to a dietitian. MUST had 24
undernutrition risk and PU from long-stay residents’ notes false negative results (89%) compared with the HFiNUT 5 results
before and six months after training. (15%). The specificity of MUST was 100% vs HFiNUT 62%.
Results: Analysis on 104 homes, 4315 residents (71.3% female; Conclusion: This study supports previous findings of high rates
mean stay 10.8 (1–278) months) in County Durham. Following of malnutrition in HF patients. Replacement of MUST with
FoU a significant difference was identified for: HFiNUTwould increase the proportion of malnourished patients
• Improved rate of weight change for ‘at risk’ residents identified and referred for dietetic intervention. Further work
( p < 0.001). Undernutrition risk significantly influenced is required to determine if these results are reproducible in
weight change (low:B1.04 kg, E0.01 kg; moderate: B− larger patient numbers.
1.79 kg, E−0.38 kg; high:B−0.83 kg, E1.00 kg, Bp < 0.001, References
E
p = 0.001)
1. Sze S, et al. (2017) Clin Res Cardiol 15,1082–1085.
• Reduced undernutrition prevalence ( p < 0.001) from 32.7%
2. Lin H, et al. Heart Fail Rev (2016) 21:549. doi: 10.1007/s10741-016-
to 29.1% residents ‘at risk’ (moderate:B13.1%, E8.9%; 9540-0.
high:B19.6%, E15.9%). Nutrition screening significantly 3. NICE (2006) CG32.
improved (B76.3%, E98.7%, p < 0.001)
• Reduced prevalence PU (51%, p < 0.001). PU prevalence
significantly increased with undernutrition severity at
baseline ( p < 0.001), but not following FoU ( p = 0.233) MON-P198
(low: B5%, E2.3%; moderate:B6.9%, E1.6%; high:B10.5%, HOSPITAL MALNUTRITION ON THE AFRICAN CONTINENT:
E
3.9%). Odds of developing PU reduced 53% (OR:0.47) WE HAVE A PROBLEM
B
:baseline; E:evaluation;OR:odds ratio R. Blaauw1 *, E. Achar1, R. Dolman2, J. Harbron3, M. Moens1,
F. Munyi1, D. Nel4, D. Nyatefe2, J. Visser1. 1Division of Human
Conclusion: These results demonstrate DAs delivering FoU Nutrition, Stellenbosch University, Cape Town, 2Centre of
significantly improves weight, undernutrition and PU preva- Excellence for Nutrition, North-West University,
lence in care homes. Indicating FoU is an effective model for Potchefstroom Campus, Potchefstroom, 3Division of Human
improving undernutrition outcomes, with the potential of Nutrition, University of Cape Town, 4Centre for Statistical
reducing possible harm, such as PU in care homes. Consultation, Stellenbosch University, Cape Town, South Africa
Reference
1. Russell C & Elia M. (2015) Nutrition Screening Survey in care homes
Rationale: Globally prevalence of malnutrition on admission to
in England. BAPEN. hospital varies between 15% and 60%. However, data regarding
Africa is lacking. This study aimed to determine the prevalence
of risk for malnutrition on admission and discharge and the
association with selected indicators.
MON-P197 Methods: In this multi-centre analytical cohort study, adult
A NEW DISEASE SPECIFIC NUTRITIONAL SCREENING TOOL FOR patients from hospitals in South Africa, Kenya and Ghana were
INPATIENTS WITH HEART FAILURE screened on admission and discharge and contacted 3 months
R. Jones1 *, H. Jackson1. 1Nutrition and Dietetics, St Georges post-discharge. Relevant morbidity and mortality outcomes
Hospital, London, United Kingdom were assessed. At-risk for malnutrition was indicated if NRS-
2002 score ≥ 3. Summary statistics, analysis of variance and
Rationale: Malnutrition contributes to poor outcomes in non-parametric methods were used. Statistical significance
patients with Heart Failure (HF) (1) and is highly prevalent at was 5%.
75–90% (2). Patients should be screened for malnutrition on Results: 2126 Adult patients (44.9 ± 15.9 years old, 52.2%
admission to hospital (3). The commonly used Malnutrition female) were screened on admission. 72.6% were at risk of
Universal Screening Tool (MUST) may not be reliable in HF malnutrition, with a higher prevalence for patients in
patients with oedema. There is no consensus for an alternative Kenya and Ghana (74.6%) versus those from South Africa
nutritional screening tool (NST). A HF inpatient NST (HFiNUT) (69.8%) (Chi2 = 4.85,p = 0.028). Discharge risk of malnutrition
was designed. This pilot study aimed to assess the HFiNUT and was 75% (n = 557). Mean length of stay (LOS) was 6.6 ± 6.3 days.
S252 Poster
During hospitalization, only 18.8% of patients were referred for MON-P200

nutrition support; 23.5% lost ≥5% body weight and discharge IS CALF CIRCUMFERENCE A GOOD INDICATOR OF MUSCLE
BMI (23.11 ± 8.56 kg/m2) was significantly lower than admis- MASS DEPLETION IN CHILDREN AND ADOLESCENTS WITH
sion BMI (24.32 ± 0.31 kg/m2)( p < 0.001). Admission nutrition MALIGNANT NEOPLASMS?
risk was associated with increased mortality (Chi2 = 17.24, R. D. L. Ferretti1 *, P. S. Maia-Lemos1, K. J. T. Guedes1,
p = 0.001); older age in men ( p = 0.008); longer LOS ( p = 0.001) E. M. M. Caran1. 1Pediatrics, Federal University of Sao Paulo,
and increased 3-month re-admission rates (Chi2 = 4.25; Sao Paulo, Brazil
p = 0.039). The latter was also significantly associated with a
greater percentage weight loss prior to admission ( p = 0.002), Rationale: Children and adolescents with malignant neoplasms
as well as a lower BMI on discharge ( p = 0.008). may present malnutrition, but this finding may be under-
Conclusion: Nearly two-thirds of all patients were at-risk of estimated when considering General Adiposity Indexes, such as
malnutrition on admission. This was associated with longer the Body Mass Index (BMI). Anthropometric measures are able
LOS, greater hospital mortality and increased 3-month re- of early detection of malnutrition, specifically muscle mass
admission rates. Routine screening practices with appropriate depletion, such as calf circumference (CC). The main objective
nutrition support action should be implemented as a matter of of this study is to verify if there is a correlation between the
urgency. measurement CC and arm muscle area (AMA), skinfold Triceps
Disclosure of Interest: None declared. (ST), and Body Mass Index (BMI).
Methods: A cross-sectional study evaluated children and
MON-P199 adolescents from 0 to 20 years of age with malignant neoplasms
NECK CIRCUMFERENCE: IS THERE CORRELATION WITH THE at a Pediatric Oncology Specialized Institute between October
ARM MUSCULAR AREA IN CHILDREN AND ADOLESCENTS WITH 2015 and August 2016. Measurements of CC were evaluated
MALIGNANT NEOPLASMS? and, for AMA calculation, middle upper arm circumference
(MUAC) and ST were evaluated. The values of weight and
R. D. L. Ferretti1 *, P. S. Maia-Lemos2, K. J. T. Guedes1, length/height were obtained for the calculation of BMI. All
E. M. M. Caran1. 1Pediatrics, Federal University of Sao Paulo, measurements were performed by trained evaluators, follow-
Sao Paulo, 2Federal University of Sao Paulo, Sao Paulo, Brazil ing anthropometric techniques standardized by the literature.
Correlation between CC and other variables (AMA, BMI and ST)
Rationale: Patients with malignant neoplasms may present
was performed through the Pearson correlation, with signifi-
malnutrition early, and this finding may be underestimated
cance value p < 0,05.
when only the Body Mass Index is considered due to the various
Results: Among the 1535 assessment, 54,72% (n = 840) were
metabolic changes, hydration status, and the side effects
male. The mean age was 9.92 (±7.47). The correlation between
caused by antineoplastic therapy, however, anthropometric
CC and the other independent variables (AMA, BMI CC), were
indicators can identify changes in nutritional status. Neck
positive and very strong between CC and AMA (r = 0.87), CC and
circumference (NC) is a measure of easy gauging and
BMI (r = 0.80) and strong between CC and ST (r = 0.74); p < 0,05.
applicability in clinical practice, in addition to reflecting
Conclusion: It is concluded that the calf circumference,
deposits of upper body subcutaneous fat, therefore the main
besides being an easy and low cost measure to be used in
objective of this study was to verify if there is a correlation
clinical practice, has a very strong correlation with AMA, which
between NC and Arm Muscular Area (AMA).
also reflects muscle mass stores, being a good indicator for
Methods: A cross-sectional study that assessed children and
monitoring the nutritional status of children and adolescents
adolescents from 0 to 20 years old with malignant neoplasms at
with malignant neoplasms.
a Pediatric Oncology Specialized Institute between October
2015 and March 2017. Measurements of NC were evaluated, Disclosure of Interest: None declared.
besides middle upper arm circumference and triceps skinfold
(to calculate AMA). Student’s t-test for independent samples, MON-P201
and Pearson’s correlation between NC and AMA were per- THE IDENTIFICATION AND CLASSIFICATION OF THE
formed, with significance level p < 0.05. NUTRITIONAL RISK RESULTING FROM AN UNDER-RESOURCED
Results: Among the 1656 assessments, 56.9% (n = 943) were DIETETIC SERVICE
male. The mean age, for male and female were 9.0 ± 5.8 and R. Hannon1, S. Mcmahon1, O. Smith1, M. O’donoghue1,
8.5 ± 5.4, respectively. Considering the groups of solid tumors D. Walsh1, B. Moore1, E. Sweeney1, C. White1, K. Mcelligott1,
(n = 1364) and hematological tumors (n = 292), there was a E. Duignan1, L. Masterson1, G. Marrinan1, M. Lyons1,
significant difference between the means for NC ( p = 0.016) M. Hannon1 *, N. Hastings1, N. Brosnan1, R. Clynes1,
and AMA ( p = 0.004), being higher for the group of hemato- S. Cunneen1, C. O’hanlon1. 1Beaumont Hospital, Dublin 9,
logical tumors. The correlation between NC and AMA was Ireland
positive and very strong for male and female (r = 0.9 vs r = 0.8;
p = 0,000) respectively. Rationale: In 2016, our Nutrition and Dietetics Department
Conclusion: It is concluded that there is a very strong experienced severe deficits in staffing. At its worst, the staffing
correlation between NC and AMA for both sexes, and this deficit for the department was equivalent to 5.5 WTE (22.6%).
outcome was higher for males. Thus, NC measurement is a good The aim of this audit was to analyse and categorise the
indicator to identify changes in the nutritional status of nutritional risk to inpatients resulting from an under-resourced
children and adolescents with malignant neoplasms. dietetic service.
Methods: In order to ensure patient safety, outpatient services mass index (BMI) of 21 kg/m2 (±2,5 kg/m2). The average time
were curtailed, day ward service was reduced and inpatient EN was 11 days (±1 days). In the baseline, RFQ was 1.5 cm
referrals received from under-resourced areas were initially (±0.2 cm) and the VF was 4,2 cm (±1.3 cm). After engrafment,
screened and those not requiring enteral or parenteral RFQ was 1.3 cm (±0.2 cm) and the VF was 4,2 cm (±1.2 cm).
nutrition were placed on a waiting list. Subsequently, an There wasn’t significant difference between baseline and
audit tool was devised and medical charts were retrospectively after engraftment, although RFQ had reduced in all patients.
reviewed to analyse the nutritional parameters and assess the Conclusion: In this cohort of patients we found reduced
level of risk to waiting list patients resulting from the absence muscle thickness after engraftment and VF didn’t have any
of dietetic intervention. The Health Service Executive (HSE) alterations. The US was a practical, economical and effective
Risk Assessment Tool was completed on each patient as a means method to evaluate these patients.
of risk analysis and categorisation. Disclosure of Interest: None declared.
Results: Ninety nine patients were referred, of these 11 were
seen within the department priority codes, 1 was not admitted
MON-P203
and no data was available for 2 due to missing medical charts.
TRANSTHYRETIN FOR ROUTINE ASSESSMENT OF
Data was collected on the remaining 85 patients. Eighty five
MALNUTRITION: AN INTERNATIONAL SURVEY OF EXPERTS IN
percent (n = 72) had two or more nutrition related risk factors.
THE FIELD
Seventy five patients had a documented weight, however, only
25% (n= 21) had an initial Malnutrition Universal Screening Tool S. Dellière1, N. Neveux1,2, J.-P. De Bandt1,2, L. Cynober1,2 *
1
(MUST) score completed. At least 36 patients were deemed at Service de Biochimie, Hôpitaux Cochin et Hôtel-Dieu, GH
risk of refeeding syndrome. HUPC, APHP, 2Laboratoire de biologie de la Nutrition EA4466
Scoring of the HSE Risk Assessment Tools revealed that 75% PRETRAM, Université Paris Descartes, Paris, France
(n = 64) were classified in the red risk category (moderate to
Rationale: Transthyretin (TTR) is suitable for assessing malnu-
extreme) as a result of malnutrition, refeeding syndrome risk or
trition.1 However, its sensitivity to inflammation and the
poor wound healing.
frequent confusion in terms of its use as a marker of diagnosis,
Conclusion: Significant dietetic staffing deficits resulted in
prognosis or of the effectiveness of refeeding, do not favor its
suboptimal nutritional management and moderate to extreme
use. Moreover, no ESPEN/ASPEN recommendations exist con-
malnutrition risk in 75% of this patient cohort.
cerning its use and cut-off values. Our aim was to evaluate the
Disclosure of Interest: None declared. overall perception of the value of this parameter and its
utilization worldwide.
MON-P202 Methods: A panel of international experts in the field were
ULTRASOUND: A NEW STRATEGY TO EVALUATE BODY asked about the use of transthyretin in clinical practice in their
COMPOSITION IN CROHN’S PATIENTS UNDERGOING country, existing guidelines by local health authorities and the
HEMATOPOIETIC STEM CELL TRANSPLANTATION (HSCT) cut-off values used to define malnutrition.
A. Z. Pereira1, S. E. A. Gonçalves1 *, B. L. de Sá2, M. Cocco3, Results: A total of 28 experts (surgery [8], nutrition [6], critical
A. A. F. Ribeiro1, N. Hamerschlak1. 1Oncology and Hematology, care [4], geriatrics [4], biology [3], pediatrics [1], internal
2
Clinical Nutrition, 3Physiotherapy, Hospital Israelita Albert medicine [1], gastroenterology [1]) from 15 countries partici-
Einstein, S.Paulo, Brazil pated. TTR appears in national guidelines in Italy, Poland and
France with cut-off values for defining mild/moderate/severe
Rationale: Crohn disease is a chronic inflammatory disorder of malnutrition: 0.22/0.17/0.10 g/L, 0.20/0.10/0.05 g/L and no/
the gastrointestinal tract with a strong polygenic immune 0.11/0.05 g/L. TTR is rarely used for routine practice in the UK
component. In refractory cases, autologous HSCT can decrease and Sweden where assessment is centralized in a few
disease activity and mucosal healing and improve quality laboratories. Argentina, Brazil, Chile, Canada, Israel, Japan,
of life. Reduced muscular mass and excess visceral fat in the Netherlands, Switzerland and USA do not use or no longer
patients undergoing HSCT are associated with higher use TTR, either for lack of evidence of its usefulness or for
mortality, longer hospitalization, longer use of immunosup- financial reasons.
pressive drugs, graft-versus-host disease, shorter disease-free Conclusion: Although often used for research purposes, TTR is
interval after the HSCT and comorbidities leading to shorter not used in clinical practice in most countries. Given the
survival time. difficulty of finding a consensus tool for the diagnosis of
Objectives: To evaluate muscle thickness and visceral fat malnutrition, such a simple and inexpensive marker should be
by US. considered. However, additional studies are required to define
Methods: We evaluated 5 HSCT patients (≥18years) at Hospital and settle international guidelines for the use of TTR and its
Israelita Albert Einstein, São Paulo, Brazil, on their first day of associated cut-off values.
hospitalization, before HSCT and after the engraftment. The Reference
thickness of the right femoral quadriceps muscle (RFQ),
1. Clin Nutr, 2017; 36: 364–370.
measured at 6 cm from the top edge of the patella was
measured using US in B-mode. The VF was measured in the Disclosure of Interest: None declared.
abdominal region, by the thickness of the fat layer between the
linea alba and the anterior wall of the aorta.
Results: Most patients were men (75%) with a mean age of 35
years (±14 years). Most patients were undernutrition, with body
S254 Poster
MON-P204 Results: Study population included 80 patients (MUST >/= 2),

DOES EXAMINATION PERIOD ALTER FOOD CHOICES OF 51% males, age 75 +/− 12.7 years, 55% bedridden, 11% were fed
UNIVERSITY STUDENTS? through feeding tube, 32% had pressure ulcers in admission. No
S. Sevim1 *, M. M. Tengilimoglu Metin1, D. Gumus1, G. G. Topal1, reference was made regarding food intake in 381 (53%) of 720
M. Kizil1. 1Department of Nutrition and Dietetics, Faculty of meals. In 8% of the patients none of the meals were
Health Sciences, Ankara, Turkey documented, only 17% of these patients were given artificial
nutrition, whereas 49% of patients with at least one meal
Rationale: University students experience high level of stress documented received artificial nutrition ( p = NS). Lunch was
due to academic workload and time management. It is thought significantly less documented (16%) than breakfast (47%) or
that some physiological and psychological mechanisms under- dinner (52%) ( p < 0.0001).
lying the mood and emotional states of humans, such as stress, Conclusion: When patients’ intake is not documented,
influence the choice of food. The aim of study was to compare artificial nutrition is given less frequently. Monitoring of oral
the food choices of university students in exam period and non- intake allows identification of patients in need of artificial
exam period. nutrition. Nurses clearly find it less convenient to document
Methods: This cross-sectional study was carried out on 103 lunch. A larger study is needed to provide information which
male and 227 female university students aged 18–30 years. In meal is preferably documented and count of how many meals
exam and non-exam period, food choice data was collected are needed to decide about a patient’s need for artificial
using the Food Choice Questionnaire (FCQ) and depression nutrition.
score was determined by beck depression scale. The Food Disclosure of Interest: None declared.
Choice Questionnaire is consist of 9 subset (health, mood,
convenience, sensory appeal, natural content, price, weight
MON-P207
control, familiarity, ethical concern) and 36 items and
THE APPROPRIATE NUTRITIONAL ASSESSMENT TO PREDICT
participants responded to each item using a 7-point bipolar
FUNCTIONAL OUTCOME WITH HIP FRACTURE PATIENTS
scale (1 = disagree strongly, 7 = agree strongly).
DURING ACUTE PHASE – THE COMPARISON OF MNA-SF, MUST,
Results: According to the beck depression score, 22.1% of the
NRS-2002 AND GNRI
students stated that they were depressed in non-exam
period, while 45.2% of the students stated that they were T. Inoue1,2 *, T. Kakehi1, M. Kakiuchi1, T. Tanaka1.
1
depressed in exam period. The mean mood score of students is Rehabilitation, Nishi-Kobe Medical Center,
2
higher in exam period (5.5) than in non-exam period (5.2). Community Health Science, Kobe University Graduate
Students told that be inclined to food which helps cope with School, Kobe, Japan
stress and life, helps relax, keeps awake/alert, cheers up,
makes feel good. Rationale: Malnutrition is common in patients with hip fracture
Conclusion: In exam period, mood of students affects their but no study has examined about ‘best screening tool’ for
food choice. Students tend to prefer food which improves mood predicting functional outcomes. The aim of the present study
when they are under stress. was to examine the optimal nutritional screening tool for
predicting functional outcomes from 4 nutritional screening
tools.
Methods: Mini Nutritional Assessment Short-form (MNA-SF),
MON-P206 Malnutrition Universal Screening Tool (MUST), Nutritional Risk
MONITORING FOOD INTAKE OF PATIENTS AT RISK FOR Score (NRS-2002), Geriatric Nutritional Risk Index (GNRI) were
MALNUTRITION IN AN INTERNAL MEDICINE DEPARTMENT – administered to 205 operated hip fracture patients. Functional
ARE WE DOING ENOUGH? outcomes were evaluated using a functional independent
S. Ilovaisky1 *, I. Papier2, Z. Zaltz1, M. Shiloah2, G. Hyams2, measurement instrument (FIM) and 10 m walking speed. We
A. Raz1, I. Chermesh3. 1Internal Medicine A, 2Nursing evaluated discharge motor-FIM score and absolute functional
Administration, 3Gastroenterology Department, Rambam gain on the motor-FIM score (discharge motor FIM score –
Health Care Campus, Haifa, Israel baseline motor FIM score).
Results: Two hundred and fifty patients were included. Mean
Rationale: There is a clear correlation between nutritional age was 83.5 ± 7.0 years and female accounted for 82.0%.
intake during hospitalization, nutritional status, and outcome. According to MNA-SF, 27.3% were well-nourished, 50.2% were at
Documentation of oral intake is of great importance and should risk of malnutrition, 22.4% were malnourished. When evalu-
allow identification of patients in need of artificial nutritional ated by MUST, 47.3% were low risk, 20.5% were medium risk,
treatment. and 66 32.2% were high risk. Based on NRS-2002, 43.4% were
Methods: Patients hospitalized in an internal medicine well-nourished, 33.7% were nutritionally at risk, 22.9% were
department for more than three days, that were defined at medium risk. According to GNRI, 21.5% were low risk, 36.1%
risk for malnutrition (MUST >/= 2) were included in the study. were medium risk, 42.4% were high risk. Multiple regression
Medical files were reviewed. Documentation of food intake for analysis showed that significant relationships were found
the first three days was drawn from the nurses’ follow-up. Data, between MNA-SF and each functional outcomes. According to
including demographic, performance status, the presence of a NRS-2002, the patients with risk group were significant poor
feeding tube, orders for medical nutrition, nutritional recom- functional recovery compared with low risk (<0.05). Based on
mendations of discharge and whether dietician counseling was GNRI, patients with major risk needed more time compared
given – were retrieved. Statistical analysis was performed. with low risk for 10 m walking speed (<0.01).
Conclusion: MNA-SF was only nutritional screening tool MON-P209

which showed significant relationships to each functional BODY COMPOSITION, PROTEIN INTAKE AND PHYSICAL
outcomes. FUNCTION IN ADULT PATIENTS WITH MITOCHONDRIAL
Disclosure of Interest: None declared. DISEASE
V. Bordier1 *, H. Zweers2, S. Leij3, D. Maas2, S. Knuijt2,
MON-P208 G. Wanten2, M. Janssen2. 1Human Nutrition Laboratory, ETHZ,
BIOELECTRICAL IMPEDANCE ANALYSIS DERIVED PHASE Zurich, Switzerland, 2Radboud Center for Mitochondrial
ANGLE AS A TOOL FOR DETECTING MALNUTRITION IN Medicine, Radboud University Medical Center, 3Nutrition and
HOSPITAL IN-PATIENTS Dietetics, HAN University of Applied Sciences, Nijmegen,
Netherlands
T. Thomas1 *, E. Player2, W. Y. Chan3, L. Alexandre4, A. Forbes4
1
Queen Elizabeth Hospital, Birmingham, 2NHS, Norwich, 3NHS, Rationale: Low physical functioning of patients with mito-
London, 4University of East Anglia, Norwich, United Kingdom chondrial disease (MD) may be due to a diminished fat free
mass. In this case, improving body composition through a
Rationale: We assessed whether bioelectrical impedance
nutritional intervention might be a promising strategy. The aim
analysis (BIA) derived phase angle (PA), plasma markers such
of this study was to analyze body composition, nutritional
as citrulline and pre-albumin could aid nutrition assessment
intake and physical function, as well as their interrelations in
and if current starving and resting protocols are required for
MD patients.
BIA.
Methods: In 37 MD patients, body composition was assessed by
Methods: 80 adult in-patients were recruited over a 40 week
Dual-energy X-rays absorptiometry. Physical functioning was
period. The Malnutrition Universal Screening Tool (MUST) and
measured by means of the hand grip strength test (HGS),
Subjective Global Assessment (SGA) were performed. Serum
6-minutes walking test (6MWT), 30-seconds sit-to-stand test
was analysed for citrulline and pre-albumin. Bodystat 4000
(30SCT), and 6-minutes mastication test (6MMT). Protein
analyser assessed PA in 3 different metabolic states: rested and
intake and needs were assessed by a dietician.
fasted, post-exercise and post food, and exercise. The
Results: Thirty-seven genetically proven MD patients (aged
reference standard for malnutrition was determined using
42 ± 12 yrs, 40% men) were studied, of whom 78% had the
SGA. Statistical analysis included paired t test and logistical
m3243A > G mutation. Although only 5% of the MD patients had
regression.
a BMI < 18.5 kg/m2, 62% had a low fat free mass index (FFMI)
Results: Total study size was 80 patients; 47(59%) male (20–86
and 49% did not meet their protein requirements. Decreased
years) and 33(41%) female (18–87 years). 66 patients com-
physical function, as evidenced by low HGS, was observed in
pleted all arms of the study; 14 patients did not consent to
43%, walking less than the predicted distance was found in
blood test arm.
100%, low 30SCT results in 86% and diminished chewing
1. SGA and PA identified 47 (59%) and 50 (63%) patients with
endurance in 48%.
malnutrition compared to 9(11%) by MUST
Low protein intake was associated with low HGS performance
2. SGA and PA identified 15(19%) and 10(13%) patients with
(r = 0.501, p < 0.01) and low 6MMT (r = 0.645, p < 0.01), but
severe malnutrition compared to 2(0.03%) by MUST
neither with the 6MWT (r = 0.216) nor the 30SCT (r = 0.371).
3. Compared to SGA, PA had sensitivity of 91%(95% CI
FFMI did not correlate with any of the function tests, nor with
80% > 98%) and specificity of 36%(95% CI 11% > 69%).
protein intake.
Positive predictive value was 86%(95% CI 80% > 91%).
Conclusion: Although the majority of these patients had
Negative predictive value was 50%(95% CI 23% > 77%)
altered body composition, decreased physical function and
4. There were no food or exercise related difference in PA
low protein intake, diminished fat free mass was not related to
( p = 0.1837; p = 0.1344 respectively)
physical function. Therefore, the true association between
5. Pre-albumin co-related with SGA ( p = 0.003), citrulline did
body composition and performance still needs clarification.
not ( p = 0.348)
However, as protein intake relates with physical functioning,
Conclusion: BIA-derived PA is an objective measurement apt supporting protein intake in MD patients seems of great
for nutritional assessment. It is sensitive for detecting importance in clinical care.
malnutrition. It has a highly significant association with SGA. Disclosure of Interest: None declared.
Current fasting and resting protocols surrounding its use are
invalid. Pre-albumin is a useful biomarker in nutritional
MON-P210
assessment.
NOVEL HOSPITAL MEAL SERVICE REDUCES FOOD WASTE
Reference WHILE IMPROVING NUTRITIONAL INTAKE OF PATIENTS
1. BAPEN The cost of malnutrition in England and potential cost savings V. E. Ijmker-Hemink1 *, D. N. Dijxhoorn1, M. G. A. van den Berg1,
from nutritional interventions Accessed:20/02/2017. G. J. A. Wanten1. 1Gastroenterology and Hepatology,
Disclosure of Interest: None declared. Radboudumc, Nijmegen, Netherlands
Rationale: Food wastage heavily compromises hospital

resources. Therefore, we investigated whether FoodforCare
(FfC), a novel meal service comprising 6–7 small protein-rich
meals per day provided directly at the bedside following
proactive advise from a nutritional assistant, can reduce food
waste compared to a traditional 3-meals per day service (TMS).
S256 Poster
Methods: This study was part of a clinical study where patients ( p > 0.05). On the other hand, supplementation usage is
who were admitted for at least one day to a medical increasing in male participants as the level of activity increases
(Gastroenterology) or surgical (Orthopedics, Gynaecology, (none of sedentary, 6.2% of moderately active, 6.7% of active
Urology) ward were offered TMS (n = 326, mean age 58 ± 17 yrs) males) was found (chi-square = 6.292, p < 0.05).
or FfC meal service (n = 311, mean age 60 ± 16 yrs). Food waste, Conclusion: Individuals’ dietary energy and nutrient intakes
i.e. all left over products from meals used on one day, was were not different according to their activity level. However, it
calculated using weighed food records. Furthermore, we was determined that active male individuals pay more
determined food waste for each meal separately. Differences attention to use supplementation regularly.
in median waste between the groups were tested using the Disclosure of Interest: None declared.
Mann-Whitney U test. Results are displayed as median [IQR]
unless stated otherwise.
MON-P212
Results: The amount of food handed out by FfC was
CONSUMPTION DIFFERENCES OF FOODS AND BEVERAGES IN
significantly higher than by the TMS (mean weight ± SD;
DIFFERENT SPORT ACTIVITY LEVELS IN ADULTS
945.2 ± 267.5 grams vs. 863.8 ± 303.4 grams, p < 0.05). In
total, FfC showed a significantly lower percentage of waste Y. Ertaş1 *, E. Karabudak1, A. Karaca2. 1Nutrition and Dietetics,
than the TMS (7.7% [22.0] vs. 14.1% [27.9], p < 0.05). The Gazi University, 2Faculty of Sport Sciences, Hacettepe
percentage of food wasted per meal was significantly lower University, Ankara, Turkey
with FfC at lunch (0.0% [11.2] vs. 1.5% [11.7], p < 0.05) and
Rationale: Having higher physical activity level and doing sport
dinner (1.9% [31.8] vs. 14.4% [39.2], p < 0.05).
regularly could be associated with healthy dietary chooses. In
Conclusion: FfC reduced overall daily food waste as well as at
order to understand this, we aimed to evaluate participants’
specific moments, i.e. during lunch and dinner. Furthermore,
consumptions of food groups according to different sport
the amount of food handed out was higher indicating that
activity levels in this study.
nutritional intake improved. These findings are in line with the
Methods: This study was conducted on 772 adults (381 male
increased energy and protein intake shown in other results of
and 391 female) adults. Sport activity levels were determined
this project. As such, this novel meal service holds promise as a
via ‘Physical Activity Assessment Questionnaire (PAAQ)’ (1) as
concept that will further improve the quality of care for these
metabolic expenditure units (METs) and divided into three
patients.
categories (2): inactive (≤3 MET), moderately active (3–6 MET)
Disclosure of Interest: None declared. and active (>6 MET). Twenty-four hour dietary recall were
obtained from the individuals. Consumption amounts of various
MON-P211 foods and beverages (milk, cheese, egg, bread, grains,
DIETARY ENERGY AND NUTRIENT INTAKES ARE SIMILAR vegetables, fruits, meat, poultry, fish, legumes, nuts/seeds,
AMONG DIFFERENT PHYSICAL ACTIVITY LEVELS IN ADULTS honey/jam, tea, coffee, soft drinks) were evaluated via
E. Karabudak1, Y. Ertaş1 *, A. Karaca2. 1Nutrition and Dietetics, Nutrition Information System for Turkey (BeBiS).
Gazi University, 2Faculty of Sport Sciences, Hacettepe Results: Mean age of participants was 36.3 ± 12.15 years.
University, Ankara, Turkey According to sport METs; inactive, moderately active and active
males were 36.5%, 33.6% and 29.9% for males and 40.2%, 51.2%
Rationale: Level of physical activity in leisure time could be a and 8.7% for females respectively. In males, consumption
demonstration of healthy lifestyle for individuals’ daily life and amounts of fruit, cheese, tea and soft drinks; in females,
dietary intakes could be shaped according to their activity consumption amounts of bread, egg, nuts/seeds, honey/jam,
levels. In this study, we aimed to evaluate physical activity tea and soft drinks were statistically significant in METs groups
levels of healthy adults and determine their dietary energy, ( p < 0.05). All these food and beverage groups except egg
nutrient intakes and supplementation status according to consumption of females were statistically lower in active group
different activity categories. than the other groups were found in both gender ( p < 0.05). Egg
Methods: This study was conducted on 381 male and 391 consumption of active females were higher than the other
female adults aged 19–67 years. Physical activity levels were female activity groups ( p < 0.05).
determined via ‘Physical Activity Assessment Questionnaire Conclusion: Active male and females have shown different
(PAAQ)’ as total metabolic expenditure units (METs) and patterns in terms of food consumptions; but similar in terms of
divided into three categories: sedentary (≤1.4 MET), moder- beverages. Furthermore, active female adults chose to
ately active (1.41–1.75 MET) and active (>1.75 MET). Twenty- decrease particularly high energy density foods. However, it
four hour dietary recall was obtained from all participants. could not be observed such pattern in males.
Dietary energy and nutrient intakes were evaluated via Disclosure of Interest: None declared.
Nutrition Information System for Turkey (BeBiS).
Supplementation status of the individuals were questioned.
MON-P213
Appropriate statistical analysis were performed.
INCREASE IN EATING DISORDER SCORES ARE RELATED WITH
Results: Mean age of male and female participants was
POOR DIET QUALITY IN FEMALES
37.8 ± 12.61 and 34.8 ± 11.51 years respectively. From seden-
tary to active group, there was a decreasing trend for mean M. Gezmen-KARADAĞ 1, H. Yildiran1, Y. ERTAŞ1 *. 1Nutrition and
dietary energy intake in both genders; however, it was not Dietetics, Gazi University, Ankara, Turkey
statistically significant ( p > 0.05). Similarly, differences in
Rationale: Eating disorders could affect diet quality. Diet
mean dietary macro- and micronutrient intakes were not
quality of individuals who have eating disorders is expected to
statistically significant among physical activity level categories
be lower and consumption of certain foods would be decreased.
In this study we aimed to determine the associations between MON-P215

dietary component scores of Healthy Eating Index (HEI) with ORTHOREXIC FEMALES PAY ATTENTION TO SODIUM INTAKES
eating disorder risk scores in female adults. AND CONSUMPTION OF WHOLE GRAINS
Methods: This study was consisted of 275 female adults aged M. Gezmen-Karadağ1, Y. Ertaş1 *. 1Nutrition and Dietetics, Gazi
18–50 years. Eating disorder risk was determined with Eating University, Ankara, Turkey
Attitude Test (EAT-40) test. HEI-2010 dietary components (total
fruit, whole fruit, total vegetables, greens and beans, whole Rationale: Diet quality indexes are related with various chronic
grains, dairy products, total protein foods, seafood, fatty acids, diseases and could allow the evaluation of food groups as their
refined grains, sodium, empty calories) and total HEI score components. In this study we aimed to determine the
were calculated from twenty-four hour food consumption associations between dietary component scores of Healthy
recall data. Correlations between eating disorder scores and Eating Index (HEI) with orthorexia nervosa risk scores in adults.
HEI scores were given. Methods: This study was conducted with 375 male and 375
Results: Eating disorder frequency of participants were female subjects. Twenty-four hour food consumption recall was
determined as 4.3%. Mean HEI score and EAT-40 score were obtained of individuals. Scores of HEI-2010 dietary components
respectively 64.7 ± 10.27 and 43.5 ± 13.79 in females with (total fruit, whole fruit, total vegetables, greens and beans,
eating disorders and 64.2 ± 9.48 and 12.3 ± 5.49 in females with whole grains, dairy products, total protein foods, seafood,
not having eating disorders. Negative correlations were fatty acids, refined grains, sodium, empty calories) and total
determined between total HEI scores (r = −0.497, p = 0.05), HEI score were calculated. Orthorexia nervosa risk was
fruit score (r = −0.659, p = 0.005) and refined grains (r = determined via ORTO-15 test. Correlations were assessed
−0.536, p = 0.032) in females with eating disorder. with SPSS 15 statistical programme.
Conclusion: Diet quality decreased as eating disorder scores Results: Mean age of male and female participants was
increased in female adults with eating disorder. Furthermore, 25.9 ± 6.60 and 25.6 ± 6.82 years respectively. Mean total HEI
the decreases were mediated with decreases in fruit scores and score and ORTO-15 score were respectively; 64.9 ± 8.92 and
increases in refined grain scores. 38.9 ± 3.31 in males and 64.2 ± 9.50 and 39.2 ± 3.25 in females.
Disclosure of Interest: None declared. Whole grain scores (r = 0.209, p = 0.004) and sodium scores
(r = 0.145, p = 0.049) components of HEI were significantly
positive correlated in orthorexic females. There were no
MON-P214
statistically significant correlation was found in males ( p > 0.05).
DIET QUALITY IS RELATED WITH DECREASED ENERGY AND FAT
Conclusion: Increase in consumption of whole grains and
INTAKE IN ADULTS
decrease in sodium intakes were observed in orthorexic
Y. Ertaş1 *, M. Gezmen-Karadağ1. 1Nutrition and Dietetics, Gazi females. It could be concluded that women who tend to
University, Ankara, Turkey orthorexia pay attention to consumption of whole grains and
reduction of sodium intake.
Rationale: Healthy eating index is a valid tool in order to
determine individuals’ diet quality and it could be a demon- Disclosure of Interest: None declared.
stration of nutrient sufficiency. In this study assessment of the
associations between HEI scores with dietary energy and macro MON-P216
nutrient intakes in adults. TELEVISION VIEWING PERIOD AND DIET QUALITY AMONG
Methods: This study was consisted of totally 750 (275 males and ADOLESCENTS
275 females) adults aged 18–50 years. Daily dietary energy and K. Isgin1, E. Bellikci Koyu2 *, A. Akyol Mutlu1, R. Nergiz Unal1,
macro nutrient intakes calculated from 24 hour food recall data A. Ayaz1, Z. Buyuktuncer1. 1Department of Nutrition and
by a nutrition information system for Turkey called BeBiS®. Dietetics, Hacettepe University, Ankara, 2Department of
Diet quality was assessed with HEI-2010. Correlations between Nutrition and Dietetics, İzmir Katip Celebi University,
dietary energy and macro nutrients with HEI scores were given. İzmir, Turkey
Results: Mean ages of participants’ were 25.9 ± 6.60 years in
males and 25.6 ± 6.82 years in females. For males, negative Rationale: An association between watching television (TV)
correlations were shown between HEI scores and dietary energy and obesity was reported. However, little is known about diet
(r = −0.173, p = 0.001), fat intake (r = −0.192, p < 0.001) and quality of people who have long TV viewing period. This study
saturated fatty acids intake (r = −0.228, p < 0.001). For aimed to compare diet quality of adolescents according to TV
females, negative correlations were determined between viewing period. This study aimed to determine the relationship
dietary energy (r = −0.154, p = 0.003), fat intake (r = −0.196, between TV viewing period and total diet quality beyond
p < 0.001), saturated fatty acid intake (r = −0.242, p < 0.001) specific food preferences in adolescents.
and monounsaturated fatty acid intake (r = −0.145, p = 0.005). Methods: A cross-sectional study was performed with 1371
Conclusion: In conclusion, as diet quality increase, daily adolescents aged 11–16 years in Ankara, Turkey. General
dietary energy, total fat and especially saturated fatty acids characteristics and TV viewing periods of adolescents were
decreased. It would be indicative of maintaining ideal body recorded. TV viewing period was classified according to
weight and composition. recommendation to adolescents of American Academy of
Disclosure of Interest: None declared. Pediatrics (≤120 and >120 minutes/day). Dietary intake was
assessed using food frequency questionnaire and diet quality
was estimated using Healthy Eating Index-2010 (HEI-2010). A
maximum score of index is 100 points; and 0–50 points is
categorized as ‘poor’, 51–100 points is ‘needs improvement/
S258 Poster
good’. Total score and subscale scores of HEI were analysed MON-P218
according to TV viewing period. EFFECT OF DIFFERENT MIS CUT OFF SCORES FOR
Results: Mean HEI score was 54.4 ± 8.95 points in all group. Long IDENTIFICATION OF MALNUTRITION – INFLAMMATION
TV watchers had a lower mean HEI score (53.7 ± 8.86) than short PREVALENCE IN HEMODIALYSIS PATIENTS
TV watchers (54.9 ± 8.99) ( p = 0.020). Furthermore, poor diet Z. Pafili1,2 *, M. Maridaki1. 1School of Physical Education and
quality was 38.1% in the participants with long TV viewing period Sport Science, National and Kapodistrian University of Athens,
whereas it was 36.1% in participants with short TV viewing Athens, 2Department of Dietetics, Volos General Hospital,
period ( p = 0.026). The difference in diet quality between TV Volos, Greece
viewing groups arisen from lower consumption of dairy products,
total vegetables and greens and beans groups. These food Rationale: Malnutrition inflammation score (MIS) is a simple
items were consumed in larger amounts by adolescents watch- tool to assess the presence of malnutrition related to
ing TV less than 120 minutes ( p < 0.05, for each). inflammation, and is associated with mortality in patients on
Conclusion: Diet quality was decreased by increasing TV maintainance hemodialysis. Total score ranges from 0 to 30 and
viewing period. Adolescents watching TV more than 120 even though higher scores denote greater risk there is no
minutes had significantly lower diet quality and this signifi- universal cut off point for patient stratification. The aim of this
cance was due to the differences consumption of dairy study was to assess the differences in patient classification into
products, vegetable and greens and beans. high and low risk using the different proposed MIS score cut off
points of >4, >7 and >10.
Methods: All stable hemodialysis patients who aggreed to take
part in the study from 3 hospital dialysis units in Greece were
MON-P217
included, totalling 67 patients (52.7 ± 14.5 years, 24.4 ± 4.1
ULNA LENGTH TO PREDICT HEIGHT IN GREEK PATIENTS
kg/m2, 6.3 ± 5.9 years in dialysis, serum albumin 4.2 ± 0.3 mg/
Z. Pafili1 *, A. Lioupis2. 1Department of Dietetics, 2General dL). MIS and SGAwere used to assess patients nutritional status.
Surgery Clinic, Volos General Hospital, Volos, Greece Results: Average patient MIS score was 5.2 ± 2.8 (median 5.0).
According to SGA 29% of patients were classified as mildy to
Rationale: Height measurement is essential for BMI calculation
moderately malnourished (scores B and C). A significantly
and patient stratification for malnutrition risk in the hospital
greater percentage of patients were classified as in risk of
setting. For ambulatory patients height cannot be directly
malnutrition when an MIS cutoff score of 4 was used (54%)
measured but can be estimated from ulna length using the
compared with cutoff scores >7 (18%) and >10 (3%) ( p < 0.01),
MUST equations. The aim of this study was to evaluate the
with no significant difference between the two later cutoff
accuracy of the published MUSTequations for predicting height
scores. MIS score was significantly positively correlated with
from ulna length in Greek adult patients.
SGA (r = 0.69, p < 0.01) whereas no correlation between MIS
Methods: The study population consisted of all patients >21
score and patient age, BMI, dialysis duration and serum albumin
years admitted in a general surgery clinic during a month in
was found.
whom ulna length and standing height could be measured.
Conclusion: The lack of a universal MIS score cutoff point
Ninety patients aged 21.6–85.2 years (37 male and 53 female)
makes the identification of hemodialysis patients who would
were included in the study. Height was predicted from ulna
benefit more from targeted medical and nutritional interven-
length using the MUST equations, and predicted values were
tions challenging.
compared with measured ones.
Results: Patients were categorised according to sex and age Reference
(<65years or ≥ 65 years) to 4 groups. There was a significant Kalantar-Zadeh K, Kopple JD, Block G, Humphreys MH. A
difference between mean measured and mean predicted malnutrition-inflammation score is correlated with morbidity and
height using the MUST equations for both male (172.5 cm vs mortality in maintenance hemodialysis patients. Am J Kidney Dis.
176.0 cm, p < 0.001 and 167.0 cm vs 169.8 cm, p < 0.02, for 2001 Dec;38(6):1251–63.
men <65 (N = 16) and ≥ 65 years (N = 21) respectively) and Disclosure of Interest: None declared.
female patients (159.9 cm vs 162.4 cm, p < 0.01 and 151.3 cm
vs 155.8 cm, p < 0.01, for women < 65 (N = 30) and ≥ 65 years MON-P219
(N = 23) respectively). Ulna length and measured height were MALNUTRITION SCREENING AND NUTRITIONAL INDICES IN
significantly correlated in men (r = 0.89, 0 < 0.01 and r = 0.68, THE SURGICAL WARD
p < 0.01 for men <65 years and ≥65 years respectively). In
Z. Pafili1 *, C. Psachoula1, M. Alexiadi1, C. Kalesopoulou1,
females ulna length and height were corellated only in patients
A. Lioupis2. 1Department of Dietetics, 2General Surgery Clinic,
<65 years (r = 0.41, p < 0.05).
Volos General Hospital, Volos, Greece
Conclusion: The MUST equations for predicting height from
ulna length should be used with extra caution in Greek Rationale: Surgical patients are considered in high malnutri-
patients, especially older ones, since they tend to singificantly tion risk, and even though there are many validated tools to
overestimate height, which could lead to errors in BMI assess risk, older indices such as albumin and total lymphocyte
calculation and malnutrition risk assessment. count depletion are still used to identify malnourished
Reference patients. The aim of this study was to assess malnutrition risk
Elia M. Screening for malnutrition: A multidisciplinary responsibility. in a surgical ward using NRS-2002, albumin and total
Development and Use of the Malnutrition Universal Screening Tool lymphocyte count.
(‘MUST’) for adults. Redditch: BAPEN; 2003. Methods: Study population consisted of all adult patients
Disclosure of Interest: None declared. admitted in the general surgery clinic of a peripheral hospital in
Greece during 30 consecutive days. 195 patients (60.6 ± 18.8 digestive system. 81.2% of all cases received oral nutritional
years), 53% of which were ≥ 65 years were included. NRS-2002 supplement (ONS), 17.3% enteral nutrition (EN) and 1.5%
was used to assess malnutrition risk in all patients and serum parenteral nutrition (PN). The mean treatment duration of ONS
albumin (where available) and total lymphocyte counts were were 209 ± 352 days, 390 ± 546 days for EN and 260 ± 457 days
recorded. for PN. The 20–39 years old patients with EN treatment duration
Results: BMI could be calculated or estimated using MUST of 892 ± 793 days differed significantly from the average
guidelines in 93.3% of the patients. According to NRS-2002 ( p < 0.001).
score 13.8% (27) of the patients were at nutritional risk (score Conclusion: By now, a large number of patients receive HAN
≥3). Of the 27 patients at nutrition risk 11 were diagnosed and tumor patients are the largest patient group. ONS were
as malnourished according to the ESPEN criteria, while in 3 used more frequently and often for short treatment period. In
patients no diagnosis could be made due to lack of BMI data. contrast, EN was used more rarely, but on average for a longer
Albumin values were obtained for 90 patients (including 23 of period especially in younger patients.
the patients at risk). Values ≤3.5 mg/dL were found in 43% of the Reference
patients with NRS score ≥3 and in 16% of patients with NRS score
1. Shaw SA, Rühlin M, Wagener N, Stanga Z, Meier R, Ballmer PE.
<3. Mean serum albumin differed significantly between patients
Home Artificial Nutrition in Switzerland: An Epidemiological Survey
with NRS score ≥3 and those with NRS score <3 (3.6 ± 0.7 vs from 2005 to 2009. Ann Nutr Metab 2013;62:205–11.
4.0 ± 0.6 mg/dL respectively, p < 0.001). Total lympocyte count
depletion (≤2000 cells/mm3) was evident in 68% of all patients, Disclosure of Interest: None declared.
with no significant difference in TLC depletion severity between
the patients with NRS score ≥3 or <3. No significant correlation MON-P221
was found for NRS-2002 score and albumin or TLC. PREVALENCE OF HOME PARENTERAL AND ENTERAL
Conclusion: Malnutrition risk prevalence was high in our NUTRITION IN THE UNITED STATES
patient cohort according to NRS-2002 score, while no correl- M. Mundi1 *, A. Pattinson2, M. Mcmahon2, R. Hurt2. 1Division of
ation between NRS-2002 score and albumin or TLC depletion Endocrinology, 2Mayo Clinic, Rochester, United States
was found.
Rationale: In the United States (US), given our healthcare
insurance landscape, it has been very difficult to ascertain the
true prevalence of HPEN.
Methods: Medicare beneficiary data for 2013 was obtained
Nutritional epidemiology 2 using the CMS Chronic Condition Data Warehouse (CCW).
MON-P220 Commonly used Healthcare Common Procedure Coding system
HOME ARTIFICIAL NUTRITION – RESULTS FROM AN (HCPCS) codes were used for both home enteral (HEN) and
EPIDEMIOLOGICAL FOLLOW-UP SURVEY IN SWITZERLAND home parenteral nutrition (HPN). Data regarding number of
patients and insurance providers was obtained from three of
L. J. Vogt1 *, M. Rühlin1,2, N. Wagener3, C. Möltgen2,4, the largest DME providers in US (Coram/CVS, Option Care
L. Genton2,5, P. E. Ballmer1,2. 1Department of Medicine and Enterprises, and Bioscrip). Using the ratio of Medicare to non-
Division of Dietetics and Clinical Nutrition, Winterthur Medicare billing, estimate of prevalence of HPEN was obtained.
Cantonal Hospital, Winterthur, 2Board Member, Swiss Society Results: For 2013, there were 6,778 Medicare beneficiaries for
for Clinical Nutrition (GESKES), Geneva, 3SVK, Swiss HPN and 114,287 for HEN. Ratio of Medicare to Non-Medicare
Consortiums of Health Insurance Companies for Joint Tasks in was 0.271 for HPN and 0.261 for HEN leading to estimated
the Field of Transplantation, Dialysis, HAN and Home prevalence of 25,011 patients on HPN (79/million US inhabi-
Ventilation, Solothurn, 4Hospital Pharmacy, Aarau Cantonal tants) and 437,882 patients on HEN (1,385/million US
Hospital, Aarau, 5Clinical Nutrition, Geneva University inhabitants).
Hospitals, Geneva, Switzerland
Rationale: Home artificial nutrition (HAN) is an important Parenteral Enteral
Nutrition Nutrition
possibility to prevent and treat malnutrition. The first analysis
of epidemiological data in Switzerland was published in 20131 Total Medicare Beneficiaries 6,778 114,287
Total Medicare Beneficiaries per million US 21 361
and the aim of this follow-up study is to examine the inhabitants
development of HAN. Total Number of Referring Providers 6,724 73,770
Methods: This study investigated retrospectively all new cases Total DME provider patients 16,193 98,550
Number on Medicare −4,388 −25,722
of HAN in Switzerland from 2010 to 2015, which were registered
Number on Medicaid −2,140 −20,842
by the Swiss Consortium of Health Insurance Companies - Number with Commercial or other −9,664 −51,966
(SVK). Demographic and anthropometric data, diagnosis, type insurance
of HAN and duration of HAN were examined. Ratio of Medicare to Non-Medicare 0.271 0.261
insurance
Results: In six years, a total of 39,624 cases (49.0% men, 51.0% Estimate of Patients for 2013 25,011 437,882
women) with an average body mass index of 21.2 ± 4.5 kg/m2 Estimate per million US inhabitants 79 1,385
and 68.9 ± 17.7 years were registered. 59.3% of all cases were Infusion company % of pediatric patients 16.5 43.2
Infusion company % of adult patients 83.5 56.8
classified as malnourished and 36.1% were at high risk for Estimate of Pediatric patients 4,129 189,036
malnutrition. The group of 60 to 79 years old persons Estimate of Adult patients 20,883 248,846
constituted the largest group of patients (45.8%). 46.0% of all
cases were diagnosed with malignant neoplasms, 12.2% with Conclusion: Compared to previous results from 1992, the
diseases of the nervous system and 11.1% with diseases of the prevalence of HEN has increased dramatically while the
S260 Poster
prevalence of HPN has declined. Prevalence of HPEN per Uncontrolled Eating (UE). Estimate the contribution of the
million inhabitants is still significantly higher in US compared to body size dissatisfaction and demographic and academic
Europe. characteristics in the eating behavior of Brazilian and
Disclosure of Interest: None declared. Portuguese university students.
Methods: 1,275 Brazilian and 1,163 Portuguese university
students participated in the study. The Portuguese version of
MON-P222
the TFEQ-18 was used. Confirmatory factor analysis was
PREVALENCE OF UNDERNUTRITION, PARASITOSIS AND
performed using the ratio of chi-square to degrees of
ANEMIA IN CHILDREN 5–12 YEARS OLD FROM ECUADORIAN
freedom (χ2/df ), Comparative Fit Index (CFI), Tucker-Lewis
RURAL COAST: POST-EARTHQUAKE ANALYSIS.
Index (TLI), and Root Mean Square Error of Approximation
M. Chisaguano1 *, M. E. Herrera Fontana1, V. Villagomez1, (RMSEA). The TFEQ-18 was not invariant between countries
M. Villar1, N. Castro1. 1Escuela de Salud Publica, Nutricion, and, therefore, it fitted a structural model for each country.
Universidad San Francisco De Quito, Quito, Ecuador The z test was used to estimate the significance of trajectories
(β) (α = 5%) of the structural model designed considering the
Rationale: Undernutrition is a public health problem in Ecuador
variables CR, EA and UE as dependent variables.
that is related to the presence of parasitic infections, adverse
Results: Brazilian students presented the EA and UE scores
health conditions, and low socioeconomic levels. This situation
higher than Portuguese students (β = 0.151–0.181 p < 0.001).
can change after natural disasters such as the earthquake that
The structural model presented satisfactory fit in Brazil
occurred in Ecuador on April 16, 2016. Thus, in this study, we
(χ2/df = 2.62; CFI = .93; TLI = 0.92; RMSEA = 0.04) and Portugal
assess the prevalence of undernutrition, intestinal parasitosis,
(χ2/df = 1.76; CFI = .95; TLI = 0.95; RMSEA = 0.02). The indivi-
and anemia in children from vulnerable families.
duals’ gender, the wish to decrease body size, and the use of
Methods: Children aged 5–12 years (n = 72) were selected from
medications to change the body shape significantly contributed
the rural community ‘La Punta’, located in the parish of
with the CR and EA factors in both countries, and age, course
Cojimíes, province of Manabí, Ecuador. The evaluation of
year and thoughts of dropping-out contributed with the UE
malnutrition was carried out using weight-for-age (WAZ),
factor. The significance of the contribution of variables such as
length-for-age (LAZ) and BMI-for-age (BMIZ) Z scores, accord-
socioeconomic stratum, course year, course performance, work
ing to the WHO child growth standards. The occurrence of
concurrent with the study, and Body Mass Index for the TFEQ-18
parasitosis was determined through the qualitative-quantita-
factor was different between countries.
tive identification of the different types of parasites. The levels
Conclusion: The contribution of the body size dissatisfaction
of anemia were determined using the Hemocue method and
and of the demographic and academic variables on the eating
hemoglobin cut-off points at sea level.
behavior of university students was different in Brazil and
Results: 34.4% of the children are infected with some type of
Portugal.
parasite, being Entamoeba histolytica the most predominant.
21.9% had mild anemia and 31.3% had moderate anemia. In Disclosure of Interest: None declared.
regard to undernutrition, 40.6% of the children are stunted.
Of these, a higher prevalence is observed in females. Not all MON-P224
cases of undernutrition had anemia and parasites, showing that CONSUMPTION OF ENERGY DRINKS AMONG NORWEGIAN
other factors can contribute to its development, such as the ADOLESCENTS; EXCESSIVE CONSUMPTION IS DETERMINED BY
quality of diet, the access to basic services, and the MALE GENDER, HIGH SCREEN TIME, SEDENTARY LIFESTYLE
socioeconomic level. AND LOW SOCIO-ECONOMIC STATUS
Conclusion: Undernutrition and anemia remain significant N. Degirmenci1 *, T. A. Strand2,3, A. Vaktskjold4,5,
problems in Ecuadorian rural areas, showing a higher level of M. N. Holten-Andersen1,6. 1Department of Pediatrics,
undernutrition (46.9%) when compared to regional data of Lillehammer Hospital, 2Division for Research, Innlandet
Manabí province (<20%). These findings show how necessary it Health Trust, Lillehammer, 3Center for Intervention Studies in
is to intervene appropriately in rural communities after natural Maternal and Child Health, University of Bergen, Bergen,
disasters. 4
Department of Public Health, Inland Norway University of
Disclosure of Interest: None declared. Applied Sciences, Elverum, 5Division for Research, Innlandet
Health Trust, Sanderud, 6Institute of Clinical Medicine,
MON-P223 University of Oslo, Oslo, Norway
EATING BEHAVIOR OF BRAZILIAN AND PORTUGUESE
Rationale: The consumption of energy drinks (ED) is increasing,
UNIVERSITY STUDENTS
causing concern among health care professionals. Case studies
M. S. Santana1 *, W. R. Silva1, J. Marôco2, J. A. D. B. Campos3. link excessive ED intake to serious adverse events. The aim of
1
Food and Nutrition, São Paulo State University, School of the study was to investigate the use of ED among Norwegian
Pharmaceutical Sciences, Araraquara, Brazil, 2William Janes adolescents and to explore determinants for regular and
Center for Research – WJCR, University Institute of excessive consumption.
Psychological Sciences, Social and Life, ISPA, Lisbon, Portugal, Methods: We used data from the Ungdata survey conducted in
3
Food and Nutrition, University Institute of Psychological 2015 and 2016. The survey is a voluntary, electronic question-
Sciences, Social and Life, ISPA, Araraquara, Brazil naire conducted annually in Norwegian schools, including
students in 8th–13th grade. In addition to an standardized
Rationale: Eating behavior can be evaluated by of the Three
questionnaire on the every-day life, the participants reported
Factor Eating Questionnaire (TFEQ-18), which investigates the
on their consumption of ED.
Cognitive Restriction (CR), the Emotional Eating (EA), and the
Results: 31,091 adolescents completed the questions about ED Conclusion: This study reveals that undernutrition is a relevant
(65.1% response rate). Of the participants, 52.3% reported problem in Belgian community dwelling older people, that is
being ED consumers, 3.5% reported to be high consumers associated with different aspects of Quality of Life and
(4 times per week or more), and 1.6% exceeded the upper limit influenced by both individual and social variables. Referring
for daily caffeine dose by their average daily ED intake alone. to the EU policy of promoting aging in place, prevention of
Compared to females, male participants consumed twice as undernutrition is a challenge for both care professionals and
much ED (mean ED difference 95.2% [CI: 88.2–102.5]), and the policymakers.
proportion of male high consumers was 3.7 [CI: 3.1–4.3] fold Disclosure of Interest: None declared.
increased. Participants who never exercised had a 2.5 fold
increased risk of being high consumers compared to partici-
MON-P226
pants who exercised once a week or more (OR: 2.5 [CI: 1.8–
DIETARY FACTORS AND NON-ALCOHOLIC FATTY LIVER
3.4]). Increasing time spent in front of a screen was associated
DISEASE INCIDENCE: A SYSTEMATIC REVIEW OF PROSPECTIVE
with an increasing risk of being a high consumer. Regular and
STUDIES
excessive intake of ED showed an increasing trend towards
lower socioeconomic class and rural residency. S. Khalatbari-Soltani1,2 *, F. Imamura1, P. Marques-Vidal2,
Conclusion: A substantial proportion of the responders N. G. Forouhi1. 1Medical Research Council, Epidemiology Unit,
consume ED. Excessive intake was predominantly seen among University of Cambridge, School of Clinical Medicine, Institute
males, those with sedentary lifestyle, those from the lowest of Metabolic Science, Cambridge, United Kingdom,
2
socioeconomic class, and those spending more time on screen Department of Medicine, Internal Medicine, Lausanne
related activities. Efforts to reduce the consumption of ED University Hospital (CHUV), Lausanne, Switzerland
should target these groups.
Rationale: Diet and nutrition are likely to be key modifiable
Disclosure of Interest: None declared. factors for the prevention of non-alcoholic fatty liver disease
(NAFLD); however, there is currently no systematic evaluation
MON-P225 of dietary factors and NAFLD incidence.
UNDERNUTRITION IN 2904 BELGIAN COMMUNITY DWELLING Methods: A systematic literature search was conducted to
OLDER PEOPLE; DATA FROM THE BELGIAN AGING identify peer-reviewed articles published by March 2017 using
STUDIES (BAS) PubMed and Web of Science. Inclusion criteria were prospective
N. De Witte1 *, J. Schols2, D. Verté1. 1Faculty of Psychology and studies examining associations of any dietary variables with the
Educational Sciences, Vrije Universiteit Brussel, Brussel, risk of NAFLD defined by clinical diagnosis or indexes of liver
Belgium, 2Health Services Research, Maastricht University, health.
Maastricht, Netherlands Results: 439 publications were identified and screened; of
which five prospective studies met our inclusion criteria. Five
Rationale: The aim of this study was to assess the prevalence of studies evaluated different dietary variables in populations
undernutrition among community dwelling older people (60+) from Australia, England and Israel. Three studies recruited
in Belgium according to age, income, activities of daily living, children/adolescents and 2 recruited adults. In one study,
quality of life, loneliness and frailty. higher total energy and energy-adjusted sugar intake (not
Methods: This study involved a secondary data analysis of data specified) in childhood was associated with greater odds of
from the Belgian Aging Studies (BAS). Within the cross-sectional NAFLD risk of 1.79 (95% CI: 1.14, 2.79) and elevated γ -glutamyl
BAS, different aspects of quality of life of community dwelling transferase (GGT) of 3 (1.00, 5.00) in late adolescence,
older people (60+) are assessed, using a structured question- respectively, while another study found no significant associ-
naire. From 2004 on, 180 municipalities in Belgium have ation between sugar intake and GGTamong older adults after 5
participated. In each municipality a proportionally stratified years follow-up. Another study reported that fructose but not
random sample of minimum 400 older people was drawn from total sugars (free mono and disaccharides) in obese adoles-
the population registers. cents aged 14 was associated with risk of NAFLD at age 17. The
As earlier studies (Cuervo et al. 2008) showed that three same study also showed a positive association of western
questions of the Mini Nutritional Assessment explained 65% of dietary pattern with the NAFLD risk. Finally, one study with 7
the variance in undernutrition in community dwelling older years follow-up in the general population found no association
people, these questions were added to the BAS questionnaire in between coffee consumption and NAFLD onset.
2013. Conclusion: Overall, the available evidence is insufficient to
Results: Within the 2904 community dwelling older people draw conclusions regarding the effects of diet on NAFLD onset
included in this study, 7,9% were severely undernourished and due to heterogeneity of study exposures and inconsistent study
11,9% showed moderate undernutrition. Chi-square tests findings. Further population-based prospective studies are
showed a significantly higher prevalence in the aged 80+ needed to establish the impact of dietary intake on NAFLD
( p = ,000), in those hampered for ADL ( p = ,000), with a onset.
monthly income <1499€ ( p = ,001) and living too far from Disclosure of Interest: None declared.
shops ( p = ,000).
Moreover, undernutrition was related to different aspects of
quality of life. Not satisfied with life ( p = ,000), loneliness
( p = ,001) and frailty were all positively associated to under-
nutrition ( p = ,000).
S262 Poster
MON-P227 were analysed by with chi-squared tests, and the Cox’s

REGIONAL DIFFERENCES OF MALNUTRITION PREVALENCE regression model was used to assess survival.
AND MANAGEMENT IN SWITZERLAND Results: Since 1979 the mean age of patients thas increased
S. Khalatbari-Soltani1 *, C. de Mestral2, G. Waeber1, from 31 ± 16.5 to 52 ± 17.6 years. There has also been a change
P. Marques-Vidal1. 1Department of Medicine, Internal in the underlying aetiology over this time period, with a
Medicine, Lausanne University Hospital (CHUV), 2Lausanne increase in percentage of patients with IF due to surgical
University Hospital, Institute of Social and Preventive complications (3.4% to 28.8% ( p < 0.001)), fewer with IBD
Medicine (IUMSP), Lausanne, Switzerland (37.9% to 22.6%) ( p < 0.001) and malignancy now forming a
proportion of our patient cohort (0% to 8.4%). Over the same
Rationale: Malnutrition is a frequent condition among hospi- time period percentages of patients with catheter related
talized patients, with a significant impact on patient’s blood-stream infections (71.4% to 42.2%) ( p < 0.005) and
outcome. Whether malnutrition is reported and managed central venous catheter associated thrombosis (36% to 5.3%)
similarly at the national level has seldom been assessed. We ( p < 0.001) have reduced. We noted that overall survival was
aimed to evaluate regional differences within Switzerland better in the pre 1995 era HR 0.2–0.4 ( p = 0.02).
regarding malnutrition prevalence and management. Conclusion: At our institution the underlying aetiology and
Methods: Observational cross-sectional study including routine demographics of patients with IF has changed. The age of our
statistics from the Swiss hospital discharge databases for years patients is increasing with a reduction in the proportion of
2013 and 2014 (seven administrative regions). All adults aged patients with IBD with an increase in surgical complications and
≥20 with length of hospital stay of at least 1 day were included. malignancy. Our data also shows that there has been a
Reported malnutrition was defined based on the International reduction in the percentage of patients with complications
Classification of Diseases (ICD)-10 codes. Nutritional manage- related to IF. Notably survival outcomes were significantly
ment was also assessed. better in the period pre 1995, which is likely explained by the
Results: Of the initial 1,784,855 hospitalizations, 66,009 (3.7%) fact that we now are treating older patients with complex
had reported malnutrition, the prevalence ranging between underlying conditions associated with poorer outcomes.
1.8% (Ticino) and 4.7% (Mittelland). Use of the different Disclosure of Interest: None declared.
malnutrition-related ICD-10 codes also varied considerably
across regions. Multivariate analysis showed a two-fold variation
MON-P229
in reported malnutrition; multivariate-adjusted odds ratio and
ALBUMIN IS CRUCIAL TO LIVE EFFECTIVELY FOR THE ELDERLY
95% confidence interval relative to Eastern Switzerland was
PEOPLE
2.21 (2.14; 2.28) for Mittelland and 0.71 (0.67; 0.76) for Ticino.
Slightly over half (54.1%) of hospitalizations with reported T. Shimizu1 *, T. Namikawa2, K. Banba3, T. Nishikimi4.
1
malnutrition also had information on malnutrition management; Department of Cerebrovascular Diseases, Wakakusa-Tatsuma
compare to Eastern Switzerland, Ticino had a lower likelihood Rehabilitation Hospital, Daito, Osaka, 2Department of
[Odds ratio (95% CI): 0.28 (0.24; 0.31)] while Zürich had a higher Rehabilitation, Suita Tokushuen, Suita, Osaka, 3Department of
likelihood [1.25 (1.17; 1.34)] of reporting any nutritional Rehabilitation, Matsubara Tokushukai Hospital, Matsubara,
management. In all regions, the most prevalent nutritional Osaka, 4Department of Medicine, Wakakusa-Tatsuma
management was a dietitian consultation, followed by enteral Rehabilitation Hospital, Daito, Osaka, Japan
nutrition, parenteral nutrition and multimodal interventions.
Rationale: It is important to live effectively with an appropri-
Conclusion: In Switzerland, there is considerable regional
ate activity of daily living (ADL). ADL may be influenced partly
variation regarding reporting of malnutrition prevalence and
by body mass index (BMI) change, infectious disease such as
management. Malnutrition appears to be insufficiently
pneumonia and degradation of nutritional status due to aging.
managed and valued.
The changes of ADL, BMI, immunity and nutritional status due
Disclosure of Interest: None declared. to aging were analyzed. Then the association of ADL with BMI,
immunity and nutritional status was investigated.
MON-P228 Methods: Eighty five elderly people (18 males, 67 females,
CHANGES IN AETIOLOGY OF TYPE 3 INTESTINAL FAILURE mean age 84 years) who has been long-term admitted in a
OVER 37 YEARS: A SINGLE CENTRE EXPERIENCE stable state to a geriatric health facility, were subjected. The
S. Oke1 *, D. A. Lloyd2, J. M. Nightingale1, S. M. Gabe1. 1Lennard correlation of age with ADL evaluated by Barthel Index, BMI or
Jones Intestinal Failure Unit, St Mark’s Hospital, Harrow, immunity reflected by the CD4 + lymphocytes count (CD4) was
2
Hampshire Hospitals NHS Foundation Trust, Winchester, investigated. Then the association of ADL with BMI, immunity
United Kingdom and the nutritional status evaluated by albumin, transferrin,
transthyretin and retinol binding protein, was investigated.
Rationale: At our institution our first patient was started on Results: ADL was not correlated with age (r = −0.032371,
long-term parenteral support for intestinal failure (IF) in the p = 0.7686). BMI was correlated with age (r = −0.30982, p =
1970’s. We now care for the largest number of intestinal failure 0.003908) and CD4 was also correlated with age (r = −0.21748,
patients in the UK. We describe changes in aetiology as seen in p = 0.04557). In the investigation of association of ADL with
our unit over the last 37 years. BMI, immunity and nutritional status, ADL was correlated
Methods: Clinical records of 974 adult patients receiving home with BMI (r = 0.354686, p = 0.00086655), but was not correlated
parenteral support for IF at our tertiary referral centre were with CD4 (r = −0.0201, p = 0.8544). ADL was correlated with
analysed from a period from January 1979 until October 2016. albumin (r = 0.41003, p = 9.732 × 10−5) but was not correlated
Demographic data was recorded. Difference between groups with other serum proteins. BMI was correlated with albumin
(r = 0.2251, p = 0.03854). CD4 was correlated with albumin MON-P231

(r = 0.229204, p = 0.034855) and transferrin (r = 0.2251, ENTERAL TUBE FEEDING IN HOSPITALIZED AND AMBULATORY
p = 0.0383). PATIENTS IN AN SPECIFIC HEALTH AREA IN SPAIN.
Conclusion: It was meaningful that ADL did not deteriorate due RETROSPECTIVE STUDY DURING 2013–2016.
to aging. On the other hand, ADL was associated with albumin V. Garcia Zafra1 *, J. F. Sanchez Romera2, A. Rubio Gambin3,
and BMI. BMI was also associated with albumin. However ADL A. Cayuela García1, A. Chica Marchal4, M. I. Pedreño Belchi1,
was not associated with CD4, good immunity is definitely M. Ferrer Gómez5, L. Ramírez1. 1Endocrinology and Nutrition,
required for healthy life. CD4 was associated with albumin and Hospital General Universitario Santa Lucia, Cartagena,
transferrin. This study suggests that albumin is crucial to live 2
Hospital Clínico Universitario Virgen de la Arrixaca, Murcia,
effectively keeping a good ADL for the elderly people. 3
Hospital General Universitario Santa Lucia, Cartagena, Spain,
4
Disclosure of Interest: None declared. Pharmacy, Hospital General Universitario Santa Lucia,
Cartagena, 5Endocrinology and Nutrition, Hospital Clínico
MON-P230 Universitario Virgen de la Arrixaca, Murcia, Spain
IS FOOD ADDICTION THE MISSING LINK TO OVERWEIGHT AND
OBESITY IN ISRAELI PRESCHOOLERS? Rationale: It is evident that undernutrition is an independent
risk factor for increased length of hospital stay, higher
V. Kaufman-Shriqui1,2 *, R. Aviram-Friedman3, D. R. Shahar4. readmission rates and hospital costs mortality. Moreover,
1
Nutritional Sciences, Ariel University, Ariel, Israel, 2Center there is a shift in care provisions from acute to community
for Urban Health Solutions (C-UHS), St., Michael’s Hospital, settings. Due to those reasons there is an increased on enteral
Toronto, Canada, 3Department of Life Sciences, Zlotowski tube feeding (ETF) use. Our objective was to evaluate key
Centre for Neuroscience, Ben-Gurion University of the Negev, aspects of all the ETF in our health area.
Israel, 4School of public Health, Faculty of Health Sciences, Methods: We conducted a retrospective study during 4 years
Ben-Gurion University of the Negev, Beer-Sheva, Israel (2013–2016) of the systematic register of enteral nutrition in
the main hospital of our area (Hospital Santa Lucia de
Rationale: Childhood obesity is a major public health concern,
Cartagena, Murcia, Spain) were all the equipments for ETF
with higher rates among children of low socioeconomic status
are collected by patients. This registry includes hospitalized
(LSES). A controversy exists on whether addiction to processed
and ambulatory ETF.
food is associated with obesity among children. This study aims
Results: A total of 1197 patients with a mean age of 73.9 (SD:
to explore the association between food addiction and weight
14.9) years were registered, of those 51% were women.
status among LSES Israeli preschoolers.
Neurologic disease was the pathology that justified the use of
Methods: Data were collected during the school year from
ETF in 64.8%, followed by cancer 24.1% and gastrointestinal
preschoolers in Southern Israel. Height and weight were
pathologies 4.5%. The most prevalent route of administration
measured, sociodemographic characteristics and food fre-
for neurological patients was nasogastric tube 78.9% and in
quency questionnaires (FFQs) were administered in an inter-
cancer patients was gastrostomy 54%. (47.2% endoscopic vs
view to mothers of children aged 4–7 years. Socioeconomic
48.2% radiological). Specific diabetes mellitus (DM) formula
status was defined using the Israeli Ministry of Welfare criteria.
was used in 25% of the sample, 29.3% in neurological disease vs
OWOB was calculated using WHO BMI-z-score cutoff values. For
16.3% in cancer (n = 47). Mean age of patients with DM formula
each FFQ food item, a score will be calculated based on an
was 77.5 years (SD: 10.1). Main reason for removing the ETF was
existing algorithm (Schulte 2015) taking into account total
death (47.9%).
calories (Kcal/day), sugar, fat, trans fatty acids, sodium
Conclusion: Our results are representative for our health area
(g/day), and the level of food processing. We will use a
because all the equipments for patients with ETF are provided
multivariable logistic regression model to identify the inde-
in this hospital. Compared with other registers, neurological
pendent contribution of addictive food to OWOB beyond
disease followed by cancer are the most prevalent reasons for
traditional risk factors.
using ETF. Although DM specific formula is not generalized
Results: Two-hundred and thirty-eight children were included,
recommended for patients with DM, in our sample is frequent
32% were LSES, 47.4% boys, mean age was 63.4 ± 6.5 months.
and more prevalent in patients with neurological disease and
Mean BMI was 16.3 ± 2.2, OWOB rate was 29.8%. Mean maternal
older.
BMI was 26.5 ± 5.6, and 16.2% of the mothers had post-secondary
education. Fifty-two percent of the children consumed Disclosure of Interest: None declared.
candies daily, 47.3% drank one or more portion of soft drinks a
day. We will present additional results on differences in the food MON-P233
addiction score comparing OWOB vs. normal weight children. NUTRITION EDUCATION IN MEDICAL, DENTAL, PHARMACY AND
Conclusion: In the present study we aim to identify an NURSING SCHOOLS IN GREECE
addictive perspective in association with Israeli children’s Z. Pafili1 *, A. Lioupis2. 1Department of Dietetics, 2General
weight status, beyond the contribution of total energy intake. Surgery Clinic, Volos General Hospital, Volos, Greece
This may shed a new light on childhood obesity, and direct
policy makers toward relevant guidelines for the prevention Rationale: Physicians, dentists, pharmacists and nurses are
and management of childhood obesity. often asked to address patients’ nutritional concerns, and
Disclosure of Interest: None declared. nutrition is an integral part of treatment in a number of
diseases. However, nutrition training of health care profes-
sionals has been found to be inadequate. Our aim was to assess
S264 Poster
the nutrition education through separate nutrition courses in Table 1: Comparison of flush method on occlusions and re-openings.
medical, dental, pharmacy and nursing schools in Greece. Flush Method Jejunal Occlusions Reopening Failed re-
Methods: Review of school curricula as presented on their web tubes (%) time openings (%)
pages and phone confirmation of their content with school
Manual 21 12 (57) 15–90 min 7 (58%)
secretaries. Automatic Pump 9 0 (0) N/A N/A
Results: Three out of 7 medical schools do not include a
separate nutrition course in their curricula. A nutrition course Over the course of one year (10 patients/nurse/d, each
is provided in 3 medical schools as an elective course, totaling receiving 4 flushes/d), manual syringe flushing (2 min/flush)
26–27 hours of lectures. Only in one medical school a nutrition versus automatic pump flushing (1 min/flush) consumes more
course is compulsory, totaling 16 hours of lectures. None of the staffing hours (486.6 versus 243.3) and nursing time cost
2 dental and 3 pharmacy schools provide a separate nutrition (€16,398 versus 8,199).
course, however some topics of nutrition are covered as part of Conclusion: In this limited analysis, automatic pump delivery
other courses. Two out of 10 nursing schools do not provide a of enteral water flushes and hydration eliminated jejunal
separate nutrition course. From the rest 8, half provide a feeding tube occlusions on a hospital ward. The use of
nutrition course as an elective course and the other half as technology to deliver water flush orders may reduce nursing
a compulsory one. Total course duration is 26 hours in the 7 time and improve nursing efficiency.
nursing schools and in the 8th (where the course is compulsory)
total course duration is 39 hours, including 26 hours of lectures Reference
and 13 hours of clinical practice. 1. Pearce CB, Duncan HD. Enteral feeding. Nasogastric, nasojejunal,
Conclusion: The majority of medical, dental, pharmacy and percutaneous endoscopic gastrostomy, or jejunostomy: its indica-
nursing school students in Greece do not attend a nutrition tions and limitations. Postgrad Med J. Apr 2002;78(918):198–204.
course during their undergraduate studies. These results are Disclosure of Interest: B. Nadeau Other: Medtronic employee,
comparable with survey results from Europe and the USA. R. Weissbrod Other: Medtronic employee, B. Trierweiler-Hauke
Other: devices were provided for evaluation by Medtronic.
Reference
Chung M, van Buul VJ, Wilms E, Nellessen N, Brouns FJPH. Nutrition
MON-P235
education in European medical schools: results of an international
survey, Eur J Clin Nutr. 2014 Jul;68(7):844–6.
TREATING SARCOPENIA IN LONG-TERM CARE RESIDENTS: AN
HYPOTHESIS GENERATING TRIAL
S. Dimori1, L. Giorgio1, L. Fior1, F. Gasparotto1, E. Cereda2 *.
1
Fondazione Angelo Poretti e Angelo Magnani ONLUS, Vedano
Olona, Varese, 2Nutrition and Dietetics Service, Fondazione
Nutritional techniques and formulations Irccs Policlinico San Matteo, Pavia, Italy
MON-P234 Rationale: Nowadays, there is little information on the
FLUSH NOW: THE USE OF TECHNOLOGY TO PREVENT potential management (screening and treatment) of sarcope-
OCCLUSIONS IN JEJUNAL FEEDING TUBES - A PILOT nia in old adults living in long-term care institutions.
EVALUATION Methods: All old residents living in a long-term care institution
B. Nadeau1, R. Weissbrod2, B. Trierweiler-Hauke3 *. 1Medtronic, were screened for the presence of sarcopenia ( phase 1). Then,
Mansfield, United States, 2Medtronic, Jerusalem, Israel, based on the Tinetti scale (TS) score, sarcopenic patients were
3
University Hospital of Heidelberg, Heidelberg, Germany included in two parallel single-arm trials ( phase 2) and
accordingly assigned to receive a vitamin D and leucine-
Rationale: The provision of water flushes and hydration via the enriched whey protein-based nutritional supplement in com-
enteral route requires a patient-specific intervention, delivery bination (TS ≥ 10) or not (TS < 10) with a supervised physical
mechanism, and prescription compliance. Inadequate water exercise rehabilitation program (a 40-min session every 3 days)
delivery may lead to feeding tube occlusion, fluid imbalance, for 12 months. The nutritional supplement was administered
and nutritional insufficiency [1]. This evaluation aimed to twice daily for the first 3 months; and then once daily for 3
assess the ability of the Kangaroo™ ePump system (Medtronic, months; none for 3 months and once daily for the last 3 months.
Mansfield, MA, USA) to deliver water flushes, with the ultimate Results: We screened 95 residents and 81 had low skeletal
goal of helping to avoid occlusions in jejunal feeding tubes and muscle mass (SMM). Functional status could be assessed in 45
improving nursing workload. subjects and 39 out of these were included in the intervention
Methods: The current facility enteral flushing protocol via phase due to sarcopenia. Patients receiving the nutritional
jejunal feeding tubes includes up to 10 flushes/day after support alone (n = 17) showed significant improvement in body
feeding, residual check, or medication. weight and composition with an increase in phase angle (PhA),
Flushes were delivered manually via a syringe or automatically fat-free mass (FFM), SMM and SMM index (SMI), but not in
using the Kangaroo™ ePump system on a sample of patients. handgrip strength (HS). However, patients in the multidiscip-
Results: Utilizing manual flushing, 57% of jejunal tubes linary program that included also exercise physical activity
became occluded, of which, only 42% could be reopened (n = 22) showed an improvement not only in PhA, FFM, SMM and
(Table 1). Conversely, using automatic pump flushing, none of SMI but also in HS, gait speed and Short Physical Performance
the jejunal tubes were occluded (Table 1). Battery (SPPB). The effect was present until discontinuation of
the intervention and was restored after its re-introduction.
Nutritional techniques and formulations S265
Conclusion: The present study showed that physical activity to use than pumps and much more reliable than roller clamps. A
and nutritional intervention could be feasible strategies to new device is here presented: a flow regulator specific for
improve muscle mass and function in old adults living in long- enteral formulas, since an IV flow regulator can not be used
term care institutions. with these solutions because of the risk of obstructions.
Disclosure of Interest: None declared. Methods: The core of an IV flow regulator is a narrow channel
called ‘mouse-tail channel’ because of its variable cross
section. This channel is too tight for enteral solutions, which
MON-P236 easily create obstructions. Therefore, an enteral flow regulator
E-LEARNING TO IMPROVE PEDIATRIC PARENTERAL NUTRITION needs to based on a new working principle. We have developed
KNOWLEDGE? A PILOT STUDY IN TWO HOSPITALS. and tested an innovative channel made of a sequence of knots,
L.-M. Petit1 *, P. Le Pape2, N. Bajwa3, L. Garzoni1, each determining a pressure drop.
D. Schluckebier1, V. Mclin1, C. Fonzo-Christe2, D. Belli1, Results: Our tests demonstrate that the new device is able to
P. Bonnabry2. 1Gastro-enterologie Pediatrique, 2Pharmacie, adjust the delivery within the range of typical administration
3
General Pediatrics, Hopital Universitaire De Geneve, Geneve flow rates. The flow remains stable over time and no
14, Switzerland obstructions are observed. This behaviour is much better
than the behaviour of a gravity system with roller clamp, which
Rationale: We aimed to assess and compare in two hospitals the needs so much frequently to be checked that it results almost
impact of a self-made E-learning module designed to teach useless. The device is aimed for PEG therapy with adult
prescription of paediatric PN, on the ability of physicians to patients in hospitals or at home care.
manage theoretical clinical cases. Conclusion: In light of these performances, the new device is
Methods: Two university hospitals (HOSP1: prescribing an ideal replacement for roller clamp and could even be
physicians, HOSP2: non-prescribing physicians, clinical employed for some applications currently in the field of
pharmacists). electronic pumps.
Physicians were randomized in 2 groups in each hospital. All
participants completed a test to establish baseline knowledge.
• Intervention-group: E-learning module followed by a post-
test, one month after test. Satisfaction of the E-learning MON-P238
module evaluated on a questionnaire. HOME PARENTERAL NUTRITION PROVISION MODALITIES FOR
• Control-group: post-test one month after test only. CHRONIC INTESTINAL FAILURE (CIF) IN ADULT PATIENTS: AN
INTERNATIONAL CROSS-SECTIONAL SURVEY
Pre- and post-test included 3 clinical cases. Six months after L. Pironi1 *, on behalf of Home Artificial Nutrition & Chronic
inclusion, HOSP1’s participants passed a 3rd test, to evaluate Intestinal Failure Special Interest Group of ESPEN. 1University
persistence of prescription skills. of Bologna, Bologna, Italy
Results: 65 physicians participated (36 HOSP1, 29 HOSP2).
Initial knowledge scores were higher in HOSP1 ( p < 0.001). Rationale: To investigate the HPN management for CIF in
No significant E-learning impact was observed globally. different Countries, a multicenter study was carried out
Improvement of knowledge by the E-learning group was higher using the structured database devised for the ESPEN ‘CIF
in HOSP2 than in HOSP1. At the 6 months test, participants of Action Day’.
HOSP1 showed persistence of knowledge without significant Methods: In March 2015, 65 centers from 22 countries enrolled
improvement compared to pre-test scores. Satisfaction with the 3239 patients (benign disease 90%, cancer 10%), recording
E-learning tool was very high: 100% of participants estimated patient characteristics, CIF pathophysiological mechanism and
that the E-learning module met their needs and would HPN provision characteristics. HPN provision was categorized as
recommend it to their colleagues. by health care system local pharmacy (LP) or by home care
Conclusion: In this pilot study, there was no impact of an company (HCC). Intravenous supplementation (IVS) was cate-
E-learning module on the knowledge of physicians. However, gorized as fluids and electrolytes alone (FE) or parenteral
the direct responsability on PN prescription appears to be in nutrition admixture either commercially premixed (PA) or
relationship with the results of initial knowledge tests. customized to the individual patient (CA) alone or plus extra FE
Persistence of ability to prescribe PN could be due to (PAFE or CAFE). Statistics: chi square.
participation in the study, which serves as training tool in Results: HPN provision (%): HCC 66, LP 34; no difference
that hospital. The high level of satisfaction with this new between benign and cancer CIF. LP was the main modality in
pedagogic tool is a sign to keep on assessing how to use it Denmark, the Netherlands and in other 9 European Countries;
optimally in post-graduate medical education. HCC prevailed in UK, Italy, France, Poland, Israel, USA, South
Disclosure of Interest: None declared. America and Oceania ( p < 0.001). IVS types (%): FE 10, PA 17,
PAFE 17, CA 38, CAFE 18; PA + PAFE was greater in cancer and
CA + CAFE was greater in benign CIF ( p < 0.001); PA + PAFE
MON-P237
prevailed in those Countries were LP HPN provision prevailed;
A NEW DEVICE FOR ENTERAL NUTRITION
CA + CAFE prevailed in the other Countries ( p < 0.001). In the
L. Casarotto1 *. 1Phoenix R&D, Rovigo, Italy CIF mechanism categories, CA + CAFE ranged from 44% in
mucosal disease to 72% in fistulas and FE ranged from 2% in
Rationale: Administration of enteral formulas is done by means
mechanical occlusion to 17% in short bowel with jejunostomy
of electronic pumps or gravity systems with roller clamp. In the
( p < 0.001).
similar field of intravenous infusion a third way exists: a gravity
system with flow regulator, which is more affordable and easier
S266 Poster
Conclusion: HCC was the main modality of HPN provision and MON-P240
CA ± FE the main type of IVS for CIF. There were significant ASSESSING THE PH OF ASPIRATE FROM NASOGASTRIC TUBES:
differences among Countries for both HPN provision and IVS ARE TWO HEADS BETTER THAN ONE?
types; provision modalities and IVS types looked associated. M. Small1 *. 1Clinical Nutrition, St Mark’s Hospital, Harrow,
IVS type also differed between the benign and malignant nature United Kingdom
of the disease and among the pathophysiological mechanisms
of CIF. Rationale: pH of aspirate is the 1st line method for assessing
Disclosure of Interest: None declared. nasogastric tube position. National guidelines recommend a 2nd
person check readings between pH 5 & 61, suggesting that
MON-P239 double checking is more accurate than single, but this has not
HIGH PROTEIN, LOW CARBOHYDRATE, 100% WHEY BASED been formally evaluated. This study aimed to determine if
ENTERAL FORMULA IS ASSOCIATED WITH LOWER BLOOD double checking resulted in more correct answers than single
GLUCOSE RESPONSE checking & how often readings obtained independently
correlated with those taken with a 2nd checker.
M. B. Huhmann1 *, J. Neutel2, S. S. Cohen3, J. B. Ochoa4. Methods: The pH of 10 clear non buffered fluids was
1
Clinical Sciences, Nestle Health Science, Florham Park, assessed using a CE marked pH indicator by 14 raters, once
2
Orange County Research Center, Tustin, 3EpidStat Institute, on their own & once with a 2nd checker. Values were
Ann Arbor, 4Nestle Health Science, Florham Park, United States compared with those from a pH meter to determine the
number of correct answers made by single raters compared to
Rationale: Hyperglycemia is prevalent among critically ill
those from a ‘group’ (rater plus 2nd checker). The measure-
patients and, similar to type 2 diabetes mellitus (T2DM), is
ments in agreement per rater was also calculated to see how
associated with insulin resistance. The role of diet, particularly
often results arrived at independently correlated with those
protein, has been insufficiently studied in this setting. The
obtained by a group.
objective of this study was to determine if a high protein, low
Results: The mean number of correct answers for the 10 fluids
carbohydrate, 100% whey based enteral nutrition (EN) formula
from the 14 single raters was 41 ± 28.2 (7–100)%, whereas the
could provide better control of postprandial blood glucose
number from the 7 groups was 31 ± 40.3 (0–100)%, p = 0.09.
relative to a high protein whey-casein based formula.
There were 5 fluids where none of the groups obtained the
Methods: This randomized, crossover clinical trial of 12 adults
correct answer, whereas the single raters obtained the
(mean age 56, range 40–66; 50% male) with T2DM assessed
correct value 3.4 ± 3.4 (1–8) times. The measurements in
glycemic and insulin responses following ingestion of an
agreement between individual raters vs those obtained by the
isocaloric amount of two EN formulas. Subjects were rando-
groups was 54 ± 26 (20–100)%. Only 1 rater obtained the same
mized to a 450 mL bolus of one of two interventions following
values for all 10 fluids when reading the values on their own vs
an overnight fast; 100% whey based (Peptamen Intense VHP
in a group.
1.0 kcal/mL, P 37%, C 29%, F 34%) or whey-casein based (Vital
HP 1.0 kcal/mL, P 35%, C 45%, F 20%) formula on two separate
days, 1 week apart. Blood glucose and insulin levels were Rater 1 2 3 4 5 6 7 8 9 10 11 12 13 14
collected at 0, 10, 20, 30, 60, 90, 120, 150, 180, 210, and 240 Measurements in 20 20 60 90 20 40 60 50 100 50 70 80 30 40
agreement %
minutes. No antidiabetic medication was provided during
this time.
Results: The mean AUC for glucose was significantly lower with Conclusion: More correct answers were obtained when raters
100% whey formula than with whey-casein formula ( p = 0.025), made their decision alone suggesting accuracy is not increased
with no difference at baseline. At 60’ ( peak), the between- by having a 2nd checker. The lack of correlation between the
group difference in change from baseline in mean glucose was values obtained singly vs those by a group highlights the
2.5 mmol/l ( p = 0.003). Mean insulin levels over time were not subjectivity of visually assessing pH values and the need for
statistically different between formulas. objective methods of assessment.
Conclusion: This study demonstrated improved blood glucose
Reference
levels in adults with T2DM following high protein, low
carbohydrate whey-based EN formula compared with a whey- 1. Patient Safety Alert NPSA/2011/PSA002
casein based formula. This suggests a potential role of EN as a Disclosure of Interest: None declared.
co-therapeutic for glucose management in critically ill patients
with hyperglycemia.
MON-P241
Disclosure of Interest: M. Huhmann Other: Employee of Nestle Health FEASIBILITY OF INTERNATIONAL PROPOSED STANDARDIZED
Science, J. Neutel Grant/Research Support from: Nestle Health ENTERAL CONNECTOR FOR SEMI-SOLID FORMULA FEEDING
Science, S. Cohen Consultant for: Nestle Health Science, J. Ochoa
Other: Employee of Nestle Health Science. M. J. Maruyama1 *, T. Higashiguchi1, I. Ishibashi1, Y. Suzuki1,
S. Iijima1, M. Inukai1, T. Iishi1, N. Kawasaki1, N. Kurata1,
M. Chiba1, F. Teramoto1, E. Nakamura1, J. Kayashita1, I. Tabei1.
1
New Connector Working Group, JSPEN, Tokyo, Japan
Rationale: Administration of semi-solid enteral formula though

a percutaneous endoscopic gastrostomy (PEG) tube is popular
practice in Japan. The current study was undertaken to assess if
the semi-solid formulas could be used for PEG patient with a
Nutritional techniques and formulations S267
new ENFit connector set with similar force to current various Conclusion: 1 step procedure to place PTEG tube in the post
PEG tubes. pylorus, using 130 cm catheter of RFB, could become the
Methods: Experiment 1: We measured the applied pressure effective method.
(force) needed to compress the syringe containing seven References: no reference
viscous semi-solid formulas of which viscosity showed 6,000– Disclosure of Interest: None declared.
20,000 mPa.s with 20Fr PEG tube and low-profile tube though
ENFit connector or the current connector. Experiment 2: This
MON-P243
experiment was conducted to evaluate the compression force
ACHIEVING NUTRITIONAL COMPLIANCE BY MANUAL
though the current connector or ENFit connector in three
ITERATIVE METHOD AND MATHEMATICAL MODEL
infusion velocity (50, 100, 150 ml/min), seven PEG tube types
with two semi-solid formulas. S. Silvestre1 *, E. P. C. Rocha Junior2, L. C. D. L. Gontijo1,
Results: Experiment 1: The force needed to compress the H. F. R. Cunha3, L. S. Monteiro da Silva3. 1Serviço de Nutrologia,
syringe though prototype ENFit connector was slightly higher Hospital Felício Rocho, 2Serviço de Nutrologia, Hospital Felício
than that through the current connector in three semi-solid Roxo, Belo Horizonte, MG, 3Nutrotech, Rio de Janeiro, Brazil
formulas with 20Fr low-profile tube, otherwise there were no
Rationale: Guidelines compliance is standard care for
significant differences between the current connector and
nutrition support and the prescription of nutrition support is
prototype ENFit connector. Experiment 2: Each of semi-solid
usually made by a trial-and-error manual iterative method
formulas required slightly higher force in prototype ENFit
(MIM) and provides feasible but not necessarily optimal
connector in 6 experimental settings out of 21.
compliance or cost solutions. The objective of this study is to
Conclusion: The ENFit connector will likely not show the
compare manual iterative method to a mathematical linear
remarkable change in the force for the compression of syringe
programming model (LPM) in terms of compliance achieve-
to administer the semi-solid formula from the current study.
ments and cost reduction.
This study revealed the feasibility of PEG patients to receive
Methods: A cross section database extraction of 36 prescrip-
the semi-solid formulas through ENFit connector in a same
tions obtained from a tertiary level hospital was used.
manner.
Anthropometric data, protein and calorie prescriptions were
Disclosure of Interest: None declared. obtained. Obese patients were excluded. Protein (1.2–2.0 g/
kg/d) and calorie (25–30 kcal/kg/d) recommendations from
MON-P242 guidelines were considered as standard compliance. Protein
5 CASES TRIAL OF THE NEW TECHNIQUE OF PERCUTANEOUS and calorie densities of enteral formulas used by the institution
TRANS ESOPHAGEAL GASTROTUBING(PTEG) WITH 130CM were obtained from regular nutrition facts table. On the other
LONG RUPTURE FREE BALLOON CATHETER FOR PLACING TO hand, costs were compared to an arbitrary formula in order to
POST PYLORUS WITH ONE STEP PROCEDURE avoid identification and prices exposure. Previous decisions
N. Katsura1 *. 1Surgery, Miyazu Takeda Hospital, Kyoto, Japan were then compared to the results obtained from the linear
programming model whose objective function was to minimize
Rationale: Percutaneous Trans Esophageal Gastrotubing(PTEG) relative costs. Compliance achievements and relative costs
has been common in Japan and some Asian countries as the were compared.
salvage method of the case that is impossible to Percutaneous Results: The results showed that MIM is inferior to LPM
Endoscopic Gastrostomy(PEG). We have sometimes experi- performance in terms of compliance achievements and relative
enced some cases that need PTEG in spite of no gastrectomy cost reduction. MIM achieved 47,22% less compliant decisions
due to no safety zone of PEG procedure. and exceeded LPM in relative cost by more than 55%. Besides
Methods: Currently, we can use the commercial based kit that, MIM used only one enteral formula, despite the fact that
(Sumitomo Bakelite Co. Ltd. Tokyo, Japan) which includes LPM achieved better results using more than one.
70 cm Rupture Free Balloon(RFB) catheter. However, it is too Conclusion: Healthcare systems and companies should review
short to reach duodenum by one step to prevent reflux to their calculation methods in order to benefit from the potential
esophagus. We tried to make 130 cm long RFB catheter and use showed in this experimentation.
it for the one step procedure to reduce the extraload of Disclosure of Interest: None declared.
patients. From December, 2015, to April, 2017, 5 cases of 1 step
method were performed PTEG with 130 cm RFB catheter. We
MON-P244
compared 5 cases with earlier 5 cases who underwent PTEG of 2
DISPENSING A HIGH CALORIC, HIGH PROTEIN ORAL
step method with 70 cm RFB catheter from the next 4 points;
NUTRITIONAL SUPPLEMENT 3 TIMES DAILY IS WELL
operation time, body temperature(BT) on post operative day
TOLERATED AND INCREASE COMPLIANCE IN ELDERLY
(POD) 1, 3, and 7, count of white blood cells, cross reacting
protein(CRP) on POD 1. C. Koch1, A. Dax1, A. Warnke1, L. Pauly2, S. Reichart2 *,
Results: We recognized significant differences statistically E. A. Pestana2, J. Stover2, K. Lekkos3. 1SocraTec R&D GmbH,
about operative time, data of BTon POD 3, and WBC, and CRP on Erfurt, 2Fresenius Kabi Deutschland GmbH, Bad Homburg,
3
POD 1; operative time, 47 ± 14 minutes with 70 cm catheter by Helios Klinikum, Hildesheim, Germany
2 step method, 39 ± 11 minutes with 130 cm catheter by one
Rationale: Malnutrition is a common problem in elderly.
step method ( p < 0.01). WBC, 11,000 ± 2450 vs 89,000 ± 1,400
Distributing small amounts (40–60 mL) of calorically dense
( p < 0.05). CRP, 3.2 ± 1.3 vs 1.3 ± 0.4 ( p < 0.01). In BT, on day 3,
supplements (≥2 kcal/mL) three or four times daily in between
36.8 ± 0.5 vs 36.2 ± 0.8 ( p < 0.05), respectively.
meals increases compliance and improves nutrition status. The
present study aimed at evaluating acceptability and
S268 Poster
compliance during administration of lower volumes of a subjects ingested the study product within one hour. The
calorically dense ONS distributed 3 times a day in elderly. majority of subjects rated the palatability of the product as
Methods: Open-label study in 20 elderly in residential homes in good or excellent after first ingestion on day 1 (smell: 18/20,
Germany (76 ± 5 years, 11 female/ 9 male, BMI 25.1 ± 1.9 taste: 16/20, appearance 16/20) and after last ingestion on day
kg*m−2). Participants received 3 × 40 mL of the ONS Fresubin® 7 (smell: 17/20, taste: 15/20, appearance 16/20). The number
3.2 kcal DRINK, corresponding to 400 kcal and 20 g protein, for of GI-symptoms was comparable at baseline and at the end of
7 days. ONS was consumed in the morning, lunchtime, evening the supplementation period. 11/20 subjects did not report any
at least 1 hour before meals, and handout with medication GI-symptoms.
round. Primary outcome was gastrointestinal (GI) tolerance; Conclusion: A high energy, high protein ONS delivered in a
secondary outcomes were palatability and compliance. Data small volume was well tolerated and accepted in elderly in
were analysed and evaluated descriptively. residential homes, with an excellent compliance. The new ONS
Results: All participants completed the 7-days study period; thus represent a clinically valuable option for improving
and consumed approx. 95% of prescribed dose, i.e., corre- effectiveness of nutritional therapy in situations with
sponding to 38/40 ml. All subjects ingested the study product restricted food and fluid tolerance
immediately and were compliant. The majority of subjects Disclosure of Interest: C. Koch Other: contracted research organization,
rated the palatability of the product as good or excellent after A. Dax Other: contracted research organization, B. Schug Other:
first ingestion on day 1 (smell: 16/20, taste: 15/20, appearance contracted research organization, L. Pauly Other: Fresenius Kabi
18/20) and after last ingestion on day 7 (smell: 16/20, taste: employee, S. Reichart Other: Fresenius Kabi employee, J. Stover
16/20, appearance 18/20). The number of GI symptoms was Other: Fresenius Kabi employee, E. Pestana Other: Fresenius Kabi
comparable at baseline and at the end of the supplementation employee, K. Lekkos Other: Helios Klinikum Department Head Geriatric
period; 13/20 subjects did not report any GI symptoms. Unit.
Conclusion: High energy, high protein ONS, delivered in 3
portions during the day, was well tolerated and accepted
among elderly in residential homes. Dispensing a lower volume Obesity and the metabolic syndrome 2
of a calorically dense ONS provides a convenient way to
supplement calories and protein and was associated with high MON-P246
compliance in elderly subjects in need of supplementation. METABOLIC ADAPTATION AFTER BARIATRIC SURGERY: A
COMPARISON OF ROUX-EN-Y GASTRIC BYPASS AND SLEEVE
Disclosure of Interest: C. Koch Other: contracted research organiza-
GASTRECTOMY
tion, A. Dax Other: contracted research organization, A. Warnke Other:
contracted research organization, L. Pauly Other: Fresenius Kabi L. Plank1 *, R. Murphy2, N. Davies2, M. B. Booth3. 1Surgery,
2
employee, S. Reichart Other: Fresenius Kabi employee, E. Pestana Medicine, University of Auckland, 3Surgery, North Shore
Other: Fresenius Kabi employee, J. Stover Other: Fresenius Kabi Hospital, Auckland, New Zealand
employee, K. Lekkos Other: Helios Klinikum Department Head Geriatric
Unit. Rationale: A reduction in resting energy expenditure (REE) is
seen after weight loss. It is not clear whether the massive
MON-P245 weight loss seen after bariatric surgery induces changes in REE
NEW HIGH PROTEIN AND HIGH ENERGY ORAL NUTRITIONAL which are consistent with changes in body composition nor
SUPPLEMENT FOR COMPLIANCE AND TOLERANCE IN whether these changes differ between types of bariatric
ELDERLY CARE surgery.
C. Koch1, A. Dax1, B. Schug1, L. Pauly2, S. Reichart2 *, J. Stover2, Methods: In a double-blind ( patient and assessor) trial of
E. A. Pestana2, K. Lekkos3. 1SocraTec R&D GmbH, Erfurt, patients with type 2 diabetes mellitus randomised to laparo-
2
Fresenius Kabi Deutschland GmbH, Bad Homburg, 3Helios scopic silastic ring Roux-en-Y gastric bypass (GBP; 17M, 23F) or
Klinikum, Hildesheim, Germany to laparoscopic sleeve gastrectomy (SG; 24M, 18F), REE was
measured by indirect calorimetry before and 12 months after
Rationale: Volume strongly determines compliance to an oral operation. All patients underwent dual-energy X-ray absorpti-
nutritional supplement (ONS), hindering to achieve the ometry for total body fat mass (FM) and fat-free mass (FFM).
effective dose of protein and energy necessary to be clinically Linear regression analysis was used to determine significant
effective in the management of malnutrition. For this, high predictors of REE at baseline. These predictors were used in a
protein, high energy ONS are considered beneficial. In the mixed-model analysis of covariance to adjust the changes in
present study, a new ONS providing high protein and energy in a REE over the 12-month period and to examine the effect of type
low volume was evaluated in daily practice of a residential of surgery.
home. Results: Twelve-month weight loss in GBP patients was
Methods: Open-label study in 20 elderly in residential homes 31.2 ± 1.7[SEM] kg made up of 25.5 ± 1.5 kg FM and
in Germany (75 ± 4 years, 12 female/ 8 male, BMI 24.7 ± 1.9 5.8 ± 0.4 kg FFM. Corresponding measures in SG patients were
kg*m−2). Participants received one bottle a day (125 ml) of the 30.4 ± 2.1 kg (P = 0.75), 24.1 ± 1.8 kg (P = 0.56) and 6.3 ± 0.5 kg
ONS Fresubin® 3.2 kcal DRINK, corresponding to 400 kcal and (P = 0.45). REE at baseline was 1739 ± 47 kcal/d in GBP and
20 g protein, for 7 days. Primary outcome was gastrointestinal 1896 ± 52 kcal/d in SG (P = 0.029). At 12 months, REE was
(GI) tolerance, secondary outcomes were palatability and 1461 ± 41 and 1543 ± 33 kcal/d, respectively. FFM, FM, age, and
compliance (ratio of prescribed vs. actual intake). Data of the sex were significant predictors of baseline REE. After adjust-
full analysis set were evaluated descriptively. ment for these variables, REE remained significantly lower than
Results: All participants completed the 7-days study period. at baseline by 94 ± 34 kcal/d for GBP (P = 0.007) and 131 ± 31
Participants consumed 96% of the prescribed volume. All
kcal/d for SG (P < 0.0001). These reductions did not differ by Disclosure of Interest: M. Torrego: None declared, A. Barabash: None
type of surgery (P = 0.25). declared, F. Cuesta: None declared, L. Fernandez: None declared,
Conclusion: Adaptive reductions in REE to weight loss in obese R. Cabrera: None declared, M. Ceballos: None declared, M. A. Rubio:
individuals were observed in the 12 months following both GBP None declared, P. Matía Grant/Research Support from: FIS PI14/00972
PREDIMED PLUS, U. Garin: None declared.
and SG bariatric surgery which may predispose these patients
to weight regain.
MON-P248
PREDICTION OF CHANGES IN THE VISCERAL FAT AREA
AND THE SKELETAL MUSCLE MASS/VISCERAL FAT AREA
MON-P247 RATIO DURING WEIGHT REDUCTION BY LIFESTYLE
SARCOPENIC OBESITY OR PHASE ANGLE IN A COHORT OF INTERVENTION
PATIENTS WITH METABOLIC SYNDROME. WHICH IS BETTER
M. M. A. Abulmeaty1,2 *, M. Y. Berika3, A. M. Al-Othman4.
PREDICTOR OF MUSCULAR STRENGTH, FUNCTIONALITY AND 1
Clinical Nutrition Program, Community Health Sciences, King
ACTIVITY LEVEL?
Saud University, Riyadh, Saudi Arabia, 2Obesity Management
M. Torrego1 *, A. Barabash1, F. Cuesta2, L. Fernandez3, and Research Unit, Medical Physiology Department, Zagazig
R. Cabrera4, M. Ceballos5, M. A. Rubio1, P. Matía1, U. Garin1. University, Zagazig, Egypt, 3Rehabilitation Sciences
1
Endocrinology, 2Geriatrics, 3Endocrinology Laboratory, San Department, King Saud University, 4Clinical Nutrition
Carlos Clinical Hospital, 4Health Care, Espronceda Center, Consultant and Head, Health and Nutrition Training Center,
5
Health Care, Lucero Center, Madrid, Spain Riyadh, Saudi Arabia
Rationale: Determinate the phase angle (PA) and the preva- Rationale: To predict the changes in the visceral fat area (VFA),
lence of sarcopenic obesity (SO) in patients with metabolic skeletal muscle mass (SMM) and SMM/VFA ratio1 during weight
syndrome (MS) and define associations with muscular strength, loss in adult men with obesity.
muscular function and level of physical activity. Methods: A prospective study included eighty-two males, 20–
Methods: Patients with MS. Body composition: Bodystat 60 y, for 3 months in the weight reduction clinic, KSU, between
QuadScan 4000 and Akern BIA 101. Skeletal muscle mass Sept, 2016 and Feb, 2017. Patients were instructed to follow a
(SMM): Jansseńs formula ([0.401 × (height – cm−2/resistance – balanced hypocaloric diet (1200–1600 kcal/d, 50% complex
omhs-) + (3.825 × gender –M = 1;F = 0-) – (0.071 × age)] + 5.102). carbohydrates, 30% unsaturated lipids, 20% protein), physical
SO: sum of low SMM/height2 < 8,25 (M) and <6,68 kg/m2 (F), activity plan for 60 min/d and a practical advice for combating
and high fat mass >25,0 (M) and >35,0% (F). Hand grip strength: the unhealthy lifestyle. Body mass index (BMI) was calculated
JAMAR Plus dynamometer; dominant arm; mean of three as weight(Wtkg)/height(m)2. The InBody-720 bioelectric
determinations. Muscle function: chair test. Physical activity at impedance was used to measure fat mass (FM), VFA, SMM,
three levels: RAPA1-Rapid Assessment of Physical Activity SMM/VFA ratio, and osseous mass (OM) before and after the
Questionnaire- + chair test: Low Active, Moderately Active study period. Percent of change in a given parameter (%) was
and Active. calculated as before-after difference/before-value x100.
Results: 124 patients, 49.2% M; 50.8% F. Median age 64 years Stepwise regression analysis was used to test the predictors
(IQR: 61–69), median BMI 32.26 (IQR: 29.5–34.7). Prevalence of of changes in FVA and SMM/VFA ratio.
SO: 19.3%; Median PA: 5.43 (IQR: 4.85–5.95). PA was associated Results: A significant reduction in Wt, BMI, VFA and FM
with grip strength (Rho spearman 0.36; p < 0.001), chair test ( p < 0.001), in addition to a significant rise of SMM/VFA ratio
number of repetitions (Rho Spearman 0.263; p = 0.006) and ( p < 0.001), and an insignificant changes of OM and SMM were
level of activity (median values of 5.2 in low, 6 in medium and detected. % Wt, BMI & VFA losses were 5.70%, 5.38%, & 13.59%,
4.95 in active;p = 0.002). respectively, while % of rise in SMM/VFA ratio was 18.14%. % VFA
Conclusion: SO diagnostic and low PA are significantly loss was predicted by this equation; 3.245 + 1.92 x %BMI loss,
associated with a lower muscular function. Low PA values are (β = 0.668, r2 = 0.447, p < 0.001). Additionally, %BMI loss signifi-
associated with lower functionality and level of physical cantly predict the rise in the SMM/VFA ratio (β = −0.588,
activity. r2 = 0.346, p < 0.001) and the equation = –5.175–2.406 x %BMI
loss.
Conclusion: The lifestyle intervention produced reduction in
SO (A = yes; B = no) Phase angle (A < 4,85;
B > 4,85) the VFA more than double that of the Wt or BMI with rise of
SMM/VFA ratio and these changes could be predicted by
Grip strength (kg);IQ A:17.9(15.9–21.3) A:20.9(18–24.9)
B:28.6(21.4–38.2) B:30(21.2–40) %BMI loss.
p < 0.001 p = 0.001 Reference
Chair test (n) A:13(10.5–14) A:12(10–14)
B:13(11–14) B:13(11–15) 1. Hwang Y, et al. The ratio of skeletal muscle mass to visceral fat area
p = 0.2 p = 0.04 is a main determinant linking circulating irisin to metabolic
Physical activity (n,%) Low. A:20(95.2); B:71 Low. A:25(92.6); B:75 phenotype. Cardiovasc Diabetol 2016; 15: 9.
(79.8) (78.1)
Medium. A:0(0); B:15 Medium. A:0(0); B:19 Disclosure of Interest: None declared.
(16.9) (19.8)
High. A:1(4.8); B:3(3.5) High. A:2(7.4); B:2(2.1)
p = 0.032 P = 0.113
*M = male, F = female
S270 Poster
MON-P249 antropometric measurements, body composition analysis and

BIOLOGICAL AND PSYCHOLOGICAL ASPECTS OF WEIGHT LOSS biochemical findings were taken for all participants. Visceral
AMONG OBESE AND OVERWEIGHT SUBJECTS adiposity index (VAI), body mass index (BMI), waist/hip ratio,
M. Černelič Bizjak1 *, M. Stubelj1, A. Petelin1, waist/height ratio, triglyceride/high-density lipoprotein chol-
Z. Jenko Pražnikar1. 1Department of Nutritional Counselling, esterol ratio (TG/HDL-C) and homeostatic model assessment of
Dietetics, University of Primorska, Faculty of Health Sciences, insulin resistance (HOMA-IR) levels were calculated in all
Izola, Slovenia individuals.
Results: The mean age of participants was 52.6 ± 10.43 years.
Rationale: This study investigate biological and psychological The mean value of HOMA-IR of men and women 7.5 ± 5.75 and
aspects of weight loss. It was hypothesised that participants 5.7 ± 4.49 respectively ( p > 0.05). HOMA-IR was not correlated
with higher body dissatisfaction over a period of 6 months will with total cholesterol (r = 0.032, p = 0.751) and low-density
exhibit increased inflammation compared with those who lipoprotein cholesterol levels (r = 0.037, p = 0.711) but HOMA-
change from dissatisfied to satisfied, and that these changes IR was positively correlated with triglyceride levels (r = 0.289,
will be independent of relevant health-related behaviour p = 0.004) and it was negatively correlated with high-density
changes. lipoprotein cholesterol levels (r = −0.364, p = 0.000) among
Methods: The participants were recruited for a multidiscip- biochemical findings but the strongest association was found
linary weight management programme. Subjects were re- with TG/HDL-C ratio (r = 0.339, p = 0.001). HOMA-IR was not
quired to be older than 25 years; to have a BMI between 25 correlated with waist to hip ratio (r = 0.176, p = 0.080) and
and 35 kg/m2; to be healthy, with no metabolic, cardiovas- waist to height ratio (r = 0.125, p = 0.216) but HOMA-IR was
cular, endocrine, acute or chronic inflammatory diseases. A positively correlated with body fat mass (r = 0.200, p = 0.046)
total of 33 subjects, aged 38.9 ± 6.5 years, completed the and visceral fat percentage (r = 0.201, p = 0.044), BMI (r =
whole intervention programme. Daily energy requirements 0.202, p = 0.035) and waist circumference (r = 0.222, p = 0.027)
were calculated from the individual’s resting metabolic rate among antropometric measurements/calculations and body
and physical activity level factor, with a moderate energy composition analysis but the strongest association was found
restriction of 2100 kJ. with VAI (r = 0.297, p = 0.003).
Results: Hierarchical regressions analyses revealed that demo- Conclusion: Visceral adiposity index and triglyceride/high-
graphics and changes in obesity indicators accounted for 26% of density lipoprotein cholesterol ratio are the practical markers
the variation in reduction of inflammation biomarker TNF-a, of insulin resistance in the clinical evaluation of type 2 diabetes
23% in CRP, 18% in increase in anti-inflammatory adiponectin. patients.
Five lifestyle behaviours explained additional 13% of the Disclosure of Interest: None declared.
variation in the reduction of serum level of CRP, 29% of TNF-a
and 25% in increase of adiponectin. The change in body
MON-P251
dissatisfaction was the significant predictor of decreased
IRON SUPPLEMENTS FOR THE TREATMENT OF IRON
inflammation level and uniquely explained 7–8% of the
DEFICIENCY AFTER ROUX-EN-Y GASTRIC BYPASS
variation of inflammatory biomarkers and 17% of the variation
of adiponectin. N. Steenackers1,2 *, I. Gesquiere1,2, M. Lannoo3,
Conclusion: The findings provide important information that B. Van der Schueren1,2, C. Matthys1,2. 1Clinical and
body dissatisfaction may be a psychological marker of a higher Experimental Endocrinology, KU Leuven, 2Endocrinology,
3
metabolic risk independently of most traditional risk factors Abdominal Surgery, University Hospitals Leuven, Leuven,
such a gender, BMI and intra-abdominal adiposity. This Belgium
constructs must be considered as relevant health-related
Rationale: Obese patients are predisposed to develop iron
factors in weight management programme.
deficiency (ID) due to inadequate dietary iron intake, increased
Disclosure of Interest: None declared. blood volume and obesity-associated inflammation. Today,
Roux-en-Y gastric bypass (RYGB) is the gold standard to treat
MON-P250 morbid obesity. However, this procedure increases the risk to
EVALUATION OF INSULIN RESISTANCE WITH develop ID. Therefore, we examined the disposition of iron
ANTHROPOMETRIC AND ATHEROGENIC PREDICTORS IN supplements in obese volunteers before and after RYGB.
DIABETES Methods: Oral absorption studies with iron(II)sulphate and iron
O. Kucukerdonmez1, M. S. Karacil Ermumcu2 *, S. Seckiner3, bisglycinate supplements were performed in 6 subjects before
E. Koksal2. 1Nutrition and Dietetics, Ege University Faculty of RYGB and in 3 subjects at 1 month after RYGB. Before oral
Health Sciences, İzmir, 2Nutrition and Dietetics, Gazi administration, blood samples were collected to determine
University Faculty of Health Sciences, Ankara, 3Endocrinology serum iron concentration, iron-related markers, hepcidin and
and Metabolism, Ege University Faculty of Medicine, İzmir, C-reactive protein (CRP). After administration, blood samples
Turkey were collected at 15, 30, 60, 90 minutes and at 2; 2.5; 3; 3.5; 4
and 5 hours to determine serum iron concentration.
Rationale: Some anthropometric and atherogenic predictors of Nutrikinetic properties of both supplements were assessed by
insulin resistance are common used in clinical. This study was calculating the adjusted for baseline AUC0-5h, Cmax and Tmax
conducted to evaluate anthropometric and atherogenic pre- before and after surgery.
dictors of insulin resistance in diabetes. Results: Before RYGB, the AUC0–5h was significantly higher after
Methods: A total of 100 (34 men and 66 women) patients with iron(II)sulfate administration compared to iron bisglycinate as
type 2 diabetes were enrolled. The demographic parameters, seen in Table 1. No significant differences were obtained for
the other nutrikinetic properties, neither after surgery. Post- should allow a better understanding of the mechanisms by
RYGB, iron status markers and hepcidin concentration were not which CIT alters fat mass in humans.
statistically significant changed, however CRP was significantly Reference
decreased ( p = 0.03).
Joffin et al. Citrulline induces fatty acid release selectively in visceral
Table 1: Nutrikinetics results at the preoperative absorption tests. adipose tissue from old rats. MNFR 2014.
Before RYGB Disclosure of Interest: None declared.
1 2
Parameters Iron(II)sulfate Iron bisglycinate P-value
(n = 6) (n = 6) MON-P253
AUC0–5h (μg/dL*h) 7.8 (5.1–12.5) 7.0 (3.7–9.4) 0.03 SARCOPENIC OBESITYAND METABOLIC SYNDROME. WHICH OF
Cmax (μg/dL) 1.9 (1.5–2.6) 1.6 (1.2–2.2) 0.06 THE INDIVIDUAL COMPONENTS ARE ASSOCIATED WITH THE
Tmax (h) 2.8 (2.3–4.3) 2.0 (1.4–3.9) 0.56 SARCOPENIC OBESITY PHENOTYPE?
P. Matía1 *, M. Torrego1, A. Barabash1, U. Garin1, M. V. Sáez1,
Conclusion: Before RYGB, disposition of iron(II)sulfate is C. Aragoneses2, C. Moreno2, M. Gonzalez-Cerrajero3,
superior compared to iron bisglycinate, while post-RYGB no M. Á. Rubio1. 1Endocrinology and Nutrition, Hospital Clínico
differences could be found. SAN CARLOS., 2Centro de Salud Lucero, 3Centro de Salud
Disclosure of Interest: None declared. Guzmán el Bueno, Atención Primaria, Madrid, Spain
MON-P252 Rationale: Associations between metabolic syndrome (MS) and

CITRULLINE INDUCES LYPOLYSIS IN SUBCUTANEOUS ADIPOSE sarcopenic obesity (SO) have been established, but how the
TISSUE FROM DYNAPENIC-OBESE ELDERLY PEOPLE individual components of MS contribute to the SO phenotype
needs further investigation. Objective:to describe relation-
P. Noirez1,2 *, A. Meziani2,3, M. Dulac2,3, G. El Hajj Boutros2,3,
ships between waist circumference (WC), glycaemic control,
V. Marcangeli2,3, J. Morais4, C. Forest5,
HDL-chol, triglycerides, inflammation, and SO in patients
M. Aubertin-Leheudre2,3. 1UFR staps, IRMES, EA7329,
with MS.
Universite Paris Descartes, Paris, France, 2Département des
Methods: Body composition:Bodystat QuadScan 4000 and
Sciences de l’activité physique, UQAM, 3Centre de Recherche
BIA 101. Skeletal muscle mass (SMM): Jansseńs formula
l’Institut Universitaire de Gériatrie de Montréal, 4Geriatric
([0.401 x (height–cm−2/resistance–omhs) + (3.825 x gender –
Department, Mc-Gill Universitary Hospital, Montréal, Canada,
5 M = 1;F = 0-) – (0.071 x age)] + 5.102). SO:sum of low SMM/
Inserm Umr-S 1124, Universite Paris Descartes, Paris, France
height2 < 8,25 (M) and <6,68 kg/m2 (F), and high fat mass >25,0
Rationale: In elderly, an increase in fat mass (FM) and a (M) and >35,0% (F). Statistics: binary logistic regression
decrease in muscle strength (dynapenia) is often oberved and (univariated and adjusted by age and gender).
could lead to the onset of metabolic syndrome. In animal Results: 110 patients. Median age 64 years (IQ: 61–69). Median
studies, Citrulline (CIT) induces lipolysis observed by the BMI 31.8 Kg/m2 (IQ: 29.5–34.7). SO: 19.3% of the sample.
release of non-esterifed fatty acids (NEFA) from white Conclusion: In our cohort of patients with MS, their individual
adipose tissue. Our aim was to evaluate the effect of an components were not associated to the OS phenotype. Only the
acute exposure (24h) of human abdominal subcutaneous WC showed a paradoxical relationship with SO. It is neccesary
adipose tissue (SCAT) to CIT in elderly dynapenic-obese (DO) to explore different definition of SO and its association with the
people. global CV risk.
Methods: Seven women (w) (age:68.6 ± 3.3 yrs; FM:46.4 ± Table 1:
2.8%; handgrip strength/BodyWeight-HS/BW:0.32 ± 0.04 kg/kg) Univariate Adjusted by age and gender
and 14 men (m) (age:66.9 ± 4.3 yrs; FM:34.3 ± 2.8%; HS/
BW:0.45 ± 0.08 kg/kg) with dynapenia (HS/BW < 0.44 for w OR (CI 95%) of SO p OR (CI 95%) of SO p
and <0.5 for m) and obesity (fat mass >30% for w and >25% Basal glucose (mg/dl) 0.986 (0.955–1.017) 0.360 0.999 (0.964–1.034) 0.940
for m) were recruited. SCAT biopsies from all participants were HbA1c (%) 0.458 (0.151–1.392) 0.169 0.458 (0.125–1.674) 0.237
HOMA 1.016 (0.820–1.258) 0.886 1.085 (0.855–1.376) 0.503
incubated in KREBS medium with glucose (5 mM). Twenty-four HDL-cholest (mg/dl) 1.003 (0.964–1.045) 0.870 0.954 (0.901–1.010) 0.103
hours later, the medium was replaced with KREBS medium, HDL-cholest (low vs 1.500 (0.567–3.967) 0.414 1.896 (0.662–5.428) 0.233
5 mM glucose, containing or not CIT (2.5 mM). At 24 h of high)*
Triglycerides (mg/dl) 1.001 (0.991–1.011) 0.817 1.003 (0.992–1.013) 0.609
incubation, the medium was collected for the estimation of
PCR (mg/dl) 1.021 (0.451–2.309) 0.961 0.897 (0.392–2.052) 0.797
NEFA (mM · mg−1) and glycerol (g · L-1 · mg−1) release. WC (cm) 0.892 (0.829–0.959) 0.002 0.923 (0.856–0.996) 0.040
Results: The analyses of lipolytic products in the medium WC (high vs low)** 1.707 (0.199–14.680) 0.626 0.345 (0.027–4.341) 0.410
suggested that CIT increased NEFA (DO w: 0.24 ± 0.13 vs
0.15 ± 0.07; DO m: 0.23 ± 0.14 vs 0.12 ± 0.06) and glycerol (DO Disclosure of Interest: P. Matía Grant/Research Support from: FIS PI14/
w: 0.22 ± 0.05 vs 0.15 ± 0.07; DO m: 0.25 ± 0.23 vs 0.09 ± 0.08) 00972 PREDIMED PLUS, M. Torrego: None declared, A. Barabash: None
declared, U. Garin: None declared, M. V. Sáez: None declared, C.
release from SCAT of both gender ( p < 0.0001).
Aragoneses: None declared, C. Moreno: None declared, M. Gonzalez-
Conclusion: As observed in animal, our data show that CIT
Cerrajero: None declared, M. Á. Rubio: None declared.
stimulates the release of NEFA and glycerol from human SCAT. To
determine whether this amino acid could potentially by used
for such a purpose in DO elderly adults, further analyses of
lipolysis, FA re-esterification and beta-oxidation processes
S272 Poster
MON-P254 Anaesthesiology, General Intensive Care and Pain Control,

WEIGHT BIAS AMONG FACULTY STAFF, PHYSICIANS IN Division Cardiac, Thoracic, Vascular Anaesthesia and Intensive
TRAINING, AND NURSES ATAN ACADEMIC MEDICAL CENTER IN Care, Medical University Vienna, Vienna, Austria
THAILAND
Rationale: Obesity is a major risk factor for developing acute
D. Ratanapichayachai1, R. Paothong1, S. Phattharayuttawat2,
and chronic disease conditions with negative impact on
P. Pramyothin1 *. 1Department of Medicine, 2Department of
mortality in the general population. Mounting evidence has
Psychiatry, Siriraj Hospital, Bangkok, Thailand
however suggested that being obese may reduce the risk of
Rationale: Weight bias among health professionals adversely death associated with several diseases. Potential interactions
affects treatment outcomes in obese patients. We aimed to between weight loss and obesity in modulating risk of death in
assess weight bias and associated factors among health acute disease conditions remain largely undefined.
professionals at the Department of Medicine of a tertiary Methods: We investigated the ESPEN nutritionDay database of
hospital in Bangkok, Thailand. hospitalized patients without missing outcome, BMI or
Methods: A questionnaire assessing demography, anthropom- PANDORA score to assess potential interactions between self-
etry, and weight bias was administered to faculty staffs, reported 3–month weight loss (WL1: 2.5–6.6%; WL2: 6.6–12.6%,
physicians in training, and nurses between 2013–2015. WL3: >12.6%) and obesity (BMI > 30 kg/m2) in modulating 30-
Validated questionnaires utilized included the Attitudes day mortality. Multivariate Cox regression was used to estimate
Toward Obese Persons (ATOP) Scale, the Fat Phobia Scale hazard ratios (HR) with confidence intervals (CI) for the two
(F-scale), and the Beliefs About Obese People (BAOP) scale. subgroups. Stable weight was used as reference category.
Results: One-hundred and twenty physicians in training (56.7% Results: In 111767 patients risk of death increased with WL.
female), 52 faculty staffs (45.1%female), and 129 nurses (98.4% After adjustment for gender, disease severity (PANDORA score)
female) were included in the study. Mean age was 28.5 ± 1.5, and surgical treatment, risk of death remained significantly
45.2 ± 8.0, and 30.6 ± 9.7 years; mean BMI was 21.5 ± 3.5, higher compared to weight-stable for class 2 and 3 WL. Absolute
23.2 ± 2.8, and 21.6 ± 4.0 kg/m2, respectively. Physicians in risk of death and relative increments through increasing WL
training had significantly more negative attitudes toward obese categories were comparable in non-obese and obese
patients as compared with faculty staffs and nurses, as individuals.
determined by lower ATOP scores and higher F-scale (ATOP
scores 68.9 ± 14.4 vs. 72.4 ± 13.0 vs. 73.2 ± 13.1, p = 0.041; F- Weight loss in last 3 HR + CI for BMI<=30 HR + CI for BMI > 30
scale 3.7 ± 0.4 vs. 3.3 ± 0.3 vs. 3.1 ± 0.4, p < 0.001). Compared months
with women, men had more negative attitudes as shown by Gained 0.89 [0.69,1.13] 1.06 [0.74,1.52]
significantly higher F-scale (3.5 ± 0.5 vs. 3.3 ± 0.5, p < 0.001) 2.5–6.6% lost 1.07 [0.93, 1.24] 0.99 [0.68,1.44]
6.6–12.6% lost 1.49 [1.31,1.70] 1.25 [0.88,1.78]
and ATOP scores which tended to be lower (69.2 ± 14.5 vs.
>12.6% lost 1.65 [1.46,1.86] 1.48 [1.06,2.07]
72.3 ± 13.4, p = 0.09). ATOP scores and F-scale did not
significantly correlate with age or BMI. BAOP scores tended to
be higher among physicians in training compared with faculty Conclusion: In the ESPEN nutritionDay cohort, stepwise
staffs and nurses (18.2 ± 5.4 vs. 17.4 ± 4.4 vs. 16.7 ± 5.3, increments in recent weight loss independently enhance 30-
p = 0.09), indicating stronger belief that obesity occurred due day mortality. Weight loss similarly enhances mortality in non-
to biological factors rather than patient’s lack of self control. obese and obese individuals. Obesity has therefore no
Conclusion: Weight bias was prevalent among Thai HCPs protective impact against weight loss-associated mortality in
practicing in internal medicine. Development of interventions hospitalized patients.
to decrease weight bias may be targeted towards physicians in
training and male HCPs.
MON-P256
THE ASSOCIATION BETWEEN BODY MASS INDEX AND
MON-P255
MOBILITY: AN ANALYSIS OF PATIENTS FROM THE
A NEGATIVE IMPACT OF RECENT WEIGHT LOSS ON RISK OF
NUTRITIONDAY HOSPITAL COHORT
DEATH IS NOT MODIFIED BY OBESITY IN HOSPITALIZED
PATIENTS – EVIDENCE FROM THE NUTRITIONDAY DATABASE R. Woerdenbach1 *, I. Sulz2, S. Kosak3, S. C. Bischoff4,
K. Schindler5, M. Hiesmayr3, R. Barazzoni6,7. 1Vrije University
R. Barazzoni1 *, I. Sulz2, K. Schindler3, S. C. Bischoff4, P. Bauer2,
Amsterdam, Amsterdam, Netherlands, 2Section for Medical
M. Hiesmayr5, on behalf of nutrition Day Research Group. 1Dept
Statistics, Center for Medical Statistics, Informatics and
of Medical, Surgical and Health Sciences, University of Trieste,
Intelligent Systems, 3Department of Anaesthesiology, General
Trieste, Italy, 2Section for Medical Statistics, Center for
Intensive Care and Pain Control, Division Cardiac -, Thoracic -,
Medical Statistics, Informatics and Intelligent Systems,
Vascular Anaesthesia and Intensive Care, Medical University
Medical University Vienna, 3BMGF, BMGF, Vienna, Austria,
4 Vienna, Vienna, Austria, 4Department of Nutritional
Department of Nutritional Medicine/Prevention, University
Medicine/Prevention, University of Hohenheim, Stuttgart,
of Hohenheim, Stuttgart, Germany, 5Department of
Germany, 5BMGF, BMGF, Vienna, Austria, 6Medical, Surgical and
Health Sciences, 7Dept of Medical, Surgical and Health
Sciences, University of Trieste, Trieste, Italy
Rationale: Evidence has shown that increased mobility is

related to better outcome. In addition, being obese in
hospitalised patients may reduce the risk of death associated socioeconomic status. ‘Restriction’ subfactor was highest in the
with several diseases. It is not clear whether this ‘obesity underweight BMI group and the lowest in the overweight BMI
paradox’, or on the other hand having a low BMI, in hospitalised group of children. ‘Pressure’ subfactor was the lowest in obese
patients are associated with differences in mobility. children and the highest in underweight children. ‘Monitoring’
Methods: Cross-sectional data from the nutritionDay database subfactor was the lowest in overweight children and the highest
of hospitalized patients was used. Patients with missing data on in underweight children.
BMI and mobility were excluded. Four BMI groups following the Conclusion: It is important to understand how parental
WHO classification were analysed in relation to three mobility concern about child weight affects parents’ and children’s
categories (can walk alone, can walk with assistance and stay in behaviors, parents’ involvement in obesity prevention inter-
bed). A Chi-square test with its associated p-value was used to ventions and, ultimately, children’s weight outcomes.
determine whether an association existed. Disclosure of Interest: None declared.
Results: The total hospital study population consisted of
128.471 patients. There was a significant association between
MON-P258
BMI and mobility: e.g. only 54.5% in the low BMI group (<18.5)
MAY TRIGLYCERIDE GLUCOSE INDEX AND TRIGLYCERIDE TO
could walk alone, whereas 65.6% in the highest BMI group
HDL RATIO BE AN INDICATOR FOR INSULIN RESISTANCE?
(>30.0) were able to walk alone (chi-square test in the 5 times 3
table of BMI groups versus mobility p < 0.0001; lowest and S. Ünal1 *, N. Ülger Öztürk2, H. Çabuk Güllüoğlu3,
highest groups shown in Table). E. Bellikci Koyu2, G. Kaner2. 1Nutrition and Diet Clinic,
Gaziemir Nevvar Salih İsgoren State Hospital, 2Faculty of
Table: Health Sciences, Department of Nutrition and Dietetics,
BMI Can walk Can walk with Stay in bed İzmir Katip Çelebi University, 3Department of Internal
alone assistance Medicine, Gaziemir Nevvar Salih İsgören State Hospital, İzmir,
<18.5 5149 (54.5%) 2682 (28.4%) 1624 (17.2%) Turkey
>30.0 16373 (65.6%) 6360 (25.5%) 2242 (9.0%)
Rationale: Triglyceride elevation in serum and tissue is
Conclusion: There is a clear relationship between BMI and related to decreased insulin sensitivity. We aimed to determine
mobility in this hospital population. In particular, very low BMI the relationship between homeostatic model assessment of
is associated with decreased mobility. insulin resistance (HOMA-IR) and plasma levels of TG and HDL
cholesterol (TG/HDL-C) as well as TG and glucose index (TyG).
Methods: A total of 183 women diagnosed with IR who applied
to diet clinic were included in this study. Weight, height, waist
MON-P257 and hip circumference was measured, body mass index (BMI),
DO ATTITUDES AND BEHAVIOURS OF THE PARENTS AFFECT ON waist to hip and waist to height ratio was calculated. TyG index,
BODY MASS INDEX IN ELEMANTARY SCHOOL CHILDREN? calculated as Ln (TG [mg/dL] × glucose [mg/dL]/2), and the
S. Erdem1 *, S. Yılmaz Işıkhan2, H. Gokmen Ozel1. 1Nutrition TG/HDL-C ratio was evaluated.
and Dietetics, Faculty of Health Sciences, 2Biostatistics Results: Mean age of women were 38.9 ± 10.66 years. A
Department, Faculty of Medicine, Hacettepe University, majority of women (72.1%) were obese and nearly all of the
Ankara, Turkey women’s (93.4%) waist circumference was higher than 88 cm. In
addition, more than half of the women’s (58.5%) waist to height
Rationale: Parents are key partners in efforts to prevent
ratio were higher than 0.6. A positive significant correlation
childhood overweight and obesity and may effect on child’s
was found between HOMA-IR and TyG index (r = 0.184, p =
meal choices, energy intake, feeling of hunger, satiety and
0.013) as well as TG/HDL-C (r = 0.158, p = 0.033).
body weight. The aim of this study was to investigate
Conclusion: Our study results suggest that TyG index and TG/
parental beliefs, attitudes and practices in elementary school
HDL-C may be useful for screening IR in women.
children.
Methods: A total of 632 (299 boys, 333 girls) children, aged Disclosure of Interest: None declared.
between 6 and 10 years and their parents aged 23–56 years (191
men, 441 woman) from different socioeconomic status were MON-P259
included. Child Feeding Questionnaire (CFQ) was used to INTEREST OF PROFILING THE GUT MICROBIOTA TO EVALUATE
measure parental beliefs, attitudes and practices in relation THE EFFECT OF DIETARY INULIN ON OBESITY-RELATED
to child feeding. CFQ classified their child’s weight on a 5-point METABOLIC DISORDERS IN HUMANS: THE FOOD4GUT
Likert scale. In this study all subfactors were administrated INTERVENTION STUDY
including, ‘perceived feeding responsibility’, ‘concerns about S. Hiel1 *, J. Rodriguez1, M. Gianfrancesco2, D. Portheault3,
child overweight’, ‘perceived parental weight’, ‘perceived G. Kalala4, A. Neyrinck1, B. Pachikian1, S. Potgëns1, L. Bindels1,
child weight’, ‘concern for child’, ‘restriction’, ‘pressure J. Bindelle4, N. Paquot2, M. Cnop3, J.-P. Thissen5, N. Delzenne1.
to eat’ and ‘monitoring’. Body weight and height were 1
LDRI, Metabolism and Nutrition Research Group, Université
measured. BMI were calculated and classified using WHO Catholique de Louvain, Brussels, 2Laboratoire de Diabétologie,
2007 Standards. Nutrition et Maladies Métaboliques, Université de Liège,
Results: ‘Perceived responsibility’ was the highest subfactor in Liège, 3ULB Center for Diabetes Research, Division of
boys of the parents among different socioeconomic status. Endocrinology, Université Libre de Bruxelles, Brussels,
Similarly ‘Perceived responsibility’ was the highest in girls of
the parents among low and high socioeconomic status and
‘monitoring’ was the highest in girls of the parents in median
S274 Poster
4
Precision LIvestock and Nutrition Unit, Gembloux Agro-Bio had higher total HEI-2005 score (63.02 ± 5.2, p < 0.05) and
Tech, Gembloux, 5Pole of Endocrinology, Diabetology and higher whole fruit, higher whole grain, higher milk and higher
Nutrition, Université Catholique de Louvain, Brussels, Belgium meat and bean scores. MHO had less mins/day in sitting time
(531.5 ± 91.6, p < 0.05) compared with MUO. No significant
Rationale: In the context of increased obesity rates in Europe, differences were observed between MHO and MUO for total PA
we launched the multidisciplinary project FOOD4GUT (funded scores and health related quality of life components.
by the Excellence Program of the Walloon Region, Belgium) Conclusion: Compared to MUO, MHO demonstrate healthier
which proposes an innovative nutritional approach – food and lifestyle habits with healthier dietary quality and less sitting
supplement intervention to increase inulin prebiotic intake – to time. But physical activity scores and HRQoL scores do not
control obesity and related metabolic disorders. We aim to support account for the absence of cardiometabolic abnormal-
examine whether a shift in the gut microbiota composition by ities in MHO. Future studies are needed to replicate this
prebiotic improves the obese phenotype. findings with larger samples with men and women.
Methods: Placebo-controlled parallel study including 150
obese subjects (BMI > 30 kg · m−2; 18–65 years, recruited in
three university hospitals in Belgium), with at least one of the
following criteria: ( pre-)diabetes, hypertension, dyslipidemia, MON-P261
and/or liver steatosis. The participants were randomly assigned EFFECTS OF A SIX WEEK INTERVENTION WITH NOVEL ΒETA-
to receive either 16 g/day of inulin (fibruline, Cosucra) or GLUCAN-ENRICHED OATCAKES ON BODY COMPOSITION IN
placebo (maltodextrin, Cargill) with dietary advice to increase OVERWEIGHT AND OBESE INDIVIDUALS: A PILOT STUDY
or not the consumption of vegetables rich in inulin type S. M. M. Zaremba1 *, I. F. Gow1, J. T. Mccluskey1,
fructans intake for 3 months. G. J. Mcdougall2, S. Drummond1. 1Dietetics, Nutrition and
Results: Recipes containing high amounts (around 15 g/day) of Biological Sciences, Queen Margaret University, Edinburgh,
2
inulin were validated prior the start of the trial. So far, 31 Environmental and Biochemical Sciences Group, James
patients were recruited in the St-Luc-UCL Hospital (age Hutton Institute, Dundee, United Kingdom
51 ± 1.9; BMI 34.9 ± 0.8 kg/m2). The gut microbiota analysis
before the intervention revealed that patients exhibiting a Rationale: EFSA claim that consuming ≥3 g β-glucan (BG) /day
higher level of Bifidobacterium and Faecalibacterium, are lowers cholesterol and blood glucose responses1, yet evidence
associated with a low level of Lactobacillus, Blautia and is inconclusive with regards to the effectiveness of BG
Akkermansia muciniphila. Some bacteria such as Bilophila are consumption on weight reduction and body composition. The
not discriminant. purpose of this study was to assess the impact of daily
Conclusion: The first outcome data will be collected in May consumption of a novel oatcake (containing 4.46 g BG) on
2017, including blood parameters, anthropometric measure- body composition in overweight/obese adults.
ments, fibroscan and abdominal CT-scan. We expect differen- Methods: Twenty-one eligible overweight subjects were
tial biological response to the dietary intervention in view of randomly assigned to the study group (n = 13; BG oatcakes
the patient’s initial microbial profile. The results will be daily for 6 wks, 228 kcal/day) or control group (n = 8;
presented for the first time in the ESPEN congress in Krackawheat® Crackers daily for 6 wks, 221 kcal/day). Both
September 2017. groups were encouraged to maintain their habitual diet and
physical exercise routine throughout the study. Anthropometric
measurements of height, weight, waist circumference (WC),
sagittal abdominal diameter (SAD) and body fat (%BF) were
MON-P260 assessed. Body composition was determined using dual
DIET QUALITY AND LIFESTYLE BEHAVIORS IN METABOLICALLY frequency bioelectrical impedance analysis.
HEALTHY AND UNHEALTHY OVERWEIGHT AND OBESE WOMEN Results: Groups did not differ significantly at baseline (BL) for
S. Öteleş1 *, P. Özekşi2, P. Bilgiç1. 1Nutrition and Dietetic, all parameters measured ( p > 0.05). There were no changes
2
Medicine, Hacettepe University, Ankara, Turkey between groups in anthropometric measurements at BL, post
intervention ( p > 0.05) or within groups ( p > 0.05). Intervention
Rationale: The aim of this study is to determine whether diet, snacks were well tolerated with only one minor SE reported
physical activity, sitting time and health related quality of life (bloating, n = 2).
differ between metabolically healthy overweight/obese (MHO)
Control (5F:3M) Intervention (11F:2M)
and metabolically unhealthy overweight/obese (MUO).
Methods: Fifty overweight/obese (BMI ≥ 25 kg/m2) premeno- BL Post BL Post
pausal women 19–50 years were classified by cardiometabolic mean SD mean SD mean SD mean SD
risk factors, including elevated blood pressure, triglyceride,
Weight (kg) 88.6 13.0 88.8 13.3 86.6 19.7 87.1 20.6
glucose, low high density lipoprotein, and insulin resistance BMI(kg/m2) 29.9 3.6 30.0 3.8 29.9 4.2 30.0 4.5
(MUO ≥ 2; MHO, <2). Healthy Eating Index 2005 (HEI-2005) WC (cm) 99.7 9.9 98.3 8.1 96.3 11.6 96.3 11.6
scores were calculated from 24-hour recall data (two days). SAD (cm) 26.9 2.3 27.3 2.7 25.9 3.5 25.9 3.5
%BF 34.1 9.6 34.2 9.3 36.3 5.1 36.1 5.0
Physical activity scores and sitting time were determined using
International Physical Activity Questionnaire- Short Form.
Health-related quality of life (HRQoL) was measured using Conclusion: This 6 wk pilot trial showed that consumption of
the Short Form 36- item questionnaire (SF-36). 4.46 g/day oat BG-enriched oatcakes had no effect on
Results: Women were 33.7 ± 10.7 years with a mean of BMI anthropometric indices associated with obesity in
30.3 ± 2.6, and %52 were MHO (n = 26). Compared to MUO, MHO
overweight/obese individuals. A larger sample size may be MON-P263

required to detect changes in such variable anthropometric INCREASED AWARENESS OF OBESITY IS RELATED WITH
measures. DECREASED METABOLIC SYNDROME RISK IN OBESE CHILDREN
Reference Y. Ertaş1 *, R. Bozbulut2, E. Köksal1. 1Nutrition and Dietetics,
2
1. EFSA Journal 2009;7(9):1254. Faculty of Medicine, GAZI University, Ankara, Turkey
Disclosure of Interest: S. Zaremba Other: Nairn’s Oatcakes Ltd., Rationale: The prevalence of metabolic syndrome (MetS) is
Edinburgh, manufactured β-glucan-enriched oatcakes and has given increasing in parallel with the increasing of obesity in
financial support towards analytical costs for SZ’s PhD study., I. Gow:
childhood. Increased knowledge about obesity in children
None declared, J. McCluskey: None declared, G. McDougall: None
declared, S. Drummond: None declared.
may reduce the risk of having MetS. Assessment of obesity
awareness and diet quality of obese children according to MetS
groups were aimed in this study.
MON-P262
Methods: This study was consist of totally 236 children (119
ACUTE EFFECTS OF DIFFERENTLY COMPOSED MEALS ON
male and 117 female) aged 10–14 years. Anthropometric
POSTPRANDIAL METABOLISM IN OLDER ADULTS WITH A CVD
measurements (body weight (kg), height (cm), waist circum-
RISK PHENOTYPE
ference (cm)) and biochemical parameters (glucose, insulin,
Y. B. Schönknecht1 *, S. Crommen1, B. Stoffel-Wagner2, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol
M. Coenen3, R. Fimmers4, P. Stehle1, S. Egert1. 1Department of (HDL-C) and triglyceride) of the children were taken.
Nutrition and Food Sciences, University of Bonn, 2Institute of Diagnosis of metabolic syndrome (MetS) were done according
Clinical Chemistry and Clinical Pharmacology, 3Study Centre, to The International Diabetes Federation (IDF) consensus
Institute of Clinical Chemistry and Clinical Pharmacology, definition. Having MetS was demonstrated as MetS (+) and not
4
Institute of Medical Biometry, University Hospital Bonn, Bonn, having was MetS (-). Obesity knowledge of children were
Germany assessed with ‘Obesity Awareness (OBA) Scale’ and diet quality
were evaluated via ‘Adapted Healthy Lifestyle-Diet Index for
Rationale: The postprandial situation is characterized by Turkey (HLD-TR)’.
lipaemia, glycaemia/insulinaemia and associated events such Results: Median ± IQR values of age were 14.0 ± 1.25 and
as oxidative stress and inflammation. Repeated overshoot of 12.0 ± 2.00 years for MetS (+) and MetS (−) respectively.
this ‘stress-like’ postprandial response may lead to low-grade Having MetS was higher in male gender (58.1%) than female
chronic inflammation, especially in individuals with an already gender. Higher median OBA index scores and HLD-TR index
existing metabolic syndrome. We hypothesize that the magni- scores were found in Met (−) group ( p < 0.001). As the OBA index
tude and duration of the postprandial response depend on the scores increased HLD-TR index scores (r = 0.265, p < 0.001),
meal composition. HDL-C levels (r = 0.205, p = 0.002) increased and body weight
Methods: In a randomized crossover design 60 subjects with (r = −0.191, p < 0.001), waist circumference (r = −0.238, p <
metabolic syndrome traits and mean age 70 ± 5 y consumed 0.001) and glucose levels (r = −0.221, p = 0.001) decreased.
three differently composed iso-energetic (4300 kJ) meals: a Conclusion: Increased obesity awareness were related with
Western diet high fat (WDHF), a Western diet high carbohydrate decreased MetS occurrence and associated health outcomes.
(WDHC), and a Mediterranean diet (MED; rich in oleic acid and Furthermore, diet quality were positively associated with
antioxidants) meal. Blood samples were collected at fasting increased obesity knowledge suggested that obesity awareness
and 1, 2, 3, 4, and 5 h postprandial and analysed for parameters have impact for healthy nutritional behaviors in obese children.
of glucose and lipid metabolism and plasma interleukin-6. Data
were analysed by linear mixed models.
Results: MED and WDHF meal showed lower glycaemic response
(incremental AUC (iAUC): MED = 244 min*mmol/l, WDHF = 177 MON-P264
min*mmol/l vs. WDHC = 293 min*mmol/l) and insulinaemic TOTAL SERUM ANTIOXIDANT CAPACITY IN HEALTHY NORMAL
response (iAUC: MED = 86108 min*pmol/l, WDHF = 63555 WEIGHT AND ASYMPTOMATIC OVERWEIGHT ADULTS
min*pmol/l vs. WDHC = 108735 min*pmol/l) than WDHC meal. Z. Jenko Pražnikar1 *, A. Petelin1, M. Stubelj1. 1Dietetics,
Magnitude of serum triglyceride increase was lowest in the University of Primorska Faculty of Health Sciences, Izola,
WDHC meal (iAUC: 175 min*mmol/l) compared with MED (iAUC: Slovenia
184 min*mmol/l) and WDHF meal (iAUC: 243 min*mmol/l).
Insulin and triglycerides remained elevated after 5 h inde- Rationale: Obesity and overweight are major contributors to
pendent of meal composition. Plasma interleukin-6 signifi- the burden of chronic disease. Both are defined as abnormal or
cantly increased postprandial without significant differences excessive fat accumulation and by increased production of free
between meals. radicals leading to oxidative stress. The aim of the present
Conclusion: In line with our hypothesis, magnitude of the study was to evaluate whether overweight and fat accumula-
postprandial response depends on the meal composition. A tion is associated with serum total antioxidant capacity (TAC) in
Mediterranean-like diet rich in unsaturated fatty acids and men and women, irrespective of nutritional habits, nutrient
antioxidative compounds may diminish the risk for the intakes, physical activity, smoking, and other confounders,
development of low-grade inflammation. which may be responsible for modifying the association
between serum TAC and overweight/obesity measures.
Methods: This cross-sectional study was conducted on 60
normal weight and 60 overweight adults aged 25–49. All
participants underwent standard anthromorphological
S276 Poster
measurements of body composition, blood pressure and malnutrition. PhA and PM were significantly lower in the high
biochemical measurements, aerobic capabilities assessment malnutrition risk patients than in the medium risk ones. A
and dietary intake evaluation. TAC was measured by using the nutritional assessment is mandatory in these patients to
photochemioluminescence method. All data were analysed ameliorate care.
with SPSS software. References
Results: Men had higher values of TAC than women and
1. Rogers PC. Importance of nutrition in pediatric oncology. Indian J
concentrations of TAC were significantly higher in overweight
Cancer 2015;52:176–8.
subjects compared to normal weight subjects. In the present 2. ESPEN Blue Book. Basics Clin Nutr-Fourth Ed 2011.
study TAC tended to be increased by various metabolic risk
factors, especially overweight/obesity parameters (body mass
index, body fat), inflammation and increased serum levels of
Cysteine, irrespective of nutritional habits, nutrient intakes, MON-P266
physical activity and smoking. SERUM IGF-1 LEVEL AND NUTRITIONAL ASSESSMENT IN
Conclusion: Overweight and obesity at an early stage may CHILDREN WITH SHORT BOWEL SYNDROME
stimulate TAC. Therefore, the elevation of TAC in overweight M. Chiba1 *, A. Toki1. 1Nutrition Support Team, Showa
adults may be a compensatory response to oxidative stress, University Hospital, Tokyo, Japan
generated by reactive oxygen species.
Rationale: Nutritional status is a key factor in the regulation of
pediatric linear growth. Measurement of the serum concentra-
tion of insulin-like growth factor-I (IGF-l) is generally used as a
screening investigation for short stature children. Moreover,
Paediatrics 2 IGF-I concentration is sensitive to alterations in the nutritional
MON-P265 state. Short bowel syndrome is a group of problems related to
PREVALENCE OF MALNUTRITION AMONG CHILDREN AND poor absorption of nutrients. However, there is no easy way to
ADOLESCENTS IN AN ONCOLOGY PEDIATRIC UNIT: measure absorption capacity. The aim of this study is to
PRELIMINARY RESULTS determine the serum levels of IGF-1 in children with short
bowel syndrome and their correlations with growth.
M. Cintoni1 *, E. Rinninella1, S. Triarico2, A. Ruggiero2, Methods: A retrospective chart review was performed on 6
P. Maurizi2, G. Attinà2, S. Mastrangelo2, R. Riccardi2, L. Basso1, patients. The correlations of changes in nutritional adminis-
S. Leone1, V. Blasi1, G. A. D. Miggiano1, A. Gasbarrini1, tration status, serum albumin (Alb), transthyretin (TTR) and
M. C. Mele1. 1Clinical Nutrition, Gastroenterology Area, IGF-1 levels, in relation to increased height and weight, were
2
Pediatric Oncology, Fondazione Policlinico ‘A. Gemelli’, analyzed. Since the rate of change in height/weight varies with
Roma, Rome, Italy age, Z-score was calculated. The difference between Z-score at
the time of evaluation and one month before was taken as the
Rationale: Malnutrition in pediatric oncology is a frequent
growth score (Growth Score). Similarly, Z-score was calculated
condition influencing drug tolerability, hospital stay and
for IGF-1.
prognosis [1]. Aim of this study is to evaluate the rate of
Results: Alb and TTR were kept in the normal range, and there
malnutrition in a Pediatric Oncology Unit.
were no correlations with Growth Score. On the other hand,
Methods: Twenty-one patients (children and adolescents)
IGF-1 levels had a significant positive correlation with Growth
admitted, between December 2016 and March 2017 in the
Score. Even when oral and enteral administration was limited,
Pediatric Oncology Division of ‘A. Gemelli’ Hospital in Rome,
increases in IGF-1 levels were recognized with the aid of an
were examined. Data collection included information on
effective nutritional administration such as increased intra-
disease, anthropometry, lab tests and STRONGkids test was
venous nutrition.
used as malnutrition risk score. Multifrequency bioimpedance
Conclusion: The serum IGF-1 levels were useful as one
analysis derived Phase Angle at 50 kHz (PhA) and Prediction
predictor for determining the nutritional dosage in consider-
Marker™ (PM) (ratio between impedance at 200 kHz and at 5
ation of the absorption capacity of the intestinal remnant. We
kHz) were used as surrogate markers of lean body mass [2].
think that in promoting intestinal rehabilitation, IGF-1 levels
Statistical analysis were performed using STATA software. PhA
will be major nutritional evaluation indicators in the future.
was reported as mean ± SD, PM as median (IQR). Differences
between groups were determined using Student’s t test or Disclosure of Interest: None declared.
Wilcoxon rank sum test. P values <0.05 were considered
statistically significant. MON-P267
Results: Eleven girls (52%) and ten boys (48%) were examined. MATERNAL SERUM AND BREAST MILK HORMONES AND
Sixteen (76%) were affected by solid tumors, eight (38%) had a WEIGHT GAIN İN İNFANCY
metastastic disease. Mean overall PhA was 4.28 ± 1.07, median M. Aydin Cil1 *, F. G. Eroglu Samur2, M. A. Gul3. 1Nutrition and
PM was 0.85 (0.81–0.88). According to STRONGkids, fifteen Dietetic, Health Science Faculty, Ataturk University, Erzurum,
(71.4%) were at medium risk and six (28.6%) at high risk of 2
Nutrition and Dietetic, Health Science Faculty, Hacettepe
malnutrition. PhA and PM were significatively worse in the high University, Ankara, 3Medical Biochemistry, Health Science
risk group, respectively 4.62 ± 0.98 vs 3.43 ± 0.33 ( p = 0.01) and Institute, Ataturk University, Erzurum, Turkey
0.84 (0.80–0.85) vs 0.88 (0.86–0.93) ( p = 0.009).
Conclusion: All children and adolescents in the Pediatric Rationale: Leptin and ghrelin are some of hormones that
Oncology Unit of our hospital were at medium or high risk of presence in maternal serum and breast milk are important of
Paediatrics 2 S277
regulation of energy balance. These are adjusting growth and 43.63 ± 2.28%, 14.58 g/dL, 16.80 ± 1.53 Kg/m2 and 120.04 ±
development in neonatal and infant period while regulating 10.78 cm, respectively. When haematological parameters were
energy balance during childhood and adulthood. The aim of this compared according to sex, it was observed that serum
study was to determine the relationship between maternal ferritin was lower in girls than boys, independently of age
serum and breast milk leptin and ghrelin levels and neonatal and BMI. No differences were found in ferritin and iron between
weight gain during 4 months. anaemic and non-anaemic children, and stunting and normal
Methods: The study was conducted with 30 healthy mother and height. BMI was higher in quartile (Q) 3 of serum ferritin than
their breast-fed infants in a prospective longitudinal study. Q2 and Q4, independently of sex and age.
Some anthropometric measurements of infants and biochem- Conclusion: School-age girls living in Andean region of
ical analysis of mothers (maternal serum and breast milk leptin, Chimborazo, Ecuador, have lower ferritin concentration than
ghrelin) were performed by using ELİSA for leptin, RIA for boys. Serum iron and ferritin were independent of nutritional
ghrelin. status of children, but ferritin was associated with BMI.
Results: The weight gain of infants was 2306.7 ± 731.0 g and Disclosure of Interest: None declared.
mean weight was 6770.0 ± 983,0 g. It was found that 1th and 4th
ghrelin levels of maternal serum and breast milk respectively
MON-P269
1973.1 ± 1182.4, 3026.5 ± 1613.7; 1888.4 ± 681.9, 3272.9 ±
FORMA STUDY: USE OF INFANT FORMULAS FOR COW’s MILK
2531.8 pg/mL. 1th and 4th leptin levels of maternal serum
PROTEIN ALLERGY BY SPANISH PAEDIATRICIANS
and breast milk was respectively 9.8 ± 5.9, 1.4 ± 0.4; 10.3 ± 6.8,
1.6 ± 0.9 ng/mL. There was determined negative statistically A. Santamaria-Orleans1, R. DE LA Iglesia-Arnaez1 *,
significant correlation between infants weight gain and A. Canals-Baeza2. 1Scientific Comunication, Laboratorios
maternal serum leptin both 1th and 4th months ( p < 0.05) Ordesa, Sant Boi del Llobregat, 2CS Alicante-Sta Faz, Servicio
while no statistically significant correlation with breast milk Valenciano de Salud, Alicante, Spain
leptin levels ( p > 0.05). First month maternal serum leptin
Rationale: Aim of FORMA study was to analyze clinical practice
levels and 4th month weights of infants had negative correlation
and recommendations regarding infant formulas destined to
( p < 0.05). No statistically significant correlation was found
dietary treatment of CMPA by Spanish paediatricians and in
between maternal serum and breast milk ghrelin levels and
particular, about [Blemil plus FH (BP FH)] (extensively
infants weight and weight gain ( p > 0.05).
hydrolyzed formula) and [Blemil plus arroz hidrolizado (BP
Conclusion: The study demostrated a negative significant
ah] (rice proteins formula).
relation between maternal serum leptin levels and infants
Methods: Clinical practice questionnaires were fulfilled by 98
weight gain. Mother’s hormones levels may effect on growth in
public and private paediatricians, providing retrospective data
infancy. Further studies are required in order to reveal the
of 366 infants with CMPA. Statistical analysis of the results was
relation between maternal serum and breast milk leptin and
performed with the IBM SPSS Statistics 22.0 program.
ghrelin levels and infant weight gain.
Results: Paediatricians estimated that 8.5% of infants attend-
Disclosure of Interest: None declared. ing their practice presented CMPA. Mean (SD) age of CMPA
diagnostic was 3.7 (2.7) months. Main parameters considered
MON-P268 to select formula in each patient were symptoms (8.6/10
ANALYSIS OF SERUM FERRITIN AND IRON CONCENTRATION points), personal experience (8.4 points) and ESPGHAN
ACCORDING TO NUTRITIONAL STATUS AND SEX IN CHILDREN recommendations (8.0 points). Formula of choice for 85.4% of
FROM THE ANDEAN REGION OF ECUADOR paediatricians was extensively hydrolyzed one, followed by
P. Miño1,2, M. Balladares-Saltos1,2, X. Robalino1,2, rice-based one (9.4%). In the 366 cases studied, 52.6% had IgE-
M. Guerendiain1,3 *. 1Metabolism and Nutrition Disorders mediated allergy and 47.4% non-IgE-mediated. Most common
Research Group, 2School of Clinical Laboratory, 3School of symptoms were crying/discomfort (56%), atopic dermatitis
Medicine, National University of Chimborazo, Riobamba, (39%) and diarrhoea (38%). 82.6% of infants took BP FH 1 or 2
Ecuador and 17.4% BP ah 1 or 2 (according to age). Average number of
days to perceive an improvement in symptoms was 10.3, higher
Rationale: Although anaemia is one of the most prevalent for infants >6 months (14.2 vs 9.4, ( p < 0,001) and in non-IgE-
public health problems in childhood and its diagnosis is difficult mediated allergies (11,3 vs 10,8; p = 0,013). Improvement was
in regions above 2500 above sea level, such as Andean considered at least moderate in 89% of cases with digestive
Cordillera, studies in highlands are limited. Thus, the objective symptoms, 80% with crying/discomfort and 60% dermatologic
of this research was to compare haematological parameters and respiratory manifestations.
according to nutritional status and sex in schoolchildren of San Conclusion: Prevalence of CMPA reported by Spanish paedia-
Juan, Chimborazo. tricians was in accordance with published data. Patient
Methods: Forty-one children (8.44 ± 1.69 years, EVANES project symptoms, personal experience and ESPGHAN recommenda-
participants) from San Juan (3240 meters above sea level) were tions were main factors considered for selecting formulas.
recruited. Blood samples were collected, and ferritin, iron, Average time to perceive an improvement was higher in older
haemoglobin and haematocrit concentration were determined. infants (>6 months) and non-IgE-mediated cases.
Weight and height were measured and body mass index [BMI, Disclosure of Interest: A. SANTAMARIA-ORLEANS Other: Laboratorios
weight (Kg)/height (m)2] was calculated. The standard Ordesa employee, R. DE LA IGLESIA-ARNAEZ Other: Laboratorios Ordesa
deviation score of BMI and height were determined. employee, A. CANALS-BAEZA: None declared.
Results: The means of iron, ferritin, haematocrit, haemoglobin,
BMI and height were 79.44 ± 32.89 μdL, 31.83 ± 12.71 ng/dL,
S278 Poster
MON-P270 2012, and started nutritional and dental intervention from the
A META-ANALYSIS OF THE EFFECTIVENESS OF DAILY ENTERAL beginning of the treatment, and compared the outcome before
NUTRITION IN THE MAINTENANCE OF LONG TERM REMISSION and after the team was established.
IN CROHN’s DISEASE Methods: Study design is case-control study. Patients, diag-
S. Ghosal1 *, S. Ghosal2. 1Paediatrics, Royal Stoke University nosed as acute lymphocytic leukemia (ALL) below 18 years of
Hospital, Stoke on Trent, 2Psychology, University of Derby, age were enrolled. The patients admitted from June 2012 to
Derby, United Kingdom October 2014 were classified as Intervention Group (IG). The
patients admitted before June 2012 matched disease severity
Rationale: Maintaining long term remission in Paediatric and age group with IG were classified as Non-intervention
Crohn’s disease without complications remains a challenge. Group (NIG). Change in body weight standard deviation (BW-
Liquid enteral nutrition treatment is safe and effective for SD), and body mass index standard deviation (BMI-SD) during
short term induction of remission, but there are few studies for hospitalization, duration of nil per os (NPO), duration of
its long term use and its application still remains limited. This stomatitis, and duration of analgesic and opioid use for
meta-analysis aims to provide stronger evidence by pooling of stomatitis were compared between NIG and IG.
current data. Results: Numbers of cases of NIG and IG were 14, respectively.
Methods: A search of Medline, Ovid and Cochrane databases Medians of BMI-SD on admission day were 0.05 (NIG) vs −0.31
were carried out (1992–2017) to identify published studies (IG), and medians of BMI-SD on discharge day were 0.63 vs 0.30
looking at the efficacy of Enteral nutrition ( providing 30–50% of (n.s.). Medians of duration of NPO were 2.1 days/year in NIG,
daily calorie intake) for the maintenance of remission in 0.6 days/year in IG (n.s.). Medians of duration of stomatitis
Paediatric Crohn’s disease. The search parameters were were 30.7 days/year, vs 19.7 days/year, and cases with
Crohn’s disease, enteral nutrition, maintenance therapy and stomatitis for more than 10 days/year were 7 vs 2 ( p < 0.05).
children. Statistical analysis was carried out by Chi square test Medians of duration of analgesic use were 23.8 days/year vs 5.0
comparing to placebo for likelihood of clinical response to days/year, and cases of analgesic use for more than 30 days
treatment. were 6 vs 1 ( p < 0.05). Medians of duration of opioid use were
Results: Seven studies met the inclusion criteria; of these 4 4.4 days/year vs 3.6 days/year (n.s.).
were prospective studies, 2 were retrospective studies and Conclusion: Changes of BMI during admission had no difference
there was 1 randomised controlled trial. Study periods ranged between NIG and IG, whereas duration of stomatitis and
from 12–60 months with 327 patients given daily liquid enteral duration of analgesic use has decreased in IG, which con-
nutrition supplements. Out of the 327 there were 245 (75%) tributed improvement of quality of life for the patients.
in remission at 1 year ( p < 0.05 compared to placebo). This Disclosure of Interest: None declared.
compares favourably with 73% (357 of 489 patients) 1 year
remission reported from use of immunomodulators and 61%
MON-P272
with placebo.1
ANALYSIS OF PERIODIC PHYSICAL EXAMINATION STATUS IN
Conclusion: Enteral nutrition is beneficial in maintaining
INFANT FROM A TOWNSHIP HOSPITAL IN POOR REGIONS OF
remission in Crohn’s disease and its efficacy is comparable
YUNNAN PROVINCE
with immunomodulators, but without their side effects.
However, taste/palatability can be a limiting factor. The X. Zheng1 *, J. Chen1, D. Yue2, Y. Fu2. 1Department of Child
limitation of this meta-analysis is due to the small sample Healthcare, Shanghai Children’s Hospital, Shanghai Jiaotong
sizes of the individual studies and their slightly different University, Shanghai, 2Wude Township Hospital, Zhenxiong
parameters. Further studies are needed to directly compare County, Zhaotong, China
enteral nutrition with immunomodulators and biologics.
Rationale: To investigate the periodic physical examination
Reference status in infant from poor areas of Yunnan province, and provide
1. Chande N, et al. Cochrane Database of Systematic Reviews. reference to facilitate the development of grass-root child
2015;10. healthcare.
Disclosure of Interest: None declared. Methods: The follow-up examination informations of infants
born from January 2015 to September 2016 and established
physical examination files in Wude Township Hospital of Yunnan
MON-P271
province were retrospectively analyzed.
EFFECT OF INTERVENTION OF CHILDHOOD CANCER
Results: A total of 237 infants were established physical
NUTRITION PROJECT TEAM FOR ACUTE LYMPHOCYTIC
examination files in Wude Township Hospitalr. Among these
LEUKEMIA
infants, only 34 (14.3%) infants were insisted on follow-up. The
T. Takamasu1,2 *, M. Wada2,3, M. Taguchi2,3, H. Goto4, prevalence of loss to follow-up were 16.0%, 12.7%, 7.6%, 10.1%,
H. Taniguchi5. 1Department of Allergy, 2Nutrition Support 4.6% and 0.4% respectively after they were accepted physical
Team, 3Department of Dietetics, 4Department of Hemato- examination at 1 month old, 3 months old, 6 month old, 8
Oncology/Regenerative Medicine, Kanagawa Children’s months old, 12 month old and 18 month old. And other 81
Medical Center, 5Perioperative Support Center, Saiseikai (34.2%) infants remained uncertainty due to the appointed
Yokohamashi Tobu Hospital, Yokohama, Japan physical examination time didn,t come yet. In addition, anemia
prevalence were 12.1% and 15.2% respectively at 6 month old
Rationale: Nutritional intervention has significant role in the
and 8 month old.
treatment of childhood cancer, however, the effect of
Conclusion: The prevence of periodic physical examination in
nutritional team approaches is not fully investigated. We
infant from the township hospital is low and the anemia at 6
established nutrition project team for childhood cancer in June
months old are not treated effectively. Extensive efforts should Results: In twelve months (February 2016 to February 2017),
be payed to improve the level of child health service and the fasting of 249 patients (41%) was abbreviated, out of a
healthcare systematic management of township hospital and to total of 605 patients who remained fasting for more than 12
strengthen child healthcare consciousness of local people at hours in our institution for surgery. Urology patients would
the same time. remain fasted for 580 hours, with the abbreviation, time
Disclosure of Interest: None declared. dropped to 152 hours (74% reduction). The orthopedics total
time was 733 hours, with the protocol the time was for 200
hours (reduction of 73%). In general surgery patients the total
MON-P273
time was 478 hours, but shortened the fast, were 124 hours
FEEDING PRACTICE IN CHILDREN WITH ACUTE PANCREATITIS
(reduction of 74%). There was reduction in one day of
IN TURKEY
hospitalization of the patients who received the abbreviation
B. Aksoy1, P. Kuyum Töz1, Y. Öztürk1 *. 1Department of Pediatric fasting and especially the patients of the specialties of
Gastroenterology, Dokuz Eylül University, School of Medicine, urology, gynecology and general surgery. As for orthopedics,
Izmir, Turkey we found that patients submitted to fracture surgeries who
received the abbreviation of fasting were three days less than
Rationale: To specify the feeding practice of in children with AP
those who did not participate in this protocol. We found that
in our center.
99% (n = 2) of the patients in the protocol had no hunger and
Methods: The medical records of children with AP were
hunger effects after returning from surgery, and 100% of the
analyzed retrospectively. Data of 46 children were evaluated.
patients did not present postoperative nausea/vomiting. 100%
Age, gender, etiology, laboratory and imaging findings,
said they would do the abbreviation again and would not mind
medications, fasting time duration, parenteral, enteral or
being woken up.
oral nutrition managements, AP related complications and
Conclusion: The abbreviation fasting therefore modifies the
mortality rate were noted.
patient’s perception of the services provided, reduces total
Results: Mean age of children with AP was 9.8 ± 4.6 years. The
fasting and hospitalization time, and avoids symptoms of
most common etiologic factors were idiopathic (%37) and
nausea and vomiting.
systemic diseases, drugs (%32.6). Twenty-eight children (%60.8)
were not fed for 1–27 days. Total parentral nutrition was Reference
applied to 34 children (%74). Tube feeding was used in five Crenshaw J.T. Preoperative fasting: will the evidence ever be put into
children (%10.8). All of the using formulas were standard practice? AmJ Nurs, v. 15, sep 2011.
polymeric formula. At the beginning of the diagnosis 7 children Disclosure of Interest: None declared.
(%15.7) fed orally. L-asparaginase induced severe necrotizing
pancreatitis developed in two children. The complication rate
MON-P275
of AP was %21.7. Mortality rate was %4.3.
IMPACT OF THE NUTRITIONAL STATUS OF HEART
Conclusion: Long-term fasting, high rate of using total
TRANSPLANT PATIENTS BEFORE AND AFTER SURGERY ON THE
parenteral nutrition, low rate of using oral and tube feeding
SURVIVAL RATE
were detected in management of children with AP at our
center. The real necessary to these treatment modalities on D. A. Almutawa1,2, M. N. Al-Muammar1, M. M. A. Abulmeaty1 *,
the basis of the patient’s characteristics should be investi- N. Selimovic3, A. S. Alnafisah4. 1Clinical Nutrition Program,
gated. This may be related to complications and/or mortality Community Health Sciences, King Saud University, 2Cardiology
rate. Clinical Nutrition, King Faisal Specialized Hospital, 3Adult
Cardiology, Heart Center, King Faisal Specialist Hospital,
Department of Nutrition Services, King Faisal Specialized
Hospital, Riyadh, Saudi Arabia
Perioperative care 2 Rationale: Nutritional assessment of the heart transplant

(HTx) candidates may expect transplant outcomes. The aim is
MON-P274 to investigate the malnutrition risk among heart recipients
FASTING ABBREVIATION: A CASE OF SUCCESS before and one-year after transplant and its impact on the
L. F. O. Figliolino1, T. F. Giacometti1, K. C. T. Piza1, survival.
U. R. Fernandes1, S. A. Garnes2 *, A. Bottoni2. 1Hospital Methods: A total of ninety adult heart transplant recipients
Rede DÓr São Luiz Unidade Villa Lobos, 2Funzionali, São (men 77.7%), between 2009 and 2015, from the King Faisal
Paulo, Brazil Specialist Hospital, Riyadh, SA, were studied. The basal
assessment included anthropometric, biochemical, bone
Rationale: The abbreviation fasting brings numerous benefits mineral density (BMD) measurements and the nutritional risk
to patients: accelerate postoperative recovery, ameliorate the index (NRI) calculation. In addition, the postoperative data also
inflammatory response, improve nitrogen and hydroelectrolyte included the mortality analysis. Paired t-test, Cox regression
balance, improve immune response and healing, and decrease and Kaplan-Meier (KM) curves were used.
length of hospital stay. Results: After 1 year, the prevalence of malnutrition risk based
Methods: Offered net diet with carbohydrate and protein up to on the NRI and severe risk (NRI < 83.5) decreased from 60% to
four hours of surgery. Morbid obese, with gastroesophageal 18.51% and 7.78–1.23%, respectively, ( p < 0.001) and males had
disorders and obstructive TGI cancer were excluded from the higher NRI scores ( p < 0.05) than females. Hemoglobin,
process. albumin, prealbumin and cholesterol increased ( p < 0.05).
Vitamin D deficiency decreased (94.19% to 76.37%, p < 0.001).
S280 Poster
Osteopenia at lumbar spine decreased (30.19–28.85%, p < 116.1 ± 29.6 ( p = 0.006), quality of life part from 69.5 ± 14.9
0.05), but increased at femoral neck (24.53–50%, p < 0.001). to 76.6 ± 21.1 ( p = 0.059), self-sufficiency from 17.2 ± 6.3 to
Osteoporosis increased more than double at both sites (3.7– 20.2 ± 5.8 ( p = 0.010), general issues 17.1 ± 4.2 to 19.5 ± 5.2
13.64% and 3.7–7.69%, respectively, p < 0.001). Among all ( p = 0.036)
studied parameters (Table 1), the moderate to severe Conclusion: An improvement in quality of life measured in our
postoperative NRI score (NRI < 97.5) had the shortest survival patients after nutritional intervention is shown. Individually
(HR= 0.82; 95% CI, 0.75–0.89; P < 0.001). each section which valued specific areas were improved,
special the self-sufficiency section
Table 1: Cox regression analysis of some variables.
Parameter Hazard Ratio 95% CI P
Pre-HTx NRI 0.97 0.92–1.02 0.20

Post-HTx NRI 0.82 0.75–0.89 <0.001
MON-P277
BMI 1.54 0–3669.1 0.91 AN OSTOMIZED NUTRITIONAL CONSULTATION FOR HIGH
Lymphocytes 0.98 0.83–1.15 0.78 OUTPUT STOMA AND ITS PHYSIOLOGICAL CONSECUENCES
Total cholesterol 0.79 0.02–31.79 0.91
CONTROL.
M. Moreno Santa Maria1,2, J. J. Arenas Villafranca1,2,
Conclusion: Nutrition risk was highly prevalent among HTx L. Visiedo Rodas1, C. López Rodriguez1, L. Rey Fernández1,
cases. All tested parameters of malnutrition were ameliorated P. Utrilla Navarro2,3, J. Abilés Osinaga1,2 *. 1Pharmacy and
1-year after HTx except BMD. Postoperative NRI was the most Nutrition Department, Hospital Costa del Sol, Marbella,
important predictor of survival as shown in KM curves. 2
Doctoral Programme in Pharmacy, 3Pharmacology
Disclosure of Interest: None declared. Department, University of Granada, Granada, Spain
Rationale: High output stoma (HOS) is an ostomies complica-

MON-P276 tions that involves a large amounts of water and electrolytes
EVALUATION OF QUALITY OF LIFE AFTER NUTRITION losses such as long-term malnutrition. Our Hospital had
CONSULTATION IN OSTOMIZED PATIENTS previously established a HOS detection and management
M. Moreno Santa Maria1,2, J. J. Arenas Villafranca1,2, protocol during admission. The goal of this study is to evaluate
C. López Rodriguez1, M. P. Utrilla Navarro2,3, the impact of a nutrition consultation for ostomized patients
M. I. González Peral4, L. Rey Fernández1, L. Visiedo Rodas1, after discharge taking into account HOS self-control and
J. Abilés Osinaga1,2 *. 1Pharmacy and Nutrition Department, nutritional status monitoring
Hospital Costa del Sol, Marbella, 2Doctoral Programme in Methods: A prospective study was performed. During admis-
Pharmacy, 3Pharmacology Department, University of Granada, sion, HOS detection and management protocol application was
Granada, 4Surgery Department, Hospital Costa del Sol, recorded. At discharge, an analytical study with electrolytes
Marbella, Spain was requested. At 7–10 days (visit1) and a month later (visit2),
the patient visits nutrition consultation for assessment and
Rationale: Ostomized patients must face situations that can diagnosis, HOS ambulatory management education and ana-
heavily affect their quality of life. The goal of the study is lytical control. Demographic parameters, nutritional diagnosis,
evaluate this quality of life after the implementation of a Na, K, Ca, P and Mg levels were recorded at each visit.
nutritional consultation at surgery discharge. Statistical analysis was performed.
Methods: A prospective study was performed. At discharge, the Results: 37 patients were recruited, median 66.9 ± 13.3years,
patient’s weight was recorded and an analytical study was 81% men. 11% patients presented HOS during hospitalization
requested. At 7–10 days (visit1) and a month later (visit2), the (100% ileostomies) and HOS protocol succeeded in all cases.
patient visits nutritionist consultation for assessment and Only two patients reported HOS at Visit2 (100% ileostomies).
diagnosis, diet progression review and output stoma control Visit1 electrolytes records showed 3.2% patients with mild
education. In both visits the quality of life was evaluated using hypokalemia (N = 31), 5.9% mild hypophosphatemia (N = 34),
the Montreux questionnaire, validated in ostomized patients. 5.7% mild hypomagnesaemia (N = 35) and 5.9% mild hypocal-
This questionnaire uses a scale of 1–5 to assess different aspects cemia (N = 34). At Visit2, There were no alterations (N = 26).
and is divided into three sections: Quality of Life, Self- Nutritional diagnosis at Visit1 was 37.8% good nutritional
Sufficiency and General Issues. Descriptive statistical analysis status, 18.9% nutritional risk, 13.5% mild malnutrition*, 27%
was performed. The mean change in qualitative variables was moderate* and 2.7% severe*; at Visit2 was 64.3% good
estimated using Mann-Whitney U test. nutritional status, 32.1% nutritional risk and 3.6 mild malnu-
Results: 37 patients were recruited, median 66.9 ± 13.3 years, trition* (*All protein-calorie).
81% men. The main cause of stoma formation was 73% Conclusion: After the first consultation visit, a significant
colorectal cancer, 2.7% gynecological cancer, 2.7% inflamma- improvement of all nutritional parameters evaluated and in
tory bowel disease, 21.6% benign causes. Nutritional diagnosis electrolytes control was observed. HOS is well controlled by
at Visit1 was 37.8% good nutritional status, 18.9% nutritional patients ambulatory and during admission.
risk, 13.5% mild protein-calorie malnutrition, 27% moderate
and 2.7% severe. At Visit2 was 64.3% good nutritional status,
32.1% nutritional risk and 3.6 mild protein-calorie malnutri-
tion. Only 24 patiens complete questionnaire in both visits. The
overall score increased between visits from 102.4 ± 21.5 to
MON-P278 outcomes. Whether these EBG are adhered to in usual clinical

MAY HIGH COMPLEXITY SURGERY, IN GYNECOLOGICAL practice remains unknown. The aim of this study was to identify
ONCOLOGY PATIENTS, WORSEN NUTRITIONAL STATUS the time to commencement of first oral feed (liquid or solid)
DURING HOSPITAL STAY? A CROSS-SECTIONAL STUDY IN AN and first solid feed among postoperative, non-critically ill,
ITALIAN UNIVERSITY HOSPITAL adult patients.
M. Cintoni1 *, E. Rinninella1, A. Fagotti2, L. Basso1, S. Leone1, Methods: MEDLINE, CINAHL, SCOPUS and Web of Science
V. Blasi1, G. Scambia2, G. A. D. Miggiano1, A. Gasbarrini1, databases were searched from inception to June 2016 for
M. C. Mele1. 1Clinical Nutrition, Gastroenterology Area, observational studies reporting liquid and/or solid feeding
2
Gynecological Oncology, Fondazione Policlinico ‘A. Gemelli’, practices among postoperative patients. Studies reporting a
Roma, Rome, Italy mean/median time to first feed or first solid feed within 24
hours of surgery or where ≥75% of patients were feeding by
Rationale: Malnutrition in gynecological oncology affects postoperative day one were deemed in-line with EBG.
between 20 and 53% of patients at diagnosis [1]. Aim of this Results: Of 5826 articles retrieved, 29 studies were included.
study is to evaluate if high complexity surgery may worsen this Only 40% and 22% of studies reported time to first feed and time
condition during hospital stay. to first solid feed in-line with EBG, respectively. Clear and free
Methods: Three hundred and nineteen oncological patients, liquids were the first diet types commenced in 86% of studies.
consecutively admitted between December 2016 and March When solids were commenced, 44% of studies reported using
2017 to the Gynecologic Oncology Division of ‘A. Gemelli’ various therapeutic diet types (e.g. light) prior to the
Hospital, were enrolled. Medical history, anthropometry, BIA commencement of a regular diet. Patients that underwent
derived Phase Angle (PhA) and lab tests were collected at gastrointestinal procedures appeared more likely to experience
admission and at discharge. Patients were divided into two delayed postoperative feeding.
broad categories: high complexity surgery (HCS) (40 patients Conclusion: Our findings demonstrate a gap between post-
12.6%), when resections of other abdominal organs (besides operative feeding evidence and its practical application. This
uterus and ovaries) and/or extended lymphadenectomy and/or information provides a strong rationale for interventions
peritonectomy were performed and standard gynecological targeting improved nutritional care following surgery.
surgery when they were not (SGS) (277 patients 87.3%). Disclosure of Interest: None declared.
Statistical analysis was performed with STATA. Data were
presented as mean ± SD, median (IQR) or number ( percentage).
MON-P280
Differences between groups were determined with Student’s t
DIFFERENT LIPID PROFILE IN PATIENTS WITH OR WITHOUT
test, Wilcoxon rank sum or signed-rank test. P values <0.05
EPIDURAL
were considered significant.
Results: Overall PhA was different between admission 5.3 (4.8– N. D. Vukovic1 *, D. Jovanovic2. 1Center for Anaesthesiology and
5.7) and discharge 4.8 (4.0–5.4), p < 0.001. Dividing the Reanimation, Clinical Center Nish, Nish, 2Center for
population according to surgery complexity, PhA decrease was Anaesthesiology and Resuscitation, Clinical Center
found only in those patients who underwent HCS [HCS: 5.1 (4.6– Kragujevac, Kragujevac, Serbia
5.6) vs 4.3 (3.6–4.9), p < 0.001; SGS: 5.3 (5.0–5.8) vs 5.1 (4.7–
Rationale: Surgery and pain lead to a sympathetic activation
6.0), p = ns] and LOS was also higher in this group [2.8 ± 2.4 days
with various metabolic responses. The aim of this study was to
vs 8.5 ± 6.8 days, p < 0.001].
compare the metabolic effects of general versus combined
Conclusion: HCS worsens nutritional status from admission to
general and epidural anaesthesia on plasma concentration of
discharge and increases LOS in our hospital setting. Patients
cholesterol, lipoproteins and triglycerides in surgery patients.
who undergo HCS should be considered for perioperative
Methods: This was retrospective observational study that
nutritional support during hospital stay.
investigated plasma concentration of cholesterol, lipoproteins
Reference and triglycerides preoperatively and on the third and fifth day
1. Obermair A, et al. Nutrition interventions in patients with after Mainz Pouch cystectomy. Patients were randomly assigned
gynecological cancers requiring surgery. Gynecol Oncol to receive either general anaesthesia or combined general and
2017;145:192–9. epidural anaesthesia. Primary outcome of study was occur-
Disclosure of Interest: None declared. rence of postoperative surgical wound complications.
Statistical analysis was performed using Student`s t-test and
Mann-Whitney test, were probability of P < 0.05 was considered
MON-P279
to be significant.
ARE POSTOPERATIVE FEEDING PRACTICES IN-LINE WITH
Results: Among 60 patients, 35 patients had general and 25 had
EVIDENCE-BASED GUIDELINES: A SYSTEMATIC REVIEW
combined general and epidural anaesthesia. The average age
M. Rattray1 *, S. Roberts2, A. Marshall3, B. Desbrow1. 1School of was 62.7 ± 7.9 years and mean body mass index 24.2 ± 3.2 kg/m2.
Allied Health Sciences, 2Menzies Health Institute Queensland, There was no statistical difference in perioperative concen-
3
School of Nursing and Midwifery, Griffith Unversity, Gold tration of measured parameters. There was statistical differ-
Coast, Australia ence on the third postoperative day between patients in group
that had epidural, were patients with wound complications had
Rationale: Early oral feeding after surgery is best practice
lower values of cholesterol, high density lipoprotein and low
among adult, non-critically ill patients. Evidenced-based
density lipoproteins (P < 0.05). In the same group, triglycerides
guidelines (EBG) recommend commencing liquid and solid
showed higher concentrations in patients with complications
feeding within 24 hours of surgery to improve patient (e.g.
(P < 0.05). High density lipoprotein was also statistically
reduced morbidity) and hospital (e.g. reduced length of stay)
S282 Poster
lower on the fifth postoperative day in the epidural group with MON-P282
wound complications (P < 0.05). EARLY ENTERAL PHARMACONUTRITION IN PREVENTION OF
Conclusion: Patients with epidural anaesthesia with wound POSTOPERATIVE INTESTINAL FAILURE
complications had significantly lower values of cholesterol and R. Yagubyan1 *, M. Petrova2, M. Storchai2, R. Mohan3,
lipoproteins and higher concentrations of triglycerides on the M. Nakade3, M. Sobolev4. 1Anesthesiology and Critical Care,
third postoperative day. Pirogov Russian National Research Medical University,
2
Disclosure of Interest: None declared. Anesthesiology and Critical Care, Rudn University,
3
Anesthesiology and Critical Care, Rudn Univercity,
4
MON-P281 Anesthesiology and Intensive Care, I.M. Sechenov First
EARLY ENTERAL NUTRITION WITHIN 24 HOURS OF LOWER Moscow State Medical University, Moscow, Russian Federation
GASTROINTESTINAL SURGERY VERSUS LATER
COMMENCEMENT – EFFECTS ON HOSPITAL STAY AND Rationale: Intestinal failure (IF) is a frequent complication of
POSTOPERATIVE COMPLICATIONS early postoperative period in abdominal surgery. One of the
main goals during early postoperative period is initiating
G. Herbert1, R. Perry1 *, H. K. Andersen2, C. Atkinson1, adequate enteral nutrition. The aim of study was to evaluate
C. Penfold1, S. Lewis3, A. Ness1, S. Thomas4. 1NIHR Bristol effectiveness of early enteral pharmaconutrition in preventing
Biomedical Research Centre (Nutrition Theme) at the development of IF after emergency abdominal surgery.
University Hospitals Bristol NHS Foundation Trust and the Methods: The study included 35 patients aged 57,5 ± 11,5 y.o.
University of Bristol, Bristol, United Kingdom, 2The Cochrane which had emergency abdominal surgery. These patients were
Collorectal Group, Bispebjerg Hosptial, Building 39N, divided in two groups: group 1 (17 pts.) during 2 days after
Copenhagen, Denmark, Copenhagen, Denmark, 3Dept of surgery received daily 500 ml of enteral pharmaconutrition
Gastroenterology, Level 7, Derriford Hospital, Plymouth, containing 30 g of glutamine and on the 3rd day – standard
4
Head and Neck Surgery, University Hospitals, Bristol NHS enteral nutrition, group 2 (18 pts.) for 2 days received daily
Trust, Bristol, United Kingdom 500 ml of balanced crystalloid solution enterally and on the 3rd
day – standard enteral nutrition. Immediately after surgery and
Rationale: To evaluate whether early commencement of
on day 3 we evaluated severity of IF based on bowel sounds’
postoperative enteral nutrition (within 24 hours) compared to
presence, intra-abdominal pressure (IAP) level and results of
traditional management (no nutritional supply) is associated
ultrasound exam of intestinal wall. Statistical analyses were
with a shorter length of hospital stay (LoHS) and fewer
conducted with IBM SPSS Statistics 21.
complications in patients undergoing lower gastrointestinal
Results: Severity of IF was scored from 1 to 3. Mean score in
surgery (where an anastomosis is formed distal to the ligament
group 1 immediately after surgery was 2,9 ± 0,2, in group 2–
of Treitz).
2,8 ± 0,3 ( p = 0,43). After initial enteral treatment on day 3 in
Methods: We searched five databases and hand-searched
group 1 mean score was 1,8 ± 0,68, in group 2–2,8 ± 0,3
reference lists of identified studies. Two authors extracted
( p < 0,05). Due to the fact that bowel sounds are less accurate
data and assessed study quality. The primary outcome was
and ultrasound exam of intestinal wall is limited in ICU settings
LoHS. The secondary outcomes were: mortality, postoperative
we recommed using dynamic of IAP as a factor of the
complications (wound infections, intraabdominal abscesses,
postoperative IF. On day 3 IAP in group 1 was 13,7 ± 1,35 cmH2O,
anastomotic dehiscence, pneumonia) and adverse events
in group 2–19,3 ± 1,6 cmH2O ( p < 0,05).
(nausea, vomiting). We used random effects models for the
Conclusion: The results allowed us to conclude, that enteral
primary outcome (LoHS) and secondary outcomes when
nutrition should be initiated with pharmaconutrition including
appropriate. Fixed effect models were used if there was only
glutamine to ensure better tolerance. The level of IAP is a
a small number of studies or events were rare.
prognostic factor of the dynamics of postoperative IF and must
Results: Seventeen RCTs were identified. The pooled mean
be used on bedside to determine the tactics of postoperative
difference in LoHS was 1.96 (−3.00 to −0.92, P < 0.001) days
nutritional therapy.
shorter in the intervention group. However, there was a high
level of heterogeneity between studies (Chi2 = 79.35, I2 = 81%, Disclosure of Interest: None declared.
P < 0.00001). There was moderate evidence of a reduction in
mortality with early post-operative feeding (RR = 0.55, 0.27– MON-P283
1.10, P = 0.09). There was also moderate evidence of an CHANGE IN DIETARY INTAKE AND NUTRITIONAL STATUS USING
increase in the relative risk of vomiting among patients fed MEALWORMS AS HOSPITAL MEAL IN POSTOPERATIVE PATIENTS
early (RR = 1.23, 0.96–1.58, P = 0.10) with little heterogeneity H. Kim1, S. Kim1 *, J. Shon1, J. S. Park2, J. Kang2, J. W. Kim3,
(Chi2 = 4.98, I2 = 0%, P = 0.55). There was no evidence of an M. Kim4, J. Hwang4, E. Yun5. 1Dept. of Nutrition and Dietetics,
effect of treatment on the postoperative complications. 2
Dept. of Surgery, Gangnam Severance Hospital, 3Dept. of
Conclusion: There is no obvious advantage in keeping patients Surgery, Chung-ang University Hospital, Seoul, 4Dept. of
‘nil by mouth’ following lower gastrointestinal surgery, so this Agricultural Biology, The National Academy of Agricultural
review continues to support the notion of early commencement Science, Rural Development Administration, Jeonju, 5Dept. of
of enteral feeding. Integrated Bioindustry, Sejong University, Seoul, Republic
Disclosure of Interest: None declared. of Korea
Rationale: The purpose of this study was to investigate the

effect of nutritional status with hospital meal intake using
Mealworms(Insect food) with increased nutrition density. We
provided a meal for postoperative patients and conducted p < 0.01) during perioperative period. Changes of body com-
analysis of dietary intake and nutritional status of patients and position values (BW, FFM, FM, SMI) did not demonstrate
assessment of acceptability of the meal. significant difference by resected organ or approach of surgery.
Methods: This study was carried out as a randomized control Conclusion: Our results demonstrated that during periopera-
trial. Patients were supplied either a hospital meal using tive period, change of body composition were observed mainly
Mealworms (Experimental group) or a regular hospital meal in fat mass not in fat free mass. Body weight loss by decrease of
(Control group). We investigated the administration amounts of fat mass preserving fat free mass was characteristic finding of
parenteral nutrition (PN) and food intake of patients after body composition during perioperative period after gastro-
surgery and measured anthropometry, body composition, and intestinal surgery.
blood tests before surgery and at hospital discharge. Data were Disclosure of Interest: None declared.
analyzed using IBM SSPS Statistic ver 23.0. The 0.05 level of
significance was used for all analyses.
MON-P285
Results: We included 34 postoperative patients who were
NUTRITIONAL AND PREOPERATIVE PROFILE OF THE PATIENT
admitted to Gangnam Severance Hospital from March to
CANDIDATE FOR ELECTIVE COLORECTAL SURGERY IN FELÍCIO
September in 2016. In the groups of patients not supplied
ROCHO HOSPITAL, BELO HORIZONTE – BRAZIL
with PN, the experimental group (964.68 ± 284.6 kcal, 38.82 ±
12.9 g) had significantly higher dietary calorie and protein T. M. Rettore1 *, E. P. Rocha Junior1, S. C. Silvestre1. 1Nutrology,
intake than the control group (666.62 ± 153.7 kcal, Hospital Felício Rocho, Belo Horizonte, Brazil
24.47 ± 4.9 g)(P < 0.05). Additionally in the group of patients
Rationale: Knowing nutritional status and previous pathologic
not supplied with PN, the experimental group (1.37%) showed a
history of patients who are about to undergo surgeries is
significantly higher increase in fat free mass index than the
important so that specific interventions could be taken. These
control group (−3.46%)(P < 0.05). In all subjects, calorie
evidence-based interventions tend to reduce post-operative
density and protein density were significantly higher in the
complications, morbidity and mortality as well as hospital stay
experimental group (P < 0.001), and acceptability of calorie
and hospitalization costs.
(P < 0.05) and protein (P < 0.05) was also significantly higher in
Methods: Cross-sectional study with adult patients, candidates
the experimental group.
to undergo coloproctological surgery in a Hospital in Brazil.
Conclusion: Therefore, the hospital meal using Mealworms
Local ethical committee approved this study before data
(Insect food) may beneficial effect on fat free mass in
collection. 31 patients were analyzed by their base disease,
postoperative patients without PN supplement.
co-morbidities, weigh history, functional status, gastrointes-
Disclosure of Interest: None declared. tinal symptoms and had anthropometric measures, such as BMI,
handgrip strength (HS) and Thickness of the Adductor Pollicis
MON-P284 Muscle (TAPM) collected. Serum albumin (SA) was also
CHANGE OF BODY COMPOSITION DURING PERIOPERATIVE analyzed, such as existence of co-morbidities and lifestyle.
PERIOD OF GASTROINTESTINAL SURGERY. All data were crossed to determine nutritional status,
T. Nagahama1 *. 1Surgery, Kudanzaka Hospital, Tokyo, Japan prevalence of diseases and the use of SA, HS and TAPM to
help in nutritional diagnosis. Statistical analyses were per-
Rationale: Dual Energy X-ray Absorptiometry (DEXA) was formed using descriptive statistics, regression, and t-test.
regarded as one of most objective and quantified method to Results: About 50% of patients were classified as malnourished
evaluate body composition. We have adopted DEXA to estimate before surgery when using Subjective Global Assessment (SGA).
the influence of gastrointestinal surgery on body composition 83,9% were diagnosed with colonic or rectum tumors.
during perioperative period, Spontaneous weight loss was prevalent in 41,9% of patients
Methods: 25 patients of gastrointestinal surgery for malignancy and 22,5% had their functional capacity reduced. Hypertension
received DEXA and body weight measurement before surgery was seen in 51,6% of patients and diabetes in 16,1%. Only one
and 2 months after surgery. By DEXA total weight of fat mass patient was an active smoker. Sedentary lifestyle was 74,1%
(FM), and fat free mass(FFM) were calculated. Skeletal Muscle prevalent. SA, HS and TAPM were not correlated to nutritional
Index(SMI) was calculated by FFM of extremities and heights status diagnosis ( p > 0,05) when compared to SGA.
(FFM of extremities/(heights)2 to evaluate the volume of Conclusion: Undernutrition was highly prevalent in this study
muscle mass. The change of body composition during peri- population and hospital stay was longer in this group. Other
operative period were evaluated. comorbidities and sedentary lifestyle were also prevalent. SA,
Results: The use of DEXA for the assessment of body HS and TAPM were not considered isolated diagnostic methods
composition was examined in 25 patients (15 male and 10 for undernutrition
females, 15 stomach and 10 colons, and 13 open surgery and 12 Disclosure of Interest: None declared.
laparoscopic surgery) ranging in age from 51 to 85 years. During
perioperative period mean FFM (Male pre-41.0, post-40.9,
Female pre-33.0, post-33.0) and mean SMI (Male pre-6.18,
post-6.10, Female pre-5.71, post-5.73) demonstrated no
significant change. Mean body weight demonstrated significant
decrease during perioperative period only in female (Male pre-
58.2, post-56.5: n.s., Female pre-54.3, post-51.4: p < 0.01)
Mean FM demonstrated significant decrease in both sex (Male
pre-14.8, post-13.2: p < 0.01, Female pre-19.6, post-13.7:
S284 Poster
Protein and amino acid metabolism 2 first urea cyclés enzyme. During severe metabolic decompen-
sation of neonatal forms of PA we often reduced hyperammo-
MON-P286 naemia using extracorporal elimination, along with pharmaco –
IS N-CARBAMOYL PUTRESCINE, A CITRULLINE elimination and symptomatic treatment. Now it is possible to
DECARBOXYLATION DERIVATIVE, AN EFFECTOR OF use a carglumic acid – a drug registered for the treatment of
METABOLISM? hyperammonaemia in N-acetylglutamatsyntase deficiency
D. Ramani1,2, S. Nakib1,2, E. Nubret1, H. Chen3, C. Garbay3, (NAGS) and in the organic acidurias.
L. Cynober1,2, J.-P. De Bandt1,2 *. 1EA4466, Université Paris Methods: Carglumic acid is a structural analogue of NAG – a
Descartes, 2Clinical Chemistry Dpt, Hôpital Cochin, APHP, natural activator of the first enzyme of urea cycle. The
3
UMR 8601 CNRS, Université Paris Descartes, Paris, France mechanism of action of carglumic acid is based on the ability
to replace the NAG function and to restore the activity of the
Rationale: Decarboxylation derivatives of ornithine and urea cycle. Recommended dose in acute hyperamonaemia is
arginine (aliphatic polyamines and agmatine respectively) 100–250 mg/kg/day enterally.
have important properties in terms of cell proliferation and Results: The authors describe their experience with the
differentiation. We questioned whether N-carbamoyl putres- carglumic acid in the treatment of acute hyperammonaemia
cine (NCP), the decarboxylation derivative of citrulline, could in patients with PA:
also have significant effects. Our aim was to evaluate the • Two neonates with manifestation of PA during the first week
effects of an oral administration of NCP in the rat either at a of life, with hyperammonaemia above 500 umol/L;
dose equivalent to the dietary intake of polyamines or at a ten- • 7 year old girl suffered by the neonatal form of PA, with
fold higher dose. repeated attacks of severe metabolic acidosis and marked
Methods: Twenty 8-week-old rats received a standard feed elevation of ammonia in blood.
alone (control) or supplemented with NCP at either 5 (NCP5) or They are documented the course of hyperammonaemia,
50 mg/kg/d (NCP50) for 14 days. Weight gain and behavior treatment and clinical course of the disease in these patients.
were monitored. At the end of the feeding period, body Conclusion: Carglumic acid effectively reduces hyperammo-
composition, hepatic and renal function, metabolic status, and naemia and has a low risk of adverse effects. Therefore, it is
plasma and tissue polyamines were evaluated. Statistics: currently recommended its early submission during severe
ANOVA and Fisher’s PLSD test; simple regression analysis. hyperammonaemia – already in the time of differential
Results: NCP did not modify animal behavior, weight gain or diagnosis and to all patients with confirmed organic aciduria
body composition at any dose. Protein content in soleus muscle caused by methabolic disorders of branched amino acids.
(but not in tibialis) was significantly increased in the NCP5
group compared to the control group (Control: 12.7 ± 1.8,
NCP5: 14.5 ± 0.7, NCP50: 14,0 ± 0.8 g/100 g; p < 0.02 NCP5 vs
control). NCP induced a dose-dependent decrease in plasma MON-P288
glutamine and ornithine and a significant increase in plasma EFFECT OF CITRULLINE COMBINED WITH HIGH-INTENSITY
urea in the NCP50 group. Finally, NCP resulted in a dose- INTERVAL TRAINING ON PHYSICAL PERFORMANCE IN OBESE
dependent decrease in spermine in the kidney and tibialis and ELDERLY ADULTS: IS IT SEX-DEPENDENT?
an increase in putrescine in the soleus. M. Dulac1 *, G. El Hajj Boutros2, L. Carvalho3, V. Marcangeli2,
Conclusion: Oral NCP at a dose of 5 mg/kg/d induces an P. Gaudreau4, G. Gouspillou2, J. Morais5, P. Noirez6,
increase in protein content of the soleus, rich in type I fibers, M. Aubertin-Leheudre2. 1Biology, 2Physical Activity Sciences,
but not in tibialis, rich in type II fibers. The role of increased UQAM, Montreal, Canada, 3Federal University of Sao Carlos,
muscle content in putrescine needs to be explored. On the Sao Carlos, Brazil, 4Université de Montreal, 5McGill, Montreal,
other hand, at a 50 mg/kg/d dose, NCP is probably inefficient Canada, 6University Paris Descartes, Paris, France
and this may be related to the observed decrease in glutamine
availability and the increase in amino acid catabolism judged Rationale: With aging, muscle mass (MM) decreases whereas
on urea production. adipose tissue (AT) increases. These changes lead to an
Disclosure of Interest: None declared. increased risk of developing metabolic dysfunctions and
functional decline. High-Intensity Interval Training (HIIT) is a
MON-P287 promising avenue to prevent these phenomena considering its
CARGLUMIC ACID IN THE TREATMENT OF HYPERAMMONAEMIC high effectiveness and short duration. Citrulline supplementa-
CRISIS IN PATIENTS WITH PROPIONIC ACIDURIA – OUR tion (CIT), a non-proteinogenic aminoacid acts on muscle tissue
EXPERIENCES (increasing protein synthesis) and AT (increasing lipolysis) in
both rats and young adults. The aim of this study was to
K. Brennerova1 *, V. Bzduch1, D. Behulova2, A. Hlavata1,
determine the effects of CIT combined with HIIT in obese
M. Skoknova3, L. Podracka4. 1Paediatric Clinic, Medical Faculty
elderly men (M) and women (W).
and University Children’s Hospital, 2Departmant of Laboratory
Methods: Thirty-five inactive elderly and obese participants;
Medicine, University Children’s Hospital, Bratislava, Slovakia,
3 15 M (AT: 31 ± 5%, 70 ± 5 y) and 20 W (AT: 39 ± 10%; 68 ± 5 y),
Neonatal Clinic of Intensive Care Medicine, Medical Faculty
were randomly and double-blindly divided into 2 groups: (1)
and University Children’s Hospital, 4Paediatric Clinic,
HIIT + CIT (n = 19, 6 M/13 W) and (2) HIIT + Placebo (PLA)
Medical Faculty and University Children’s Hospital,
(n = 16, 9 M/7 W). Supplementation: single ingestion of 10 g/
Bratislava, Slovakia
day of CITor PLA. Intervention: 12-week HIIT (elliptical device;
Rationale: Hyperammonaemia in the patients with propionic cycle: 30 sec at 85% and 90 sec at 65% of maximal age-
aciduria (PA) is caused secondary, by the blocking activity of the predicted heart rate; 3 × 30 min/week). Body composition [BC]
(DXA: MM and AT) was measured pre and post-intervention. Disclosure of Interest: N. Tennoune El hafaia: None declared,
p < 0.05 was considered significant. G. Ventura: None declared, S. Le Plénier: None declared, C. Choisy:
Results: At baseline, all groups were comparable in age and BC. None declared, N. Neveux: None declared, L. Cynober Consultant for:
Following the intervention, in M, total ATwas further decreased Nestlé Health Science, J.-P. De Bandt Grant/Research Support from:
Nestlé Health Science, A. Raynaud-Simon: None declared.
in HIIT + CIT(delta% [HIIT + PLA vs. HIIT + CIT]: 0.74 ± 1.29% vs.
−4.88 ± 1.31%; p = 0.018). However, in W, total MM was further
increased in HIIT + CIT. (delta% (HIIT + PLA vs. HIIT + CIT): MON-P290
−0.92 ± 1.22% vs. 0.34 ± 1.15%; p = 0.003). ASSOCIATIONS BETWEEN BRANCHED CHAIN AMINO ACID
Conclusion: The present results suggest more favorable effects INTAKE AND FASTING SERUM LEUCINE IN LEAN AND OBESE
of HIIT when combined with CIT on BC in elderly obese people. N. Mohorko1 *, A. Petelin1, Z. Jenko-Pražnikar1. 1University of
These effects appear to involve different sex-dependent Primorska, Faculty of Health Sciences, Izola, Slovenia
mechanisms of action, which is reflected in M by a decrease
in AT, but in W by an increase in MM. These promising Rationale: It is not clear, whether the increased fasting serum
preliminary results are currently being validated in a larger leucine level (fsLeu), typical of disrupted metabolic state in
cohort. obese, is associated with high Leu and branched-chain amino
acid (BCAA) intake and is direct contributor to insulin
resistance or is merely the consequence and thereby the
marker of the later (Yoon, 2016).
MON-P289 Methods: 96 participants were divided into three groups:
EFFECT OF AGEING ON IMMUNE-ENHANCING DIET (IED) AMINO MetS0: no MetS component, MetS1: one MetS component, and
ACID AVAILABILITY AFTER A SURGICAL STRESS MetS2, two or more MetS components. MetS0 and MetS2
N. Tennoune El hafaia1 *, G. Ventura1, S. Le Plénier1, C. Choisy1, significantly differed in BMI, metabolic health characteristics,
N. Neveux1,2, L. Cynober1,2, J.-P. De Bandt1,2, fitness index and fsLeu, and represented normal and disrupted
A. Raynaud-Simon1,3. 1EA4466, Université Paris Descartes, metabolic state, accordingly. Sera of the participants were
2
Clinical Chemistry Dpt, Hôpital Cochin, APHP, 3Geriatry, analysed for fsLeu and C-reactive protein (CRP). Three-day
Hôpital Bichat, APHP, Paris, France weighted habitual food intake record was analysed, and BCAA
and BCAA source intake data associations with fsLeu within
Rationale: Amino acid (AA) requirements increase after a each group were analysed by Spearman correlation.
surgical stress while systemic AA availability from the diet Results: Leu and BCAA intake significantly positively correlated
decreases with age, owing to splanchnic sequestration (SSAA). with fsLeu in MetS0, but significantly negatively correlated
While IEDs have been recommended for the nutritional with CRP in MetS0. There were no correlations between Leu and
management of surgical patients, the adequacy of their AA BCAA intake and fsLeu nor CRP in MetS2. Milk and dairy intake
supply has not been evaluated in aged patients. This was positively correlated with fsLeu in MetS0, with no correlations
determined in surgically-stressed IED-fed aged rats. in MetS2. On the other hand, meat intake positively correlated
Methods: Thirty-four 5-month or 21-month old male SD rats with fsLeu and CRP in MetS2, with no correlations with fsLeu
were used. After gastrostomy and placement of a jugular vein nor CRP in MetS0.
catheter and a one-week recovery, the animals underwent 24h- Conclusion: Increased fsLeu in disrupted metabolic state was
enteral feeding (Impact®, Nestlé Health Science) before not associated with BCAA intake. Associations between
(healthy state) and 18 h after laparotomy (surgical stress). BCAA and protein source intake differ in different metabolic
Blood samples were repeatedly collected for the measurement states. BCAA dietary source is relevant when observing the
of plasma AA enrichment (areas under the curve: AUC) at 5 and effect on fsLeu.
24 h. Surgical stress was evaluated from urinary cathechola-
mines, and plasma protein profile. Statistical analysis: two way Reference
ANOVA. Yoon MS. Nutrients 2016;8. pii: E405.
Results: Aged rats presented significantly higher catechol- Disclosure of Interest: None declared.
amine response to surgery than adults but similar inflammation
and lower plasma glucose. Plasma AA AUC between t0 and 5 h MON-P291
were similar whatever age and stress. At 24 h, Met, Phe, and His DIETARY PROTEIN CONTENT MODULATES THE AMINO-ACID
AUC, and Ser AUC only in adults, were lower in stressed than in AND IGF1 RESPONSES TO SUCROSE OVERFEEDING IN
healthy rats (−140 to −50%, p < 0.05). Asn, Gly, Cys AUC were HUMANS.
lower in healthy aged compared to healthy adults (−160 to
P. Jegatheesan1,2 *, A. Surowska2, V. Campos2, J. Cros2,
−40%, p < 0.05), and for Gly and Cys in stressed aged compared
N. Stefanoni2, V. Rey2, P. Schneiter2, J.-P. De Bandt1, L. Tappy2.
with stressed adults (−170 to −60%, p < 0.05). Arg, Orn and Cit 1
EA4466 Laboratoire de Biologie de la Nutrition, University of
AUC were similar in the 4 conditions.
Paris Descartes, Paris, France, 2Department of Physiology,
Conclusion: IED administration similarly increases the plasma
University of Lausanne, Lausanne, Switzerland
concentration of all AA in aged and adult stressed rats and the
peripheral availability of Arg and most AA from IED is not Rationale: High sucrose diets decrease muscle anabolism
affected by ageing in this stress situation. The lower plasma through insulin resistance and changes in plasma amino acid
Gly, and Cys enrichment in stressed aged rats may be (AA) level in animal studies while data in humans remain
independent of SSAA as it appears only after 5 h of EN and unknown. This study proposes to compare the short-term
related to increased glutathione turnover. effects of high vs low protein intake during a short-term
S286 Poster
hypercaloric high-sucrose diet on fasting blood AAs and IGF1 hypothalamus, colon and liver, we observed that LC3II/LC3I
concentrations in healthy humans. ratio was increased in ABA mice ( p < 0.05 vs CT), but not in LFA
Methods: We performed a randomized, crossover study on 12 mice. Interestingly, the protein synthesis rate was increased in
healthy young male and female volunteers. Each participant hypothalamus in ABA mice ( p < 0.05 vs CT), while it was
was studied after a 3-day run-in diet containing 100% daily decreased in the colon and the soleus muscle ( p < 0.05 vs CT).
energy requirement (45% starch, 10% sucrose, 33% lipid, 12% Finally, in liver and anterior tibialis muscle, the protein
protein), and after 7-day on hypercaloric diet containing 150% synthesis rate was similar in the three groups.
daily energy requirement with 45% starch, 50% sucrose, 10% Conclusion: Our results reveal a tissue-specific adaptive
lactose, and either 37.5% lipid and 7.5% protein (HSLP) or 15% response for protein metabolism during activity-based anorexia
lipid and 30% protein (HSHP). Fasting and postprandial plasma in female mice. In particular, only hypothalamus exhibits
insulin, glucagon and IGF1 concentrations were assessed before stimulated protein synthesis certainly to favour food intake.
and after each intervention, and fasting plasma AAs level. Disclosure of Interest: None declared.
Results: Compared to basal, HSHP increased plasma glucagon
(19.2 ± 1.0 vs 26.0 ± 2.5 ng/ml*300 min, p < 0.05), while HSLP
MON-P293
had no effect. Neither HSHP nor HSLP changed insulin level.
EFFECT OF DIFFERENT TYPES OF PHYSICAL EXERCISE ON THE
HSHP and HSLP increased Ala and Pro, and decreased Ser levels.
INCREASE IN PLASMA CITRULLINE LEVELS AFTER POST-
The increase in Ala elicited by sucrose overfeeding was blunted
EXERCISE GLUTAMINE SUPPLEMENTATION
with HSHP (249 ± 18 vs 386 ± 11 μM, p < 0.001) compared to
HSLP (251 ± 20 vs 464 ± 33 μM). Leu concentration decreased S. Kartaram1 *, M. Mensink2, M. Teunis1, E. Schoen3, G. Witte4,
(130 ± 4 vs 116 ± 5 μM) after HSLP, but not after HSHP (139 ± 6 vs E. Voogd4, L. Janssen-Duijghuijsen2, M. Verschuren5,
140 ± 7 μM). Compared to HSLP, plasma BCAA, Phe, Tyr, and Pro A. van Helvoort4, L. M’rabet1, J. G. Garssen4, R. Witkamp2,
were significantly higher with HSHP than HSLP. Fasting IGF1 R. Pieters1, K. van Norren2. 1Innovative Testing in Life Sciences
concentration increased (174 ± 18 vs 208 ± 15 μg/dl) after HSHP and Chemistry, Utrecht University Of Applied Sciences,
and decreased (212 ± 13 vs 173 ± 12 μg/dl) after HSLP Utrecht, 2Division Human Nutrition, Wageningen University &
( p = 0.04). Research, Wageningen, 3Netherlands Organization for Applied
Conclusion: Sucrose overfeeding decreases IGF1 and Leu level Scientific Research (TNO), Zeist, 4Nutricia Research, Utrecht,
5
when associated with a LP intake. This may be associated with Research group Analysis techniques in the Life Science, Avans
decreased muscle protein synthesis. These effects are pre- University of Applied Sciences, Breda, Netherlands
vented when sucrose overfeeding is associated with a HP
Rationale: Citrulline, a marker for enterocyte metabolic mass,
intake.
is reduced in case of intestinal dysfunction. The aim of the
Disclosure of Interest: None declared. present study was to investigate whether the post-exercise rise
in citrulline levels after oral glutamine intake is dependent on
MON-P292 the intensity of the exercise and the hydration status and
EVALUATION OF PROTEIN TURNOVER REVEALS A TISSUE- whether there is a relation with intestinal dysfunction.
SPECIFIC ADAPTIVE RESPONSE IN FEMALE MICE DURING Methods: Fifteen healthy young men performed in a randomly
ACTIVITY-BASED ANOREXIA assigned cross-over design five experimental protocols with
S. Nobis1,2, A. Morin1,2, N. Achamrah1,2,3, A. Goichon1,2, different intensity and/or hydration status: (1) rest,( 2) and (3)
C. L’huillier1,2, A. Amamou1,2, J. C. do Rego2,4, 70% Wmax respectively euhydrated and dehydrated, (4) 50%
P. Déchelotte1,2,3 *, L. Belmonte1,2,3, M. Coeffier1,2,3. 1INSERM Wmax, (5) intermittent 85/55% Wmax in blocks of 2 min. After
U1073, Normandie Univ, URN, 2Institute for Research and exercise or rest, subjects received a glutamine-alanine bolus.
Innovation in Biomedicine, Normandie Univ, 3Nutrition Blood samples were collected before, during and at several
Department, Rouen University Hospital, 4Animal Behavior time points up to 24 h afterwards Citrulline was analyzed by
Platform SCAC, Normandie Univ, Rouen, France UFLC. Serum intestinal fatty acid binding protein (iFABP), as
marker of intestinal dysfunction, was measured with ELISA.
Rationale: Anorexia nervosa is an eating disorder leading to a Data was analyzed using a multilevel mixed linear statistical
severe undernutrition with reduced lean and fat mass and to model, with multiple test correction.
metabolic alterations. To better understand the regulation of Results: The mild exercise protocol (50% Wmax) showed the
energy-protein homeostasis in anorexia, we aimed to evaluate highest increase in citrulline levels (44.04 μm/L ± 2.5, p < 0.05)
the protein turnover in different tissue in the activity-based compared to rest (32.13 μm/L ± 1.6). The strenuous exercise of
anorexia (ABA) model in female mice. 70% Wmax in dehydrated condition however, showed less
Methods: Female C57Bl/6 mice were placed in cages with increase compared to the resting condition and hydrated
activity wheel (ABA) or not (Control, CT and limited food protocols. In contrast, serum iFABP levels increased in the
access, LFA). Both ABA and LFA mice had a progressive limited moderate exercise at 70% Wmax in hydrated condition, but
access to food from 6 hours/d at d6 to 3 hours/d at d9 and until showed the highest levels in the strenuous dehydrated protocol
the end of experiment. At d17, 20 minutes before euthanasia, (1443.72 μm/L ± 249.9, p < 0.001).
intravenous injection of puromycin was performed to evaluate Conclusion: This study indicates that the art and intensity of
in different tissues the protein synthesis rate by SUnSET the exercise affects the post-exercise rise of citrulline levels
method. In addition, autophagy was assessed by measuring after glutamine supplementation. Moreover, it indicates that
LC3II/LC3I ratio by western blot. this rise might be related to intestinal dysfunction measured by
Results: At d17, ABA mice exhibited lower body weight and levels of iFABP.
lower cumulative food intake than LFA mice ( p < 0.05). In Disclosure of Interest: None declared.
Vitamins, antioxidants and minerals 2 (ICU) to wards and their relationwith re-admission to ICU and
mortality rate.
MON-P294 Methods: This study was conducted prospectively in Erciyes
MAGNESIUM SULPHATE ALLERGY AND SUBSEQUENT University Medical ICU. Patients who are above 18 years old and
TOLERANCE TO MAGNESIUM CHLORIDE IN A PATIENT WITH stayed in the ICU more than 48 hours and then transferred to a
INTESTINAL FAILURE ward were included into the study. Blood samples for
K. C. Fragkos1 *, S. Mehta1, S. Di Caro1, F. Rahman1, micronutrient levels were taken at the time of transfer.
M. Dziadzio2, J. Lukawska2,3. 1GI Services, 2Specialist Allergy Results: We enrolled 100 patients. Total of 52 of patients were
and Clinical Immunology, University College London Hospitals male (52%) and 48 were female (48%). Mean agewas 56.2 ± 19.2
Nhs Foundation Trust, 3Imaging Sciences, King’s College years. Mean APACHE II score was 15,4 ± 7,8. Mean SOFA score at
London, London, United Kingdom the time of discharge from ICU was 3 (range 0–7). The route for
nutrition was oral in 50%, enteral in 21%, oral and enteral in 13%
Rationale: Magnesium is commonly used in hospital medicine and parenteral in 15% of the patients. Low levels of thiamine
in treatment of eclampsia and preeclampsia, arrhythmia, (98%), vitamin B6 (98%), vitamin B12 (11%), copper (21%), zinc
severe asthma, and migraine. Its utilisation is customary in (90%), selenium (36%), chromium (98%), and cobalt (35%)were
patients with short bowel syndrome and intestinal failure, who identified in the patients. Low levels of vitamin B6 was an
often require intravenous magnesium sulphate (MgSO4). MgSO4 independent risk factor for 90 day mortality and re-admission
is also a routine additive in intravenous fluids for parenteral to the ICUin multivariate analysis(OR: 0,283, CI 95%:0,099–
nutrition formulations. In spite of its frequent use, reports of 0,812, p: 0,019 OR: 0,231 CI 95%:0,071–0,745, p: 0,014
allergic reactions to the compound are very rare (1). respectively). Median duration of ICU stay was 5 (range 3–32)
Methods: Case report days. Re-admission rate to the ICU within 90 days was 24% and
Results: We present a case of a 40-year-ol female with a 90 day mortality rate was 29%.
background of ileostomy and intestinal failure, who developed Conclusion: Vitamin B1, B6, zinc and chromium levels were
allergic reactions (skin flushing, skin rash, lip angioedema and very low in these group patients. Low levels of vitamin B6
throat tightness) to intravenous MGSO4 infusions, which identified as an independent risk factor for 90 day mortality
precluded its further use. Patient was seen by in-house rate and re-admission to the ICU.
Clinical Allergy Service and skin testing to MgSO4 was Disclosure of Interest: None declared.
performed. She tested negative to neat skin prick and positive
at intradermal testing at 1:100 (non-irritant concentration). MON-P296
Suggesting possible IgE mediated mechanism. Skin testing was A SNAPSHOT OF VITAMIN D DEFICIENCY IN HOME PARENTERAL
repeated with Magnesium Chloride (MgCl2). Patient tested NUTRITION PATIENTS IN NORTHERN ENGLAND
negative to MgCl2 neat skin prick test and to intradermal testing
L. Shabeer1 *, D. Burke2. 1School of Medicine, University of
at the same concentration. Subsequently, magnesium chloride
Leeds, 2Department of Colorectal Surgery, St. James’s
infusion was performed and well tolerated with no evidence of
University Hospital, Leeds, United Kingdom
allergic reaction.
Conclusion: Magnesium is one of the most abundant minerals in Rationale: Vitamin D deficiency is increasingly common with an
human body and it is essential to our well-being. Allergic occurrence of 1 in every 5 adults, approximating to 10 million
reactions to MGSO4 are very rare (only 3 cases described in the people across England in the general population. Those on
literature), however, when suspected pose a significant home parenteral nutrition (HPN) are at increased risk of
problem for patients and their clinicians. Following careful deficiency, making these patients of clinical interest. However,
allergological review and skin testing, MgCl2 may represent a current data are limited to small sample size and the topic has
safe alternative in patients with allergy to MGSO4. not recently been explored in northern European countries.
Reference The aim of this study was to examine the prevalence of vitamin
D deficiency in HPN patients in northern England.
1. Al-Fares AA, Abdulmalek KA, Al-Herz W. Magnesium sulfate-
induced nonallergic anaphylaxis. Annals of Allergy, Asthma and Methods: Serum Vitamin D (25-hydroxyvitamin D [(25(OH)D])
Immunology 98: 303, No. 3, Mar 2007. values from all HPN patients at St James’s Hospital, Leeds were
obtained with sufficiency defined by the range, 75–250 nmol/
L. The most recent non-fasting serum values for vitamin D in
MON-P295 the last six months, patient age and ethnicity were recorded.
ASSOCIATION BETWEEN SERUM MICRONUTRIENT LEVELSIN Results: Data were obtained on 139 patients (51 male and 88
PATIENTS DISCHARGED FROM ICU TO WARDS AND 90-DAY female). 94% of patients were of White British ethnicity.
MORTALITY, RE-ADMISSION TO INTENSIVE CARE UNIT: SINGLE Vitamin D levels in the sub-normal range were seen in 61.2%.
CENTER OBSERVATIONAL STUDY Five patients did not have any recorded vitamin D values within
the last six months. Similar levels of vitamin D insufficiency
K. Gundogan1 *, Y. Gunay1, R. Coskun1, N. A. Mendil1,
were seen between male and female cohorts (60.8% and 61.4%
M. Guven1, M. Sungur1. 1Erciyes University, Kayseri, Turkey
respectively). 28% of patients were over the age of 65 with
Rationale: Trace elements included in nutritional support have 51.3% of these having insufficient vitamin D levels.
a central role in maintaining human physiological functions. Conclusion: This study uses the largest sample size to date and
The study aim of this study is to identify serum micronutrient is the first study conducted in a European cohort. Inadequate
levels in patients who are transferred from intensive care unit vitamin D levels were seen amongst a large number of HPN
patients, despite monitored supplementation. There is a need
S288 Poster
for a consideration of the most effective methods to sustain releated conditions.1 The aim of the study is to determine the
adequate levels of vitamin D in HPN patients. vitamin D deficiency of the IBD patients in a referal center.
Disclosure of Interest: None declared. Methods: IBD patients admitted to outpatient clinic between
january 2016-january 2017 were retrospective evaluated.
Diseases activity, location, extraintestinal complications and
MON-P297
medical history were recorded from charts. Serum biochemical
JAPANESE HOSPITAL’S ORDINARY MEAL 2ND REPORT –FOCUS
parameters and serum vitamin D levels were measured on day
ON VITAMIN B1
of admission. Body mass index and mini nutrutional assesment
M. Hasegawa1 *, M. Shiga2. 1Physician, 2Dietitian, Kariya Toyota test (MNA) were recorded. Vit D levels were categorised as
General Hospital Takahama Branch, Takahama, Japan follow; <25 mmol was defined as severe deficiency, 25–50 mmol
as mild deficiency and 50–125 mmol as normal.
Rationale: In 2015, we reported ordinary meal in Japanese
Results: Fortynine (42%) patients have the diagnosis of Crohn’s
hospital about total energy, protein, lipids and carbohydrate.
disease and 68 of patients (58%) were ulcerative colitis. The
Methods: We surveyed using questionnaire total energy,
mean age was 45,7 years, mean BMI 24 kg/m2. A total of 117
protein, lipids, carbohydrate some vitamins and minerals on
patients were 58 women. Out of 117 patients %17 had severe,
November 5th–7th 2014. And obtain 96 data. Type: acute care
37% had mild, 46% had normal vit D levels. Twenty of the
setting (AC) 39, rehabilitation setting (Reha) 32, Nursing home
patients (17%) were malnourished, 45(37%) were at risk of
etc (NH) 25.
malnutrition and 52(46%) were normal. Relation between
Results: Show 3 days average. Total energy 1835 ± 137 kcal,
disease related paremeters and Vit D levels were analysed.
Protein 69.5 ± 5.9 g, Lipid 45.4 ± 5.0g, Carbohydrate 277 ±
No statistical relation between of vitamin d deficiency and
28.5g. Energy ratio Protein 15.1 ± 0.9%, Lipids 22.0 ± 0.7%,
disease parameters such as age, gender and body mass index
Carbohydrate 61.0 ± 3.2%. Salt 8.3 ± 1.3 g,VA 946 ± 1256 (μg
(BMI) and nutritional status were found.
RAE), VB1 1.10 ± 0.49 (mg), VB2 1.15 ± 0.19 (mg),VB6
Conclusion: Vit D deficiency is common among the IBD patients
1.35 ± 0.25(mg), VB12 6.91 ± 18.46 (μg), VC 115.5 ± 30.9 (mg),
and it should be take into account of worse disease outcome.
VD 16.2 ± 42.6 (μg), VE 7.96 ± 4.26 (mg), Potassium 2324 ± 662
(mg), Calcium 623 ± 87.7 (mg), Iron 9.19 ± 3.34 (mg), Zinc Reference
8.89 ± 4.15 (mg), Copper 1.39 ± 1.49 (mg), Phosphorus 1046 ± 1. Pallav Kumar, Riche Daniel, May Warren L, Sanchez Patrick,
91.8 (mg). Total energy doesn’t corre1late with VB1 r = 0.114 Gupta Nitin K . Predictors of vitamin D deficiency in inflammatory
( p = 0.164), VB2 r = 0.024 ( p = 0.820). But it correlate with bowel disease and health: A Mississippi perspective. World J
Phosphorus r = 0.533 ( p = 5.41E-8). Gastroenterol 2017 January 28; 23(4): 638–645.
0.61 ± 0.26 mg VB1 per 1000 calories. AC 0.54 ± 010, Reha Disclosure of Interest: None declared.
0.60 ± 0.24, NH 0.56 ± 0.18 respectively
Dietary Reference Intakes for Japanese (2015) says, the MON-P299
recommended dietary allowance for VB1 (thiamine hydrochlor- VITAMIN D LEVELS AND DEFICIENCY RISKS ANALYSIS IN
ide) is 0.54 mg per 1000 calories. This sentence means the SPANISH TOP ATHLETES
recommended dietary allowance for thiamine is 0.45 mg per
N. Palacios1 *, E. Saura2, J. Fernández3, G. Elvira2, E. Diaz1.
1000 calories. Judging from this figure, 54.3% of facilities are 1
Centro de Medicina del Deporte, AEPSAD, Consejo Superior de
short of thiamine. On the other hand, FAO/ WHO joint report
Deportes, Madrid, 2Hospital Clínico Universitario Virgen de la
(1967) 1 says, the recommended intake for thiamine is 0.40 mg
Arrixaca, Murcia, 3Centro de Medicina del Deporte, AEPSAD.
per 1000 calories. Judging from this figure, 18.1% of facilities
Consejo Superior de Deportes, Madrid, Spain
are short of VB1.
Conclusion: Japanese hospital. ordinary meal contains much Rationale: Describe Vitamin D levels in athletes of different
VB12, Copper and Phosphorus, less VE and Calcium. VB1 part of sports and to investigate the influence of sport(indoor or
Dietary Reference Intakes for Japanese might need review. outdoor)and the season of the year when the samples were
Reference taken(autumn/winter or spring/summer).
1. World Health Organization Technical Report series No362. FAO Methods: From February 2016 to February 2017 we included
Nutrition Meeting Report Series No.41. Requirements of Vitamin A, 126 athletes who had their annual medical examination at
Thiamine, Riboflavin and Niacin. Sports Medicine Center High Sport Council (49 female, 77 male,
Disclosure of Interest: None declared. average age 24.4 ± 6.1, 23 ± 2.7 IMC, 13.03 ± 6.7 fat percent-
age, 17 Gymnastics, 37 Field Hockey, 12 Boxing, 27 Basketball,
7 Handball and 18 Rowing) Vitamin D levels were determined by
MON-P298
radio immunoanalysis.
THE PREVALENCE OF VITAMIN D DEFICIENCY IN PATIENTS
Results: According to the European Guidelines of
WITH INFLAMMATORY BOWEL DISEASE
Endocrinology, normal levels of Vitamin D are defined as
N. G. Ünal1, N. Oruç1 *, A. Ö. Özütemiz1. 1Gastroenterology, Ege those over 30 ng/ml, insufficiency between 20.05–30 ng/ml
University Faculty of Medicine, İzmir, Turkey and deficiency below 20 ng/ml.
According to the sport, there was significantly more insuffi-
Rationale: It’s well known that thevitamin D deficiency may ciency-deficiency in boxing, gymnastics and handball( p <
predispose a higher disease activity, suboptimal response to 0.001)being all of them indoor sports.
treatment and higher incidence of hospitalization in IBD In Field Hockey, of 5 goalkeepers 1(20%)deficiency and 2(40%)
patients.1 On the other hand IBD patients maybe at an insufficiency, of 32 field players 6(18.7%)had insufficiency, no
increased risk for low serum 25 (OH) D levels cause of disease cases of deficient levels. The prevalence of insufficiency-
deficiency among goalkeepers was 60%,significantly higher Table 1: Univariate binary logistic regression analysis for AMD versus no AMD,
than the 18.7%among field players( p < 0.001)Of 17gymnastic adjusted for age and gender.
athlets who showed low vitamin D levels in the beginning of the OR 95%Cl p
follow-up showed an adverse evolution in the absence of
Vitamin A 1.0 0.99–1.0 0.011
treatment, with a mean decrease of 5.5 ± 5.3 ng/ml after 1 Lutein + zeaksantin 1.0 0.99–1.0 0.003
year( p < 0.01) Carotenoids 0.70 0.61–0.93 0.036
Vitamin C 0.97 0.80–1.03 0.000
Vitamin E 0.76 0.63–0.88 0.130
Mean Vitamin D(ng/ml) Athletes Zinc 0.38 0.20–0.50 0.002
Selenium 1.49 0.22–98.3 0.853
Indoor 31.6 ± 14.1 71(56%) Dietary antioxidant capacity 1.0 0.99–1.00 0.094
Outdoor 41.6 ± 12.2 55(44%)
Autumn/Winter 23.4 ± 9.7 36(29%)
Spring/Summer 41 ± 12.5 90(71%)
Normal 44.5 ± 9.8 80(63.4%)
Insufficiency 24.7 ± 2.7 29(23.01%) MON-P301
Deficiency 14.9 ± 3.8 17(13.4%)
RELATIONSHIP BETWEEN SERUM 25-HYDROXYVITAMIN D
(p < 0.001) LEVELS AND FALL RISK AS MEASURED BY DYNAMIC STABILITY
AND MOBILITY-RELATED OUTCOMES IN OLDER ADULTS
Conclusion: In our study, a high percentage of athletes showed
T. Lockhart1 *, S. Garvey2, O. Kelly2. 1Biomedical Engineering,
inadequate Vitamin D levels according to current guidelines.
Arizona State University, Mesa, 2Abbott Nutrition R&D,
With these results, we recommend vitamin D levels to be
Columbus, United States
determined in this population in order to avoid its deficiency
and the possible negative effects, above all in those at higher Rationale: Sufficient vitamin D is critical for infant and
risk(indoor sports and those with low solar exposure) childhood bone growth, yet additionally implicated in chronic
Disclosure of Interest: None declared. disease risk in adults. In particular, low circulating levels of the
vitamin D catabolite, 25-hydroxyvitamin D [25(OH)D], have
MON-P300 been reported to be related to decreased muscle function and
THE ASSOCIATION BETWEEN DIETARY INTAKE OF increased risk of falls in older adults.
ANTIOXIDANTS AND AGE RELATED MACULAR DEGENERATION Methods: A total of 34 older adults (mean age: 82 years
old ± 4.1 years; 21 females; 13 males) were studied. Serum 25
S. Arslan1 *, S. Kadayıfçılar2, G. Samur1. 1Nutrition and
(OH)D levels were classified as relatively high (>40 ng/ml),
Dietetics, 2Department of Ophthalmology, Hacettepe
medium (30–40 ng/ml), or low (<30 ng/ml). Dynamic stability
University, Ankara, Turkey
parameter linked to fall risks (root mean square ratio-RMSR)
Rationale: In current data, the effect of the intake of was assessed using the inertial sensors at the trunk segment in
carotenoid and antioxidant increased with diet on AMD is not anterior-posterior (AP) and medial-Lateral (ML) directions
coherent. This study was planned with the aim of the possible during 2 minute walking task. The RMSR is the ratio between
effect of nutrition on the occurrence of disease was evaluated the RMS value in Vertical, Mediolateral, Anterior-Posterior
by comparing healthy individuals with dietary total antioxidant Direction and the RMS vector Magnitude. Additionally, mobility
capacity. parameters were derived using the ABC scores.
Methods: Total 200 (100 study group, 100 control group), >50 Results: A significant differences were found between the RMS
years old participants in Hacettepe University are attended to ratio in Medial-Lateral direction during normal walking for the
the study. By using food intake frequency amounts, dietary three groups (F-ratio = 3.751, p = 0.045). The mean (LSM) value
total antioxidant capacity was tried to be determined of RMSR in Medial-Lateral direction during normal walk in the
approximately with the use of data obtained from a large- INS group is higher than the HS and LS group for the sample
scale study made by Carlsen (Carlsen et al. 2010) for developing population. The mean of RMSR in Medial-Lateral Direction is
a database including total antioxidant component of essential 0.097 for HS, 0.12 for LS and.13 for INS groups. Dynamic
nutrients. stability and mobility were closely linked to their vitamin D
Results: While the dietary total antioxidant activity of case serum levels (r = .82). Furthermore, risk of falls (both indoors
group was 1232.8 ± 346.6 mmol/day, it was 1490.6 ± 501.8 and outdoors) were associated with vitamin D serum levels
mmol/day in control group. The dietary total antioxidant below 35 ng/ml similar to normal mobility function.
activity of control group was found statistically higher than Conclusion: To summarize, older adults with serum 25(OH)D
case group ( p < .001). levels lower than 35 ng/ml may benefit from vitamin D
When food intake frequencies were analyzed; it was found that supplementation to improve or maintain mobility and stability.
the individuals, who intake carotenoids, vitamin c, vitamin e References: none
and zinc higher, have lower risk of disease (respectively Disclosure of Interest: None declared.
OR:0.70, OR:0.97, OR:0.76, OR:0.38). (Table 1).
Conclusion: Consequently, in our study, compared with healthy
individuals, and their dietary total antioxidant intake was also
found lower, compared with healthy individuals. We found that
participants who had higher intake of carotenoids, vitamin c,
vitamin e and zinc have lower risks of AMD.
S290 Poster
MON-P302 indirectly as enzyme activity (reduction of organic peroxides

PREVALENCE OF VITAMIN D3 ON INTESTINAL FAILURE- by c-GPx). Comet assay was carried on for the analysis of DNA
ASSOCIATED LIVER DISEASE IN SHORT BOWEL SYNDROME: A integrity.
PILOT STUDY Results: On admission to the ICU, GPx enzyme activity was
Y. Li1 *, S. Fan2. 1Department of Surgery, Shanghai Ninth below the reference value (<5.6 U/mL) in 65,4% of the
People’s Hospital, Shanghai Jiaotong Univesity School of patients, and this proportion had increased significantly to
Medicine, Shanghai, 2Department of Surgery, Gulou Hospital, 87,2% ( p < 0.05) by day 7 of their ICU stay. Normal activity levels
Nanjing Univsersity School of Medicine, Nanjing, China were not seen in any of the patients (>24 U/mL). Mean plasma
concentration of selenium was 53 ± 10.5 μg/dL, and on the
Rationale: The aim of this study was to investigate the day of admission 67.7% of the patients were selenium deficient.
protective effect of vitamin D3 on intestinal failure associated By day 7 of their ICU stay this proportion had increased
liver disease. significantly to 100% ( p < 0.05). A significant association
Methods: From July 2014 to July 2015, we recruited 11 patients ( p < 0.05) was found between both, GPx activity and Se
with short bowel syndrome who were treated in our center and plasma levels, with DNA integrity at the end of the stay.
met the inclusion criteria. We assigned them into two groups Conclusion: During their ICU stay, antioxidant GPx enzyme
randomly: control group and experimental group. In the activity and plasma concentration of selenium decreased in the
experimental group, patients were given an oral vitamin D3 critical care patients. This selenium deficiency can lead to
supplementation. The dose and duration of vitamin D3 increased oxidative stress and an increased DNA damage during
supplementation was 800 IU/time three times daily for one ICU stay. This situation can exhaust the available plasma stores
month. Blood samples were collected each week for analysis of of this trace element in which patients depend on. In patients
liver function. admitted to the ICU, selenium support should be monitored in
Results: Serum bilirubin and liver enzyme were highly order to ensure optimum antioxidant response and palliate the
increased in control group than that in experimental group adverse effects of this nutritional deficiency.
(P < 0.05). After four weeks, there were significant differences Disclosure of Interest: None declared.
as to serum bilirubin and liver enzyme between control group
and experimental group, the intestinal failure associated liver MON-LB304
disease relevant indicators of experimental group were
FOLLOW-UP OF BIOELECTRICAL IMPEDANCE ANALYSIS (BIA)
significantly better than that of control group.
IN THE CRITICALLY ILL
Conclusion: Supplementation of vitamin D3 was effective in
the protection of intestinal failure associated liver disease in K. Dams1 *, N. Van Regenmortel2, P. G. Jorens1. 1Intensive Care
patients with short bowel Medicine, Antwerp University Hospital, Edegem, 2Intensive
Care Medicine, Ziekenhuis Netwerk Antwerpen Campus
Stuivenberg, Antwerp, Belgium
Rationale: To assess the time course of BIA parameters (Xc

Late Breaking Abstract 2 (reactance), Rz (resistance), PhA ( phase angle)), as well as
their association with intensive care (ICU) mortality in critically
MON-LB303 ill patients.
SELENIUM STATUS AND DNA INTEGRITY IN CRITICALLY ILL Methods: We conducted a longitudinal, single-centre, obser-
PATIENTS WITH SIRS vational cohort study in a mixed ICU-setting. In 73 adult
E. Planells1 *, J. Molina-López1, L. Herrera-Quintana1, patients, estimated to be mechanically ventilated for >48 h, Xc
B. Quintero-Osso2, M. Rodriguez-Elvira3, A. Pérez de la Cruz4, and Rz were measured (BIA 101 Akern SRL, Italy; 800 mA, 50-
I. Pérez-Moreno1, Y. Gamarra-Morales1. 1Physiology, kHz alternating currents) within 48 h of admission, PhA was
2
Physicochemical, University of Granada, Spain, 3Unidad calculated. BIA was reassessed on a weekly basis, at discharge
Critical Care, Hospital Universitario Granada, 4Nutricion, and 180 days after admission. We also collected data on age,
University of Granada, Spain, Granada, Spain gender, body weight, BMI and severity of disease (SAPS-3
score). We graphically explored the evolution of Rz, Xc and PhA
Rationale: Selenium deficient status could affect the integrity over time, dichotomized by ICU mortality. Univariable logistic
of DNA and clinical course during the patient’s stay in the regression models of the different BIA-parameters were
intensive care unit (ICU), and together with hypercatabolic constructed with ICU-mortality as the outcome variable.
state, could result in an increase of oxidative stress which has Finally, the models were adjusted for confounding by introdu-
been recognized as a central mechanism in the pathophysiology cing age, BMI and SAPS-3.
of critical illnesses, particularly the appearance of multiorgan Results: 73 patients were studied (51% survived). Already
failure. within 48h of admission, PhA was significantly lower in non-
Methods: A blood sample was obtained on the day of admission survivors compared to survivors (2.8 vs 3.7; p = 0.02) While PhA
in the ICU from 65 critically ill patients in Granada province in non-survivors was consistently low, it decreased gradually
(southern Spain) who fulfilled the inclusion criteria, i.e., over time in survivors, only recovering after discharge.
presence of systemic inflammatory response syndrome (SIRS) Univariable logistic regression models show a clear association
and APACHE score >15 (among others). Plasma concentration of between mortality and BIA parameters at admission: Xc (OR
selenium and erythrocyte concentration of GPx enzyme were 0.96, p = 0.048; 95%CI 0.93–0.10) and PhA (OR 0.72, p-value
determined. Selenium was measured with inductively coupled 0.039, 95% CI 0.53–0.98). After introducing age, BMI and SAPS-
plasma mass spectrometry (ICP-MS). GPx was measured 3, however, this association ceased to be significant.
Conclusion: Xc and PhA, assessed shortly after admission in MON-LB306

mechanically ventilated critically ill patients, act as markers of PROTEIN INTAKE AND CLINICAL OUTCOME IN ICU PATIENTS: A
severity of disease and outcome. They do not improve, SYSTEMATIC REVIEW AS A BASIS FOR ESPEN GUIDELINES
however, the prognostic power of the current ICU-score. In DEVELOPMENT
survivors, they recover only after discharge. M. Guadagni1 *, M. T. Streppel2, C. Schuurman2, G. Biolo1,
Disclosure of Interest: None declared. Y. Boirie3, O. Rooijackers4, J. Kondrup5, P. J. Weijs2,6,7.
1
Department of Medical, Surgical and Health Sciences, Clinica
MON-LB305 Medica, ASUITs, University of Trieste, Trieste, Italy, 2Faculty of
EARLY ENERGY OVERFEEDING IS ASSOCIATED WITH HIGHER Sport and Nutrition, Amsterdam University of Applied
MORTALITY IN ICU PATIENTS WITH REFEEDING Sciences, Amsterdam, Netherlands, 3Human Nutrition Unit,
HYPOPHOSPHATEMIA, A RETROSPECTIVE STUDY Department of Clinical Nutrition, University of Clermont
Auvergne, Clermont-Ferrand, France, 4Department of Clinical
M. Guadagni1 *, W. G. Looijaard2, M. Tieland3, G. Biolo1,
Science, Intervention and Technology Clintec, Karolinska
H. M. Oudemans-van Straaten2, P. J. Weijs2,3,4. 1Department of
Institutet, Stockholm, Sweden, 5Clinical Nutrition Unit,
Medical, Surgical and Health Sciences, Clinica Medica, ASUITs,
Rigshospitalet University Hospital, Copenhagen, Denmark,
University of Trieste, Cattinara University Hospital, Trieste, 6
Department of Nutrition and Dietetics, Internal Medicine,
Italy, 2Department of Intensive Care Medicine, VU University 7
Department of Intensive Care Medicine, VU University
Medical Center, 3Faculty of Sport and Nutrition, Amsterdam
Medical Center, Amsterdam, Netherlands
University of Applied Sciences, 4Department of Nutrition and
Dietetics, Internal Medicine, VU University Medical Center, Rationale: Recent evidence suggests that enhancing protein
Amsterdam, Netherlands intake can attenuate catabolic response and improve outcome
in critically ill patients. Optimal protein intake is still debated;
Rationale: The relationship between early energy delivery and
current guidelines indicate as target 1.2–1.5 g/kg/day and
outcome in ICU patients with refeeding syndrome has been
expert opinion even higher intake. Solid data on the effect of
scarcely investigated1. We hypothesized that early overfeeding
protein intake on clinical and functional outcome parameters
would be associated with increased mortality in patients
are lacking.
developing refeeding hypophosphatemia.
Methods: We performed a systematic review to assess the
Methods: We included ventilated ICU patients from our
evidence behind protein intake and hospital outcome in ICU
nutritional database with energy expenditure (EE) measured
patients, focusing on clinical and functional outcome based
by indirect calorimetry. Refeeding hypophosphatemia was
studies. MEDLINE was searched for original articles published
defined as a decrease of serum phosphate to ≤0.65 mmol/L
up until June 2017. Quality assessment was done according to
within 72h after starting nutrition; early energy overfeeding as
guidelines devised by the Nordic Nutrition Recommendations
mean energy intake in the first 2 days ≥100% of measured EE.
(NNR) 5 Working Group. The level of evidence was graded as
Cox regression analysis, adjusted for age, BMI and APACHE II
convincing, probable, suggestive or inconclusive.
score, was performed in patients developing refeeding hypo-
Results: A total of 28 full text articles were included in the
phosphatemia and patients who did not (as suggested by
systematic review: 15 randomized clinical trials (RCTs) and 13
statistical interaction).
prospective cohort studies. Overall, protein intake was low, not
Results: A total of 646 patients were included. Mean age was
achieving current recommendations in 72% of the studies. The
63 ± 16 years, BMI 26 ± 5.9 kg/m2 and APACHE II 23 ± 8.
evidence was graded as suggestive for an association between
Refeeding hypophosphatemia developed in 273 (42.3%)
higher protein intake and lower mortality in ICU patients. The
patients. Hospital mortality was 31.9% vs. 39.5% in the
limited amount of studies and low actual intake of protein
refeeding and non-refeeding cohort respectively (P = 0.057).
preclude conclusions on other outcomes, such as duration of
Early energy overfeeding was an independent risk factor for
mechanical ventilation, length of hospital and ICU stay, and
hospital mortality in patients with refeeding hypophosphate-
nosocomial infection. From two studies included in the review,
mia (HR = 3.19, 95% CI 1.16–8.79, P = 0.025), but not in patients
a promising positive role of protein on physical performance
without (HR = 1.71, 95% CI 0.73–4.02, P = 0.217). Hospital
emerged.
mortality was significantly higher in overfed compared to
Conclusion: Future RCTs, matching recommended protein
non-overfed patients only in the refeeding hypophosphatemia
target (or even higher target) and comparing different
cohort (71.4% vs. 30.6%, P = 0.022).
protein intake, are urgently needed to assess the evidence
Conclusion: Energy overfeeding in the early phase of
behind protein intake in ICU patients.
critical illness is specifically associated with high hospital
mortality in ventilated ICU patients developing refeeding Disclosure of Interest: None declared.
hypophosphatemia.
Reference
1. Doig et al. Lancet Respir Med. 2015
S292 Poster
MON-LB307 within 24–48 hours of admission in the critically ill patient who
RELATIONSHIP BETWEEN NUTRITIONAL ASSESSMENT AND is unable to maintain volitional intake. This audit served as a
NUTRITIONAL ADEQUACY IN ICU tool to provide regional data of nutritional practices in ICU, of
N. Higashibeppu1 *, D. K. Heyland2, on behalf of Investigators which there is minimal published data. The aims were to
of the International Nutrition Survey. 1Department of determine the time from ICU admission to initiation of enteral
Anesthesia and Critical Care, Kobe City Medical Center feeding and quantify the amount of calories and protein
General Hospital, Kobe, Japan, 2Clinical Evaluation delivered to patients over the first five days of ICU admission.
Research Unit, Kingston General Hospital, Kingston, Methods: A prospective observational audit was conducted in
Ontario, Canada the ICU at Cleveland Clinic Abu Dhabi (CCAD). Patients were
included if they were >18 years old with an expected length of
Rationale: Nutritional assessment at the initiation of nutri- stay >48 hours and if they were mechanically ventilated within
tional therapy is considered important in the care of critically 24 hours of admission. Patients who met the inclusion criteria
ill patients, but there are no reports demonstrating its value. had their Electronic Medical Record (EMR) reviewed for date
We examined the effect of the initial nutritional assessment on and time of initiation of EN. For five consecutive days the
subsequent nutritional adequacy. patients’ EMR was reviewed to obtain the volume and type of
Methods: Design: Prospective observational cohort. Setting: A feed prescribed and delivered. This included the delivery of
total of 196 ICUs worldwide. Patients: A total of 3943 any protein modules. All statistical analyses were performed
mechanically ventilated patients in ICU. We omit patients using Microsoft Excel 2010.
that received oral intake only. Interventions: none. Results: Twenty patients met the inclusion criteria. Enteral
We compared the adequacy of nutrition therapy between nutrition was started within the first 23 (2–51) hours of
nutritional assessed group ( patients which had the target admission. Over the first five days of their ICU admission,
dosage of energy and protein set at the start of nutrition) and patients received an average of 1268 ± 385 kcal/day. This
non-assessed. The primary outcome was the absolute amount translated to an average of 73 ± 22% of their prescribed
of energy (kcal/kg/day) and protein (g/kg/day) in the first 12 energy requirements. Patients also received an average of
days in ICU, and the secondary outcome was the percentage of 61 ± 21 g of protein over the first five days. This translated to
patients who received enteral nutrition and parenteral and an average of 68% (±23%) of prescribed protein
nutrition. requirements.
Normally distributed continuous variables were analyzed with Conclusion: In the first 16–20 months of operation, the ICU at
T test and the categorical variables were analyzed with the chi- CCAD was able to meet international guidelines of early
square test. Also, we conducted a multivariate analysis using initiation of enteral feeding in critically ill patients within
multiple regression analysis and binomial logistic analysis with 24hours. Patients achieve approximately 70% of their prescribed
assessment, APACHEII score, duration of nutrition evaluable energy and protein requirements over the first five days.
days, and geographic regions as covariates. SPSS® ver. 23 was Disclosure of Interest: None declared.
used for statistical analysis.
Results: 3363 cases (85.5%) were assessed nutritionally.
MON-LB309
The assessed group were given more energy and protein than
NEUROMUSCULAR ELECTRICAL STIMULATION (NMES) MAY
the non-assessed. Energy; mean, 22.4, standard deviation (SD)
ALTER THE ENERGY SUBSTRATE METABOLISM AND SURVIVAL
11.4 vs 10.7 (11.4) kcal/kg/day, p < 0.01; 95% adjusted
OF THE ACUTE ENDOTOXIC SHOCK MICE
confidential interbal (aCI), 3.19–4.54; Protein: 1.11 (0.65) vs
0.44 (0.55) g/kg/day, p < 0.01; 95% aCI, 0.19–0.26, p < 0.01. T. Irahara1 *, N. Sato2, K. Otake1, S. Murata3, K. Inoue4,
The assessed group received more EN than non-assessed (OR, K. Koike3, H. Yokota1. 1Department of Emergency and Critical
6.56; 95%CI, 5.42–7.93), the aOR, 4.3; 95%aCI, 2.97–5.50). The Care Medicine, Nippon Medical School, Tokyo, 2Department of
assessed group received less PN with no clinical reason (OR, Aeromedical Services for Emergency and Trauma Care, Ehime
0.26; 95%CI, 0.14–0.46), the aOR, 0.36; 95%aCI;0.24–0.53). University, Matsuyama, 3Department of Primary Care and
Conclusion: Timely assessment of nutritional requirements Emergency Medicine, 4Laboratory of Nutrition Chemistry,
may improve adequacy of nutrition therapy in critically ill Graduate School of Agriculture, Kyoto University, Kyoto, Japan
patients.
Rationale: We have revealed that low-intensity exercise in the
Disclosure of Interest: N. Higashibeppu Speaker bureau of: Otsuka, acute phase of endotoxic shock mice might exert a therapeutic
Meiji, Yoshindo, D. Heyland Consultant for: GlaxoSmithKline, Speaker effect such as improving lipid metabolism and survival by
bureau of: GlaxoSmithKline.
stimulating PGC-1α expression (PMID:26953756). In this study,
we investigated whether neuromuscular electrical stimulation
MON-LB308 (NMES) also have a similar effect.
BENCHMARKING ENTERAL NUTRITION PROVISION IN A NEWLY Methods: C57BL/6 mice were given 20 mg/kgBW of lipopoly-
ESTABLISHED INTENSIVE CARE UNIT (ICU) IN THE UNITED saccharide (LPS) intraperitoneally and divided into C (control)
ARAB EMIRATES group and NMES groups (n = 10–12/group). NMES to the bilateral
R. Kaddoura1 *, A. Speedy1. 1Cleveland Clinic Abu Dhabi, Abu gastrocnemius muscle was performed to NMES groups for 1
Dhabi, United Arab Emirates hour. Frequency and voltage were set to low-frequency
(LF = 2 Hz) or high-frequency(HF = 50 Hz) and low-voltage
Rationale: The European Society of Parenteral and Enteral (LV = 10V) or high-voltage(HV = 50V). The alterations of energy
Nutrition (ESPEN) and the American Society of Parenteral and metabolism were measured using indirect calorimetry until 24
Enteral Nutrition (ASPEN) recommend the initiation of EN hours after NMES. Survival proportions were also measured
until 72 hours after LPS administration. Next, in LF-LV and LF-

FiO2 [%] VO2_Deltatrac® VO2_Quark RMR®
HV group, NMES was performed twice to compare with [ml/min] [ml/min]
those receiving once. Lastly, PGC-1α expression after NMES
Infinity 500® 39.5 (0.2) 241 (11) 238 (9)
was evaluated in liver and gastrocnemius muscle by quantita- S1® 40.2 (0.5) 250 (10) 267 (37)
tive PCR.
Results: NMES altered the energy substrate metabolism and
survival depending on its conditions. In LF-LV group, fatty acid Conclusion: Stability of FiO2 provided by the mechanical
oxidation (FAO) increased ( p < 0.05) and carbohydrate oxida- ventilators greatly influenced the VO2 measured by the breath-
tion (CHO) decreased ( p < 0.05). In LF-HV group, FAO also by-breath indirect calorimeter. This point should be addressed
increased ( p < 0.01) and CHO did not change. In HF-LV group, in future development and validation studies of ICs for
both FAO and CHO did not change. In HF-HV group, FAO mechanically ventilated subjects.
markedly increased ( p < 0.0001) and CHO did not change. Disclosure of Interest: T. Oshima Grant/Research Support from: Public
Survival proportions significantly improved only in LF-LV group Foundation Nutrition 2000plus, Geneva University Hospital, Other:
( p < 0.01). When NMES was performed twice in LF-LV group, COSMED, Nestle, C.-P. Heidegger Other: Baxter, Nestle Nutrition, A.-M.
both FAO and CHO tended to increase. In LF-HV group, FAO Makhlouf: None declared, S. Graf: None declared, Y.-M. Dupertuis:
increased and CHO did not change. Survival proportions None declared, C. Pichard Grant/Research Support from: Swiss
National Science Foundation, Nestle Nutrition, Baxter, BBraun,
significantly improved in LF-HV group ( p < 0.05) and worsened
Fresenius-Kabi, COSMED, Consultant for: Baxter, Abbott, BBraun,
in LF-LV group ( p < 0.05) compared with those receiving once. COSMED, Fresenius-Kabi, Novartis, Danone, Pfizer, Solvay, Vifor.
PGC-1α expression after NMES once in LF-LV group and twice in
LF-HV group was significantly upregulated ( p < 0.05) in
gastrocnemius muscle. MON-LB311
Conclusion: NMES may exert a therapeutic effect especially IN-VITRO VALIDATION OF THE NEW INDIRECT CALORIMETER
under the conditions that mildly change energy metabolism AGAINST MASS SPECTROMETRY MEASUREMENTS IN
from glucose into lipid predominance. These effects may occur SIMULATED GAS EXCHANGE
through PGC-1α upregulation like exercise intervention. T. Oshima1 *, Y.-M. Dupertuis1, S. Graf1, A.-M. Makhlouf1,
Disclosure of Interest: None declared. M. Ragusa2, C.-P. Heidegger3, C. Pichard1. 1Clinical Nutrition,
Geneva University Hospital, Geneva, 2Research and
Development, Cosmed Srl, Rome, 3Service of Intensive Care,
MON-LB310
Geneva University Hospital, Geneva, Switzerland
CAN MECHANICAL VENTILATORS AFFECT INDIRECT
CALORIMETRY MEASUREMENTS? Rationale: This study aimed at validating the accuracy of the
T. Oshima1 *, C.-P. Heidegger2, A.-M. Makhlouf1, S. Graf1, new IC developed for the ICALIC study1 (Q-NRG; Cosmed, Italy)
Y.-M. Dupertuis1, C. Pichard1. 1Clinical Nutrition, 2Service of by simulating human gas exchange under mechanically venti-
Intensive Care, Geneva University Hospital, Geneva, lated condition in the in-vitro setting. Gold standard mass
Switzerland spectrometer (MS) was used in the gas composition analysis of
the reference IC using the mixing chamber technique.
Rationale: Stability of inhaled O2 fraction (FiO2) is important Methods: Mechanical ventilator (Dräger, Germany) generated
for the stable O2 consumption (VO2) measurement in indirect respiratory cycles at different FiO2 (21, 40, 60%). Simulator
calorimetry. We measured the FiO2s generated by 2 different circuit consisting of a test lung and mass flow controller
ventilators, and investigated the effect of FiO2 stability on (Bronkhorst, Germany) was connected in place of the patient.
the VO2 measurements by different indirect calorimetry CO2 gas mixtures of equal concentrations to the FiO2 (21, 40,
techniques. 60%) were injected into the circuit to simulate CO2 production
Methods: FiO2s of Infinity 500® (Dräger, Germany) and S1® (VCO2) and O2 consumption (VO2) of 250 ml/min. Measurements
(Hamilton Medical, Switzerland) mechanical ventilators by the Q-NRG were compared with the reference IC.
adjusted to 40% were measured by a quadruple mass Results: Means of 10 measurements by the Q-NRG (VO2,
spectrometer (MAX300-LG®, Extrel) calibrated to measure O2 VCO2_Q-NRG) were within 3% of the reference IC measure-
and CO2 gas concentrations. CO2 gas mixture (40%, balance N2) ments (VO2, VCO2_MS) in all test conditions.
was injected into the pneumatic circuit of the mechanical
ventilators using precision mass flow controllers to simulate
VO2 and VCO2 of 250 ml/min. Indirect calorimetry was FiO2 VO2_Q-NRG VO2_MS VO2_Diff VCO2_Q-NRG VCO2_MS VCO2_Diff
conducted using devices with different technologies: mixing (%) (ml/min) (ml/min) (%) (ml/min) (ml/min) (%)
chamber (Deltatrac®, Datex, Finland) and breath-by-breath 21 236 243 −3.0 239 240 −0.5
(Quark RMR®, Cosmed, Italy). Stability was evaluated as 40 246 250 −1.2 249 247 + 0.9
60 222 228 −2.8 233 233 + 0.1
accuracy and precision: accuracy was defined as closeness of
the measured values to the supposed values, and precision was
defined as smaller standard deviation (SD). Conclusion: Excellent agreement between the Q-NRG and the
Results: Results are presented as mean (SD). Infinity 500 reference IC measurements confirms the accuracy of the
presented better FiO2 precision while S1 presented better measurement by the Q-NRG in the clinically relevant conditions
accuracy. Deltatrac measured the simulated VO2 accurately and simulated in the in-vitro setting.
precisely, regardless of the type of ventilator. Imprecision of Reference
FiO2 by S1 had great influence on the precision and accuracy of
1. International multicenter study for the development and validation
the VO2 measurement by Quark RMR®.
of a new indirect calorimeter, sponsored by ESPEN.
S294 Poster
Disclosure of Interest: T. Oshima Grant/Research Support from: Public MON-LB313

Foundation Nutrition 2000plus, Geneva University Hospital, Other: EVALUATION OF NUTRITIONAL STATUS IN PRE-OPERATIVE
COSMED, Nestle, Y.-M. Dupertuis: None declared, S. Graf: None PATIENTS WITH GASTROINTESTINAL SYSTEM CANCER WITH
declared, A.-M. Makhlouf: None declared, M. Ragusa Other: COSMED, TWO DIFFERENT NUTRITIONAL SCREENING TOOLS
C.-P. Heidegger Other: Baxter, Nestle Nutrition, C. Pichard Grant/
Research Support from: Swiss National Science Foundation, Nestle A. Sahin Kaya1 *, A. G. Pekcan2. 1Nutrition and Dietetics, Namık
Nutrition, Baxter, BBraun, Fresenius-Kabi, COSMED, Consultant for: Kemal University School of Health, Tekirdağ, 2Nutrition and
Baxter, Abbott, BBraun, COSMED, Fresenius-Kabi, Novartis, Danone, Dietetics, Hasan Kalyoncu University School of Health,
Pfizer, Solvay, Vifor. Gaziantep, Turkey
MON-LB312 Rationale: To determine the nutritional status of gastrointes-

QUALITY INDICATOR FOR NUTRITIONAL MANAGEMENT OF tinal cancer patients with two different nutritional screening
HOSPITALIZED PATIENTS tools and compare the tools.
Methods: This study was held in 110 patients (female; 41.8%
A. L. C. C. Rodrigues1 *, A. N. Severine1, A. Yamaguti1.
1 male: 58.2%), aged 19–65 years, admitted to hospital,
Nutrition, Hospital Sírio-Libanês, São Paulo, Brazil
diagnosed with gastrointestinal system cancer (not operated).
Rationale: Malnutrition can adversely affect the clinical The objective was to determine the nutritional status of the
evolution of hospitalized patients, increasing the incidence of patients with nutrition screening tools (Subjective Global
infections, associated diseases and postoperative complica- Assessment-SGA, Nutritional Risk Screening-NRS 2002),
tions and prolonging the length of stay and hospital costs. compare the tools, and describe the malnutrition status of
The aim of this study is to evaluate the efficacy of nutritional patients. Socio-demographic characteristics, anthropometric
management to hospitalized patients through a quality measurements, biochemical parameters and 24-hour dietary
indicator. recalls, frequency of foods consumed were determined.
Methods: This study describes the monitoring of the indicator Results: Out of total, 54.7% of males and 56.5% of females had
to evaluate the quality of nutritional care in order to facilitate normal Body Mass Index-BMI. Using SGA, 49.1% of the patients
the diagnosis of nutritional disorders and the follow-up of had serious, 41.8% had moderate degree of malnutrition.
dietary interventions. A database containing information on According to NRS-2002, percentages of severely, moderately
nutritional markers such as the presence of edema, changes in and mildly undernourished patients were 54.6%, 33.6% and
laboratory tests, altered anthropometric variables (Body 11.8%, respectively. The percentage of patients meeting the
Mass Index, Calf Circumference in the elderly over 60 years, recommended daily allowances was 47.2% and 58.1%, respect-
Brachial Circumference and Bioelectrical Impedance analysis) ively for males and females. According to NRS and SGA tools,
has been obtained. Three quality indicators have been statistically significant differences with current weight, ideal
monitored: improvement of nutritional status, maintenance body weight, usual body weight, percentage of weight loss,
of nutritional status and worsening of nutritional status, being BMI, mid-upper arm circumference, triceps skinfold thickness,
monitored every 10 days of hospitalization of each patient at mid-upper arm muscle area, mid-upper arm muscle circumfer-
nutritional risk. ence and mid-upper arm fat area ( p < 0.05) were found.
Results: 7936 patients at nutritional risk have been evaluated Nutritional status of patients with SGA and NRS tests showed
between March 2016 and March 2017. From those 677 patients consistent similarity (κ = 0.671, p < 0.001). Similar changes
presented improvement in nutritional status, 6.515 main- were found between SGA and NRS scores. Consistency was
tained nutritional status and 744 worsened their nutritional found statistically significant (r = 0.786 and p =< 0.001).
status. All patients with worsening nutritional status received Conclusion: One of the malnutrition screening tools could be
individualized nutritional interventions to ensure the best preoperatively applied in gastrointestinal system cancer
therapy for clinical recovery or quality of life. The average patients. Nutritional support should be planned and adminis-
nutritional interventions were: 11 enteral/parenteral nutri- tered, when needed.
tion therapy adjustments; 5 proteins, lipids and fiber modules Disclosure of Interest: None declared.
introduction; 13 nutritional supplements introduction or
adaptation and 10 dietary changes to improve food MON-LB314
acceptance. AN EVALUATION OF THE SUGGESTED ESPEN MALNUTRITION
Conclusion: It is paramount to systematically evaluate the CRITERIA IN LIGHT OF THE CRITERIA FOR MALNUTRITION AS
nutritional status of patients at nutritional risk for adequate PRESENTED IN THE NORWEGIAN NATIONAL GUIDELINES
interventions in the prevention and treatment of malnutrition. H. K. Brekke1, E. Hoeisaether1, C. Holth1 *. 1University of Oslo,
Reference Oslo, Norway
Kondrup J, Allison SP, Elia M, et al. ESPEN Guidelines for Nutrition
Screening 2002. Clin Nutr 2003; 22(4):415–21. Rationale: The European society of clinical nutrition and
metabolism (ESPEN) recently published a consensus for
malnutrition criteria. Our aim was to evaluate the newly
suggested ESPEN malnutrition criteria (EMC) in light of the
currently used Norwegian national criteria for malnutrition
(ICD-10 NO) in cancer patients. Furthermore, we aimed to
examine the overlap between the three ESPEN criteria, and
whether bioelectrical impedance analysis (BIA) could replace
dual energy X-ray absorptiometry (DXA) as method for References

determining Fat Free Mass Index (FFMI). Murphy WJ, Steiber AL. A new breed of evidence and the tools to
Methods: We recruited 69 outpatient cancer patients. The generate it: Introducing ANDHII. Journal of the Academy of Nutrition
patients were assessed for nutritional risk using Patient- and Dietetics. 2015;115:19–22.
Generated Subjective Global Assessment (PG-SGA) and Nutrition care process and model part I: the 2008 update. J Am Diet
Nutrition risk screening 2002 (NRS-2002), and considered for Assoc. 2008;108:1113–1117.
malnutrition using the EMC and the ICD-10 NO. FFMI was Nutrition Care Process Part II: Using the International Dietetics and
Nutrition Terminology to Document the Nutrition Care Process.
measured using DXA (Lunar iDXA, GE Healthcare) and BIA (Seca
Journal of the American Dietetic Association. 2008;108:1291–1293.
BCA 515).
Results: Initial assessment by PG-SGA and NRS-2002 showed Disclosure of Interest: None declared.
that 41 (59.4%) and 31 (44.9%) patients were at nutritional risk,
respectively. EMC and ICD-10 NO identified 16 (23.2%) and 29 MON-LB316
(42.0%) patients as malnourished, respectively. The three VALIDATION STUDY OF A HANDHELD METABOLIC ANALYZER IN
ESPEN criteria showed low degree of overlap. Assessment of MEASURING ENERGY EXPENDITURE AND RESPIRATORY
FFMI showed similar results using BIA and DXA. QUOTIENT.
Conclusion: The newly suggested malnutrition criteria by A. Atsalakis1, P. Papadiamantis1, T. Souren1, P. Papageorgiou1,
ESPEN showed limited agreement to the Norwegian malnutri- D. Karagiannis2 *, A. Baschali2. 1Research, Development Team,
tion criteria. The disagreement was primarily caused by EMC 2
Clinical Nutrition and Dietetics, Evangelismos Hospital,
not considering WL alone a criterion for malnutrition. The Athens, Greece
criterion including FFMI identified the majority of malnour-
ished patients when using the EMC. BIA (Seca BCA 515) and DXA Rationale: Recently, many new indirect calorimeters were
(Lunar iDXA GE Healthcare) could be used interchangeably for introduced as a convenient solution to determine resting
assessing FFMI. metabolic rate (RMR) for assessment of daily energy needs.1
Disclosure of Interest: None declared. The aim of this study was to report the validity of a new, hand-
held indirect calorimeter device developed by ENDO Medical
Inc.
MON-LB315
Methods: Twenty-five (25) healthy volunteers (17 male, 8
USING ANDHII TO APPLY THE NUTRITION CARE PROCESS AND
female) with an age range 23–60 years old were asked to breath
ANSWER NUTRITION RESEARCH QUESTIONS
for at least 5 minutes to a mouthpiece that was connected in
C. Papoutsakis1 *, A. Steiber1. 1Research International series withthe hand-held device of ENDO Medical and with a
Scientific Affairs, Academy of Nutrition and Dietetics, Metabolic Cart (Quark CPET, COSMED) that allowed the
Chicago, United States simultaneous analysis of the subjects’ breath by both
devices. The Quark CPET system represents an established
Rationale: There is limited data on the impact on nutrition care
clinical standard that has been validated against clinical and
and related health outcomes, and research tools are lacking to
industrial golden standard devices (Deltratrac, Datex-Ohmeda,
aggregate data in a systematic fashion.
Finland) as well as a Douglas Bag system. Statistical significance
Methods: The Academy of Nutrition and Dietetics Health
was set at p < 0.05 level and values are presented as mean ± SD.
Informatics Infrastructure (ANDHII) is a web-based platform
Results: The system developed by ENDO Medical exhibited
designed to enter individual patient data and aggregate
good agreement with the Quark CPET by COSMED with an
outcomes of nutrition interventions. Nutrition professionals
average mean difference of −7.1 ± 11.5 mL/min for VO2 ( p =
are able to use ANDHII from anywhere in the world via internet
0.70) and −7.6 ± 11.9 mL/min for VCO2 ( p = 0.78). The 95%
access. ANDHII is based on the Nutrition Care Process (NCP) and
confidence intervals for the limits of agreement were found
terminology (NCPT: Nutrition Care Process Terminology).
within the acceptable range of ±50 mL/min as defined by the
Results: Nutrition care data has been collected on a national
medical grade accuracy standards of indirect calorimetry, using
scale (in the US) and internationally (in Australia, New Zealand,
the Bland-Altman test ([−38, 23] for VO2 and [−39, 24] for
and Singapore). ANDHII has over 2,000 practitioner users
VCO2). The mean energy expenditure measured by both
entering case data that contributes to nutrition outcomes
devices was in a very good agreement as well (2484 ± 475
research, education initiatives in academia and practice
kCal/day for Quark CPET of COSMED and 2432 ± 482 kCal/day
placements, quality improvement, and impact demonstration.
for the hand-held device of ENDO Medical, p = 0.72).
To date, 10 clinical projects are collecting data using ANDHII in
Conclusion: These data indicate that the handheld metabolic
different areas of practice including acute care, private
analyzer that has been developed by ENDO Medical Inc. is in
practice, and public health nutrition.
good agreement with a Metabolic Cart Analyzer, making it
In this poster presentation, we present up-to date data
reliable for energy expenditure and RQ measurements based on
collection activity by clinical project, usage of most nutrition
the medical grade accuracy criterion of ± 50 mL/min for VO2
assessment terms, diagnoses, and respective nutrition
and VCO2.
interventions.
Conclusion: ANDHII makes possible the aggregation of data to Reference
explore the impact of nutrition care on patient outcomes in 1. Oshima T, Berger MM, De Waele E, Guttormsen AB, Heidegger CP,
different countries and settings. Still, experimental research is Hiesmayr M, Singer P, Wernerman J, Pichard C. Indirect
necessary to duplicate findings and account for confounding calorimetry in nutritional therapy. A position paper by the ICALIC
factors. study group. Clin Nutr. 2017 Jun;36(3):651–662
S296 Poster
MON-LB317 University of Groningen, University Medical Center Groningen,

NUTRITION-RELATED PROGNOSTIC SCORE FOR HOSPITALIZED Groningen, Netherlands
PATIENTS VIA EMERGENCY ROOM
Rationale: Sarcopenia is a major problem and is common in
H. Baba1 *, J. Hatakeyama2, H. Ono1, J. Unoura3, Y. Nakayama4,
community-dwelling elderly. In daily practice, there is need for
on behalf of Nutrition support team. 1Surgery, 2Intinsive Care
low cost and easily assessable measurement tools to assess
Medicine, 3Respiratory Medicine, 4Emergency Medicine,
depletion of skeletal muscle (SM) mass, for example as one of
Yokohama City Red Cross Hospital, Yokohama, Japan
the indicators of sarcopenia. Bio-electrical impedance analysis
Rationale: There are literatures describing the relationship (BIA) is often used to estimate body composition, whereas
between abnormal electrolytes and increased in-hospital ultrasound measurement is an upcoming and promising tool, as
mortality among the elderly who are hospitalized via emer- it is quick, easy to use and inexpensive in comparison with other
gency room. However, whether association of nutrition-related tools that assess SM mass. Ultrasound could assess site-specific
prognostic score in this setting is unknown. loss of SM mass and determine myoesteatosis. Therefore, in this
Methods: We retrospectively investigated the relationship pilot study we aimed to assess agreement between muscle
between the nutrition-related prognostic score and the thickness of rectus femoris (RF) by ultrasound and SM mass by
elderly who were hospitalized at our tertiary emergency BIA in an older population.
medical center. 185 patients who visited our emergency room Methods: Twenty-six older adults (mean ± standard deviation
in ten consecutive days starting from January 1, 2015 were (SD) age 64 ± 5.0 y, 62% women) from the Hanze Health and
retrospectively reviewed. Obstetric and pediatric emergency Ageing Study were included. SM mass by BIA was estimated
patients were excluded. Serum albumin, C-reactive protein using the Janssen equation. Muscle thickness of RF was
and leukocytes were investigated and nutritional prognostic assessed by analyzing ultrasound images from the right leg.
index (NPI), neutrophil-lymphocyte ratio (NLR) and Glasgow Two non-parametric tests were used for analysis. Correlation
prognostic score (GPS) were calculated. Patients were between ultrasound and BIA was assessed with Spearman Rho.
classified into three groups, below 65 (group A), between Agreement was determined with Kendall’s coefficient of
65 and 80 (group B) and 80 or more (group C). Data analysis concordance (Kendall’s W). In both tests a score ≥ 0.7 was
was performed using SPSS software. Continuous variables considered a strong correlation.
were expressed as mean ± SD. Chi-squared test was used to Results: Mean (±SD) RF thickness was 18.9 (±3.8) mm. Median
identify significant differences between proportions and SM mass (Interquartile range) was 23.5 (20.8–34.7) kg.
variables. Kaplan-Meier analysis was used to analyze patient Correlation between RF thickness and SM mass was moderately
survival rate. A p value <0.05 was considered statistically positive (Spearman r = 0.611; P = 0.001), whereas Kendall’s W
significant. showed a strong agreement (W = 0.835; P = 0.002).
Results: Among 185 admissions, 151 were eligible for the study. Conclusion: Ultrasound measurement of RF showed an
Median age was 73 (range; 18∼98). NPI of each group was 46.0, acceptable agreement with skeletal muscle mass assessed by
41.2 and 37.6, respectively ( p < 0.05). NLR was 9.7, 10.3 and BIA in our sample of older adults. Therefore, ultrasound could
13.7, respectively. 54 patients were GPS 0, 44 were GPS 1 and be a promising portable tool to estimate muscle size.
46 were GPS 2 ( p < 0.05). Hospital stay were longer as age Disclosure of Interest: None declared.
became higher, group A being 9.5days, group B, 12 days and
group C, 14.5 days. In-hospital mortality rate was 13.2%, group MON-LB319
C being the majority counting 85% of all deaths and was INTRA- AND INTER-RATER RELIABILITY OF ASSESSMENT OF
statistically significant ( p = 0.001). Kaplan-Meier survival curve BICEPS MUSCLE SIZE BY ULTRASOUND IN ELDERLY
showed a trend towards the lower the GPS, the better the
J. P. Pinho1 *, R. Azevedo1,2, J. Silveira3, P. Rocha4, W. Nijholt5,6,
survival.
H. Jager-Wittenaar6,7. 1Nutrition Services, Centro Hospitalar
Conclusion: In-hospital mortality is significantly high in the age
Médio Ave, EPE, V.N. Famalicão, 2Faculty of Nutrition and Food
80 or more group. Among several nutrition-related prognostic
Science, University of Porto, 3Nutrition Services, Eurico de
scores, GPS may be closely associated to survival among
Almeida, ORL Clinic, 4Radiotherapy Service, Francisco Gentil
patients hospitalized via emergency room.
Portuguese Institute of Oncology of Porto, EPE, Porto,
Disclosure of Interest: None declared. Portugal, 5Department of Rehabilitation Medicine, University
of Groningen, University Medical Center Groningen, 6Research
MON-LB318 Group Healthy Ageing, Allied Health Care and Nursing, Hanze
AGREEMENT BETWEEN RECTUS FEMORIS MUSCLE THICKNESS University of Applied Sciences, 7Maxillofacial Surgery,
BY ULTRASOUND AND SKELETAL MUSCLE MASS BY BIO- University of Groningen, University Medical Center Groningen,
ELECTRICAL IMPEDANCE ANALYSIS: A PILOT STUDY Groningen, Netherlands
I. L. Rodenburg1 *, W. Nijholt1, M. J. Sealy2,3, C. P. van de
Schans1,4,5, J. S. Hobbelen1,6, H. Jager-Wittenaar1,2. Rationale: Although ultrasound has been reported as valid and
1
Research Group Healthy Ageing, Allied Health Care and reliable tool to assess muscle size in older adults1, little is
Nursing, Hanze University of Applied Sciences, 2Department of known about intra-rater reliability (intra-RR) and inter-rater
Maxillofacial Surgery, 3Research Group Healthy Ageing, Allied reliability (inter-RR) of BodyMetrix in specific to assess small
Health Care and Nursing, 4Departement of Health Psychology muscles. Therefore, in this study we aimed to assess intra-RR
Research, 5Department of Rehabilitation Medicine, and inter-RR of biceps muscle size (thickness) in elderly.
6
Departement of General Practice and Elderly Care Medicine, Methods: Thirty elderly (81.9 ± 6.3 years; 80% women; BMI
26.7 ± 5.3 kg/m2) living in a Portuguese nursing home/
residence were included. To assess procedural intra-RR and Table:

inter-RR, ultrasound measurements were performed by two RMR RMR < 80% RMR80–89% RMR90–110% RMR111–119% RMR > 119%
raters (R1, R2, beginners level) by BodyMetrixTM BX2000, on the
biceps of the right arm. R1 repeated the ultrasound measure- N = 82 5(6%) 4(5%) 9(11%) 6(7%) 58(71%)
Average kcal/day kcal/day kcal/day kcal/day kcal/day
ment once. To assess measurement intra-RR and inter-RR, RMR (HB) 1578 2059 1684 1754 1675
images were analyzed by three raters (R1, R2, and R3 RMR (IC) 1166 1739 1723 2027 2274
[experienced level]). Agreement was analyzed by intraclass Difference +412 +320 −39 −273 −599
kcal/day
correlation coefficient. ICC values of 0.50–0.75 were consid- n = 82 BMI predicted% RMR-HB RMR-IC day of IC
ered moderate to good, and >0.75 as good to excellent. vs HB kcal/d kcal/d
Statistical significance was set at p < 0.05. mean 25,6 124 1694 2101 6,7
SD (4,1) (23,1) (266,1) (468,0) (2,3)
Results: Mean muscle thickness at 1st and 2nd measurement
(R1) was 23.4 ± 4.5 and 23.7 ± 3.8 mm, respectively. For
procedural intra-RR, ICC was 0.630. For inter-RR of image 1 Conclusion: Indirect calorimetry is easy to perform and give a
(R1) vs. image 2 (R2), ICC was 0.622. For inter-RR of image 2 measurement of current metabolism for each individual
(R2) vs. image 3 (R1) ICC was 0.534. For measurement patient, compared with calculated results. Most patients
reliability, ICCs for intra-RR of R1 and R2 were 0.865 and after liver transplantation have higher metabolism than
0.766, respectively. ICCs for inter-RR of R1 vs. R2, R2 vs. R3, and calculated based on the Harris-Benedicts equation. Indirect
R1 vs. R3 were 0.865, 0.800, and 0.815, respectively. All ICCs calorimetry should be performed routinely in all liver trans-
were statistically significant ( p ≤ 0.001). planted patients to ensure adequate energy intake for each
Conclusion: The results of our study indicate that procedural patient.
reliability of biceps muscle size as assessed by BodyMetrix in Disclosure of Interest: None declared.
elderly is moderate to good, and measurement reliability is
good to excellent. Increasing the level of experience may MON-LB321
further improve procedural reliability. AMINO ACID DERIVED ACYL-CARNITINE CONCENTRATIONS
Reference CHANGE DOSE-DEPENDENTLY UPON CHICKEN MEAT INTAKE
1. Nijholt W, Scafoglieri A, Jager-Wittenaar H, et al. The reliability P. J. Giesbertz1 *, B. Ott2, Y.-M. Lee2, H. Daniel1, T. Skurk2.
and validity of ultrasound to quantify muscles in older adults: a 1
Lehrstuhl für Ernährungsphysiologie, Technische Universität
systematic review. Journal of Sarcopenia Cachexia and Muscle. 2017 München, 2Core Facility Human Studies, ZIEL, Institute for
[in press] Food and Health, Freising, Germany
Rationale: Metabolic responses are highly individual upon
MON-LB320 ingestions of different types of foods. We aimed to study
INDIRECT CALORIMETRY AFTER LIVER TRANSPLANTATION IS appearance and disappearance of metabolite markers in
NEEDED TO ENSURE THE RIGHT AMOUNT OF ENERGY plasma and urine after intake of different doses of chicken
SUPPLIED. meat.
Methods: Within the JPI funded FOODBALL-consortium, we
P. Nordstedt1 *, C. Lindqvist2, G. Nowak1. 1Department of
performed a well-controlled human cross-over intervention in
Transplantation Surgery, 2Department of Clinical Nutrition,
which 12 volunteers (6 m/6 f ) consumed defined doses of
Karolinska University Hospital, Stockholm, Sweden
chicken breast (0g, 100 g and 200 g) and were followed during
Rationale: Patients undergoing liver transplantation may have subsequent 24 hours. Using our targeted LC-MS/MS method, we
an altered metabolism, that is individual and difficult to measured plasma and urine samples and analysed a broad panel
predict. To ensure the right amount of energy supplied to each of acylcarnitine species,
individual patient we compared calculated with measured Results: In plasma, a dose-dependent increase in acylcarnitine
resting metabolic rate, using Harris-Benedicts equation (HB) species derived from amino acid breakdown could be observed
and indirect calorimetry (IC). (see Table: increases at higher doses are expressed as relative
Methods: During the period 2010–2017, energy requirements compared to 0 g chicken meat). In contrast, no changes in rates
were measured with indirect calorimetry(IC) and calculated of appearance and disappearance between the different doses
with the Harris-Benedicts equation (HB). All measurements of meat were seen for fatty acid-derived acylcarnitine species.
were performed on the postoperative day 2–15. The measure- Analysis of urine showed similar dose-dependency of amino
ments were standardized and performed with Cosmed Fitmate acid derived acylcarnitines.
apparatus with a breathing mask for 20 minutes. Table:
Results: Totally, 82 measurements in 82 patients were Acylcarnitine Relative peak Relative peak
performed. Of these, 71% of the patients, had a high measured increase 100 g/0g increase 200 g/0g
resting metabolic rate (mean 2095 kcal/d), in average 124%
C3 1 1.49 1.77
compared to predicted using Harris-Benedicts equation (mean 3-M-C4 1 1.39 1.63
1701 kcal/d). The difference between measured and calcu- 2-M-C4 1 1.44 1.59
lated needs varied widely, with an underestimation of 2-M-C3 1 1.21 1.37
C5-M-DC 1 1.04 1.28
599 kcal/day in average. Center results in Table C4 1 1.07 1.16
2/3-M-C4:1 1 1.24 1.13
S298 Poster
Conclusion: The intake of meat caused a dose-dependent Reference

increase in amino acid derived acylcarnitines. Increased plasma Scalfi L, et al. The prediction of basal metabolic rate in female patients
concentrations of amino acid-derived acylcarnitine species at with anorexia nervosa. Int J Obes Relat Metab Disord, 2001. 25(3):
high doses were seen 12 hours at consumption and changes in 359–364.
plasma concentrations largely mirrored changes in urine. Disclosure of Interest: None declared.
MON-LB323
MON-LB322 ULTRASOUND MEASURED MUSCLE SIZE IN RELATION TO
SUITABILITY OF THE EQUATIONS BY HARRIS-BENEDICT AND MUSCLE STRENGTH AND MASS: AN EXPLORATIVE STUDY IN
MÜLLER, SCALFI AND SCHEBENDACH FOR ESTIMATING PATIENTS WITH COPD
RESTING ENERGY EXPENDITURE IN MODERATELY TO W. Nijholt1,2 *, L. ter Beek2,3, J. S. M. Hobbelen2,4,
SEVERELY UNDERWEIGHT WOMEN H. van der Vaart3, J. Wempe3, C. P. van der Schans1,2,5,
S. Ramminger1 *, L. Valentini1, U. Elbelt2, H. Jager-Wittenaar2,6. 1Department of Rehabilitation
K. Kohlenberg-Müller3, J.-P. Keil4, D. Lamers5. Medicine, University of Groningen, University Medical Center
1
Neubrandenburg Institute of Evidence-based Dietetics, Groningen, 2Research Group Healthy Ageing, Allied Health
Neubrandenburg University of Applied Sciences, Care and Nursing, Hanze University of Applied Sciences,
Neubrandenburg, 2Department of Endocrinology, Diabetes and Groningen, 3Department of Pulmonary Diseases and
Nutrition, Charité-Universitätsmedizin Berlin, Berlin, Tuberculosis, Center for Rehabilitation, University of
3
Department of Ecotrophology, University of Applied Sciences Groningen, University Medical Center Groningen, Haren,
Fulda, Fulda, 4Dietrich Bonhoeffer Klinikum Neubrandenburg, Groningen, 4Department of General Practice and Elderly Care
Neubrandenburg, 5Profil Institute for Metabolic Research, Medicine, 5Department of Health Psychology Research,
6
Neuss, Germany Department of Maxillofacial Surgery, University of Groningen,
University Medical Center Groningen, Groningen, Netherlands
Rationale: In underweight women conventional equations for
estimating resting energy expenditure (REE), such as Harris- Rationale: Muscle wasting is common in patients with COPD and
Benedict or Müller, are commonly used in clinical practice. Yet, may impact exercise tolerance and quality of life. Ultrasound
it is unclear if these equations provide reliable results or if can be used to quantify specific muscles. This study aims to
special equations should be used. The objective was to correlate ultrasound measured muscle size with muscle
compare measured REE with 2 universal and 2 specific strength and mass in patients with COPD.
equations. Methods: Patients with COPD at the start of a pulmonary
Methods: REE was measured in 57 underweight women (28 ± 10 rehabilitation program were asked to participate in this cross-
years, BMI 15.2 ± 2.2 kg/m²) by indirect calorimetry (IC) sectional study. Rectus femoris muscle size (thickness in cm)
(Cosmed, Quark RMR, Rome, Italy) under standardized condi- was determined by ultrasonography (Philips VISIQ). Skeletal
tions. Overall, 49 women (86%) were diagnosed with anorexia muscle mass (SMI) was estimated by BIA using the equation of
nervosa, the remaining 8 women were healthy. REE-IC was Janssen et al (kg/m2). Handgrip strength was measured in
compared with the equations of Harris Benedict and Müller kilograms (HGS in kg) and the five times sit to stand test
2004 (both for the general population), Scalfi (18–30-year-old (seconds, higher scores indicating decreased strength) was
women with anorexia nervosa) and Schebendach (modified assessed as a proxy measure of lower extremity strength. The
Harris-Benedict formula for anorexia nervosa). relationships between muscle size and mass and strength were
Results: The participants had a mean REE-IC of 1019 ± 194 kcal/ determined using a Spearman or Pearson’s correlation
d. Scalfi reached comparable results to REE-IC (mean devi- coefficient.
ation: −2 ± 16%) in the BMI range of 14–18.4 kg/m², but Results: 30 COPD patients (mean age 59.77 ± 8.55 years, 43%
underestimated REE with BMI <14 kg/m². All remaining male, median FEV1%pred 37 [IQR = 23–52]) were included.
equations led to significant mean deviations of + 16 ± 25% Mean muscle size was 1.81 ± 0.40 cm for males and 1.58 ± 0.28
with Harris-Benedict, −24 ± 15% with Müller and −15 ± 17% cm for females. Muscle size was correlated to SMI and HGS
with Schebendach (see Table 1). (r = 0.553, p = 0.002 and r = 0.475, p = 0.009, respectively). The
correlation between muscle size and lower extremity strength
Table 1: Comparison between the measured and estimated resting energy was r=-0.332, p = 0.091.
expenditure (REE).
Conclusion: This exploratory study shows that, in patients
BMI (kg/m²) REE-IC Scalfi Schebendach HB Müller with COPD, rectus femoris muscle size is moderately strong
(kcal/d) (kcal/d) (kcal/d) (kcal/d) (kcal/d)
correlated with skeletal muscle mass and handgrip strength. A
<14.0 (n = 16) 900 ± 210 794 ± 90* 695 ± 126** 1158 ± 69*** 614 ± 88*** weak, not significant, correlation was found between muscle
14.0–16.4 (n = 21) 980 ± 146 951 ± 94 837 ± 133** 1235 ± 72*** 743 ± 90***
size and lower extremity strength, maybe due to low power.
16.5–18.4 (n = 20) 1155 ± 142 1154 ± 113 983 ± 120*** 1314 ± 65*** 905 ± 137***
These findings may indicate the potential of ultrasound to
Unpaired t-test, *p < 0.001, **p < 0.01, ***p < 0.05, IC = indirect calorimetry, quantify muscle status COPD patients.
HB = Harris Benedict.
Reference
Conclusion: Universal equations for estimating REE (Harris- Janssen I, Heymsfield SB, Baumgartner RN, et al. Estimation of
Benedict, Müller) are unreliable for underweight women, even skeletal muscle mass by bioelectrical impedance analysis. J. Appl
in moderate underweight. Only the simple equation of Scalfi Physiol 2000;89:465–71.
(REE = 96.3 x body weight) seems suitable for underweight Disclosure of Interest: None declared.
women, at least for BMIs equal or higher than 14 kg/m².
MON-LB324 The University of Tokyo Graduate School of Medicine, 4Global

APPLICATION OF NRS-2002 AND MNA TO SCREEN Nursing Research Center, The University of Tokyo Graduate
NUTRITIONAL RISK IN ELDERLY PATIENTS IN A CHINESE School of Medicine, Tokyo, 5Department of Nursing Science,
UNIVERSITY HOSPITAL Faculty of Nursing and Social Welfare Sciences, Fukui
X. Zhigang1 *, Y. Wang1, J. Yu1. 1General Surgery, Peking Union Prefectural University, Fukui, 6School of Health and Nursing
Medical College Hospital, Beijing, China Science, Wakayama Medical University, Wakayama,
7
Department of Skincare Science, 8Global Nursing Research
Rationale: We aimed to investigate nutritional risk in elderly Center, The University of Tokyo Graduate School of Medicine,
patients using Nutrition risk screening-2002 and Mini-nutri- Tokyo, 9Advanced Health Care Science Research Unit,
tional assessment, and to determine the difference and Innovative Integrated Bio-Research Core, Kanazawa University,
consistence of nutritional risk assessment tools. Ishikawa, Japan
Methods: In this prospective observational study, 284 patients
in department of general surgery over 65 years old were Rationale: Energy inadequacy has a significant impact on
included from July 2010 to April 2011. The nutrition risk profile patient’s clinical outcomes, though it is difficult to assess
was determined using NRS-2002 and MNA on admission. energy status of bedridden elderly patients. Recently, we have
Nutrition-related hematological levels, nutrition support and revealed that temporal muscle thickness (TMT) reflects the
health-economic data were collected. Comparisons between nutritional status indicators such as body mass index. Since
patients ‘at risk’ and ‘not at risk’ and logistic regression changes in muscle mass are associated with imbalanced energy
analyzes were performed. intake, we hypothesize that changes in TMT can be used as a
Results: Nutrition risk rate in elderly patients using NRS-2002 marker for detecting energy inadequacy. The aim of this study
and MNA was 37.7% and 26.8% respectively. When using NRS- is to examine the relationship of changes in TMTand the energy
2002 tool, nutrition risk rate in GI tumor (72.8%, 83/114) is status of patients.
higher than that in cholelithiasis (23.1%, 18/78), thyroid tumor Methods: A prospective cohort study of bedridden elderly
(8.5%, 5/59), hernia (10%, 3/10). While using MNA tool, individuals was conducted from September 2015 to June 2016.
nutrition risk rate in GI tumor, cholelithiasis, thyroid tumor TMT was measured using ultrasonography at baseline and after
and hernia were 48.2%, 19.2%, 5.1%, 10% respectively. Serum 4 weeks. Average daily energy intake was calculated using the
total protein(TP), albumin, prealbumin(PA), BMI in patients at photographic diet records of 4 weeks. Energy inadequacy was
nutritional risk were significantly lower than those without defined as energy intake/energy needs <75%. Harris-Benedict
nutrition risk ( p < 0.05 as significance). And nutritional risk equation was used to estimate energy needs.
patients had significantly longer length of stay (LOS) and higher Results: Forty-eight participants were included in the study
medical expenses. NRS-2002 and MNA for nutritional status (mean age 84.4 ± 7.8 years; 26 women [54.2%]; 32 on an oral
assessment show good consistency. While we analyzed those diet [66.7%]). The mean TMT was 3.6 ± 0.9 mm at baseline and
patients with GI tumor assessed as at nutrition risk using NRS- 3.5 ± 1.0mm at 4 weeks, therefore the change after 4 weeks
2002 but not at nutritional risk using MNA. These patients with was −0.1 ± 0.7 mm (−1.9 ± 21.8%). Mean daily energy intake
preoperative nutrition support(PNS) had significantly shorter and energy adequacy were 1099 ± 294 kcal and 92.2 ± 28.1%,
LOS (10.3 ± 3.3 vs 14.8 ± 5.9 d, p = 0.014) and lower medical respectively. The percentage change in TMT significantly
expenses (9841 ± 4264 vs 16863 ± 10040 RMB, p < 0.020). correlated with energy adequacy (r = 0.733, p < 0.001).
Conclusion: Elderly patients especially those with GI tumor Receiver operating characteristic analysis identified a percent
had a relatively high nutritional risk rate. Patients at nutrition change of TMTof -3.6% as an optimal cut-off point for detecting
risk had significantly lower TB, albumin, PA, BMI and higher LOS energy inadequacy, with a sensitivity of 92.9% and a specificity
and medical expenses. PNS helps to decrease postoperative of 76.5%.
LOS. NRS-2002 maybe more suitable for elderly patients Conclusion: Ultrasonographic evaluation of TMT can detect
than MNA. energy inadequacy, and thus could be useful for detecting
energy status in bedridden elderly patients.
References
1. Kondrup J, et al. Clin Nutr. 2003,22(4):415–21.
2. Guigoz Y, et al. Nutr Revi, 1996,54(1):s55–s65.
3. Schiesser M, et al. Surgery. 2009,145(5):519–26. MON-LB326
THE ASSOCIATION OF FAST FOOD PATTERN AND ITS RELATION
Disclosure of Interest: X. Zhigang Grant/Research Support from:
Central Health Care Program, Y. Wang Grant/Research Support WITH HISTORY OF HYPERTENSION IN WOMEN LIVING IN
from: Central Health Care Program, J. Yu Grant/Research Support NORTH OF TEHRAN
from: Central Health Care Program. A. Rezazadeh1 *, B. Rshidkhani1, N. Omidvar1, on behalf of.
1
Department of Community Nutrition National Nutrition and
MON-LB325 Food Technology Research Institute Faculty of Nutrition
A CHANGE IN TEMPORAL MUSCLE THICKNESS CORRELATES Sciences and Food Technology Shahid Behehshti University of
WITH PAST ENERGY ADEQUACY IN ELDERLY INDIVIDUALS: A Medical Sciences, Tehran, Islamic Republic of Iran
PROSPECTIVE COHORT STUDY
Rationale: Emerging evidences suggest that high consumption
Y. Uehata1,2 *, M. Yoshida3,4, A. Sato5, Y. Fujimoto6, of fast food is positively related to hypertension. This study
T. Minematsu7,8, J. Sugama9, R. Sekine1, N. Kubota1, aimed to determine the association between fast food dietary
H. Sanada2,8. 1Department of Clinical Nutrition Therapy, The pattern and having history of hypertension in women living in
University of Tokyo Hospital, 2Department of Gerontological Tehran.
Nursing/Wound Care Management, 3Imaging Nursing Science,
S300 Poster
Methods: In this cross-sectional study, 460women aged 20– Depression Scale (CES-D). Ordered logit and standard logit
50years were selected through stratified random sampling. regressions were employed to analyze the associations
Dietary information was collected by a valid and reliable semi- between malnutrition and various health outcomes. Subjects’
quantitative food frequency questionnaire by trained dieti- socio-demographics were also controlled for.
tians. History of hypertension was assessed through having Results: Malnutrition was associated with significantly lower
systolic/diastolic Blood pressure ≥140/90mmHg, previously IADLs (OR = 0.87, p < 0.05), poorer health status (OR = 0.68,
diagnosed by a doctor. Anthropometric data were measured p < 0.001), higher probability of stroke (OR = 1.40, p <0.05) and
with standard methods. Physical activity level was obtained chronic stomach disease (OR = 1.24, p < 0.001). Consequently,
with a validated questionnaire for Iranians Fast food dietary malnutrition was associated with an increased hospital cost of
pattern was defined through factor analysis of four items ¥214 (14% increase, p < 0.01) per person per year. Furthermore,
(hamburger, salami, sausages, fried potato and pizza). malnutrition was associated with a 51% higher likelihood of
Multivariate logistic regression was used to estimate odds being depressed (OR = 1.513, p < 0.001) and a 66% increase
ratio(OR) and 95% confidence intervals(CI). P-Value < 0.05 was ( p < 0.01) in healthcare cost among depressed older adults.
considered as significant. Conclusion: Malnutrition was associated with poorer mental
Results: The mean ± SD age of participants was 33.5 ± 9.7 and physical health, and higher hospital costs among commu-
years. History of diagnosed hypertension was reported by 47 nity-dwelling older Chinese adults. Our results highlight the
(10.2%) of subjects. The mean ± SD of fast foods consumption importance of malnutrition and depression screening, identi-
were 89.03 ± 114.01 g/month for sausages, 77.81 ± 145.5 g/ fication/assessment, and treatment.
month for salami,46.3 ± 167 g/month for hamburger, 120.27 ± Disclosure of Interest: S. Goates Shareholder at: Abbott Nutrition,
177.2 g/month for pizza and 359.3 ± 1083 g/month for fried Other: Employee of Abbott Nutrition, J. Wei: None declared, L. Claytor
potato. After adjusting for confounders (age, smoking, physical Shareholder at: Abbott Nutrition, Other: Employee of Abbott Nutrition,
activity and energy intake), being in the highest quartile Y. Zhang: None declared, S. Li Shareholder at: Abbott Nutrition, Other:
category of fast food dietary pattern was positively associated Employee of Abbott Nutrition, L. Fan Other: Employee of Abbott
with having history of hypertension (OR:1.9,95%CI:1.67–4.01) Nutrition, S. Sulo Shareholder at: Abbott Nutrition, Other: Employee of
compared to the lowest quartile ( p-trend: P < 0.05). Abbott Nutrition, J. Partridge Shareholder at: Abbott Nutrition, Other:
Conclusion: Our findings support the positive relation between Employee of Abbott Nutrition.
hypertension and fast food pattern in the studied women. This
finding should be noted in interventional and educational MON-LB328
programs. A RETROSPECTIVE EVALUATION OF TPN UTILIZATION FOR
Reference
SHORT-TERM NUTRITIONAL SUPPORT: RESULTS OF A FIVE-
YEAR STUDY
Odegaard AO, Koh WP, Yuan J-M, Gross MD, Pereira MA. Western-Style
Fast Food Intake and Cardiometabolic Risk in an Eastern V. Alivizatos1 *, P. Athanasopoulos2, G. Tzouvekas2,
CountryClinical Perspective. Circulation. 2012;126(2):182–8. P. Demetriou2, L. Tchabashvili2, A. Kanellopoulou1. 1Surgery,
Nutrition Unit, 2Surgery, General Hospital of Patra,
Patra, Greece
MON-LB327 Rationale: TPN use is generally considered appropriate if the

ASSOCIATION BETWEEN MALNUTRITION, HEALTH OUTCOMES patient cannot be fed enterally for a period of at least 7–10
AND HEALTHCARE COSTS AMONG OLDER CHINESE ADULTS days. However, occasionally there are patients who receive TPN
S. Goates1 *, J. Wei2, L. Claytor3, Y. Zhang4, S. Li5, L. Fan6, for less than one week, whereas the documentation for TPN
S. Sulo7, J. Partridge8. 1Abbott Laboratories, Abbott administration may be often unclear and incomplete; these
Laboratories, Columbus, United States, 2Beijing Hospital, factors may lead to complications and influence the cost/risk
Beijing, China, 3Abbott Laboratories, Singapore, Singapore, and cost/benefit ratios. The aim of this study was to evaluate
4
National Health Development Research Center, Beijing, the appropriateness of short-term (<7 days) TPN therapy, if
5
Abbott Laboratories, Shanghai, China, 6Abbott Laboratories, other alternative nutritional methods such as enteral nutrition
Urbana-Champaign, 7Abbott Laboratories, Chicago, 8Abbott could have been utilized, or if the period of time the patient
Laboratories, Columbus, United States was unable to receive oral diet or enteral nutrition warranted
TPN use.
Rationale: China has the largest elderly population in the Methods: All adult patients of the department of surgery of our
world, but limited research assessing the relation between hospital who received TPN for less than 7 days during a five-year
malnutrition and the health of older Chinese adults exists. This period (1/1/2012–31/12/2016) were retrospectively studied.
research investigated the association between malnutrition, The parameters evaluated were the TPN indications (gastro-
health outcomes, depression, and healthcare costs among intestinal tract non-functioning and/or non-usuable), the
community-dwelling older Chinese adults. adaptation to the patients needs (excessive versus inadequate
Methods: A national sample of over 5,900 adults aged 60 years energy provision, addition or absence of trace elements and
or older from the 2013 China Health and Retirement vitamins), and whether the patients met criteria for the
Longitudinal Study (CHARLS) survey was used. Handgrip appropriateness of TPN therapy.
strength, body mass index, and weight loss were utilized as Results: Out of 115 patients who received TPN during the whole
indicators of malnutrition. Functional independence was study period, 38 (33%) received TPN for less than 7 days (range
assessed with activities of daily living (ADLs) and instrumental 2–6, mean 4.6 ± 1.2 days). Out of these, TPN was discontinued
ADLs (IADLs). Mental health and depressive symptoms were in 29 (76.3%) due to tolerance to an oral diet or tube enteral
evaluated through the Center for Epidemiological Studies feeding, in 7 (18.4%) due to patient discharge, and in 2 (5.2%)
due to patient’s death. Twenty eight patients (73.6%) had a MON-LB330

clear indication for TPN, while the remaining 10 (26.3%) had ENDOSCOPIC NASOENTERAL FEEDING TUBE FIXATION WITH
questionable appropriateness or inappropriateness. Althought HEMOCLIP REDUCES TUBE DISLODGEMENT
indications for short-term TPN were justified in 73.6% of the J. Han1 *, H. K. Na1, J.-Y. Ahn1, J. H. Lee1, D. H. Kim1,
cases, the adaptation to the patients needs was 47.3%. K. W. Jung1, K. D. Choi1, H. J. Song1, G. H. Lee1, H.-Y. Jung1.
Conclusion: The results of this study show that, a considerable 1
Division of Gastroenterology, Department of Internal
percentage of patients receiving short-term TPN support has Medicine, University of Ulsan College of Medicine, Asan
not clear and complete documentation for TPN therapy, Medical Center, Seoul, Republic of Korea
whereas the nutritional support is often not adapted to the
patient nutritional requirements. These findings create the Rationale: Spontaneous retrograde migration of nasoenteral
need for the development of a TPN quality control program that feeding tube is frequent in clinical practice. The aim of study
must be available to physicians when they initiate TPN which was to evaluate the effectiveness of nasoenteral feeding tube
will aid to use cost effective and appropriate nutritional tip fixation with hemoclips to prevent the tube dislodgement.
therapies. Methods: We retrospectively reviewed the patients who
Disclosure of Interest: None declared. underwent endoscopic nasoenteral feeding tube insertion
with or without tube tip fixation with hemoclips at Asan
MON-LB329 Medical Center in Korea from January 2016 to January 2017. We
TAUROLIDINE-CITRATE CVC-LOCK SOLUTION REDUCES CRBSI compared the incidence of tube dislodgment and procedure
RATE IN PATIENTS WITH CHRONIC INTESTINAL FAILURE IN HPN related complications between two groups.
Results: Of the total 207 procedures, 57 procedures were
F. D. Merlo1 *, C. Ivaldi1, U. Aimasso1, A. De Francesco1. performed with clip-assisted method while 150 procedures
1
Clinical Nutrition and Dietetics, A.O.U. Citta Della Salute were performed with standard non clip-assisted method. Tube
E Della Scienza, Torino, Italy dislodgement occurred in 2 (3.5%) clipping group and 21 (14%)
non clipping group ( p = 0.03). The Odd ratio for tube
Rationale: Home parenteral nutritition (HPN) is a life–saving
dislodgement was 4.48 (95% confidence interval 1.02–19.75).
therapy for patients with chronic intestinal failure (CIF).
Incidence bleeding, aspiration pneumonia, Mallory-Weiss tear,
Central venous catheters (CVC) are essential devices for
ileus and tube obstruction were not different between two
parenteral nutrition’ administration. Unfortunately, the use
groups. Procedure time did not differ significantly between two
of these devices can lead to catheter-related bloodstream
groups (17.4 ± 8.9 in clipping group vs. 16.4 ± 8.3 in non-
infections (CRBSI) that are associated with increased morbidity
clipping group, p = 0.45).
and mortality rates. Previous studies showed the efficacy of
Conclusion: Clip-assisted fixation of nasoenteral feeding tube
taurodine lock-solution for secondary prevention of CRBSI in
was effective to prevent the tube dislodgement.
adult and pediatric patients on hemodialysys and chemother-
aphy. Recently a number of studies confirmed the efficacy of Disclosure of Interest: None declared.
taurolidine in HPN patients at high risk of CRBSI and also ESPEN
guidelines on CIF in adults suggest that CVC-lock with MON-LB331
taurolidine may be used to prevent infections. The aim of the NEX-METHOD STILL THE BEST PRACTICE? ESTIMATING
authors was to evaluate the impact of a taurolidine lock INTERNALTUBE LENGTH TO PREDICT THE IDEALTIP POSITION
solution on CRBSI rate in HPN adult patients with CIF at high risk OF A NASOGASTRIC TUBE: A RANDOMIZED
of CRBSI CONTROLLED TRIAL
Methods: Enrollment started in january 2013 (when taurolidine T. Torsy1 *, R. Saman1, K. Boeykens2. 1Health Care, Odisee
lock solution was first available in our Care Center), ended in University College, 2Health Care, AZ Nikolaas, Sint-Niklaas,
december 2013. We retrospectively collected data on 139 Belgium
patients in HPN for CIF from january 2011 to december 2012
and selected those who had at least one CRBSI in the 24 months. Rationale: A correct position of nasogastric tubes in the
We also selected patients presenting with a first CRBSI from stomach is essential to minimize complications such as reflux
january to december 2013. Overall 23 high risk patients (10 and aspiration of tube feeding in the lungs. The NEX-method
females, 13 males) were enrolled in the study. Taurolidine- (nasal tip – earlobe – xiphoid process) is widely used to estimate
citrate 4% CVC-lock solution was applied from enrollment. the insertion length. Several observational or retrospective
Patients were observed prospectively for 12 months after the studies revealed that this method is probably unreliable[1].
start. Incidence rates of CRBSI were expressed per 1000 Already in 1979 Hanson suggested to use a formula
catheter-days. (NEX × 0,38696) + 30,37 cm to pursue correct positioning[2].
Results: CRBSI rate decreased from 1.65/1000 catheter-days to This study compares the use of that formula with the use of the
0.00/1000 catheter-days respectively before and after starting NEX-method in adults.
taurolidine-citrate lock ( p = 0.004) Methods: A 9-month RCT was conducted in a Belgian general
Conclusion: Taurolidine-citrate lock solution was safe and hospital. External measurement to define the internal tube
effective in reducing the CRBSI rate in high risk patients with length was performed by two specialized nutrition support
CIF in HPN. Further researches are needed to confirm these nurses. During the study, two different methods were used to
results in larger series of patients define the internal tube length: NEX-method and
Disclosure of Interest: None declared. (NEX × 0,38696) + 30,37 cm. After (re)positioning, 183 tubes
were eligible to be assessed through X-ray by 3 radiologists. The
S302 Poster
ideal tube position was defined as a tube placed with the tip 3 Conclusion: The CoNEX-method can be a valuable alternative
cm or more beyond the LES (= lower esophageal sphincter)[1]. to predict the internal tube position of a nasogastric tube. The
Results: There is no significant difference between the NEX- CoNEX-method makes it also possible to obtain gastric aspirate
method and (NEX × 0,38696) + 30,37 cm to become an ideal tip in a higher amount of cases than the other two described
position into the stomach. In respectively 20,2% and 22,6% of methods.
the patients, ideal tip positioning was underestimated (too References
close to the LES or even not beyond the LES). In the NEX-group
[1] Torsy T., Saman R., Boeykens K. (2017). [Internal length determin-
was an overestimation of the tube length to be inserted. In
ation]. Unpublished raw data.
17,2% of the patients tip position was located more than 10 cm [2] Correction of the NEX.
beyond the LES. [3] Ellett et al. (2005). Predicting the insertion distance for placing
Conclusion: Unlike earlier research, (NEX × 0,38696) + gastric tubes. Clinical Nursing Research, 14 (1), 11–27.
30,37 cm does not result in a better positioning of the tube
into the stomach with the tip 3 cm or more beyond the LES as a
benchmark. Further research is needed to determine which
theoretical concept of length determination is applicable in MON-LB333
order to insert the tube to the appropriate length into the THE SUPPLYMENT OF Ω3 POLYUNSATURATEDFATTY ACIDS
stomach. ATTENUATES OBESITY-INDUCED INFLAMMATION AND ALTERS
GUT MICROBIOTA IN HIGH FAT DIET-FED MICE
References
Z. Li1, Z. Cao1, J. Yu1 *, W. Kang1. 1Department of General
[1] Ellett M.L., Beckstrand J., Flueckiger J., Perkins S.M. & Johnson C. Surgery, Peking Union Medical College Hospital, Chinese
S. (2005). Predicting the insertion distance for placing gastric
Academy of Medical Sciences And Peking Union Medical
tubes. Clinical Nursing Research, 14 (1), 11–27.
[2] Hanson R.L. (1979). Predictive criteria for length of nasogastric
College, Beijing, China
tube insertion for tube feeding. Journal of Parenteral and Enteral
Rationale: High dietary fat intake can cause metabolic
Nutrition, 3 (3), 160–163.
syndrome, and previous studies have demonstrated the effect
Disclosure of Interest: None declared. of ω3 polyunsaturated fatty acids (PUFA) on dyslipidemia. Here,
we examined the anti-inflammatory and intestinal barrier-
MON-LB332 protecting effect of ω3 PUFA in mices.
VALUABLE ALTERNATIVE TO THE NEX-METHOD? CONEX AS A Methods: Sprague-Dawley mices were fed a normal-fat diet
NEW METHOD TO PREDICT THE INTERNAL TUBE POSITION OF (NFD), high-fat diet (50% kcal from fat, HFD), NFD supplemen-
A NASOGASTRIC TUBE: A PILOT STUDY ted with ω3 PUFA (NFDω3) and HFD supplemented with ω3 PUFA
T. Torsy1 *, R. Saman1, K. Boeykens2. 1Health Care, Odisee (HFDω3) for 10 weeks. The changes in gut microbial compos-
University College, 2Health Care, AZ Nikolaas, Sint-Niklaas, ition was detected by real-time PCR. Portal vein were analyzed
Belgium for hsCRP and cytokine levels using ELISA, and endotoxin levels
using modified azo chromogenic substrate limulus amebocyte
Rationale: The NEX-method (nose-earlob-xiphoid process) is lysate assay. Western blotting was used to detect tight junction
widely used to predict internal nasogastric tube length. A protein of intestinal mucosa.
possible alternative is the Hanson formula: (NEX × 0,38696) + Results: PUFA ω3 had no effect on food consumption but
30,37 cm. Earlier unpublished research[1] revealed that with prevented weight gain (HFD: 680.5 ± 26.3 g; NFD:554.0 ±
both methods, tip position was located too close or even not 113.5 g; HFDω3:609.2 ± 15.9 g; NFDω3:540.8 ± 36.7 g, HFD vs
beyond the lower esophageal sphincter (=LES) in >20% of all HFDω3 P < 0.01, NFD vs NFDω3 P > 0.01). There were more
patients. Assessment of the internal tube length by 3 contents of the Firmicutes, Enterobacteriales, and less con-
radiologists in 183 patients suggested a correction of the tents of Bacteroidetes, Bifidobacterium spp. and ratios of
Hanson formula: (NEX × 0,38696) + 30,37 cm ± 6 cm. Aim of the Bacteroidetes to Firmicutes in the fecal of the rats from HFD
study is to determine whether this correction can be a valuable group compared to the NFD and HFD ω3 groups. The Pearson’s
alternative to the other methods. correlation coefficient shows that there was a negative
Methods: A 3-month pilot study was conducted in a Belgian correlation between the body weight and the ratios of
general hospital. External measurement to define the internal Bacteroidetes-to-Firmicutes. Intestinal permeability(L/M)
tube length was performed by 2 nutrition support nurses. The was increased significantly in HFD group compared to NFD
CoNEX[2]-method used to determine the internal tube length and HFDω3 groups. The endotoxin (HFD: 0.074 ± 0.025 EU/ml,
was (NEX × 0,38696) + 36,37 cm. After (re)positioning, 58 tubes NFD:0.045 ± 0.014EU/ml, P < 0.01) and inflammatory factors
were eligible to be assessed through X-ray by 2 independent (CRP,TNF-α,IL-6) levels from rats of HFD group were higher than
radiologists. The ideal tube position was defined as a tube NFD and HFD ω3 groups, but expression of claudin and occludin
placed with the tip 3 cm or more beyond the LES[3]. in intestinal mucosa of HFD group were lower NFD and HFDω3
Results: There is a significant difference between the use of groups.
the CoNEX-method and the two other methods (‘NEX. and Conclusion: HFD-induced obesity changed the gut microbiota
‘(NEX × 0,38696) + 30,37 cm’) to become an ideal tip position. and increased intestinal permeability. Supplement with
The use of the CoNEX-method in all patients (n = 58) led to 100% ω3PUFAs could counteract these gut dysbiosis and reduce the
of well-positioned nasogastric tubes. The CoNEX-method also intestinal permeability as well as improve inflammatory factors
resulted in a significantly higher probability to aspirate gastric and the body weight.
contents after the insertion of the nasogastric tube: 69% of all Disclosure of Interest: None declared.
patients compared to 56% or less in both two other methods.
MON-LB334 between the rate of gastric emptying and human eating,

THE RELATIONSHIP BETWEEN OXIDATIVE STRESS there is inconsistent data regarding the effect of oat β-glucan
PARAMETERS AND NUCLEAR FACTOR KAPPA B AND consumption on appetite and energy intake.2
PEROXISOME PROLIFERATOR ACTIVATING RECEPTOR GAMMA Methods: Thirty-one healthy normal-overweight subjects (20
IN METABOLIC SYNDROME female/11 male, mean age (yrs): 27.0 ± 5.9, BMI (kg/m2):
A. O. Sahin1, O. Tabak2 *, H. Uzun1, F. Erdenen3, E. Altunoglu3, 23.5 ± 2.0) completed the study. In a double-blinded, rando-
S. Civelek1. 1Biochemistry, Cerrahpasa School of Medicine, mized, placebo-controlled cross-over fashion, subjects con-
2
Internal Medicine, Kanuni Sultan Suleyman Education sumed a breakfast that consisted of Rice Krispies cereal with
Research Hospital, 3Internal Medicine, Istanbul Education milk and Greek-style yoghurt, with and without the addition of
Research Hospital, Istanbul, Turkey 4 g oat β-glucan (14.7 g OatWell®28). Protein, fat and carbo-
hydrate content of each breakfast were matched. Visual
Rationale: The aim of this study was to investigate the analogue scales were used to assess subjective appetite
importance of the levels of the nuclear factor-kappa (NF-κB) ratings, which were administered every 15 minutes over a 150
and the peroxisome proliferator-activating receptor-gamma minute period, after which an ad libitum lunch was served.
(PPAR-γ) in patients with metabolic syndrome (MetS) and also Two-factor ANOVA was used to identify treatment effects over
to enlighten the relationship between the components of MetS the postprandial period. Differences between caloric intakes
with these parameters. In addition, the redox homeostasis has were assessed by paired samples t-tests.
been evaluated via determination of serum malondialdehyde Results: Preliminary analysis showed there was an effect on
levels (MDA) and serum catalase (CAT) and CuZn-superoxide subjective appetite with increased satisfaction ( p < 0.05) and
dismutase (CuZn-SOD) activities in patients with MetS. reduced feelings of prospective food consumption ( p < 0.05)
Methods: 52 patients (17 M, 35 F) referring to Ministry of over the 150 minute postprandial period following oat β-glucan
Health, Istanbul Education and Research Hospital Internal consumption. No significant effect was identified in caloric
Medicine Clinic who has received MetS diagnosis according to intakes during the ad libitum lunch, with 722 kcal ± 287
National Cholesterol Education Program-Adult Treatment Panel consumed following the control breakfast and 689 kcal ± 256
III (NCEP-ATP III) criteria and 28 healthy individuals (10 M, 18 F) after the oat β-glucan breakfast (n = 28, p > 0.05).
as a control group has been included in the study. The levels of Conclusion: This acute study showed that consumption of 4 g
NF-κB and PPARγ has been studied via ELISA method and MDA oat β-glucan at breakfast beneficially modulates subjective
levels, CAT and CuZn-SOD activities has been studied via appetite, yet ad libitum eating did not change. Although
spectrophotometric methods in the samples taken from study feeling more satisfied did not directly translate into eating less,
and control groups. this effect may be of benefit during calorie-restricted diets.
Results: In the study, the NF-κB and MDA levels were Perhaps a shorter inter-meal interval is required to detect an
significantly higher in MetS group whereas PPARγ levels, CAT effect of viscous fibres on energy intakes.
and CuZn-SOD activities were significantly lower compared to References
control group. When the diagnosis of MetS has been investigated
1. Grundy et al. 2016 BJN (116), 816–833.
by ROC analysis, NF-κB had the highest sensitivity and
2. Clark and Slavin 2013 JACN (32), 200–212.
specificity. There was a significant negative correlation in all
groups between PPARγ and BMI, waist and hip ratio, HOMA-IR and Disclosure of Interest: S. Zaremba: None declared, J. McCluskey: None
declared, I. Gow: None declared, S. Drummond: None declared,
NF-κB.
R. Steinert Other: RES is an employee of DSM Nutritional Products. DSM
Conclusion: Our findings indicates that the oxidative stress has
provided the study with OatWell®28.
been increased and the redox homeostasis has been deterio-
rated because of increased levels of MDA and decreased
MON-LB336
activities of CAT and CuZn-SOD. It has been suggested that,
IMPACT OF ORANGE JUICE ON THE METABOLIC PROFILE OF
with its high sensitivity and specificity, NF-κB can be included in
INDIVIDUALS WITH METABOLIC SYNDROME
components of MetS. PPAR-γ could be a new anti-diabetic
marker because of the negative correlation between PPAR-γ and T. B. Cesar1 *, O. F. Ponce1, R. O. Benassi1. 1Food and Nutrition,
HOMA-IR. Yet, more studies are needed to support our findings. Sao Paulo State University, UNESP, Araraquara, Brazil
Disclosure of Interest: None declared. Rationale: Previously it was shown that the habitual intake of
orange juice by obese1 and dyslipidemic2 subjects improved
MON-LB335 metabolic parameters and reduced cardiovascular risk. In this
SUBJECTIVE RATINGS OF APPETITE AND AD LIBITUM FOOD study, subjects with metabolic syndrome (MetSyn) received
INTAKE FOLLOWING A BREAKFAST CONTAINING 4G OAT two cups of orange juice per day, incorporated into a balanced
Β-GLUCAN IN HEALTHY SUBJECTS: A PILOT STUDY diet for 12 weeks, aiming to improve their metabolic condition
S. M. M. Zaremba1 *, J. T. Mccluskey1, I. F. Gow1, S. Drummond1, and health status.
R. E. Steinert2. 1Dietetics, Nutrition and Biological Sciences, Methods: A randomized controlled study of 70 subjects with
Queen Margaret University, Edinburgh, United Kingdom, 2R&D metabolic syndrome (ATP III, AHA/NHLA) divided into parallel
Human Nutrition and Health, DSM Nutritional Products Ltd., groups were individually instructed to maintain a balanced diet
Basel, Switzerland for 12 weeks. Control group (n = 35) was treated with balanced
and controlled diet, while the experimental group (n = 35)
Rationale: Adding viscous soluble fibre to food alters the received two additional cups of orange juice (OJ) daily
structural properties of meals and the viscosity of digestive (500 mL/d), nor exceeding the Estimated Energy Requirement
contents, thus slowing gastric emptying.1 Despite a link (EER). It was evaluated biochemical and clinical parameters
S304 Poster
associated with MetSyn, and diet composition along to the Hulst JM, Zwart H, Hop WC, et al. Dutch national survey to test the
intervention. STRONGkids nutritional risk screening tool in hospitalized children.
Results: All subjects showed similar reduction of body weight Clin Nutr 2010; 29: 106–111.
(2 kg), body fat mass (2 kg) and waist circumference (6.5 cm) Van der Velde K, Olieman JF, Winder E, et al. Follow-up of
malnourished hospitalized children: a Dutch multicenter study. Clin
( p < 0.05). In both groups was a decreased of LDL-C (11%),
Nutr 2014;33 (Suppl 1):S8.
triglycerides (5%) and systolic and diastolic blood pressure (8% World Health Organisation. International Statistical Classification of
and 9%, respectively, p < 0.05), with no changes for HDL-C and Diseases and Related Health Problems, 10th Revision (ICD-10).
insulin levels. Nevertheless, orange juice group have shown a Geneva: WHO, 1992 (Accessed Dec 7th, 2016 at http://www.
reduction in glycaemia over the experimental period (3%; icd10data.com/ICD10CM/Codes].
p < 0.05). Both groups presented similar results for energy and Disclosure of Interest: K. Freijer Grant/Research Support from:
macronutrient consumption, but OJ group increased vitamin C unrestricted agreement with NAMN to do research for Maastricht
intake by 157%. University, E. Puffelen: None declared, K. Joosten: None declared,
Conclusion: Orange juice associated with balanced dietary has J. Hulst: None declared, M. Koopmanschap: None declared.
decreased hyperglycemia, in addition to ameliorate lipid
profile, and contribute nutritionally to the quality of the MON-LB338
diet. Therefore, OJ may be consider as a functional food on the DOES LONG TERM PARENTERAL NUTRITION DURING
nutrition therapy for MetSyn. CHILDHOOD INFLUENCE GROWTH AND FINAL ADULT HEIGTH?
References M. M. Leuvrey1 *, E. Dugelay1, F. Liebert1, B. Dubern2,
1. Ribeiro et al., Nutrition 2017; 38:13. E. M. Marinier1. 1Pediatric Gastroenterology, Hopital R Debré,
2
2. Aptekmann and Cesar Lipids in Health and Disease 2013; 12:119. Pediatric Gastroenterology, Hopital Trousseau, Paris, France
Rationale: Long term parenteral nutrition (PN) is used to cover
nutritionnal requirements and achieve a normal growth in
MON-LB337 children when digestive route is impossible because of
THE ADDITIONAL COSTS OF DISEASE RELATED MALNUTRITION transient or chronic intestinal failure.
IN HOSPITALIZED CHILDREN Whether patients under PN during chilhood reach a normal
K. Freijer1 *, E. V. Puffelen2, K. F. Joosten2, J. M. Hulst2, target size (TS) is not known, nor are others factors responsible
M. A. Koopmanschap3. 1Maastricht University, Maastricht, for, under this condition. We designed a retrospective study to
2
Erasmus Medical Centre-Sophia, 3Erasmus University, adress these questions.
Rotterdam, Netherlands Methods: Patients attending our PN clinic between 1995 and
2016 were selected according to the following criterias:
Rationale: The objective of the current study was to estimate
Age > 16 years, PN duration >1 year, onset of PN prior to 11 years
the annual additional costs of Disease Related Malnutrition in
of age.
pediatric patients as was done for adults.
Exclusion criteria: intestinal transplantation, death <16 years
Methods: A cost-of-illness analysis was performed to calculate
old.
the annual additional costs of DRM in 2015 pediatric patients
We collected : Weight and size when patient >16 years old, TS
(aged 1 month up to and including 17 years) admitted to non-
( parenteral sizes +/− 6.5)/2), duration of PN, underlying
academic hospitals in The Netherlands. DRM was assessed with
disease, birth data.
weight-for-age, weight-for-height and height-for-age. Input
Results: 51 patients (26 girls) were eligible for study. Mean age
variables in the formula used were length of stay and prevalence
was 22 y +/− 5 y (16 y–35 y). Mean parenteral duration was
of DRM. The costs were estimated per disease as classified in the
8.4 +/− 6.6 y (1 y–18 y); (for patients older than 18 y still under
International Classification of Diseases by the WHO (ICD-10), per
PN we collected data up to 18 y).
gender and age group. The results were expressed as an absolute
Underlying disease was: Short bowel syndrome (SBS) 39%,
monetary value as well as a percentage of the Dutch national
Congenital enteropathy (CE) 18%, CIPO 25%, Aganglionosis 12%,
health expenditure. Robustness of the results was checked by a
miscellanous 6%.
sensitivity analysis.
Seven patients were lost for follow up. 2 patients had no target
Results: The total additional direct medical costs of DRM in
size available (adoption)
pediatric patients in 2013 were estimated to be €51 million for
69% of patients reached >93% of their TS (>-2DS) (groupA). 31%
acute malnutrition, €46 million when focused on chronic
were <-2ds of the TS (group B). There was no difference in PN
malnutrition and €80 million in case of overall malnourished
duration (Group A : 8.6 +/− 6y; Group B: 10.3 +/− 7 y) In
children. This equals 5.6% of the total Dutch hospital costs for
contrast the repartition according to the underlying disease
these hospitalized children.
show:
Conclusion: This study has shown that DRM in hospitalized
SBS : 46% in Group B, vs 31% in group A; CE: 38% in B vs 10% in A,
children increase the annual hospital costs with an additional
motility disorders (CIPO and Aganglionosis) 8% in B vs 54% in A
amount of €80 million, of which acute malnutrition account for
Birth data show : prematurity in 45% of patients in group B
the largest part.
versus 16% in group A
References Conclusion: 69% of patients reached their TS +/− 2 ds. Among
Freijer K, Tan SS, Koopmanschap MA, et al. The economic costs of predictive factors of small final size, the underlying disease and
disease related malnutrition. Clin Nutr 2013; 32: 136–141. neonatal conditions have a major importance. PN is effective
Hecht C, Weber M, Grote V, et al. Disease associated malnutrition to help reaching a normal adult size.
correlates with length of hospital stay in children. Clin Nutr 2015; 34:
53–59.
MON-LB339 for patients undergoing elective colectomy, particularly

PREDICTORS OF EARLY POST-OPERATIVE FEEDING: AN postoperative insulin resistance
OBSERVATIONAL STUDY IN A COLORECTAL SURGERY Methods: All patients undergoing elective colectomy is
POPULATION included and randomized to the control arm or treatment
C. Atkinson1 *, V. Short2, A. Ness1, S. Lewis3, R. Longman4, arm. The control arm consists of the standard bowel prepar-
S. Thomas5, S. Leary1, W. Hollingworth6, C. Penfold1. 1NIHR ation and one day of NPO, while the treatment arm consists of
Bristol Biomedical Research Centre (Nutrition Theme) at the the standard bowel preparation and allowing carbohydrate-rich
University Hospitals Bristol NHS Foundation Trust and the oral rehydration solution intake until 2 hours before surgery.
University of Bristol, Bristol, 2National Perinatal Epidemiology The Homeostatic Model Assessment – Insulin Resistance (HOMA-
Unit, Nuffield Department of Population Health, University of IR) will be determined right after induction, 6 hours, 24 hours,
Oxford, Oxford, 3Plymouth Hospitals NHS Trust, Plymouth, and 48 hours postoperativelyand compared between the two
4
University Hospitals Bristol NHS Foundation Trust, 5School of groups.
Oral and Dental Sciences, 6School of Social and Community Results: There was no significant in the difference of HOMA-IR
Medicine, University of Bristol, Bristol, United Kingdom according to groups and time (Repeated-Measure ANOVA)
although the graph looked like showing some differences
Rationale: Early post-operative feeding is recommended as ( p = 0.516). Cortisol and TG were also not significant,
part of the enhanced recovery after surgery programme. We respectively ( p = 0.706, p = 0.241). Patients who drunk ORS
conducted an observational analysis in a contemporary colo- preoperatively were satisfied ( p < 0.001)
rectal surgery population to describe post-operative feeding Conclusion: Preoperative oral carbohydrate-rich solution had a
practices and to explore factors associated with early feeding. limited effect on postoperative Insulin-resistance in patients
Methods: Data from 321 participants in a previously conducted undergoing colectomy.
RCT of chewing gum vs. usual care were used in this analysis. References
Amounts of meals eaten on post-operative days (POD) 1–5 were
1. Ljungqvist O. Jonathan E. Rhoads Lecture 2011: Insulin resistance
recorded as none, a quarter, half, three-quarters, or all. ‘Early’ and enhanced recovery after surgery. J Parenter Enteral Nutr
consumers were classed as those who ate at least a quarter of a 2012;36:389–99
meal on POD1. ‘Early’ tolerance was classed as the consump- 2. Ljungqvist O, Nygren J, Thorell A. Modulation of post-operative
tion of at least half of three meals on POD1 or 2 without insulin resistance by pre-operative carbohydrate loading. Proc Nutr
vomiting. Selected peri-operative factors (bowel preparation, Soc 2002;61:329–335.
pre-operative dietary preparation, surgical approach, primary 3. Kratzing C. Pre-operative nutrition and carbohydrate loading. Proc
procedure, POD1 anti-emetics, POD1 opiate analgesics) were Nutr Soc 2011;70:311–5.
assessed as potential predictors of early feeding and tolerance 4. Yang DJ, Zhang S, He WL, et al. Fast tract surgery accelerate the
in unadjusted and adjusted analyses. recovery of postoperative insulin sensitivity. Chin Med J
2012;125:3261–5.
Results: 236 (73.5%) consumed solid food early, and 115 (35.8%)
5. Søreide E, et al. Pre-operative fasting guidelines: an update. Acta
tolerated solid food early. Preliminary findings suggest that:
Anaesthesiol Scand. 2005; 49(8):1041–7.
pre-operative bowel preparation is associated with delayed
feeding and tolerance; pre-operative diet preparation is Disclosure of Interest: K. Jung Grant/Research Support from: Daesang
WeLife, C. Sio Grant/Research Support from: Daesang WeLife, M.-O.
associated with early feeding; and laparoscopic/laparoscopic
Yoon Grant/Research Support from: Daesang WeLife, H.-J. Jang Grant/
assisted vs. open/converted to open surgery is associated with
Research Support from: Daesang WeLife, H. J. Jang Grant/Research
early feeding and tolerance. Some potential differences Support from: Daesang WeLife.
related to primary procedure were also observed.
Conclusion: In this population, almost three quarters ate solid
MON-LB341
food early but only one third tolerated solid food early. Data
‘FEED NOT FAST’: A MULTIDISCIPLINARY SYSTEMS APPROACH
are being further explored, but our preliminary findings suggest
TO MALNUTRITION IN AN ACUTE HOSPITAL
that avoidance of bowel preparation, use of pre-operative
dietary preparation, and laparoscopic surgery are associated S. Courtice1 *, A. Mohanlal1, L. Ward1, S. Naidu2, J. Finucane3,
with early consumption and tolerance of solid food. O. Wright4. 1Nutrition and Dietetics, 2Department of Surgery,
3
Nursing Director Medical, Queen Elizabeth II Jubilee Hospital,
School of Human Movement and Nutrition Sciences, University
of Queensland, Brisbane, Australia
MON-LB340
THE EVALUATION OF PREOPERATIVE ORAL CARBOHYDRATE- Rationale: A redesign of the nutrition model of care in an acute
RICH SOLUTION EFFECTS ON INSULIN RESISTANCE IN hospital with a focus on malnutrition was developed in response
PATIENTS UNDERGOING COLECTOMY to a malnutrition prevalance of 30%, low rates of malnutrition
K. Jung1 *, C. A. Sio2, M.-O. Yoon3, H.-J. Jang3, H. J. Jang4. screening and inadequate nutritional intakes.
1 Methods: Clinical redesign methodology was used to engage
General Surgery, Jeju National University Hospital, Jeju,
Republic of, Korea, 2General Surgery, Department of Surgery, hospital staff. Multidisciplinary nutrition action teams were
University of Santo Tomas Hospital, Manila, Philippines, formed and priority areas identified. The menu was reviewed
3
General Surgery, 4Nuclear Medicine, Seoul National University and evaluated using a validated patient satisfaction survey and
Bundang Hospital, Seongnam, Republic of Korea energy and protein intake consumed. Key nutrition indicators
were developed by the multidisciplinary team and evaluated
Rationale: This study aims to show the benefits of oral regularly.
rehydration solution administration two hours prior to surgery
S306 Poster
Results: Nursing led malnutrition screening increased from 53% current smoking status, vitamin/mineral supplement use,
to 88%; weights on admission from 47% to 86%; timely feeding antihypertensive drug use, oral antidiabetic drug use, insulin
assistance from 55% to 92%; an increase in patient satisfaction use, dietary fat intake (g/day) and dietary saturated fat intake
with foodservices from an overall score of 3.7/5 to 4.4/5 (g/day), dietary fiber intake (g/day) and dietary calcium/
(n = 65); increased energy intake of main meals by 16% (n = 47); magnesium ratio)
a reduction in preoperative fasting time in elective colorectal Results: In diabetic patients with hypomagnesemia, serum
surgery patients from an average of 15.4 hours to 3.2 hours levels of fasting plasma glucose, postprandial plasma glucose
(n = 30) and a 30% increase in patients coded with a diagnosis of and HbA1c were significantly higher compared to patients with
malnutrition each month. normomagnesemia (respectively 179.0 ± 64.9 vs. 148.7 ± 52.0
Conclusion: Aligning the hospital team with a multidisciplinary mg/dl, p < 0.01 for Model 1 but not significant for other models;
systems approach to nutrition care can improve malnutrition 287.9 ± 108.4 vs. 226.8 ± 89.4 mg/dl, p < 0.01 for Model 1 and
screening and diagnosis, patient satisfaction with foodservices p < 0.05 for others; %8.0 ± 1.9 vs. %6.5 ± 1.2, p= 0.000 for all
and nutritional intake. Clinical redesign can assist in embed- models). Although serum magnesium concentration was asso-
ding system change in acute care. ciated to glycemic control parameters, dietary magnesium
References
intake wasn’t significantly related to glycemic parameters.
Conclusion: Hypomagnesemia in T2D is directly associated
Ben-Tovim D, Dougherty M, O’Connell T, McGrath K. Patient journeys:
with poor glycemic control. Clinical care should therefore
the process of clinical redesign. Med J Aust 2008; 188(6):14.
Capra S, Wright O, Sardie M, Bauer J, Askew D. The acute hospital
focus on increasing dietary magnesium intake or magnesium
foodservice patient satisfaction questionnaire: the development of a supplementation to improve glycemic control in type 2
valid and reliable tool to measure patient satisfaction with acute diabetics.
care hospital foodservices. Journal of Foodservice 2005; 16:1–14. Disclosure of Interest: None declared.
Ferguson M, Capra S, Bauer J, Banks M. Development of a valid and
reliable malnutrition screening tool for adult acute hospital
MON-LB343
patients. Nutrition 1999:15(6):458–464.
Gustarfsson U, Scott M, Schwenk W, Demartines N, Roulin D, Francis EFFECT OF INTRADIALYTIC-AEROBIC EXERCISE ON CLINICAL
N, McNaught C, MacFie J, Liberman A, Soop M, Hill A, Kennedy R, OUTCOMES OF HEMODIALYSIS PATIENTS IN UNITED ARAB
Lobo D, Fearon K, Ljungqvist O. Guidelines for perioperative care in EMIRATES: STUDY PROTOCOL AND BASELINE DATA
elective colonic surgery: Enhanced Recovery After Surgery (ERAS) M. Karavetian1 *, N. Salhab2, J. Kooman3, E. Fiaccadori4.
Society recommendations. Clin Nutr 2012;31:783–800. 1
Department of Health Sciences, Zayed University, Dubai,
Disclosure of Interest: None declared. United Arab Emirates, 2Maastricht University, Maastricht,
Netherlands, 3Maastricht University, Maastricht, United Arab
MON-LB342 Emirates, 4Parma University, Parma, Italy
INFLUENCE OF MAGNESIUM STATUS ON THE GLYCEMIC
Rationale: Examine the effect of intradialytic aerobic exercise
CONTROL IN PATIENTS WITH TYPE 2 DIABETES
on hemodialysis (HD) patient clinical outcomes and the barriers
H. Ozcaliskan Ilkay1 *, F. G. Samur2. 1Nutrition and Dietetics, to physical activity in united arab emirates (UAE)
Erciyes University/Faculty of Health Sciences/Department of Methods: An HD unit was randomly chosen from UAE, ethical
Nutrition and Dietetics, Kayseri, 2Nutrition and Dietetics, approval was received from Zayed University and Ministry of
Hacettepe University/Faculty of Health Sciences/Department Health’s ethical committees, after which, all patients (n = 150)
of Nutrition and Dietetics, Ankara, Turkey in the unit were included in the interventional study. Patients
were their own controls, and study parameters were collected
Rationale: Some epidemiological studies have reported hypo-
before and after the study for each patient inclusion criteria
magnesemia in type 2 diabetes (T2D) owing to the fact that
were: stable HD patients ≥ 18 years, dialyzing 3 times per
magnesium occupies an important position in carbohydrate and
week, cognitively aware, able to sign a consent form and
insulin metabolism. The aim of this study was therefore to
received a clearance from the nephrologist to enter the study.
investigate the relationship between serum magnesium level
The intervention will include an intradialytic aerobic low
and glycemic control among type 2 diabetics.
intensity exercise of 45 minutes per HD session, tailored to each
Methods: The study included 119 type 2 diabetics (93 female,
the patients’ fitness scale (BORG scale) for 6 months. Patients
mean age 54.7 ± 8.4 years) who were admitted to an university
will be educated on the importance of exercise, its effect on
endocrinology department in the period from January to May
quality of life and efficacy of dialysis. Main outcome measures
2014 in Turkey. Serum magnesium level was measured by
were barriers to exercise, serum phosphorus-P, Urea Reduction
spectrophotometric method. Hypomagnesemia was defined as
Ratio (URR), malnutrition inflammation score (MIS), quality of
a serum magnesium level less than 0.75 mmol/L whereas
life (QOL using euroqol5) collected at baseline and will be
normomagnesemia was defined as serum magnesium level
collected post intervention
≥0.75 mmol/L. Other biochemical measurements were also
Results: 54 patients were included in the study, 58% were
performed using standard methods. The collected data
males; 90% suffered with hypertension, 61% with diabetes and
included comprehensive assessment of nutritional status and
26% with cardiovascular disease. Mean age was 51.8 ± 14.7
anthropometric indexes/measures. The data were analysed
years, BMI 25.3 ± 5.6, serum P 5.6 ± 1.66 mg/dl, URR
with univariate general linear model to adjust for potential
69.4 ± 14.9% and kt/v’s 1.33 ± 0.11. The main barrier to
non-dietary and dietary confounders (adjustments for age,
exercise was identified to be fatigue on HD days by 60% of
gender, dietary energy intake (kcal/day), body mass index,
patients, followed by shortness of breath, pain and lack of time improvement. The intradialytic exercise regimen, if proven to
(37%). Finally, 96% of patient were mildly malnourished (MIS be effective, can be integrated in routine practice and improve
score), and QOL scale was 63.55% ± 20.5. patients’ outcomes
Conclusion: The current clinical trial is the first in UAE to Disclosure of Interest: None declared.
reveal patient clinical characteristics and to introduce an
exercise regimen in the HD unit. The data show room for
Clinical Nutrition
Author index
A Akishita, M., S167 (SUN-LB307) Amálio, S., S161 (SUN-P291)
Akiyama, D., S199 (MON-P055) Amamou, A., S286 (MON-P292)
Abadía, B., S37 (PT04.3) Akiyama, K., S75 (SUN-P059) Amaral, T. F., S192 (MON-P035)
Abad, S. Molinero, S233 (MON-P146) Aksan, A., S124 (SUN-P191) Ambroszkiewicz, J., S42 (PT06.5), S52 (PT10.6)
Abbasi, E., S164 (SUN-P300) Aksoy, B., S279 (MON-P273) Amemiya, F., S32 (PT02.4)
Abbasi, H., S141 (SUN-P235) Aksungar, F. B., S53 (SUN-P001) Amiri-Moghadam, S., S76 (SUN-P061)
Abdelhamid, E. R., S19 (OR47), Aktaş, A., S98 (SUN-P118) Amizur-Levi, R., S179 (SUN-LB338)
S144 (SUN-P244) Akyol Mutlu, A., S142 (SUN-P238), Ammann, R. A., S17 (OR43), S20 (OR50)
Abdelrazek, M., S163 (SUN-P297) S257 (MON-P216) Amparo, F. C., S100 (SUN-P125)
Abdullah, D. F., S245 (MON-P182) Akyüz, C., S217 (MON-P104), S218 (MON-P105) Anastácio, L., S17 (OR41)
Abiés, J., S229 (MON-P136) Al Kalaldeh, M. T., S180 (MON-P004) Andersen, H. K., S282 (MON-P281)
Abilashan, M. S., S213 (MON-P093) Alaidarous, T. A., S134 (SUN-P216) Andersen, J. R., S35 (PT03.5),
Abilés Osinaga, J., S237 (MON-P158), Alcocer-Varela, J., S226 (MON-P129) S108 (SUN-P147), S155 (SUN-P275),
S280 (MON-P276), S280 (MON-P277) Aldisi, D., S223 (MON-P121) S213 (MON-P093)
Ablett, J., S108 (SUN-P145), S160 (SUN-P288) Alejo-Ramos, M., S115 (SUN-P165), Andersen, S. K., S35 (PT03.5)
Abraham, A., S10 (OR23) S115 (SUN-P166), S116 (SUN-P167), Andrade, J.R.D., S219 (MON-P109)
Abuin-Fernandez, J., S89 (SUN-P095), S143 (SUN-P240) Andraus, W., S124 (SUN-P190)
S89 (SUN-P096) Alessandri, F., S57 (SUN-P012) Andreeva, N., S192 (MON-P033)
Abulmeaty, M.M.A., S134 (SUN-P216), Alexandre, J., S221 (MON-P116) Andreotti, S., S178 (SUN-LB334)
S223 (MON-P121), S269 (MON-P248), Alexandre, L., S255 (MON-P208) Andres, B., S223 (MON-P120)
S279 (MON-P275) Alexiadi, M., S258 (MON-P219) Andurell, L., S197 (MON-P048)
Acar Tek, N., S241 (MON-P171), S242 (MON- Alferink, L., S80 (SUN-P072) Ang, B., S59 (SUN-P019)
P172) Ali Abdelhamid, Y., S180 (MON-P003) Angkatavanich, J., S247 (MON-P187)
Aceto, P., S96 (SUN-P115) Alikhanian, H., S145 (SUN-P246), Angulo, R. Cañas, S234 (MON-P150)
Achamrah, N., S200 (MON-P057), S244 (MON- S159 (SUN-P287) An, J. Y., S174 (SUN-LB325), S175 (SUN-LB327)
P180), S286 (MON-P292) Alivizatos, V., S300 (MON-LB328) Antczak, K., S100 (SUN-P124)
Achar, E., S251 (MON-P198) Alkhtani, N. M., S134 (SUN-P216) Antunes, M. S., S164 (SUN-P298)
Açıkgöz, A., S124 (SUN-P191) Al-Leswas, D., S27 (OR68), S199 (MON-P052), Anzolin, F., S132 (SUN-P212)
Adal, E., S200 (MON-P056) S199 (MON-P053) Aoun, A., S84 (SUN-P083), S113 (SUN-P160),
Adiguzel, E., S131 (SUN-P208) Allinquant, B., S69 (SUN-P044) S113 (SUN-P161), S162 (SUN-P295)
Adjemian, D., S61 (SUN-P023) Allo Miguel, G., S214 (MON-P094) Aperstein, Y., S24 (OR60)
Aeberhard, C., S120 (SUN-P179) Almadani, N. K., S223 (MON-P121) Apostolopoulou, A., S56 (SUN-P011)
Agca, M., S233 (MON-P147) Almajwal, A. M., S223 (MON-P121) Applegate, L. A., S50 (PT10.1)
Agnes Peyron, M., S167 (SUN-LB306) Al-Muammar, M. N., S279 (MON-P275) Aprobato, F.G.G., S164 (SUN-P298)
Agostinho, L., S219 (MON-P109) Almutawa, D. A., S279 (MON-P275) Aragoneses, C., S271 (MON-P253)
Agostini, F., S202 (MON-P062) Alnafisah, A. S., S279 (MON-P275) Arai, S., S165 (SUN-P301)
Aguilar-Diosdado, M., S123 (SUN-P187) Al-Othman, A. M., S269 (MON-P248) Arakawa, K., S165 (SUN-P301)
Ahmed, N., S154 (SUN-P272) Alparslan Mesci, B., S136 (SUN-P221) Arantes, S., S27 (OR67)
Ahn, J. Y., S79 (SUN-P070) Alquraishii, M., S223 (MON-P121) Arapaki, M., S111 (SUN-P153)
Ahn, J.-Y., S301 (MON-LB330) Alramadan, M., S140 (SUN-P232) Araújo, L. B., S95 (SUN-P111)
Aikawa, M., S153 (SUN-P269) Alsharari, Z., S55 (SUN-P009) Araújo, W.M.C., S65 (SUN-P034)
Aimasso, U., S301 (MON-LB329) Altieri, S., S96 (SUN-P115) Ardoino, G., S135 (SUN-P219),
Ait, S., S48 (PT09.2), S77 (SUN-P065) Altunoglu, E., S303 (MON-LB334) S189 (MON-P028)
Ajgal, Z., S221 (MON-P116) Altwegg, J., S129 (SUN-P205) Aredes, M. A., S90 (SUN-P097),
Ajibodu, S., S109 (SUN-P150), S215 (MON- Alvarez, A., S147 (SUN-P254) S211 (MON-P087), S212 (MON-P088)
P096), S215 (MON-P097) Alvaro, E., S229 (MON-P136) Arenas Villafranca, J. J., S237 (MON-P158),
Akal Yıldız, E., S45 (PT07.5), S147 (SUN-P252), Alves, F. R., S122 (SUN-P186) S280 (MON-P276), S280 (MON-P277)
S165 (SUN-P302) Alves, F., S122 (SUN-P185) Arenas, J., S229 (MON-P136)
Akashi, Y. J., S247 (MON-P188) Alves, R., S100 (SUN-P125) Arensberg, M. E., S168 (SUN-LB308)
Akatsu, H., S165 (SUN-P301) Amabile, M. I., S57 (SUN-P012), S96 (SUN-P115) Arhip, L., S203 (MON-P064), S203 (MON-P065),
Akbıyık, H., S103 (SUN-P133), S104 (SUN-P134) Amado, A., S129 (SUN-P203) S212 (MON-P089)
S310 Author index
Ariëns, M. P., S84 (SUN-P082) Balladares-Saltos, M., S277 (MON-P268) Bellikci Koyu, E., S146 (SUN-P249),
Ariës, M. J., S25 (OR61) Ballesteros-Pomar, M. D., S115 (SUN-P165), S257 (MON-P216), S273 (MON-P258)
Arikan, N., S82 (SUN-P078) S115 (SUN-P166), S116 (SUN-P167), Bellikci-Koyu, E., S164 (SUN-P299)
Arinc, S., S233 (MON-P147) S143 (SUN-P240) Bell, J., S125 (SUN-P194)
Arjaans, W., S49 (PT09.4) Ballmer, P. E., S141 (SUN-P234), Belmonte, L. E., S200 (MON-P057)
Arman, G., S138 (SUN-P227) S259 (MON-P220) Belmonte, L., S286 (MON-P292)
Armengol-Debeir, L., S5 (OR11) Bally, L., S120 (SUN-P179) Bemer, P., S102 (SUN-P129), S231 (MON-P140)
Arrais, A. V., S122 (SUN-P185) Banba, K., S195 (MON-P043), Benassi, R. O., S303 (MON-LB336)
Arribas, L., S91 (SUN-P101), S211 (MON-P085) S262 (MON-P229) Benazzo, M., S24 (OR59)
Arruda, A.R.D. C., S64 (SUN-P033) Bandt, J.-P. De, S221 (MON-P116) Bendavid, I., S25 (OR63), S183 (MON-P012),
Arshad, A., S88 (SUN-P094), S93 (SUN-P106), Banning, L. B., S132 (SUN-P211) S184 (MON-P013)
S93 (SUN-P107), S94 (SUN-P108), Barabash, A., S269 (MON-P247), Benincá, S. C., S116 (SUN-P169)
S214 (MON-P095) S271 (MON-P253) Bergeat, D., S143 (SUN-P242),
Arslan, D. O., S53 (SUN-P001) Baracos, V. E., S47 (PT08.5) S209 (MON-P082)
Arslan, S., S45 (PT07.6), S289 (MON-P300) Baracos, V., S219 (MON-P109) Berger, M. M., S50 (PT10.1), S183 (MON-P011)
Arthey, K., S83 (SUN-P080) Barahona, R., S177 (SUN-LB332) Bergoin, C., S48 (PT09.2), S77 (SUN-P065)
Ashbolt, K., S175 (SUN-LB328) Barajas-Galindo, D., S115 (SUN-P165), Berika, M. Y., S269 (MON-P248)
Ashikaga, K., S247 (MON-P188) S115 (SUN-P166), S116 (SUN-P167), Bering, T., S133 (SUN-P213), S202 (MON-P063)
Ashmore, T., S176 (SUN-LB329) S143 (SUN-P240) Berlana, D., S61 (SUN-P024)
Athanasopoulos, P., S300 (MON-LB328) Barata, A., S163 (SUN-P296) Bernal Canales, T., S234 (MON-P150)
Atkins, M., S172 (SUN-LB320) Barata, A.T.D.C.F., S83 (SUN-P079) Bernardi, J. R., S136 (SUN-P222)
Atkinson, C., S282 (MON-P281), Barazzoni, R., S1 (OR01), S6 (OR15), Bernardo, K., S155 (SUN-P276)
S305 (MON-LB339) S74 (SUN-P056), S272 (MON-P255), Bersani, G., S50 (PT09.5)
Atsalakis, A., S295 (MON-LB316) S272 (MON-P256) Bertéus Forslund, H., S194 (MON-P039),
Attinà, G., S276 (MON-P265) Barbosa, E., S41 (PT06.1) S194 (MON-P040)
Aubertin-Leheudre, M., S38 (PT04.5), Barcellos, P. S., S231 (MON-P142) Berthet, D., S129 (SUN-P205)
S229 (MON-P137), S271 (MON-P252), Barceló, M., S119 (SUN-P178) Betriu, L., S61 (SUN-P024)
S284 (MON-P288) Barcelos, S., S16 (OR40) Bétry, C., S77 (SUN-P065)
Aubry, E., S37 (PT04.2), S120 (SUN-P179) Bardon, L. A., S30 (PT01.3), S131 (SUN-P209), Beurskens Meijerink, J., S108 (SUN-P146)
Augsburger, M., S50 (PT10.1) S189 (MON-P027) Beurskens, D., S22 (OR55)
Au-Yeung, C., S15 (OR37) Bardou-Jacquet, E., S209 (MON-P082) Bezmarevic, M., S23 (OR56), S181 (MON-P006)
Avanzi, G. C., S64 (SUN-P032) Barichella, M., S101 (SUN-P128) Bhangal, C., S214 (MON-P095)
Avdjukevics, J., S138 (SUN-P226) Barnoud, D., S48 (PT09.2), S77 (SUN-P065) Bhardwaj, V., S220 (MON-P113)
Avilés, V., S239 (MON-P165), S240 (MON-P166) Barnova, I., S50 (PT10.2) Biesinger, V., S196 (MON-P046)
Aviles, V., S197 (MON-P048) Barragry, J., S96 (SUN-P114), S109 (SUN-P150), Bilgiç, P., S131 (SUN-P208), S274 (MON-P260)
Aviram-Friedman, R., S263 (MON-P230) S215 (MON-P096), S215 (MON-P097) Bilgic, P., S166 (SUN-LB304)
Ayaz, A., S257 (MON-P216) Barrera Rebollo, A., S225 (MON-P125) Bilgrau, A. E., S213 (MON-P091)
Ayçiçek, G. S., S241 (MON-P169), Bartol-Puyal, F., S37 (PT04.3) Bilku, D. K., S27 (OR68), S199 (MON-P052),
S243 (MON-P177) Başar, H., S58 (SUN-P017) S199 (MON-P053), S199 (MON-P054)
Aydin Cil, M., S242 (MON-P174), Baschali, A., S101 (SUN-P126), Bindelle, J., S273 (MON-P259)
S276 (MON-P267) S295 (MON-LB316) Bindels, L., S22 (OR54), S273 (MON-P259)
Aydin, A., S81 (SUN-P076) Basile, R., S193 (MON-P036) Bingisser, R., S67 (SUN-P040)
Azevedo, G. A., S179 (SUN-LB337) Basrai, M., S196 (MON-P046) Biolo, G., S64 (SUN-P032), S291 (MON-LB305),
Azevedo, M. J., S26 (OR64) Basso, L., S87 (SUN-P091), S152 (SUN-P267), S291 (MON-LB306)
Azevedo, R., S296 (MON-LB319) S276 (MON-P265), S281 (MON-P278) Biondi, A., S152 (SUN-P267)
Azriel Mira, S., S178 (SUN-LB336) Basualdo Hammond, C., S172 (SUN-LB320) Biruete, A., S35 (PT03.4)
Bathe, O. F., S47 (PT08.5) Bischoff, S. C., S196 (MON-P046),
B Batırel, S., S200 (MON-P056) S272 (MON-P255), S272 (MON-P256)
Bats, H. D., S205 (MON-P071) Bise, T., S198 (MON-P049)
Baba, H., S296 (MON-LB317) Bauer, J., S131 (SUN-P209) Bjøro, T., S91 (SUN-P100)
Badía-Tahull, M., S79 (SUN-P069) Bauer, P., S83 (SUN-P080), Blaak, E. E., S25 (OR61)
Bae, J. M., S174 (SUN-LB325), S219 (MON-P108) S272 (MON-P255) Blaauw, R., S251 (MON-P198)
Baek, S., S190 (MON-P029) Bayoumy, A., S19 (OR47) Blais, R., S19 (OR48)
Baggerman, M. R., S25 (OR61) Beau, P., S5 (OR11) Blanchet, S., S157 (SUN-P280)
Baggerman, M., S22 (OR55) Beck, A. M., S43 (PT07.1), S97 (SUN-P117), Blanc, M.-C., S221 (MON-P116)
Bahlouli, W., S97 (SUN-P116) S166 (SUN-LB305) Blanco, L., S224 (MON-P122)
Bahr, L., S110 (SUN-P151), S110 (SUN-P152) Becker, W., S30 (PT01.4) Blasi, V., S276 (MON-P265), S281 (MON-P278)
Baik, H. W., S176 (SUN-LB331) Beermann, T., S217 (MON-P102) Blat, S., S143 (SUN-P242)
Bailén-García, M. Á., S123 (SUN-P187) Beheshti-Namdar, A., S76 (SUN-P061) Blauw, G. J., S72 (SUN-P051)
Bajwa, N., S265 (MON-P236) Behulova, D., S284 (MON-P287) Blauwhoff-Buskermolen, S., S112 (SUN-P157)
Bakers, F. C., S25 (OR61) Beijer, S., S84 (SUN-P082), S174 (SUN-LB324) Blomhoff, R., S46 (PT08.1), S91 (SUN-P100)
Bakker, G. J., S54 (SUN-P004) Beijers, R.J.H.C.G., S232 (MON-P145) Blyth, F., S30 (PT01.5)
Balbino, A. M., S179 (SUN-LB337) Bejarano, S., S120 (SUN-P180) Boaz, M., S176 (SUN-LB330)
Balcı, C., S241 (MON-P169) Belaidi, E., S6 (OR14) Bobovnick, S., S185 (MON-P017)
Balci, C., S243 (MON-P177) Belarmino, G., S16 (OR40), Bobowicz, M., S173 (SUN-LB323)
Baldevarona, J. L., S162 (SUN-P293) S124 (SUN-P190) Bochud, M., S17 (OR43)
Baldwin, C., S43 (PT07.1), S97 (SUN-P117) Belle, F. N., S17 (OR43), S20 (OR50) Bodier, V., S126 (SUN-P195)
Baldwin, J., S120 (SUN-P180) Belli, D., S265 (MON-P236) Boehm, V., S5 (OR11)
Author index S311
Boeing, H., S167 (SUN-LB306) Broens, B., S186 (MON-P020) Cárdenas, G., S16 (OR39), S197 (MON-P048),
Boel, T., S155 (SUN-P275) Brosnan, N., S252 (MON-P201) S239 (MON-P165), S240 (MON-P166)
Boesveldt, S., S69 (SUN-P045), Brouns, J., S249 (MON-P191), Cardoso, A., S17 (OR41)
S171 (SUN-LB318) S250 (MON-P194) Carlsen, M. H., S91 (SUN-P100)
Boeykens, K., S301 (MON-LB331), Brouwer-Brolsma, E. M., S31 (PT01.6) Carlsson, A., S55 (SUN-P009)
S302 (MON-LB332) Brouwer, I. A., S12 (OR30) Carneiro, D., S64 (SUN-P031)
Bøhn, S. K., S46 (PT08.1) Brummer, R., S194 (MON-P039), Carnell, J., S204 (MON-P066)
Boirie, Y., S34 (PT03.1), S291 (MON-LB306) S194 (MON-P040) Caronni, S., S101 (SUN-P128)
Bolayır, B., S241 (MON-P169), S243 (MON-P177) Brundrett, D., S51 (PT10.3) Carpentier, B., S23 (OR57)
Bole-Feysot, C., S200 (MON-P057) Bruno, K. A., S90 (SUN-P097) Carrascal Fabián, M. L., S203 (MON-P064)
Bolliri, C., S101 (SUN-P128) Bruno, K.D.A., S211 (MON-P087) Carrascal Fabian, M. L., S212 (MON-P089)
Bol, M. E., S25 (OR61) Bruno, L. L., S50 (PT09.5) Carrasqueira, H., S161 (SUN-P291)
Bol, M., S22 (OR55) Buettner, S., S80 (SUN-P072), S80 (SUN-P073) Carrier, N., S75 (SUN-P057)
Bolstad, N., S91 (SUN-P100) Bufato, H. F., S118 (SUN-P175) Carsin, M., S32 (PT02.2)
Boltes Reis, G., S178 (SUN-LB334) Buhler, S., S172 (SUN-LB320) Carus, A., S217 (MON-P102)
Bonato, V., S74 (SUN-P056) Burgos, R., S16 (OR39), S61 (SUN-P024), Carvalho, A. M., S57 (SUN-P013)
Bond, A., S10 (OR23) S197 (MON-P048), S239 (MON-P165), Carvalho, L. P., S229 (MON-P137)
Bonetti, L., S68 (SUN-P042), S135 (SUN-P219), S240 (MON-P166) Carvalho, L., S284 (MON-P288)
S189 (MON-P028) Burke, D., S287 (MON-P296) Carvalho, L.S.F., S65 (SUN-P034)
Bonnabry, P., S265 (MON-P236) Busni, D., S227 (MON-P131) Carvalho, R., S185 (MON-P015)
Bonoli, A., S50 (PT09.5) Butler-Browne, G., S72 (SUN-P051) Casal, M. C., S109 (SUN-P148)
Booth, M. B., S268 (MON-P246) Buturovic-́ Ponikvar, J., S98 (SUN-P119) Casanova Rodriguez, C., S178 (SUN-LB336)
Boracchi, P., S135 (SUN-P219) Buyuktuncer, Z., S240 (MON-P168), Casarotto, L., S265 (MON-P237)
Borba, L.G.D., S60 (SUN-P022) S257 (MON-P216) Casarsa, C., S64 (SUN-P032)
Bordier, V., S255 (MON-P209) Bzduch, V., S284 (MON-P287) Casillas, E., S224 (MON-P122)
Borek, P., S119 (SUN-P176) Casique-Pérez, V., S209 (MON-P081)
Borges, N., S231 (MON-P142) C Cassani, E., S101 (SUN-P128)
Borins, E. P., S138 (SUN-P226) Castaldo, A., S68 (SUN-P042),
Borroni, F., S227 (MON-P131) Caballero Arredondo, M., S41 (PT06.2) S135 (SUN-P219), S189 (MON-P028)
Bosaeus, I., S216 (MON-P099) Cabezas Garcia, G., S225 (MON-P124) Castellano, I., S172 (SUN-LB319)
Bossche, N., S20 (OR49), S80 (SUN-P072), Cabrera, A., S147 (SUN-P254) Castello, L. M., S64 (SUN-P032)
S80 (SUN-P073) Cabrera, R., S269 (MON-P247) Castellote, A. I., S36 (PT04.1), S41 (PT06.2)
Bot, D., S75 (SUN-P060), S78 (SUN-P067) Cabrita, P., S161 (SUN-P291) Castillo, C. Montes, S226 (MON-P127)
Bottoni, A., S279 (MON-P274) Çabuk Güllüoğlu, H., S273 (MON-P258) Castillo-Martínez, L., S117 (SUN-P170),
Bou Mosleh, J., S113 (SUN-P161) Caccialanza, R., S24 (OR59) S209 (MON-P081), S226 (MON-P129)
Boudjema, K., S143 (SUN-P242), Cachero Triadú, M., S94 (SUN-P109) Castro-Eguiluz, D., S209 (MON-P081)
S209 (MON-P082) Cachero, M., S136 (SUN-P223) Castro, M., S181 (MON-P005)
Boulbasakos, G., S101 (SUN-P126) Caferoglu, Z., S18 (OR45), S43 (PT06.6) Castro, N., S260 (MON-P222)
Bouma, G., S49 (PT09.4) Cai, Z., S201 (MON-P060), S202 (MON-P061) Catalina, I., S177 (SUN-LB332)
Bouras, E., S63 (SUN-P029) Cakmak, G., S145 (SUN-P247) Caviezel, D., S233 (MON-P148)
Bourgoin-Voillard, S., S157 (SUN-P279) Calderón Vicente, D., S140 (SUN-P232) Cawley, C., S108 (SUN-P145)
Boutry, C., S4 (OR09) Calder, P., S12 (OR29), S58 (SUN-P016) Cawood, A. L., S7 (OR18), S175 (SUN-LB328)
Bouville, A., S135 (SUN-P218) Çalışkan, H., S241 (MON-P169), Cawthon, P. M., S12 (OR30)
Bouyon, S., S6 (OR14) S243 (MON-P177) Cayón-Blanco, M., S236 (MON-P156)
Bovera, M. M., S120 (SUN-P181) Calvo, P., S37 (PT04.3) Cayon-Blanco, M., S134 (SUN-P217)
Bozbulut, R., S275 (MON-P263) Camblor Álvarez, M., S203 (MON-P064), Cayuela García, A., S263 (MON-P231)
Bozkurt Cakir, I., S136 (SUN-P221) S203 (MON-P065) Cazaubon, E., S4 (OR09)
Bradley, E., S249 (MON-P192) Camblor Alvarez, M., S212 (MON-P089) Ceballos, M., S269 (MON-P247)
Bradshaw, C., S159 (SUN-P286) Camblor, M., S177 (SUN-LB332) Cecati, M., S227 (MON-P131)
Brand, H., S74 (SUN-P055) Campos, J.A.D. B., S260 (MON-P223) Cederholm, T., S30 (PT01.4), S55 (SUN-P009)
Brandt, C. F., S39 (PT05.3), S234 (MON-P149) Campos, V., S285 (MON-P291) Ceniccola, G. D., S64 (SUN-P033),
Brant, C. Q., S117 (SUN-P172) Campoy, C., S36 (PT04.1), S41 (PT06.2) S65 (SUN-P034)
Bras, L., S131 (SUN-P210) Canals-Baeza, A., S277 (MON-P269) Ceniceros Rozalen, I., S62 (SUN-P028)
Breedveld-Peters, J.J.L., S84 (SUN-P082) Cando, I., S150 (SUN-P260) Cereda, E., S24 (OR59), S101 (SUN-P128),
Breen, A., S159 (SUN-P286) Cani, P., S22 (OR54) S264 (MON-P235)
Brekke, H. K., S294 (MON-LB314) Cankurtaran, M., S241 (MON-P169), Černelič Bizjak, M., S141 (SUN-P236),
Brennerova, K., S284 (MON-P287) S243 (MON-P177) S243 (MON-P176), S270 (MON-P249)
Bresolin, N. L., S41 (PT06.1) Cano, N., S62 (SUN-P028) Cervantes, L. S., S35 (PT03.4)
Bretón Lesmes, I., S203 (MON-P064), Cano-Rodríguez, I., S115 (SUN-P165), César, R., S185 (MON-P015)
S203 (MON-P065), S212 (MON-P089) S115 (SUN-P166), S116 (SUN-P167), Cesar, T. B., S303 (MON-LB336)
Breton, I., S177 (SUN-LB332) S143 (SUN-P240) Cetina-Pérez, L., S209 (MON-P081)
Breuillard, C., S3 (OR07), S6 (OR14), cao, S., S221 (MON-P115) Chadwick, P., S10 (OR23)
S157 (SUN-P279) Cao, S., S188 (MON-P023) Chambrier, C., S5 (OR11), S48 (PT09.2),
Breuillé, D., S4 (OR09) Cao, Z., S302 (MON-LB333) S77 (SUN-P065)
Brinksma, A., S11 (OR26) Cappello, S., S24 (OR59) Chammas, R., S113 (SUN-P161)
Brito-Ashurst, I. D., S65 (SUN-P034) Caraccia, M., S24 (OR59) Chan, C. K., S15 (OR37)
Brøbech, P., S39 (PT05.3) Caran, E.M.M., S252 (MON-P199), Chang, Y.-S., S23 (OR58)
Broebech, P., S234 (MON-P149) S252 (MON-P200) Chan, L., S15 (OR38)
S312 Author index
Chan, P., S97 (SUN-P116) Claytor, L., S168 (SUN-LB309), Creus, G., S91 (SUN-P101)
Chan, W. Y., S255 (MON-P208) S300 (MON-LB327) Crommen, S., S275 (MON-P262)
Chan, Y. H., S59 (SUN-P019) Clynes, R., S252 (MON-P201) Cros, J., S285 (MON-P291)
Chao, C.-T., S44 (PT07.4) Cnop, M., S273 (MON-P259) Croveto, M., S133 (SUN-P215)
Chapman, M., S180 (MON-P003) Cobilinschi, C., S60 (SUN-P020), Crudo, M., S96 (SUN-P115)
Chapple, L., S180 (MON-P003) S60 (SUN-P021) Cruthirds, C., S34 (PT03.2), S36 (PT03.6)
Charidemou, E., S176 (SUN-LB329) Cocco, M., S253 (MON-P202) Cruz, R., S219 (MON-P109)
Charrière, M., S183 (MON-P011) Coebergh van den Braak, R., S80 (SUN-P073), Cuellar Olmedo, L., S225 (MON-P124),
Chaves, G. V., S39 (PT05.2), S90 (SUN-P097), S128 (SUN-P201) S225 (MON-P125)
S211 (MON-P087), S212 (MON-P088) Coëffier, M., S34 (PT03.1), S97 (SUN-P116), Cuerda Compés, C., S212 (MON-P089)
Chee, V., S120 (SUN-P180) S200 (MON-P057), S244 (MON-P180) Cuerda Compés, M. C., S203 (MON-P064),
Chełchowska, M., S42 (PT06.5), S52 (PT10.6) Coeffier, M., S286 (MON-P292) S203 (MON-P065)
Chen, C. W., S86 (SUN-P087) Coelho, M.P.P., S133 (SUN-P213), Cuerda, C., S177 (SUN-LB332)
Cheng, H., S152 (SUN-P266) S202 (MON-P063) Cuesta, F., S269 (MON-P247)
Cheng, T. P., S15 (OR37) Coenen, M., S275 (MON-P262) Cui, H., S243 (MON-P175)
Chen, H., S284 (MON-P286) Cohen Fox, L., S24 (OR60) Cukier, C., S122 (SUN-P186)
Chen, J., S139 (SUN-P230), S278 (MON-P272) Cohen, J., S24 (OR60), S25 (OR63), Culkin, A., S51 (PT10.3), S76 (SUN-P063)
Chen, L., S138 (SUN-P228) S183 (MON-P012), S184 (MON-P013) Cullen, K., S249 (MON-P192)
Chen, W., S138 (SUN-P228) Cohen, S. S., S266 (MON-P239) Cumming, R., S30 (PT01.5)
Chen, W.-J., S79 (SUN-P071) Coker, A., S81 (SUN-P076) Cunha, C., S219 (MON-P109)
Chermesh, I., S254 (MON-P206) Cola, C., S193 (MON-P036) Cunha, H.F.R., S267 (MON-P243)
Cheung, K., S130 (SUN-P207) Colange, G., S244 (MON-P180) Cunin, V., S157 (SUN-P279)
Cheung, W., S199 (MON-P054) Colizzi, E., S68 (SUN-P041) Cunneen, S., S252 (MON-P201)
Chiang Alvarez, M., S234 (MON-P150) Collado Amores, M. C., S203 (MON-P064), Cuvelier, I., S190 (MON-P030)
Chiarello, P., S81 (SUN-P074) S203 (MON-P065) Cynober, L., S69 (SUN-P044), S90 (SUN-P098),
Chiba, M., S266 (MON-P241), S276 (MON-P266) Collins, A. R., S46 (PT08.1) S221 (MON-P116), S253 (MON-P203),
Chica Marchal, A., S263 (MON-P231) Collins, P. F., S231 (MON-P141) S284 (MON-P286), S285 (MON-P289)
Chikhi, M., S113 (SUN-P159), S129 (SUN-P205) Collo, A., S172 (SUN-LB319) Czarnecki, D., S100 (SUN-P124)
Chikugo, M., S178 (SUN-LB335) Colls-González, M., S79 (SUN-P069) Czyzewska, M., S105 (SUN-P139)
Chisaguano Tonato, A. M., S36 (PT04.1), Colombo, M. G., S73 (SUN-P054)
S41 (PT06.2) Colombo, S., S24 (OR59)
D
Chisaguano, M., S260 (MON-P222) Çolpan Öksüz, D., S87 (SUN-P090)
Chi-Sheng, W., S23 (OR58) Comas Martínez, M., S240 (MON-P166) D’Albuquerque, L.A.C., S124 (SUN-P190)
Chittawatanarat, K., S247 (MON-P187) Comas, M., S197 (MON-P048), S239 (MON-P165) D’almeida, C. A., S215 (MON-P098)
Chiu, P., S15 (OR38) Commeyne, S., S150 (SUN-P261) D’almeida, C., S29 (PT01.2)
Chmielewski, M., S119 (SUN-P176) Concollato, E., S74 (SUN-P056) d’Assignies, G., S62 (SUN-P028)
Cho, H. J., S190 (MON-P029) Conde Vicente, R., S225 (MON-P124) D’ugo, D., S152 (SUN-P267)
Choi, K. D., S79 (SUN-P070), Contaldo, F., S40 (PT05.6), S44 (PT07.2), da Camara, A. O., S212 (MON-P088)
S301 (MON-LB330) S103 (SUN-P131), S126 (SUN-P196) Dale, H. F., S32 (PT02.3)
Choi, M. G., S174 (SUN-LB325), Contreras-Bolivar, V., S89 (SUN-P095), Damaraju, V., S47 (PT08.4)
S219 (MON-P108) S89 (SUN-P096) Damiani, L., S124 (SUN-P190)
Choi, N.-J., S182 (MON-P009) Contreras, M. G., S173 (SUN-LB321) Dams, K., S290 (MON-LB304)
Choisy, C., S285 (MON-P289) Cooke, J., S27 (OR68), S93 (SUN-P106), Daniel, H., S297 (MON-LB321)
Chopard, P., S129 (SUN-P205) S93 (SUN-P107), S94 (SUN-P108), Danko, M., S18 (OR44), S150 (SUN-P262)
Chourdakis, M., S56 (SUN-P011), S199 (MON-P052), S199 (MON-P053) Danner-Boucher, I., S56 (SUN-P010)
S63 (SUN-P029), S109 (SUN-P148), Cook, M. E., S213 (MON-P091), Dardevet, D., S167 (SUN-LB306)
S140 (SUN-P233) S217 (MON-P102) Darmaun, D., S56 (SUN-P010)
Cho, Y. Y., S219 (MON-P108) Corbella, F., S24 (OR59) Darwish Murad, S., S80 (SUN-P072)
Cho, Y., S69 (SUN-P044) Corcos, O., S5 (OR11) Davies, N., S268 (MON-P246)
Chriestya, F., S226 (MON-P128) Corish, C. A., S189 (MON-P027) Dax, A., S267 (MON-P244), S268 (MON-P245)
Chung, W. Y., S214 (MON-P095) Corish, C., S30 (PT01.3), S131 (SUN-P209) de Aguilar-Nascimento, J. E.,
Chung, W., S23 (OR58), S93 (SUN-P106), Corne, C., S3 (OR07) S118 (SUN-P175)
S93 (SUN-P107), S94 (SUN-P108) Correia, M. I., S17 (OR41) De Aguilar-Nascimento, J. E., S27 (OR67)
Chu, Q., S47 (PT08.4) Correia, M.I.T. D., S133 (SUN-P213), De Baat, C., S74 (SUN-P055)
Cicek, B., S145 (SUN-P248) S202 (MON-P063) De Bandt, J.-P., S7 (OR17), S90 (SUN-P098),
Cieślak, W., S100 (SUN-P124) Cortez, I., S57 (SUN-P014) S253 (MON-P203), S284 (MON-P286),
Çiftçi, S., S235 (MON-P153) Cortina, R. A., S35 (PT03.4) S285 (MON-P289), S285 (MON-P291)
Cignacco, E., S20 (OR50) Coskun, R., S287 (MON-P295) de Bree, R., S83 (SUN-P081)
Cil, M. Aydin, S228 (MON-P133) Costa, F., S219 (MON-P109) de Bruin, R., S80 (SUN-P072), S80 (SUN-P073),
Cintoni, M., S87 (SUN-P091), S152 (SUN-P267), Costa, H., S185 (MON-P015) S128 (SUN-P201)
S276 (MON-P265), S281 (MON-P278) Costa, M.P.S., S151 (SUN-P264) De Caprio, C., S40 (PT05.6), S44 (PT07.2),
Cioffi, I., S103 (SUN-P131), S126 (SUN-P196) Costa, V. L., S26 (OR64) S103 (SUN-P131)
Ciudin, A., S16 (OR39) Couchet, M., S3 (OR07), S6 (OR14) De Cloet, J., S150 (SUN-P261)
Civelek, S., S303 (MON-LB334) Couratier, P., S34 (PT03.1), S34 (PT03.3) De Colle, P., S74 (SUN-P056)
Clamagirand, C., S69 (SUN-P044) Courtice, S., S305 (MON-LB341) de Damas Medina, M., S226 (MON-P127)
Clarke, M., S30 (PT01.3), S131 (SUN-P209), Courtin, C., S22 (OR54) De Faire, U., S55 (SUN-P009)
S189 (MON-P027) Cravo, M., S151 (SUN-P264), S219 (MON-P109) De Filippo, E., S40 (PT05.6), S44 (PT07.2),
Clausen, J.K.B., S108 (SUN-P147) Crespo Soto, C., S225 (MON-P125) S103 (SUN-P131)
Author index S313
De Francesco, A., S172 (SUN-LB319), Dennison, A. R., S199 (MON-P054), Doornink, N., S84 (SUN-P082)
S301 (MON-LB329) S214 (MON-P095) Dos Santos, N.D.C., S64 (SUN-P033)
de Groot, C. P., S166 (SUN-LB305) Dennison, A., S23 (OR58), S27 (OR68), Dos Santos, P.F.S., S64 (SUN-P033)
De Groot, I.A.M., S104 (SUN-P136) S88 (SUN-P094), S93 (SUN-P106), Dos Santos, S.S.M., S64 (SUN-P033)
de Groot, L. C., S9 (OR21) S93 (SUN-P107), S94 (SUN-P108), Doulatram-Gamgaram, V., S89 (SUN-P096)
De Groot, L., S167 (SUN-LB306) S199 (MON-P052), S199 (MON-P053) Doundoulakis, I., S63 (SUN-P029)
de Groot, M. H., S68 (SUN-P043) Desbrow, B., S281 (MON-P279) Doves, M., S72 (SUN-P052)
De Groot, M., S220 (MON-P112) Desmet, S., S63 (SUN-P030) Dronkelaar, C., S129 (SUN-P204)
de Jong, N., S72 (SUN-P051) Desport, J. C., S8 (OR19), S19 (OR48), Droop, A., S75 (SUN-P060), S78 (SUN-P067)
De Koning, B., S42 (PT06.4) S34 (PT03.1), S34 (PT03.3), S127 (SUN-P200) Druet-Cabanac, M., S8 (OR19)
de la Garza Puentes, A., S36 (PT04.1), Deutz, N. E., S46 (PT08.3), S70 (SUN-P046), Druml, W., S25 (OR62)
S41 (PT06.2) S70 (SUN-P047), S99 (SUN-P123), Drummond, S., S274 (MON-P261),
DE LA Iglesia-Arnaez, R., S277 (MON-P269) S156 (SUN-P277), S227 (MON-P130) S303 (MON-LB335)
De Lorenzi, D.R.S., S98 (SUN-P120) Deutz, N., S34 (PT03.2), S36 (PT03.6), Drustrup, L., S211 (MON-P086)
De Luca, A., S148 (SUN-P255), S155 (SUN-P276) S244 (MON-P178) Duarte, Y. C., S102 (SUN-P130)
de Man, R. A., S133 (SUN-P214) Devriese, L. A., S83 (SUN-P081) Dubern, B., S304 (MON-LB338)
de Mestral, C., S262 (MON-P227) Dewansingh, P., S250 (MON-P195) Dubin, J., S125 (SUN-P193)
De Oliveira, A.B.M., S65 (SUN-P034) Dhaliwal, R., S210 (MON-P083) Dubrova, K., S65 (SUN-P035)
de Paula, N. S., S90 (SUN-P097), Di Caro, S., S50 (PT10.2), S96 (SUN-P114), Dubrov, S., S65 (SUN-P035)
S211 (MON-P087), S212 (MON-P088) S109 (SUN-P150), S130 (SUN-P207), Ducrotté, P., S97 (SUN-P116)
de Pinho, N. B., S215 (MON-P098) S215 (MON-P096), S215 (MON-P097), Dugelay, E., S304 (MON-LB338)
de Sá, B. L., S253 (MON-P202) S287 (MON-P294) Duignan, E., S252 (MON-P201)
De Schepper, J., S151 (SUN-P263) Di Girolamo, F. G., S64 (SUN-P032) Duizer, L., S75 (SUN-P057)
de Smoker, M., S238 (MON-P161) di Rosa, M., S193 (MON-P036) Du, K., S168 (SUN-LB308)
de Theije, C. C., S26 (OR66) Di Somma, S., S64 (SUN-P032) Đukanovic,́ M., S127 (SUN-P198)
de van der Schueren, M. A., S30 (PT01.3), Di Vincenzo, O., S126 (SUN-P196) Dulac, M. C., S229 (MON-P137)
S71 (SUN-P050), S72 (SUN-P052), Diamantopoulos, P., S111 (SUN-P153) Dulac, M., S38 (PT04.5), S271 (MON-P252),
S131 (SUN-P209), S166 (SUN-LB305) Díaz Guardiola, P., S178 (SUN-LB336) S284 (MON-P288)
De Van Der Schueren, M. A., S238 (MON-P161) Diaz, E., S288 (MON-P299) Dulery, R., S23 (OR57)
de Van Der Schueren, M., S112 (SUN-P157) Díaz, M., S228 (MON-P134) Duncan, S., S108 (SUN-P147)
de van der Schueren, M., S216 (MON-P101) Diaz, M., S225 (MON-P126) Dundar, G., S249 (MON-P193)
De van der Schueren, M., S69 (SUN-P045), Dibb, M., S10 (OR23) Dupertuis, Y.-M., S293 (MON-LB310),
S73 (SUN-P053), S83 (SUN-P080), Diekmann, R., S73 (SUN-P054) S293 (MON-LB311)
S93 (SUN-P105) Diemer, D., S159 (SUN-P284) Dupont Cuisinier, M., S8 (OR19)
De Vogel-Van den Bosch, J., S232 (MON-P144) Diez-Garcia, R. W., S48 (PT08.6), Durán-Aguero, S., S133 (SUN-P215)
de Vries, J., S107 (SUN-P144) S95 (SUN-P111), S95 (SUN-P112) Durand, J.-P., S90 (SUN-P098)
De Wachter, E., S151 (SUN-P263) Dijk, A. V., S112 (SUN-P158) Dussaulx, L., S32 (PT02.2)
De Waele, E., S62 (SUN-P027), Dijkhuizen, M., S107 (SUN-P144) Dynnyk, N., S204 (MON-P068)
S180 (MON-P002) Dijkstra, G., S205 (MON-P071) Dziadzio, M., S287 (MON-P294)
De Witte, N., S261 (MON-P225) Dijxhoorn, D. N., S10 (OR24), S255 (MON-P210)
Deane, A. M., S33 (PT02.6) Dikmen, D., S116 (SUN-P168),
E
Deane, A., S180 (MON-P003) S135 (SUN-P220), S142 (SUN-P239)
Debain, A., S180 (MON-P002) Dimori, S., S264 (MON-P235) Ebiloğlu, D., S58 (SUN-P017)
De-Bandt, J.-P., S69 (SUN-P044) Dimosthenopoulos, C., S59 (SUN-P018) Ede, G., S17 (OR42), S124 (SUN-P191)
Déchelotte, P., S97 (SUN-P116), Dinçbaş, F. Ö., S87 (SUN-P090) Egert, S., S275 (MON-P262)
S200 (MON-P057), S244 (MON-P180), Diniz, K.G.D., S133 (SUN-P213), Eggink, H. M., S54 (SUN-P004)
S286 (MON-P292) S202 (MON-P063) Eghtesadi1, S., S76 (SUN-P061)
Degirmenci, N., S260 (MON-P224) Djurhuus, M., S155 (SUN-P275) Eglseer, D., S71 (SUN-P048)
Dehnavi, Z., S121 (SUN-P183) do Carmo, A. S., S111 (SUN-P154) El Gerges, N., S113 (SUN-P160),
Dekker, I., S187 (MON-P021) do Rego, J. C., S286 (MON-P292) S162 (SUN-P295)
Del Piano, C., S103 (SUN-P131) Doaei, S., S213 (MON-P090) El Hajj Boutros, G., S38 (PT04.5),
Delay, J., S200 (MON-P057), Dobinsky, R., S176 (SUN-LB330) S229 (MON-P137), S271 (MON-P252),
S244 (MON-P180) Dock, D. D., S118 (SUN-P175) S284 (MON-P288)
Delgado-Martínez, A. D., S226 (MON-P127) Dock-Nascimento, D. B., S27 (OR67) El Jabbour, F., S113 (SUN-P160)
Delgado-Rodríguez, M., S226 (MON-P127) Dogan Varan, H., S11 (OR27), S195 (MON-P042) El Osta, L., S84 (SUN-P083), S113 (SUN-P160)
Dell’utri, D., S57 (SUN-P012) Doğru Ersöz, D., S103 (SUN-P133), El Osta, N., S84 (SUN-P083)
Dellière, S., S253 (MON-P203) S104 (SUN-P134) Elbelt, U., S298 (MON-LB322)
Delzenne, N., S2 (OR04), S22 (OR54), Doğrul, R. T., S241 (MON-P169), El-gendy, Y. G., S19 (OR47)
S273 (MON-P259) S243 (MON-P177) El-Gohary, P.C.G., S12 (OR29)
Demetriou, P., S300 (MON-LB328) Doherty, L., S159 (SUN-P286) Eliakim, R., S13 (OR31)
Demiral Sezer, S., S218 (MON-P107) Doi, S., S247 (MON-P188) Elizur, A., S179 (SUN-LB338)
Demirel, Z. Büyüktuncer, S235 (MON-P152), Dolman, R., S251 (MON-P198) Elsadek, M. F., S223 (MON-P121)
S235 (MON-P153) Domingo, J. C., S119 (SUN-P178) Elshakankiry, H. M., S19 (OR47)
Demir, N. B., S11 (OR27) Domin, I., S65 (SUN-P035) El-Tweri, A., S23 (OR58)
Demir, N., S103 (SUN-P132) Doncel-Moriano, A., S123 (SUN-P187) Elvira, G., S288 (MON-P299)
Demol, J., S62 (SUN-P027) Donini, L. M., S7 (OR16) Emanuelli, M., S227 (MON-P131)
Deniz, O., S11 (OR27), S195 (MON-P042) Donker, A., S78 (SUN-P067) Emiralioğlu, N., S103 (SUN-P133),
Denneman, N., S186 (MON-P020) Doorduijn, A., S69 (SUN-P045), S73 (SUN-P053) S104 (SUN-P134)
S314 Author index
Emken, B.-E. G., S77 (SUN-P064) Fernandez, L., S269 (MON-P247) Fujimoto, Y., S299 (MON-LB325)
Endo, R., S139 (SUN-P229) Fernández-Lucas, M., S224 (MON-P122), Fujiwara, T., S14 (OR33)
Endo, S., S52 (PT10.5) S225 (MON-P126) Fukatsu, K., S1 (OR02), S15 (OR36),
Engberink, M. F., S10 (OR25), S12 (OR30) Fernandez-Lucas, M., S228 (MON-P134) S46 (PT08.2), S78 (SUN-P068),
Engberink, M., S135 (SUN-P218) Fernández-Martínez, P., S115 (SUN-P165), S85 (SUN-P085), S171 (SUN-LB316),
Engelbert, R., S129 (SUN-P204) S115 (SUN-P166), S116 (SUN-P167), S201 (MON-P058)
Engelen, M. P., S46 (PT08.3), S70 (SUN-P046), S143 (SUN-P240) Fukushima, R., S139 (SUN-P229)
S70 (SUN-P047), S99 (SUN-P123), Ferreira, A. S., S151 (SUN-P264) Fumelli, D., S227 (MON-P131)
S156 (SUN-P277), S227 (MON-P130) Ferreira, C., S219 (MON-P109) Funakoshi, H., S78 (SUN-P066),
Engelen, M., S34 (PT03.2), S36 (PT03.6), Ferreira, D. F., S122 (SUN-P185) S189 (MON-P026)
S244 (MON-P178) Ferreira, L.S.A., S133 (SUN-P213) Fu, Y., S278 (MON-P272)
Engelheart, S., S194 (MON-P039), Ferreira, S. C., S17 (OR41)
S194 (MON-P040) Ferreirea, D. F., S122 (SUN-P186)
G
Engel, T., S13 (OR31) Ferrer Gómez, M., S263 (MON-P231)
Erbakan, A., S136 (SUN-P221) Ferrer Gomez, M., S234 (MON-P150) Gabe, S. M., S4 (OR10), S8 (OR20),
Erdem, N. B., S205 (MON-P070) Ferreras, A., S37 (PT04.3) S33 (PT02.5), S51 (PT10.3), S81 (SUN-P075),
Erdem, S., S273 (MON-P257) Ferretti, R.D.L., S252 (MON-P199), S230 (MON-P139), S262 (MON-P228)
Erdenen, F., S303 (MON-LB334) S252 (MON-P200) Gabrielli, C. P., S116 (SUN-P169)
Erdinc, A. S., S135 (SUN-P220) Ferri, V., S101 (SUN-P128) Gaillard, T., S168 (SUN-LB308)
Eren Fidanci, B., S149 (SUN-P257) Fiaccadori, E., S182 (MON-P008), Gajete-Martín, L. M., S115 (SUN-P165),
Ergen, S. A., S87 (SUN-P090) S306 (MON-LB343) S115 (SUN-P166), S116 (SUN-P167),
Ergun, R., S235 (MON-P152) Fidilio, E., S16 (OR39) S143 (SUN-P240)
Ersin, S., S218 (MON-P107) Figliolino, L.F.O., S279 (MON-P274) Gajewska, J., S42 (PT06.5), S52 (PT10.6)
Ersoy, G., S246 (MON-P184), S246 (MON-P185) Figueiras, M., S161 (SUN-P291) Gallego Herreros, G., S225 (MON-P124),
Ersoy, N., S246 (MON-P184), S246 (MON-P185), Figueiredo, E. J., S64 (SUN-P031) S225 (MON-P125)
S247 (MON-P186) Fimmers, R., S275 (MON-P262) Gallon, C. W., S98 (SUN-P120),
ERTAŞ, Y., S256 (MON-P213) Fini, L., S96 (SUN-P114) S116 (SUN-P169), S136 (SUN-P222),
Ertaş, Y., S256 (MON-P211), S256 (MON-P212), Fink, J. S., S40 (PT05.4), S111 (SUN-P154) S143 (SUN-P241)
S257 (MON-P214), S257 (MON-P215), Finocchiaro, E., S172 (SUN-LB319) Galmiche, M., S200 (MON-P057)
S275 (MON-P263) Finucane, J., S305 (MON-LB341) Gamarra-Morales, Y., S290 (MON-LB303)
Ertugrul, M., S88 (SUN-P093) Fior, L., S264 (MON-P235) Gao, X., S222 (MON-P118)
Esfarjani, F., S145 (SUN-P246), Fiotti, N., S64 (SUN-P032) Gapeyeva, H., S72 (SUN-P051)
S159 (SUN-P287) Firat, O., S218 (MON-P107) Garbay, C., S284 (MON-P286)
Esin, K., S200 (MON-P056) Fischer, M., S37 (PT04.4) García Castañeda, M. A., S126 (SUN-P197)
Espinoza, V., S133 (SUN-P215) Fisher, V., S186 (MON-P018) García Cayuela, A. M., S234 (MON-P150)
Esteban-Sánchez, C., S79 (SUN-P069) Fisunoglu, M., S138 (SUN-P227) García de Gregorio, J., S178 (SUN-LB336)
Esteves, L., S185 (MON-P015) Fitzgerald, P., S117 (SUN-P171) Garcia Garcia-Doncel, L., S134 (SUN-P217),
Estrella, A., S102 (SUN-P130) Fliers, E., S54 (SUN-P004) S236 (MON-P156)
Etienne, Q., S205 (MON-P069) Flood, V., S162 (SUN-P294) García Peris, P., S203 (MON-P064),
Ettema, R., S152 (SUN-P268) Flores-Cisneros, L., S209 (MON-P081) S203 (MON-P065), S212 (MON-P089)
Euwes, M., S250 (MON-P195) Flores, M., S120 (SUN-P180) Garcia Zafra, V., S234 (MON-P150),
Evill, R. H., S217 (MON-P103) Floros, I., S59 (SUN-P018) S263 (MON-P231)
Folope, V., S200 (MON-P057), S244 (MON-P180) García-Bermudez, M., S36 (PT04.1),
Fong, D. Y., S15 (OR37) S41 (PT06.2)
F Garcia, F. D., S133 (SUN-P213)
Fonseca, D. C., S16 (OR40), S38 (PT04.6)
Fabri, M., S227 (MON-P131) Fonseca, J., S83 (SUN-P079), S128 (SUN-P202), Garcia-FIgueras Mateos, C., S134 (SUN-P217)
Fafournoux, P., S155 (SUN-P276) S163 (SUN-P296) Garcia-Figueras Mateos, C., S236 (MON-P156)
Fagnani, D., S193 (MON-P036) Fontaine, E., S3 (OR07), S157 (SUN-P280) Garcia-Figueras-Mateos, C., S236 (MON-P155)
Fagotti, A., S281 (MON-P278) Fonzo-Christe, C., S265 (MON-P236) García, G. Cabezas, S224 (MON-P123)
Faierman, S. A., S101 (SUN-P128) Forbes, A., S255 (MON-P208) García-Morales, J. M., S226 (MON-P129)
Fakhoury, J., S84 (SUN-P083) Forchielli, M. L., S50 (PT09.5) Garcia, N., S197 (MON-P048)
Fan, L., S168 (SUN-LB309), S300 (MON-LB327) Forest, C., S38 (PT04.5), S271 (MON-P252) Garcia-Peris, P., S177 (SUN-LB332)
Fan, S., S4 (OR08), S290 (MON-P302) Formolo, J. P., S136 (SUN-P222) García-Valdés, M. L., S36 (PT04.1),
Farah, S., S214 (MON-P095) Forouhi, N. G., S261 (MON-P226) S41 (PT06.2)
Farcomeni, A., S57 (SUN-P012) Fort, E., S91 (SUN-P101) Garib, R. A., S164 (SUN-P298)
Farias, M. S., S41 (PT06.1) Fragkos, K. C., S96 (SUN-P114), Garin, U., S269 (MON-P247), S271 (MON-P253)
Farías, S. S., S57 (SUN-P014) S109 (SUN-P150), S130 (SUN-P207), Garla, P. C., S164 (SUN-P298)
Farre, M., S61 (SUN-P024) S287 (MON-P294) Garla, P., S16 (OR40), S38 (PT04.6)
Farshidfar, F., S47 (PT08.5) Fragkos, K., S50 (PT10.2), S215 (MON-P096), Garnes, S. A., S279 (MON-P274)
Fauler, G., S3 (OR06) S215 (MON-P097) Garrido, V., S10 (OR25)
Faustmann, G., S3 (OR06), S156 (SUN-P278) Franco, L., S107 (SUN-P142) Garssen, J. G., S286 (MON-P293)
Fayemendy, P., S8 (OR19), S19 (OR48), Frandsen, L. S., S228 (MON-P132) Garvey, S., S289 (MON-P301)
S34 (PT03.1), S34 (PT03.3), S127 (SUN-P200) Franssen, F., S6 (OR13) Garzoni, L., S265 (MON-P236)
Feferbaum, R., S185 (MON-P016) Franz, K., S110 (SUN-P151), S110 (SUN-P152) Gasbarrini, A., S87 (SUN-P091),
Feldblum, I., S166 (SUN-LB305) Freijer, K., S304 (MON-LB337) S152 (SUN-P267), S276 (MON-P265),
Fellinger, T., S25 (OR62) Freitas, B. J., S64 (SUN-P031) S281 (MON-P278)
Feo Ortega, G., S212 (MON-P089) Frost, G. S., S111 (SUN-P155) Gasparotto, F., S264 (MON-P235)
Fernández, J., S288 (MON-P299) Fuglsang, K. A., S39 (PT05.3), S234 (MON-P149) Gaspersz, M., S80 (SUN-P073)
Author index S315
Gasser, M., S37 (PT04.2) Goldberg, M. R., S179 (SUN-LB338) Gumus, D., S118 (SUN-P174), S125 (SUN-P192),
Gaudreau, P., S229 (MON-P137), Goldwasser, F., S90 (SUN-P098), S241 (MON-P170), S254 (MON-P204)
S284 (MON-P288) S221 (MON-P116) Gunay, Y., S287 (MON-P295)
Gauthier, J., S23 (OR57) Gomez Giralda, B., S225 (MON-P125) Gundogan, K., S287 (MON-P295)
Gautier, Y., S143 (SUN-P242) Gonçalves, S.E.A., S253 (MON-P202) Güneş Yalçın, E., S103 (SUN-P133),
Geerlings, P., S191 (MON-P031), Gonen, O., S136 (SUN-P221) S104 (SUN-P134)
S248 (MON-P190), S249 (MON-P191), Gontijo, L.C.D. L., S267 (MON-P243) Gunnarsdottir, I., S43 (PT07.1), S97 (SUN-P117)
S250 (MON-P194) Gonzalez Granda, A., S196 (MON-P046) Guo, S., S138 (SUN-P228)
Gehrke, I., S190 (MON-P030) González López, J., S140 (SUN-P232) Gurba, F., S113 (SUN-P159)
Geirsdottir, O. G., S43 (PT07.1), González Peral, M. I., S280 (MON-P276) Gürsel, O., S208 (MON-P078),
S97 (SUN-P117) Gonzalez Sagrado, M., S225 (MON-P124), S208 (MON-P079), S209 (MON-P080)
Geisler, C., S118 (SUN-P173) S225 (MON-P125) Gussoni, M., S68 (SUN-P042)
Gelvez, J., S173 (SUN-LB321) Gonzalez-Cerrajero, M., S271 (MON-P253) Gutierrez Gutierrez, G., S178 (SUN-LB336)
Genton, L., S113 (SUN-P159), S129 (SUN-P205), González-Herráez, L., S115 (SUN-P165), Guven Sade, E., S192 (MON-P034)
S141 (SUN-P234), S197 (MON-P047), S115 (SUN-P166), S116 (SUN-P167), Guven, M., S287 (MON-P295)
S259 (MON-P220) S143 (SUN-P240)
George, E., S169 (SUN-LB311) Gonzalez, M. C., S124 (SUN-P190) H
Geraldi, M. V., S95 (SUN-P112) González-Tampán, R., S91 (SUN-P101)
Gesquiere, I., S270 (MON-P251) Gonzalo, M., S89 (SUN-P095) Hafner-Giessauf, H., S3 (OR06)
Gezmen-KARADAĞ , M., S256 (MON-P213) Goodarzi, M. T., S105 (SUN-P137) Hagiwara, G., S199 (MON-P055)
Gezmen-Karadağ, M., S257 (MON-P214), Goron, A., S157 (SUN-P279), S157 (SUN-P280) Haidich, A. B., S56 (SUN-P011)
S257 (MON-P215) Gortan Cappellari, G., S1 (OR01), S6 (OR15), Haken, A., S184 (MON-P014)
Ghiorghiu, Z., S60 (SUN-P020), S60 (SUN-P021) S74 (SUN-P056) Haler, Ž., S98 (SUN-P119)
Gholamalizadeh, M., S213 (MON-P090) Gosker, H. R., S232 (MON-P145) Halfens, R. J., S9 (OR21)
Ghosal, S., S278 (MON-P270) Goto, H., S278 (MON-P271) Halil, M., S241 (MON-P169), S243 (MON-P177)
Ghouzali, I., S97 (SUN-P116) Gouspillou, G., S229 (MON-P137), Hall, T., S27 (OR68), S199 (MON-P052),
Giacca, M., S1 (OR01) S284 (MON-P288) S199 (MON-P053), S199 (MON-P054)
Giacometti, T. F., S279 (MON-P274) Gow, I. F., S274 (MON-P261), S303 (MON-LB335) Halmos, G. B., S131 (SUN-P210)
Gianfrancesco, M., S273 (MON-P259) Grabher, J., S3 (OR06) Haloun, A., S56 (SUN-P010)
Giannella Neto, D., S16 (OR40) Graf, C. E., S197 (MON-P047) Hamaguchi, Y., S14 (OR35), S39 (PT05.1),
Giannella-Neto, D., S38 (PT04.6) Graf, S., S129 (SUN-P205), S293 (MON-LB310), S76 (SUN-P062), S153 (SUN-P270),
Gibney, E. R., S30 (PT01.3), S131 (SUN-P209), S293 (MON-LB311) S206 (MON-P072)
S189 (MON-P027) Gramlich, L. M., S172 (SUN-LB320) Hamerschlak, N., S253 (MON-P202)
Giebułtowicz, J., S49 (PT09.3) Gramlich, L., S210 (MON-P083) Hammarqvist, F., S2 (OR03)
Giesbertz, P. J., S297 (MON-LB321) Gravelat, M., S8 (OR19) Hanachi, M., S102 (SUN-P129),
Gies, I., S151 (SUN-P263) Griffin, J. L., S176 (SUN-LB329) S231 (MON-P140)
Gil Martínez, C., S203 (MON-P065) Grigioni, S., S200 (MON-P057), Hanai, T., S170 (SUN-LB313)
Gillam, M., S172 (SUN-LB320) S244 (MON-P180) Han, J., S301 (MON-LB330)
Gil, N. L., S178 (SUN-LB334), S179 (SUN-LB337) Grill, E., S73 (SUN-P054) Hankard, R., S148 (SUN-P255),
Ginguay, A., S69 (SUN-P044) Groen, A. K., S54 (SUN-P004) S155 (SUN-P276)
Gionti, L., S193 (MON-P038) Groot Koerkamp, B., S80 (SUN-P073) Hannon, M., S252 (MON-P201)
Giorgini, N., S193 (MON-P036) Gross, L. A., S26 (OR64) Hannon, R., S252 (MON-P201)
Giorgio, L., S264 (MON-P235) Groszek, P., S106 (SUN-P140) Han, W. M., S92 (SUN-P103)
Giribés, M., S239 (MON-P165), Gruber, H.-J., S156 (SUN-P278) Han, Y., S14 (OR34)
S240 (MON-P166) Guadagni, M., S291 (MON-LB305), Harada, N., S178 (SUN-LB335)
Giribes, M., S16 (OR39) S291 (MON-LB306) Harada, T., S247 (MON-P188)
Gisbertz, I.A.M., S104 (SUN-P136) Guarda, I.F.D.M.S., S38 (PT04.6) Harbron, J., S251 (MON-P198)
Gislason, T., S43 (PT07.1), S97 (SUN-P117) Guarda, I.F.M. S., S16 (OR40) Hardis, A.L.S., S35 (PT03.5)
Glavas, S., S82 (SUN-P077) Guedes, K.J.T., S252 (MON-P199), Harris, T. B., S12 (OR30)
Gnessi, L., S7 (OR16) S252 (MON-P200) Harrykissoon, R., S34 (PT03.2),
Goates, S., S168 (SUN-LB308), Guerendiain, M., S122 (SUN-P184), S99 (SUN-P123)
S168 (SUN-LB309), S300 (MON-LB327) S148 (SUN-P256), S150 (SUN-P260), Hartman, E., S73 (SUN-P053)
Godin, J.-P., S4 (OR09) S277 (MON-P268) Harvey, M., S176 (SUN-LB329)
Goessens, J. P., S2 (OR05) Guérin, C., S200 (MON-P057) Hasegawa, M., S288 (MON-P297)
Goetzenich, A., S26 (OR65) Guerin, S., S143 (SUN-P242) Hashimoto, K., S220 (MON-P111)
Goichon, A., S97 (SUN-P116), S286 (MON-P292) Guerra, R. S., S192 (MON-P035) Hassan, H. M., S223 (MON-P121)
Gojda, J., S139 (SUN-P231), S184 (MON-P014) Guerrero, M., S16 (OR39), S239 (MON-P165), Hastings, N., S252 (MON-P201)
Gokalp, K., S228 (MON-P133), S242 (MON-P174) S240 (MON-P166) Hatakeyama, J., S296 (MON-LB317)
Goker, B., S11 (OR27), S195 (MON-P042) Gugiari, M. C., S68 (SUN-P042), Hatanaka, T., S78 (SUN-P066), S85 (SUN-P084),
Goker, E., S81 (SUN-P076) S135 (SUN-P219), S189 (MON-P028) S219 (MON-P110)
Gokmen Ozel, H., S18 (OR45), S43 (PT06.6), Guidetti, M., S202 (MON-P062) Hatipoglu, N., S18 (OR45), S43 (PT06.6)
S104 (SUN-P134), S208 (MON-P078), Guidon, C., S148 (SUN-P255) Hatlebakk, J. G., S32 (PT02.3), S77 (SUN-P064)
S208 (MON-P079), S209 (MON-P080), Guildford, N., S7 (OR18), S175 (SUN-LB328) Hauser, B., S151 (SUN-P263)
S217 (MON-P104), S218 (MON-P105), Guimaraes, M. P., S122 (SUN-P185) Haushchild, D. B., S41 (PT06.1)
S273 (MON-P257) Guimarães, M., S122 (SUN-P186) Hausken, T., S207 (MON-P076)
Gökmen Özel, H., S103 (SUN-P132), Guimber, D., S148 (SUN-P255) Havel, E., S186 (MON-P019)
S103 (SUN-P133), S124 (SUN-P191) Güleç, A., S142 (SUN-P238) Hebestreit, A., S167 (SUN-LB306)
Goktas, Z., S144 (SUN-P243), S205 (MON-P070) Gul, M. A., S276 (MON-P267) Heide, F.V.D., S205 (MON-P071)
S316 Author index
Heidegger, C.-P., S293 (MON-LB310), Holst, M., S211 (MON-P086), S213 (MON-P091), Ilhan, A., S114 (SUN-P162), S166 (SUN-LB304)
S293 (MON-LB311) S228 (MON-P132) Ilovaisky, S., S254 (MON-P206)
Heinen, M., S152 (SUN-P268) Holten-Andersen, M. N., S260 (MON-P224) Imai, K., S168 (SUN-LB310)
Helal, R. G., S19 (OR47) Holth, C., S294 (MON-LB314) Imamura, F., S154 (SUN-P273),
Helder, J.V.D., S129 (SUN-P204), Holwerda, A. M., S2 (OR05) S261 (MON-P226)
S159 (SUN-P284) Ho, M., S152 (SUN-P266) Imarisio, I., S24 (OR59)
Hellenius, M.-L., S55 (SUN-P009) Hong, L., S149 (SUN-P259) Inagawa, M., S78 (SUN-P066), S85 (SUN-P084),
Hellerman, M., S182 (MON-P008) Hong, S. K., S166 (SUN-P303) S189 (MON-P026)
Hendricks, A., S196 (MON-P046) Hong, T. H., S190 (MON-P029) İnanç, N., S245 (MON-P183)
Hennequin, M., S84 (SUN-P083) Honore, P., S180 (MON-P002) Inan-Eroglu, E., S116 (SUN-P168)
Henriksen, C., S46 (PT08.1) Hopanci, D. B., S81 (SUN-P076) Ingadottir, A. R., S43 (PT07.1)
Henriksen, H. B., S46 (PT08.1) Horcajada, M.-N., S4 (OR09) Ingadottir, A., S97 (SUN-P117)
Henriques, M., S185 (MON-P015) Horie, L. M., S181 (MON-P005) Inoue, K., S165 (SUN-P301), S292 (MON-LB309)
Herbert, G., S282 (MON-P281) Horsmans, Y., S205 (MON-P069) Inoue, T., S254 (MON-P207)
Hernandez, I., S102 (SUN-P130), Horst, C., S27 (OR68), S199 (MON-P052), Inukai, M., S266 (MON-P241)
S120 (SUN-P180) S199 (MON-P053), S199 (MON-P054) Iorio, L., S101 (SUN-P128)
Hernandez, L., S107 (SUN-P142) Hoshino, T., S78 (SUN-P066), S85 (SUN-P084) Irahara, T., S292 (MON-LB309)
Hernández-Moreno, A., S116 (SUN-P167) Hosoda, A., S32 (PT02.4) Iryaningrum, M. R., S226 (MON-P128)
Hernandez-Moreno, A., S115 (SUN-P165), Hosonuma, K., S219 (MON-P110) Isabel, M. G.-M. G.-M., S229 (MON-P136)
S115 (SUN-P166), S143 (SUN-P240) Hosseini, H., S159 (SUN-P287) Isgin, K., S257 (MON-P216)
Herren, S., S37 (PT04.2) Hosseinipanah, S. M., S141 (SUN-P235) Isherwood, J., S23 (OR58), S88 (SUN-P094),
Herrera Fontana, M. E., S260 (MON-P222) Houinato, D., S127 (SUN-P200) S93 (SUN-P106), S93 (SUN-P107),
Herrera-Fontana, M. E., S120 (SUN-P181) Houston, D. K., S12 (OR30) S94 (SUN-P108), S214 (MON-P095)
Herrera-Quintana, L., S290 (MON-LB303) Hovdenak, N., S32 (PT02.3), S207 (MON-P076) Ishibashi, I., S266 (MON-P241)
Herrera, V., S223 (MON-P120) Hronek, M., S186 (MON-P019) Ishida, R., S16 (OR40), S38 (PT04.6)
Herreros, G. Gallego, S224 (MON-P123) Hruz, P., S233 (MON-P148) Ishiguro, K., S189 (MON-P026)
Herrmann, F. R., S197 (MON-P047) Hsu, Y.-P., S188 (MON-P024) Ishihara, H., S189 (MON-P026)
Heyland, D. K., S63 (SUN-P029), Huang, C. W., S86 (SUN-P087) Ishii, M., S167 (SUN-LB307)
S292 (MON-LB307) Huang, C.-W., S87 (SUN-P089) Ishii, S., S139 (SUN-P229)
Heyland, D., S26 (OR65) Huang, Y., S4 (OR08) Ishitani, M., S52 (PT10.5)
Heyman, J. K., S169 (SUN-LB312) Hueso, T., S23 (OR57) Ishizaki, M., S170 (SUN-LB315)
Heymsfield, S. B., S16 (OR40), S124 (SUN-P190) Huhmann, M. B., S266 (MON-P239) Ito, C., S247 (MON-P188)
Heymsfield, S., S38 (PT04.6) Huijbers, A., S31 (PT02.1) Ito, M., S52 (PT10.5)
Hickson, M., S111 (SUN-P155) Huisman - de Waal, G., S152 (SUN-P268) Iuchi, M., S178 (SUN-LB335)
Hiel, S., S2 (OR04), S273 (MON-P259) Huisman de Waal, G., S108 (SUN-P146) Ivaldi, C., S301 (MON-LB329)
Hiesmayr, M., S272 (MON-P255), Hukins, C., S231 (MON-P141) Iwayama, S., S96 (SUN-P113)
S272 (MON-P256) Hulst, J. M., S304 (MON-LB337) Iyer, K., S230 (MON-P139)
Higashibeppu, N., S292 (MON-LB307) Hulst, J., S11 (OR26), S42 (PT06.4) Izurieta, R., S120 (SUN-P180)
Higashiguchi, T., S75 (SUN-P059), Hung, K.-Y., S44 (PT07.3), S44 (PT07.4)
S266 (MON-P241) Huppertz, V., S9 (OR21) J
Higashizono, K., S1 (OR02), S15 (OR36), Hurtós, L., S91 (SUN-P101), S211 (MON-P085)
S46 (PT08.2), S85 (SUN-P085), Hurt, R., S204 (MON-P066), S259 (MON-P221) Jaalouk, D., S113 (SUN-P161)
S171 (SUN-LB316), S201 (MON-P058) Hu, W., S243 (MON-P175) Jackson, H., S251 (MON-P197)
Higuera Pulgar, I., S203 (MON-P064), Huysentruyt, K., S151 (SUN-P263) Jacobsen, C. K., S77 (SUN-P064)
S203 (MON-P065) Huysmans, S., S232 (MON-P145) Jafari, P., S50 (PT10.1)
Hill, S., S42 (PT06.4) Hwang, J., S282 (MON-P283) Jager-Wittenaar, H., S84 (SUN-P082),
Hinojosa-Azaola, A., S226 (MON-P129) Hyams, G., S254 (MON-P206) S129 (SUN-P203), S131 (SUN-P210),
Hirani, V., S30 (PT01.5) Hyodo, T., S234 (MON-P151) S132 (SUN-P211), S158 (SUN-P282),
Hisajima, T., S168 (SUN-LB310) Hyspler, R., S170 (SUN-LB314) S160 (SUN-P289), S222 (MON-P119),
Hisamori, S., S220 (MON-P111) S247 (MON-P187), S250 (MON-P195),
Hishikawa, H., S170 (SUN-LB315) S296 (MON-LB318), S296 (MON-LB319),
I S298 (MON-LB323)
Hiyama, K., S154 (SUN-P273)
Hlais, S., S162 (SUN-P295) Ianes, A., S68 (SUN-P042), S135 (SUN-P219), Jagielak, D., S119 (SUN-P177)
Hlavata, A., S284 (MON-P287) S189 (MON-P028) Jakus, T., S141 (SUN-P236)
Hobbelen, J. S., S296 (MON-LB318) Ibrahim, K., S193 (MON-P037) Jang, H. J., S305 (MON-LB340)
Hobbelen, J.S.M., S298 (MON-LB323) Ichikawa, H., S55 (SUN-P008) Jang, H.-J., S305 (MON-LB340)
Hoeisaether, E., S294 (MON-LB314) Iglesias, C., S237 (MON-P160) Janse, A., S31 (PT01.6)
Hoek, B. V., S78 (SUN-P067) Iida, T., S189 (MON-P026) Jansen, I., S129 (SUN-P204)
Hofstede, J., S67 (SUN-P039) Iijima, S., S266 (MON-P241) Jansen, J., S159 (SUN-P284)
Hogrel, J.-Y., S29 (PT01.1), S72 (SUN-P051) Iishi, T., S266 (MON-P241) Janssen-Duijghuijsen, L., S286 (MON-P293)
Ho, J. W., S15 (OR37) Ijmker-Hemink, V. E., S255 (MON-P210) Janssen, M., S104 (SUN-P135),
Ho, L., S162 (SUN-P293) Ijzermans, J., S80 (SUN-P072), S80 (SUN-P073), S126 (SUN-P195), S255 (MON-P209)
Holanda, T. P., S65 (SUN-P034) S128 (SUN-P201) Januszczyk, J., S105 (SUN-P139)
Holec, E., S100 (SUN-P124) Ijzermans, J.N.M., S133 (SUN-P214) Japur, C. C., S95 (SUN-P111)
Hollander, F., S112 (SUN-P158) Ikarashi, M., S55 (SUN-P008) Jarkovský, J., S229 (MON-P135)
Holle, R., S73 (SUN-P054) Ikematsu, Y., S173 (SUN-LB322), Jaskiewicz, J., S173 (SUN-LB323)
Hollingworth, W., S305 (MON-LB339) S196 (MON-P044) Jazayeri, S., S76 (SUN-P061)
Holm, M. O., S213 (MON-P093) Ilgaz, F., S103 (SUN-P132), S124 (SUN-P191) Jegatheesan, P., S7 (OR17), S285 (MON-P291)
Author index S317
Jenkins, B., S58 (SUN-P016) Kaido, T., S14 (OR35), S21 (OR53), Kawamura, K. S., S181 (MON-P005)
Jenko Pražnikar, Z., S141 (SUN-P236), S39 (PT05.1), S76 (SUN-P062), Kawasaki, N., S266 (MON-P241)
S243 (MON-P176), S270 (MON-P249), S153 (SUN-P270), S206 (MON-P072) Kaya, E. B., S98 (SUN-P118)
S275 (MON-P264) Kakavas, S., S101 (SUN-P126) Kaya, S., S11 (OR27), S195 (MON-P042)
Jenko-Pražnikar, Z., S285 (MON-P290) Kakehasi, A. M., S202 (MON-P063) Kayashita, J., S266 (MON-P241)
Jeon, M. S., S227 (MON-P130) Kakehi, T., S254 (MON-P207) Kaydıhan, N., S87 (SUN-P090)
Jeppesen, P. B., S4 (OR10), S33 (PT02.5), Kakiuchi, M., S254 (MON-P207) Kaymak, Ç., S58 (SUN-P017)
S39 (PT05.3), S81 (SUN-P075), Kakizaki, S., S78 (SUN-P066), S85 (SUN-P084), Kayser, N., S102 (SUN-P129), S231 (MON-P140)
S230 (MON-P139), S234 (MON-P149) S219 (MON-P110) Kazeminia, N., S182 (MON-P010)
Jeppesen, P., S13 (OR32) Kalala, G., S273 (MON-P259) Keane, N., S50 (PT10.2), S96 (SUN-P114),
Jésus, P., S8 (OR19), S19 (OR48), S34 (PT03.1), Kalesopoulou, C., S258 (MON-P219) S109 (SUN-P150), S130 (SUN-P207),
S34 (PT03.3), S127 (SUN-P200) Kamarli Altun, H., S192 (MON-P034) S215 (MON-P096), S215 (MON-P097)
Jeung, H. C., S95 (SUN-P110) Kameyama, H., S55 (SUN-P008) Kearney, P., S167 (SUN-LB306)
Jiang, T., S187 (MON-P022) Kamiga, M., S154 (SUN-P273) Keil, J.-P., S298 (MON-LB322)
Jiang, Y., S14 (OR34) Kamiya, A., S165 (SUN-P301) Kelishadi, R., S145 (SUN-P246)
Jiang, Z., S54 (SUN-P006) Kamo, N., S14 (OR35), S39 (PT05.1), Keller, H., S75 (SUN-P057), S125 (SUN-P193),
Jiménez, C. Tenorio, S226 (MON-P127) S76 (SUN-P062), S153 (SUN-P270), S125 (SUN-P194)
Jimenez, I., S223 (MON-P120) S206 (MON-P072) Kelly, M., S167 (SUN-LB306)
Jiménez-Lima, R., S209 (MON-P081) Kampman, E., S171 (SUN-LB318) Kelly, O., S289 (MON-P301)
Jimenez, R., S177 (SUN-LB332) Kampman, N., S104 (SUN-P136) Kennis, M., S174 (SUN-LB324)
Jiménez-Sanmartín, M., S37 (PT04.3) Kanai, M., S189 (MON-P026) Kerim, E. S., S249 (MON-P193)
Jirka, A., S56 (SUN-P010) Kanellopoulou, A., S300 (MON-LB328) Keskinler, M. V., S136 (SUN-P221)
Joaquín Ortiz, C., S94 (SUN-P109) Kanematsu, T., S165 (SUN-P301) Khaksar, R., S159 (SUN-P287)
Joaquin, C., S136 (SUN-P223) Kaner, G., S51 (PT10.4), S123 (SUN-P188), Khalafi, M., S145 (SUN-P246)
Jobse, I., S166 (SUN-LB305) S131 (SUN-P208), S145 (SUN-P248), Khalatbari-Soltani, S., S261 (MON-P226),
Joly, F., S5 (OR11) S146 (SUN-P249), S146 (SUN-P250), S262 (MON-P227)
Jonckheer, J., S180 (MON-P002) S146 (SUN-P251), S192 (MON-P034), Khalili, M., S76 (SUN-P061)
Joncquel Chevalier Curt, M., S23 (OR57) S245 (MON-P183), S273 (MON-P258) Khan, Z. A., S5 (OR12)
Jones, D., S88 (SUN-P094) Kang, J., S282 (MON-P283) Khodadadi Kholan, I., S164 (SUN-P300)
Jones, R., S251 (MON-P197) Kang, W., S138 (SUN-P228), S171 (SUN-LB317), Khodadadi Kohlan, I., S105 (SUN-P137)
Jones, S. E., S214 (MON-P095) S302 (MON-LB333) Khosravi, A., S76 (SUN-P061)
Jongejan, H., S104 (SUN-P136) Kanioura, E., S111 (SUN-P153) Kida, K., S247 (MON-P188)
Jonkers, R., S99 (SUN-P123) Kan, W. S., S15 (OR37) Kieslinger, P., S3 (OR06)
Joosten, K. F., S20 (OR49), Kaoura, A., S111 (SUN-P153) Kiesswetter, E., S73 (SUN-P054),
S304 (MON-LB337) Karabudak, E., S242 (MON-P173), S167 (SUN-LB306)
Joosten, K., S11 (OR26) S256 (MON-P211), S256 (MON-P212) Kievit, W., S48 (PT09.1)
Jorens, P. G., S290 (MON-LB304) Karaca, A., S256 (MON-P211), S256 (MON-P212) Kiliç, S., S149 (SUN-P258)
Joskova, V., S186 (MON-P019) Karachaliou, A., S101 (SUN-P126) Kilicturgay, S., S249 (MON-P193)
Jouinot, A., S90 (SUN-P098) Karacil Ermumcu, M. S., S241 (MON-P171), Kim, D. H., S79 (SUN-P070), S301 (MON-LB330)
Joundi, J., S113 (SUN-P160) S242 (MON-P172), S242 (MON-P173), Kim, H. M., S95 (SUN-P110)
Jousse, C., S155 (SUN-P276) S270 (MON-P250) Kim, H., S282 (MON-P283)
Jovanovic, D., S281 (MON-P280) Karadimitris, A., S174 (SUN-LB326) Kim, J. W., S282 (MON-P283)
Jukic Peladic, N., S193 (MON-P036) Karaduman, A. A., S103 (SUN-P132) Kim, J., S190 (MON-P029)
Julià Torras, J., S94 (SUN-P109) Karagiannis, D., S295 (MON-LB316) Kim, M., S190 (MON-P029), S282 (MON-P283)
Julian, A. R., S111 (SUN-P155) Karavetian, M., S306 (MON-LB343) Kim, S., S174 (SUN-LB325), S219 (MON-P108),
Juliano, Y., S117 (SUN-P172) Karayiannis, D., S101 (SUN-P126), S282 (MON-P283)
Jung, H.-Y., S79 (SUN-P070), S137 (SUN-P224) Kimura, K., S199 (MON-P055)
S301 (MON-LB330) Karber, M., S204 (MON-P067), S206 (MON-P073) Kimura, M., S189 (MON-P026)
Jung, J. H., S182 (MON-P009) Karimeh, T., S162 (SUN-P295) Kim, Y. J., S219 (MON-P108)
Jung, K. W., S79 (SUN-P070), S301 (MON-LB330) Karli, A., S101 (SUN-P126) Kim, Y. N., S175 (SUN-LB327)
Jung, K., S305 (MON-LB340) Karlsen, A. S., S91 (SUN-P100) Kingma, B.R.M., S232 (MON-P145)
Junqueira, G., S177 (SUN-LB333) Karlsson, M., S30 (PT01.4) Kiper, N., S103 (SUN-P133), S104 (SUN-P134)
Jurczak, P., S21 (OR52), S106 (SUN-P140) Kar, P., S180 (MON-P003) Kirbiyik, F., S88 (SUN-P093)
Jurdana, M., S141 (SUN-P236) Karsegard, V. L., S197 (MON-P047) Kiryachkov, Y., S188 (MON-P025)
Justina, T. D., S116 (SUN-P169) Kartaram, S., S286 (MON-P293) Kiselev, J., S110 (SUN-P151), S110 (SUN-P152)
Kasapidou, E., S140 (SUN-P233) Kishi, J., S178 (SUN-LB335)
Kashiya, S., S216 (MON-P100) Kiss, C., S67 (SUN-P040), S233 (MON-P148)
K
Kaska, M., S170 (SUN-LB314) Kitajima, Y., S234 (MON-P151)
Kabasakal Çetin, A., S124 (SUN-P191), Kasperts, N., S83 (SUN-P081) Kitamoto, Y., S85 (SUN-P084)
S142 (SUN-P238) Kasteler, R., S17 (OR43) Kizilarslanoğlu, M. C., S195 (MON-P042)
Kabata, P., S173 (SUN-LB323) Katayama, T., S32 (PT02.4) Kizilarslanoglu, M. C., S11 (OR27)
Kadayıfçılar, S., S45 (PT07.6), S289 (MON-P300) Katsura, N., S244 (MON-P179), Kizil, M., S118 (SUN-P174), S125 (SUN-P192),
Kaddoura, R., S292 (MON-LB308) S267 (MON-P242) S145 (SUN-P247), S241 (MON-P170),
Kagan, I., S24 (OR60), S25 (OR63), Katz, Y., S179 (SUN-LB338) S254 (MON-P204)
S182 (MON-P008), S183 (MON-P012), Kaufman-Shriqui, V., S263 (MON-P230) Klek, S., S105 (SUN-P139), S207 (MON-P074)
S184 (MON-P013) Kauppi, K., S130 (SUN-P206) Klemarczyk, W., S42 (PT06.5)
Kahrs, G. E., S77 (SUN-P064) Kawahara, Y., S189 (MON-P026) Klersy, C., S24 (OR59)
Kaibori, M., S170 (SUN-LB315) Kawamura, H., S52 (PT10.5) Knap, B., S98 (SUN-P119)
S318 Author index
Knap, K., S98 (SUN-P119) Kucukerdonmez, O., S242 (MON-P173), Lauretani, F., S68 (SUN-P041),
Knappe-Drzikova, B., S85 (SUN-P086), S270 (MON-P250) S193 (MON-P038)
S114 (SUN-P163), S206 (MON-P073) Kudo, T., S85 (SUN-P084) Lau, S. Y., S15 (OR37)
Kneppers, A.E.M., S26 (OR66) Kuehni, C. E., S17 (OR43), S20 (OR50) Lautrette, G., S34 (PT03.3)
Knuijt, S., S255 (MON-P209) Kuise, T., S14 (OR33) Lauverjat, M., S48 (PT09.2), S77 (SUN-P065)
Knüppel, S., S85 (SUN-P086) Kumakura, A., S189 (MON-P026) Lau, W. S., S15 (OR37)
Kobayashi, A., S14 (OR35), S39 (PT05.1), Kunecki, M., S49 (PT09.3), S207 (MON-P075) Laviano, A., S57 (SUN-P012), S83 (SUN-P080)
S76 (SUN-P062), S153 (SUN-P270), Kungler, E., S67 (SUN-P040) Layec, S., S32 (PT02.2)
S206 (MON-P072) Kupczyk, K., S62 (SUN-P028) Le Flahec, C., S8 (OR19)
Kobayashi, T., S55 (SUN-P008) Kurata, N., S32 (PT02.4), S266 (MON-P241) Le Pape, P., S265 (MON-P236)
Koch, C., S267 (MON-P244), S268 (MON-P245) Kurmukov, I., S216 (MON-P100) Le Plénier, S., S285 (MON-P289)
Koek, M., S128 (SUN-P201) Kuroda, M., S178 (SUN-LB335) Leander, K., S55 (SUN-P009)
Koelfat, K. V., S31 (PT02.1), S33 (PT02.6) Kurokawa, Y., S109 (SUN-P149) Leão, D.O.D., S64 (SUN-P033)
Koelfat, K., S22 (OR55) Kuwamura, J., S109 (SUN-P149) Leary, S., S305 (MON-LB339)
Koeman, F., S46 (PT08.3), S70 (SUN-P046), Kuyum Töz, P., S279 (MON-P273) Lebrun, V., S205 (MON-P069)
S156 (SUN-P277) Kværner, A. S., S46 (PT08.1) Leclercq, I. A., S205 (MON-P069)
Kofina, K., S56 (SUN-P011) Kwok, H., S96 (SUN-P114), S109 (SUN-P150), Lee, A., S190 (MON-P029)
Kohlenberg-Müller, K., S298 (MON-LB322) S215 (MON-P096), S215 (MON-P097) Lee, G. H., S79 (SUN-P070), S301 (MON-LB330)
Køhler, M., S40 (PT05.5), S239 (MON-P164) Kwok, S. S., S15 (OR37) Lee, H.-M., S4 (OR10), S33 (PT02.5),
Koike, K., S292 (MON-LB309) Kwon, A.-H., S170 (SUN-LB315) S81 (SUN-P075), S230 (MON-P139)
Kok, A., S83 (SUN-P081), S84 (SUN-P082), Kwon, M., S212 (MON-P089) Lee, J. H., S59 (SUN-P019), S79 (SUN-P070),
S112 (SUN-P158) Kwon, S. Y., S190 (MON-P029) S174 (SUN-LB325), S301 (MON-LB330)
Kok, D. E., S171 (SUN-LB318) Lee, J. I., S190 (MON-P029)
Köksal, E., S275 (MON-P263) L Lee, J., S15 (OR38)
Koksal, E., S242 (MON-P173), S270 (MON-P250) Lee, K. F., S15 (OR38)
Köksel, H., S235 (MON-P152), L’huillier, C., S286 (MON-P292) Lee, M.W.K., S15 (OR37)
S235 (MON-P153) La Meir, M., S62 (SUN-P027) Leermakers-Vermeer, M. J., S83 (SUN-P081)
Kolak, Z., S198 (MON-P050) La Spada, C., S117 (SUN-P171) Lee, S. O., S15 (OR37)
Kolay, M., S53 (SUN-P001) Lacaze, L., S209 (MON-P082) Lee, Y.-M., S297 (MON-LB321)
Komino, A.C.M., S178 (SUN-LB334) Lachowicz, K., S21 (OR52), S106 (SUN-P140), Leibovitz, E., S176 (SUN-LB330)
Kondrup, J., S291 (MON-LB306) S106 (SUN-P141) Leiderman, I., S58 (SUN-P015)
Kong, E., S162 (SUN-P293) Lackoff, A. S., S231 (MON-P141) Leij - Halfwerk, S., S181 (MON-P007)
Konstantyner, T., S42 (PT06.3) Ladwig, K.-H., S73 (SUN-P054) Leij-Halfwerk, S., S131 (SUN-P209)
Kontogianni, M., S137 (SUN-P224) Lahav, M., S13 (OR31) Leij, S., S104 (SUN-P135), S126 (SUN-P195),
Koo, J., S92 (SUN-P103) Lai, B., S162 (SUN-P294) S255 (MON-P209)
Kooman, J., S306 (MON-LB343) Lai, C., S96 (SUN-P115) Lei, Q., S187 (MON-P022)
Koopmanschap, M. A., S304 (MON-LB337) Lai, H.-S., S79 (SUN-P071) Leistra, E., S121 (SUN-P182),
Kopp Lugli, A., S67 (SUN-P040) Lai, S., S96 (SUN-P115) S174 (SUN-LB324), S238 (MON-P161)
Kosak, S., S272 (MON-P256) Lai, S.-L., S79 (SUN-P071) Leiva-Badosa, E., S79 (SUN-P069)
Kossovsky, M., S113 (SUN-P159) Lakenman, P.L.M., S248 (MON-P189) Lekkos, K., S267 (MON-P244), S268 (MON-P245)
Kostin, D., S62 (SUN-P026) Lallemand, J., S5 (OR11) Lelieveld, M., S78 (SUN-P067)
Kosugi, S.-I., S55 (SUN-P008) Lal, S., S10 (OR23), S108 (SUN-P145), Lemieux, M., S26 (OR65)
Kosyura, S., S157 (SUN-P281) S160 (SUN-P288) Lengyel, C., S75 (SUN-P057)
Kotani, J., S139 (SUN-P229) Lamarche, F., S3 (OR07) Lenicek, M., S31 (PT02.1), S33 (PT02.6)
Kotlowitz, J., S154 (SUN-P272) Lam, C. F., S15 (OR37) Lennon, R., S159 (SUN-P286)
Kouw, I.W.K., S191 (MON-P031) Lamers, D., S298 (MON-LB322) Lenzi, A., S7 (OR16)
Kovacs, C., S100 (SUN-P125) Landgraf, M. A., S178 (SUN-LB334), León Sanz, M., S214 (MON-P094)
Kovarik, M., S186 (MON-P019) S179 (SUN-LB337) Leone, S., S87 (SUN-P091), S152 (SUN-P267),
Koyama, I., S153 (SUN-P269) Landgraf, R. G., S178 (SUN-LB334), S276 (MON-P265), S281 (MON-P278)
Koyama, Y., S55 (SUN-P008), S139 (SUN-P229), S179 (SUN-LB337) León, J., S35 (PT03.4)
S189 (MON-P026) Lang, A., S13 (OR31) Lepoivre, T., S56 (SUN-P010)
Kramer, I. F., S2 (OR05) Langen, R.C.J., S26 (OR66) Leung, L. K., S15 (OR37)
Krasnova, T., S157 (SUN-P281) Langius, J., S75 (SUN-P060), S78 (SUN-P067), Leung, W. S., S15 (OR37)
Kravanja, I., S71 (SUN-P048) S83 (SUN-P080), S112 (SUN-P157), Leuvrey, M. M., S304 (MON-LB338)
Kremer, S., S25 (OR63) S216 (MON-P101) Levolger, S., S80 (SUN-P073), S128 (SUN-P201)
Kremers, S., S6 (OR13) Langius, J.A.E., S68 (SUN-P043), Lewandowski, L., S52 (PT10.6)
Kressig, R., S67 (SUN-P040) S220 (MON-P112) Lewis, S., S282 (MON-P281), S305 (MON-LB339)
Kriel, J., S154 (SUN-P272) Langleite, T. M., S46 (PT08.1) Leyva Islas, J. A., S126 (SUN-P197)
Krijger, I., S75 (SUN-P060) Lannoo, M., S270 (MON-P251) Leyva, J. A., S35 (PT03.4)
Krill, M., S47 (PT08.5) Lanthier, N., S205 (MON-P069) Liaño, F., S224 (MON-P122), S225 (MON-P126),
Kristensen, S. T., S161 (SUN-P292) Laquente, B., S91 (SUN-P101) S228 (MON-P134)
Kruijning, S., S129 (SUN-P204) Lardiés, B., S37 (PT04.3) Liaskas, T., S111 (SUN-P153)
Kruizenga, H. M., S238 (MON-P161) Lardiés-Sánchez, B., S114 (SUN-P164) Lichodziejewska–Niemierko, M.,
Kruizenga, H., S121 (SUN-P182) Larsen, T., S207 (MON-P076) S119 (SUN-P176)
Krznaric, Z., S62 (SUN-P028) Larumbe, M.C.Terroba, S224 (MON-P123), Lichthart, S., S174 (SUN-LB324)
Książyk, J., S18 (OR44) S225 (MON-P124) Lieben, C. K., S70 (SUN-P046), S70 (SUN-P047),
Ksiazyk, J., S150 (SUN-P262) Lascouts, E., S62 (SUN-P028) S99 (SUN-P123)
Kubota, N., S299 (MON-LB325) Laur, C., S125 (SUN-P193), S125 (SUN-P194) Lieben, C., S244 (MON-P178)
Author index S319
Liebert, F., S304 (MON-LB338) Luna-Camacho, Y., S101 (SUN-P127) Marinho, R., S129 (SUN-P203)
Lied, G. A., S32 (PT02.3), S207 (MON-P076) Lupia, E., S64 (SUN-P032) Marinier, E. M., S304 (MON-LB338)
Liener, U. C., S196 (MON-P046) Luse, L., S226 (MON-P128) Marino, L., S58 (SUN-P016)
Lienhardt-Roussie, A., S19 (OR48) Lusignani, M., S68 (SUN-P042), Marklund, M., S55 (SUN-P009)
Ligerini, L., S148 (SUN-P256) S135 (SUN-P219), S189 (MON-P028) Marnic,́ M., S127 (SUN-P198)
Li, J., S187 (MON-P022), S222 (MON-P118) Lydon, R., S159 (SUN-P286) Marôco, J., S260 (MON-P223)
Lilleby, W., S91 (SUN-P100) Lyons, M., S252 (MON-P201) Marques, G., S95 (SUN-P112)
Lima, A., S17 (OR41) Marques-Vidal, P., S261 (MON-P226),
Lima, F. B., S178 (SUN-LB334) M S262 (MON-P227)
Lima, F. C., S64 (SUN-P033) Marquet-de Rougé, P., S69 (SUN-P044)
Lim, C., S162 (SUN-P293) M’bouyou-Boungou, J., S7 (OR17) Marra, M., S40 (PT05.6), S44 (PT07.2),
Lim, C.Y.S., S59 (SUN-P019) M’rabet, L., S286 (MON-P293) S103 (SUN-P131), S126 (SUN-P196)
Lim, Y. P., S161 (SUN-P290), S162 (SUN-P293) Maasberg, S., S85 (SUN-P086), Marrinan, G., S252 (MON-P201)
Li, N., S14 (OR34) S114 (SUN-P163), S206 (MON-P073) Marrugo, J., S107 (SUN-P142)
Lindqvist, C., S297 (MON-LB320) Maas, D., S255 (MON-P209) Marshall, A., S281 (MON-P279)
Lins, L., S122 (SUN-P185), S122 (SUN-P186) Ma, C.-J., S86 (SUN-P088) Martín González, C., S178 (SUN-LB336)
Lin, V. A., S155 (SUN-P275) Macarena, F., S133 (SUN-P215) Martín Iglesias, D., S140 (SUN-P232)
Lioupis, A., S258 (MON-P217), MaCdonald - Ottevanger, M., S123 (SUN-P189) Martinelli, A.D.L. C., S177 (SUN-LB333)
S258 (MON-P219), S263 (MON-P233) Machado, N. M., S16 (OR40), S38 (PT04.6) Martinez Del Rio Requejo, I., S126 (SUN-P197)
Li, S., S168 (SUN-LB309), S300 (MON-LB327) Maciejewski, T. M., S52 (PT10.6) Martinez Del Rio, I., S35 (PT03.4)
Lissner, L., S71 (SUN-P049) Macovei, R. A., S60 (SUN-P020), S60 (SUN-P021) Martínez López, E., S94 (SUN-P109)
Li, T., S47 (PT08.5) Madali, B., S116 (SUN-P168) Martinez, B., S107 (SUN-P142)
Liu, D., S171 (SUN-LB317) Madden, M., S214 (MON-P095) Martinez, E., S136 (SUN-P223)
Liu, K., S169 (SUN-LB312) Maggio, M. G., S193 (MON-P038) Martinez, F., S147 (SUN-P254)
Liu, S. Y., S144 (SUN-P245) Maggio, M., S68 (SUN-P041) Martínez, M. Garrido, S226 (MON-P127)
Liu, X., S138 (SUN-P228) Magnes, C., S156 (SUN-P278) Martínez-Ramírez, M. J., S226 (MON-P127)
Liu, Y., S138 (SUN-P228) Magnoni, D., S60 (SUN-P022), S100 (SUN-P125) Martinez-Tyson, D., S120 (SUN-P180)
Livantsova, E., S157 (SUN-P281) Magri, M., S68 (SUN-P042), S135 (SUN-P219), Martin, L., S159 (SUN-P286), S172 (SUN-LB320)
Li, X., S138 (SUN-P228), S176 (SUN-LB329) S189 (MON-P028) Martin, M., S136 (SUN-P223)
Li, Y., S201 (MON-P060), S202 (MON-P061), Mahjoub, H., S141 (SUN-P235) Martin, N., S214 (MON-P095)
S290 (MON-P302) Maia-Lemos, P. S., S252 (MON-P199), Martinsen, L., S108 (SUN-P147)
Li, Z., S302 (MON-LB333) S252 (MON-P200) Martinsson, I., S130 (SUN-P206)
Ljungqvist, O., S2 (OR03), S194 (MON-P039), Maier, A. B., S29 (PT01.1), S71 (SUN-P050), Martion Giol, M., S94 (SUN-P109)
S194 (MON-P040) S72 (SUN-P051), S72 (SUN-P052), Martucci, R. B., S29 (PT01.2), S215 (MON-P098)
Llop-Talaveron, J., S79 (SUN-P069) S195 (MON-P041) Maruyama, M. J., S266 (MON-P241)
Llorente, L., S226 (MON-P129) Maillard, G., S6 (OR14) Maruyama, M., S165 (SUN-P301)
Lloyd, D. A., S8 (OR20), S262 (MON-P228) Maio, R., S219 (MON-P109) Masaki, Y., S165 (SUN-P301)
Lockhart, T., S289 (MON-P301) Maissen, S., S233 (MON-P148) Maslim, Y., S226 (MON-P128)
Lohrmann, C., S71 (SUN-P048) Maitre, I., S167 (SUN-LB306) Masterson, L., S252 (MON-P201)
Loh, Y. J., S59 (SUN-P019) Majewska, K., S21 (OR52), S49 (PT09.3), Masters, R., S251 (MON-P196)
Longman, R., S305 (MON-LB339) S91 (SUN-P102), S106 (SUN-P140), Mastora, Z., S101 (SUN-P126)
Looijaard, W. G., S186 (MON-P020), S106 (SUN-P141), S207 (MON-P075) Mastrangelo, S., S276 (MON-P265)
S187 (MON-P021), S291 (MON-LB305) Makhlouf, A.-M., S62 (SUN-P028), Mastroluca, D., S96 (SUN-P115)
Lopes, A., S161 (SUN-P291) S113 (SUN-P159), S293 (MON-LB310), Mastrominas, M., S137 (SUN-P224)
Lopes, M., S129 (SUN-P203) S293 (MON-LB311) Matía Martin, P., S203 (MON-P065)
López Rodriguez, C., S237 (MON-P158), Maki, H., S32 (PT02.4) Matía, P., S269 (MON-P247), S271 (MON-P253)
S280 (MON-P276), S280 (MON-P277) Malfroot, A., S151 (SUN-P263) Matsuda, H., S247 (MON-P188)
Lopez, C., S102 (SUN-P130) Małgorzewicz, S., S119 (SUN-P176), Matsui, K., S170 (SUN-LB315)
Lopez-Lluch, G., S107 (SUN-P142) S119 (SUN-P177) Matta, L. F., S19 (OR47)
Lopez-Martinez, I., S89 (SUN-P095), Manca, C. S., S177 (SUN-LB333) Matthys, C., S270 (MON-P251)
S89 (SUN-P096) Manca, C., S81 (SUN-P074) Matuhara, A. M., S185 (MON-P016)
López-Sabater, M. C., S36 (PT04.1), Mandal, A.K.A., S5 (OR12), S220 (MON-P113) Matushima, H., S170 (SUN-LB315)
S41 (PT06.2) Mansinho, H., S83 (SUN-P079) Maurizi, P., S276 (MON-P265)
López-Urdiales, R., S91 (SUN-P101) Mantovani, M., S68 (SUN-P041) Mayorga-Mazón, C., S148 (SUN-P256),
Lopez-Urdiales, R., S223 (MON-P120) Marano, G., S135 (SUN-P219) S150 (SUN-P260)
Lorite, R., S197 (MON-P048) Marburger, C., S190 (MON-P030) Mazurak, V. C., S47 (PT08.4), S47 (PT08.5)
Lourenço, A.D.S. N., S42 (PT06.3) Marcadenti, A., S40 (PT05.4), S111 (SUN-P154) Mazur, J., S52 (PT10.6)
Lou, Y. T., S86 (SUN-P087) Marcangeli, V., S38 (PT04.5), S229 (MON-P137), Mazzanti, L., S227 (MON-P131)
Low, E., S161 (SUN-P290), S162 (SUN-P293) S271 (MON-P252), S284 (MON-P288) Mc Cloat, A., S159 (SUN-P286)
Lozada-Mellado, M., S226 (MON-P129) Mareschal, J., S129 (SUN-P205) Mc Loone, M., S159 (SUN-P286)
Lozano, A., S211 (MON-P085) Maria, M. Moreno Santa, S229 (MON-P136) McCaughan, G. W., S169 (SUN-LB312)
Lozano-Andreu, T., S79 (SUN-P069) Mariani, S., S7 (OR16) Mccluskey, J. T., S274 (MON-P261),
Lubisco, A., S101 (SUN-P128) Maribo, T., S191 (MON-P032) S303 (MON-LB335)
Lubrano, C., S7 (OR16) Maric, L., S147 (SUN-P254) Mcdonald, B., S26 (OR65)
Luiking, Y. C., S66 (SUN-P037), S66 (SUN-P038), Maridaki, M., S236 (MON-P154), Mcdougall, G. J., S274 (MON-P261)
S67 (SUN-P039), S158 (SUN-P283) S258 (MON-P218) Mcelligott, K., S252 (MON-P201)
Luisa, G., S151 (SUN-P264) Marin, B., S34 (PT03.1), S34 (PT03.3) Mclin, V., S265 (MON-P236)
Lukawska, J., S287 (MON-P294) Marinho, A., S129 (SUN-P203) McMahon, M., S204 (MON-P066)
S320 Author index
Mcmahon, M., S259 (MON-P221) Mihara, C., S139 (SUN-P229) Moriya, T., S1 (OR02), S201 (MON-P058)
Mcmahon, S., S252 (MON-P201) Mijan de la Torre, A., S233 (MON-P146) Moroboshi, A., S189 (MON-P026)
McMonagle, G., S159 (SUN-P286) Mikkelsen, K. K., S155 (SUN-P275) Moro, K., S55 (SUN-P008)
McNally, B., S176 (SUN-LB329) Millan-Lopez, M., S238 (MON-P162), Morrison, J., S75 (SUN-P057)
McNicholl, T., S125 (SUN-P194) S238 (MON-P163) Moser, C. E., S39 (PT05.3), S234 (MON-P149)
Mcnicholl, T., S125 (SUN-P193) Millotte, C., S8 (OR19) Mosillo, P., S57 (SUN-P012)
Mcphee, J. S., S29 (PT01.1) Mills, S., S193 (MON-P037) Mossavibahar, H., S141 (SUN-P235)
Mearelli, F., S64 (SUN-P032) Minaguchia, J., S46 (PT08.1) Mota, I.C.P., S60 (SUN-P022)
Meessen, E. C., S54 (SUN-P004) Minano, E., S102 (SUN-P129) Motilla de la Cámara, M. L., S203 (MON-P064)
Meex, S. J., S232 (MON-P145) Minematsu, T., S299 (MON-LB325) Motilla De La Cámara, M., S212 (MON-P089)
Mega, A. M., S59 (SUN-P018) Miño, P., S277 (MON-P268) Motilla, M., S177 (SUN-LB332)
Mehdizadeh Hakkak, A., S76 (SUN-P061) Mirkovic, D., S23 (OR56), S181 (MON-P006) Motter, F. R., S136 (SUN-P222)
Mehta, S., S50 (PT10.2), S96 (SUN-P114), Mitichkin, A., S82 (SUN-P078) Mottolese, A., S101 (SUN-P128)
S109 (SUN-P150), S130 (SUN-P207), Mitri, C. Bou, S113 (SUN-P161) Mouillot, T., S77 (SUN-P065)
S215 (MON-P096), S215 (MON-P097), Mitrovic, M., S23 (OR56) Moulin, S., S6 (OR14)
S287 (MON-P294) Miura, K., S55 (SUN-P008) Moura, A., S60 (SUN-P022)
Meier, C., S37 (PT04.2) Miura, T., S168 (SUN-LB310) Moura, E.G.H., S16 (OR40), S38 (PT04.6)
Meijerink, M., S93 (SUN-P105) Miyawaki, Y., S153 (SUN-P269) Mühlebach, S., S120 (SUN-P179)
Meinitzer, A., S156 (SUN-P278) Mizéhoun-Adissoda, C., S127 (SUN-P200) Muiesan, M. L., S64 (SUN-P032)
Meirelles, C. S., S48 (PT08.6) Mizuide, M., S85 (SUN-P084) Mullally, D., S30 (PT01.3)
Meisinger, C., S73 (SUN-P054) Modreker, M. K., S190 (MON-P030) Müller, M. J., S118 (SUN-P173)
Melchior, J.-C., S102 (SUN-P129), Moens, M., S251 (MON-P198) Müller-Werdan, U., S110 (SUN-P151),
S231 (MON-P140) Moeyerson, W., S180 (MON-P002) S110 (SUN-P152)
Mele, M. C., S87 (SUN-P091), S152 (SUN-P267), Mohammadi, F., S145 (SUN-P246), Mulliez, A., S62 (SUN-P028)
S276 (MON-P265), S281 (MON-P278) S159 (SUN-P287) Munaò, R., S1 (OR01)
Melgaard, D., S191 (MON-P032) Mohanlal, A., S305 (MON-LB341) Mundi, M., S204 (MON-P066),
Melissopoulou, T., S59 (SUN-P018) Mohan, R., S282 (MON-P282) S259 (MON-P221)
Membrez, F., S4 (OR09) Mohorko, N., S285 (MON-P290) Muñoz, A., S133 (SUN-P215)
Memelink, R. G., S10 (OR25), S232 (MON-P144) Moinard, C., S3 (OR07), S6 (OR14), Muñoz-Blanco, J. L., S177 (SUN-LB332)
Mena, F., S133 (SUN-P215) S157 (SUN-P279), S157 (SUN-P280) Munyi, F., S251 (MON-P198)
Mendes, K. G., S98 (SUN-P120), Moisejevs, G., S138 (SUN-P226) Murakoshi, S., S1 (OR02), S15 (OR36),
S136 (SUN-P222), S143 (SUN-P241) Mojarrad, M., S76 (SUN-P061) S46 (PT08.2), S78 (SUN-P068),
Mendil, N. A., S287 (MON-P295) Mok, Y. H., S59 (SUN-P019) S85 (SUN-P085), S171 (SUN-LB316),
Mendonça, V. S., S65 (SUN-P034) Molfino, A., S57 (SUN-P012), S96 (SUN-P115) S201 (MON-P058)
Mendorou, C., S137 (SUN-P224) Molina-López, J., S290 (MON-LB303) Murata, S., S292 (MON-LB309)
Menéndez, A. M., S57 (SUN-P014) Möltgen, C., S141 (SUN-P234), Murena, L., S74 (SUN-P056)
Menendez, C., S148 (SUN-P256) S259 (MON-P220) Murphy, R., S47 (PT08.4), S268 (MON-P246)
Meng, Q., S14 (OR34) Monaco, T., S24 (OR59) Murray, K., S109 (SUN-P150), S215 (MON-P096),
Mensink, M., S181 (MON-P007), Monajemi, F., S101 (SUN-P128) S215 (MON-P097)
S286 (MON-P293) Monfá Bosch, J. M., S224 (MON-P123) Muscaritoli, M., S57 (SUN-P012),
Mercanlıgil, S. M., S45 (PT07.5), Monsonego-Ornan, E., S179 (SUN-LB338) S96 (SUN-P115)
S147 (SUN-P252), S165 (SUN-P302) Monteiro da Silva, L. S., S267 (MON-P243) Mustafa, N., S214 (MON-P095)
Merdrignac, A., S209 (MON-P082) Monteiro, A. S., S100 (SUN-P125)
Merlo, F. D., S301 (MON-LB329) Montemerlo, H. J., S57 (SUN-P014)
N
Mesa, J., S16 (OR39) Montero-Galván, A., S123 (SUN-P187)
Meschi, T., S68 (SUN-P041), S193 (MON-P038) Montes Goyanes, R., S36 (PT04.1), S41 (PT06.2) Naaman, N., S84 (SUN-P083)
Mesia, R., S211 (MON-P085) Montserrat, M., S223 (MON-P120) Nachshon, L., S179 (SUN-LB338)
Meskers, C. G., S71 (SUN-P050), Monzón, A., S148 (SUN-P256) Nadeau, B., S264 (MON-P234)
S72 (SUN-P051), S72 (SUN-P052) Mooney, E., S159 (SUN-P286) Nagahama, T., S283 (MON-P284)
Meskers, C.G.M., S29 (PT01.1), Moore, B., S252 (MON-P201) Nagahashi, M., S55 (SUN-P008)
S195 (MON-P041) Moore, F., S176 (SUN-LB330) Naganathan, V., S30 (PT01.5)
Mesotten, D., S20 (OR49) Moradkhani, S., S164 (SUN-P300) Naganuma, A., S78 (SUN-P066),
Metcalfe, M., S27 (OR68), S93 (SUN-P106), Moraes, R. B., S26 (OR64) S85 (SUN-P084), S189 (MON-P026),
S93 (SUN-P107), S94 (SUN-P108), Morais, J. A., S229 (MON-P137) S219 (MON-P110)
S199 (MON-P052), S199 (MON-P053) Morais, J., S38 (PT04.5), S271 (MON-P252), Nagashima, T., S219 (MON-P110)
Metnitz, B., S25 (OR62) S284 (MON-P288) Nagel, G., S167 (SUN-LB306)
Metnitz, P., S25 (OR62) Morales Cerchiaro, A., S212 (MON-P089) Na, H. K., S79 (SUN-P070), S301 (MON-LB330)
Metselaar, H. J., S133 (SUN-P214) Morales, F., S122 (SUN-P184) Nahar-van Venrooij, L., S123 (SUN-P189)
Metselaar, H., S80 (SUN-P072) Moreira Carrasco, L. P., S173 (SUN-LB321) Naidu, S., S305 (MON-LB341)
Meulen van der, T., S49 (PT09.4) Moreira, P., S100 (SUN-P125) Nair, P., S162 (SUN-P294)
Meurice, P., S209 (MON-P082) Moreno Santa Maria, M., S237 (MON-P158), Nakade, M., S282 (MON-P282)
Meza, C., S107 (SUN-P142) S280 (MON-P276), S280 (MON-P277) Nakajima, M., S55 (SUN-P008)
Meziani, A., S38 (PT04.5), S271 (MON-P252) Moreno Zabaleta, R., S178 (SUN-LB336) Nakamura, E., S266 (MON-P241)
Midtgaard, J., S160 (SUN-P289) Moreno, C., S271 (MON-P253) Nakamura, H., S189 (MON-P026)
Miecinikovsski, R., S98 (SUN-P120) Moreno, Y.M.F., S41 (PT06.1) Nakamura, T., S55 (SUN-P007)
Miggiano, G.A.D., S87 (SUN-P091), Moriarty, C., S159 (SUN-P286) Nakamura, Y., S170 (SUN-LB315)
S152 (SUN-P267), S276 (MON-P265), Morin, A., S286 (MON-P292) Nakano, Y., S154 (SUN-P273)
S281 (MON-P278) Morita, S., S21 (OR53) Nakatake, R., S170 (SUN-LB315)
Author index S321
Nakayama, Y., S296 (MON-LB317) Nouvenne, A., S68 (SUN-P041) Olieman, J., S11 (OR26)
Nakaya, Y., S178 (SUN-LB335) Novo, N. F., S117 (SUN-P172) Olinto, M.T.A., S98 (SUN-P120),
Nakib, S., S7 (OR17), S284 (MON-P286) Nowak, G., S297 (MON-LB320) S143 (SUN-P241)
Namikawa, M., S219 (MON-P110) Ntanasis-Stathopoulos, I., S174 (SUN-LB326) Oliva, A., S147 (SUN-P253)
Namikawa, T., S195 (MON-P043), Nubret, E., S7 (OR17), S284 (MON-P286) Olivar Roldán, J., S178 (SUN-LB336)
S196 (MON-P045), S262 (MON-P229) Nuijten, M., S237 (MON-P159) Oliveira Filho, R. S., S164 (SUN-P298)
Narayanan, V., S214 (MON-P095) Nunes, G., S83 (SUN-P079), S128 (SUN-P202), Oliveira, A. R., S57 (SUN-P013)
Narici, M. V., S72 (SUN-P051) S163 (SUN-P296) Oliveira, F.L.C., S42 (PT06.3)
Narici, M., S68 (SUN-P041) Nuñez Ortega, F., S225 (MON-P125) Oliveira, L.D.D. A., S41 (PT06.1)
Naudin, S., S48 (PT09.2) Nurmohamed, S., S112 (SUN-P157) Oliveira, P., S219 (MON-P109)
Navarro, A. M., S177 (SUN-LB333) Nussler, A. K., S196 (MON-P046) Oliveira, P.A.D., S60 (SUN-P022)
Navis, G. J., S158 (SUN-P282) Nuzzo, A., S5 (OR11) Oliveira, R. B., S177 (SUN-LB333)
Navratilova, M., S229 (MON-P135) Nyatefe, D., S251 (MON-P198) Olivier, C., S4 (OR10), S33 (PT02.5),
Neelemaat, F., S166 (SUN-LB305) S81 (SUN-P075), S230 (MON-P139)
Neelis, E., S42 (PT06.4) Olmedilla, Y., S177 (SUN-LB332)
O
Nel, D., S251 (MON-P198) Olmedo, L. Cuellar, S224 (MON-P123)
Nelson, G., S172 (SUN-LB320) O’callaghan, S., S109 (SUN-P150), Olszewska, K., S18 (OR44), S150 (SUN-P262)
Nematy, M., S76 (SUN-P061), S121 (SUN-P183) S215 (MON-P096), S215 (MON-P097) Olveira, G., S89 (SUN-P095), S89 (SUN-P096)
Nergiz Unal, R., S257 (MON-P216) O’connor, E., S167 (SUN-LB306) Omidi, M., S106 (SUN-P141), S207 (MON-P075)
Nergiz-Unal, R., S53 (SUN-P002), O’connor, P., S249 (MON-P192) Omidvar, N., S299 (MON-LB326)
S54 (SUN-P003) O’donoghue, M., S252 (MON-P201) Oñate, G., S133 (SUN-P215)
Neri, D. A., S42 (PT06.3) O’hanlon, C., S252 (MON-P201) Ongan, D., S164 (SUN-P299)
Ness, A., S282 (MON-P281), S305 (MON-LB339) O’herlihy, E., S167 (SUN-LB306) Ong, C., S59 (SUN-P019), S92 (SUN-P103)
Neutel, J., S266 (MON-P239) O’keeffe, M., S167 (SUN-LB306) Ono, H., S296 (MON-LB317)
Neveu, N., S221 (MON-P116) O’toole, P., S167 (SUN-LB306) Oogiku, M., S196 (MON-P044)
Neveux, N., S90 (SUN-P098), S253 (MON-P203), Obama, K., S220 (MON-P111) Orford, E., S176 (SUN-LB329)
S285 (MON-P289) Obbard, S., S109 (SUN-P150), Orlandoni, P., S193 (MON-P036)
Newman, A. B., S12 (OR30) S215 (MON-P096), S215 (MON-P097) Ors, E. D., S144 (SUN-P243)
Neyrinck, A., S2 (OR04), S22 (OR54), Obeid, C., S162 (SUN-P295) Ortiz, A., S16 (OR39)
S273 (MON-P259) Oberänder, N., S37 (PT04.4) ORUÇ, N., S245 (MON-P181)
Ng, E. K.-W., S144 (SUN-P245) Obermayer-Pietsch, B., S156 (SUN-P278) Oruç, N., S288 (MON-P298)
Ng, E., S15 (OR38) Obregón, A. M., S133 (SUN-P215) Oruc, N., S81 (SUN-P076)
Nguyen, T., S180 (MON-P003) Obukhova, O., S216 (MON-P100) Oshima, T., S293 (MON-LB310),
Nicolaes, G., S22 (OR55) Ocampo, Y., S107 (SUN-P142) S293 (MON-LB311)
Nicolai, A., S227 (MON-P131) Ochoa, J. B., S266 (MON-P239) Osowska, S., S49 (PT09.3), S207 (MON-P075)
Nicolai, G., S227 (MON-P131) Ogasawara, T., S173 (SUN-LB322), Osumi, S., S167 (SUN-LB307)
Nicoll, A., S169 (SUN-LB311) S196 (MON-P044) Otake, K., S292 (MON-LB309)
Nicol, M., S34 (PT03.1), S34 (PT03.3) Ogata-Medel, M., S226 (MON-P129) Ota, Y., S52 (PT10.5)
Nielsen, M. M., S191 (MON-P032) Ogawa, K., S109 (SUN-P149) Öteleş, S., S274 (MON-P260)
Nielsen, R. E., S217 (MON-P102) Ogawa, S., S167 (SUN-LB307) Ott, B., S297 (MON-LB321)
Niessen, W., S128 (SUN-P201) Ogawa, T., S78 (SUN-P066), S85 (SUN-P084), Otten, L., S110 (SUN-P151), S110 (SUN-P152)
Nieuwdorp, M., S54 (SUN-P004) S189 (MON-P026) Ottery, F. D., S129 (SUN-P203),
Nightingale, J. M., S8 (OR20), S262 (MON-P228) Ogawa, Y., S78 (SUN-P066), S85 (SUN-P084), S131 (SUN-P210), S222 (MON-P119),
Nijholt, W., S296 (MON-LB318), S189 (MON-P026) S247 (MON-P187), S250 (MON-P195)
S296 (MON-LB319), S298 (MON-LB323) Öge Yılmaz, B., S145 (SUN-P248) Öttl, K., S3 (OR06)
Nikolenko, A., S58 (SUN-P015) Ogiku, M., S173 (SUN-LB322) Oudaert, E., S150 (SUN-P261)
Nilsson, B., S35 (PT03.5) Oguz, A., S136 (SUN-P221) Oudemans, H., S187 (MON-P021)
Nishigori, T., S220 (MON-P111) Ohanyan, H., S102 (SUN-P129), Oudemans-van Straaten, H. M.,
Nishihara, Y., S78 (SUN-P068) S231 (MON-P140) S186 (MON-P020), S291 (MON-LB305)
Nishikimi, T., S195 (MON-P043), Ohara, H., S165 (SUN-P301) Oudshoorn, C., S248 (MON-P189)
S262 (MON-P229) Ohnawa, M., S78 (SUN-P068) Ouelaa, W., S7 (OR17)
Nishioka, Y., S178 (SUN-LB335) Oh, S. E., S174 (SUN-LB325) Ouro, S., S151 (SUN-P264)
Nishizawa, M., S170 (SUN-LB315) Ohyama, T., S219 (MON-P110) Ouwehand, M., S49 (PT09.4)
Nitichai, N., S247 (MON-P187) Okajima, H., S14 (OR35), S39 (PT05.1), Overkamp, M., S2 (OR05)
Nobili, A., S68 (SUN-P042), S135 (SUN-P219), S76 (SUN-P062), S153 (SUN-P270) Ozawa, Y., S32 (PT02.4)
S189 (MON-P028) Okamoto, K., S153 (SUN-P269) Ozcaliskan Ilkay, H., S306 (MON-LB342)
Nobis, S., S286 (MON-P292) Okamura, A. B., S64 (SUN-P033) Özcan, A., S58 (SUN-P017)
Nobuoka, D., S14 (OR33) Oke, S., S8 (OR20), S262 (MON-P228) Özcan, N., S58 (SUN-P017)
Noda, S., S139 (SUN-P229) Okumura, S., S39 (PT05.1), S76 (SUN-P062), Özçelik, H. U., S103 (SUN-P133),
Noguchi, M., S15 (OR36), S46 (PT08.2), S153 (SUN-P270), S206 (MON-P072) S104 (SUN-P134)
S78 (SUN-P068), S85 (SUN-P085), Okumura, T., S170 (SUN-LB315) Ozdemir, A., S116 (SUN-P168), S142 (SUN-P239)
S171 (SUN-LB316), S201 (MON-P058) Olde Damink, S. W., S25 (OR61), S31 (PT02.1), Özekşi, P., S274 (MON-P260)
Noirez, P., S38 (PT04.5), S229 (MON-P137), S33 (PT02.6), S54 (SUN-P004) Ozel, H. Gokmen, S235 (MON-P152),
S271 (MON-P252), S284 (MON-P288) Olde Damink, S., S22 (OR55) S235 (MON-P153)
Noordhoff, H., S205 (MON-P071) Olde Damink, S.W.M., S47 (PT08.5) Ozgen, G., S164 (SUN-P299)
Noort, H. V., S152 (SUN-P268) Olea Salinas, O. O., S126 (SUN-P197) Ozgen, L., S137 (SUN-P225)
Nordstedt, P., S297 (MON-LB320) Olea, O. O., S35 (PT03.4) Özgürtaş, T., S247 (MON-P186)
Norman, K., S110 (SUN-P151), S110 (SUN-P152) Olesen, S. S., S40 (PT05.5), S239 (MON-P164) Ozhan Oktar, S., S11 (OR27)
S322 Author index
Ozisik, H., S164 (SUN-P299) Paulussen, K. J., S2 (OR05) Piloquet, H., S148 (SUN-P255)
Ozkan, E., S88 (SUN-P093) Pauly, L., S267 (MON-P244), S268 (MON-P245) Pinarbasi, A., S53 (SUN-P001)
Özsürekçi, C., S241 (MON-P169) Paur, I., S46 (PT08.1), S91 (SUN-P100) Pina, S., S161 (SUN-P291)
Özsürekci, C., S243 (MON-P177) Pautex, S., S113 (SUN-P159) Pineda-Juárez, J. A., S226 (MON-P129)
Ozturk Duran, E. E., S137 (SUN-P225) Pawlucha, K., S100 (SUN-P124) Pinelli, G., S101 (SUN-P128)
Ozturk-Duran, E. E., S135 (SUN-P220) Paz, L.P.S., S64 (SUN-P033) Pinho, J. P., S296 (MON-LB319)
Öztürk, S., S217 (MON-P104), S218 (MON-P105) Pazzeschi, C., S202 (MON-P062) Pinho, J., S129 (SUN-P203)
Öztürk, Y., S279 (MON-P273) Pearson, M., S51 (PT10.3) Pinho, N., S29 (PT01.2)
Özütemiz, A. Ö., S245 (MON-P181), Pedrazzoli, P., S24 (OR59) Pintor De La Maza, B., S115 (SUN-P165),
S288 (MON-P298) Pedrazzoni, M., S68 (SUN-P041) S115 (SUN-P166), S116 (SUN-P167),
Pedreño Belchi, M. I., S263 (MON-P231) S143 (SUN-P240)
P Pedrollo, T., S116 (SUN-P169) Piovacari, S. F., S64 (SUN-P031)
Pedziwiatr, M., S207 (MON-P074) Piro, F., S50 (PT09.5)
Pablo-Francisco, A., S101 (SUN-P127) Peers, G., S20 (OR49) Pironi, L., S13 (OR32), S19 (OR46), S21 (OR51),
Pachikian, B., S2 (OR04), S273 (MON-P259) Peiró, I., S91 (SUN-P101), S211 (MON-P085) S202 (MON-P062), S265 (MON-P238)
Pafili, Z., S236 (MON-P154), S258 (MON-P217), Pekcan, A. G., S294 (MON-LB313) Pisarska, M., S207 (MON-P074)
S258 (MON-P218), S258 (MON-P219), Penaforte, F., S17 (OR41) Pita Martín, M. L., S57 (SUN-P014)
S263 (MON-P233) Pena, J. W., S147 (SUN-P253) Piza, K.C.T., S279 (MON-P274)
Paganno, A. P., S81 (SUN-P074) Pence, M. C., S11 (OR27) Planells, E., S290 (MON-LB303)
Paine, P., S160 (SUN-P288) Penfold, C., S282 (MON-P281), Plank, L., S268 (MON-P246)
Paiva, C.C.J., S100 (SUN-P125) S305 (MON-LB339) Plauth, M., S11 (OR28), S240 (MON-P167)
Pak, M., S53 (SUN-P001) Pennestrì, F., S152 (SUN-P267) Player, E., S255 (MON-P208)
Palacios, N., S288 (MON-P299) Pequeno, R.S.F., S65 (SUN-P034) Plenier, S. Le, S221 (MON-P116)
Palanca, A., S136 (SUN-P223) Pereira, A. Z., S253 (MON-P202) Pleple, A., S102 (SUN-P129)
Palavra, M., S101 (SUN-P126) Pereira, C.C.A., S16 (OR40) Plumb, A., S130 (SUN-P207)
Palazzo, C., S95 (SUN-P111) Pereira, M., S81 (SUN-P074) Plummer, M. P., S33 (PT02.6)
Palibrk, I., S127 (SUN-P198) Pereira, S., S168 (SUN-LB308) Podracka, L., S284 (MON-P287)
Palma, D., S42 (PT06.3) Pereira, T. G., S40 (PT05.4) Poekes, L., S205 (MON-P069)
Palmela, C., S151 (SUN-P264) Peres, W., S29 (PT01.2) Poggiogalle, E., S7 (OR16)
Palomeque, M., S120 (SUN-P181) Peres, W.A.F., S215 (MON-P098) Pokrotnieks, J., S138 (SUN-P226)
Pamuk, G., S51 (PT10.4) Peretti, N., S148 (SUN-P255) Polak, W., S80 (SUN-P072)
Panisic, M., S181 (MON-P006) Pérez de la Cruz, A., S290 (MON-LB303) Polinder, S., S20 (OR49)
Panisic-Sekeljic, M., S23 (OR56) Pérez Jiménez, C., S237 (MON-P158) Politis, D., S111 (SUN-P153)
Pantet, O., S50 (PT10.1), S183 (MON-P011) Pérez Rodríguez, J., S140 (SUN-P232) Pollard, C., S23 (OR58), S93 (SUN-P106),
Pantoja, F., S50 (PT10.2) Perez-Cruz, E., S101 (SUN-P127) S93 (SUN-P107), S94 (SUN-P108)
Paothong, R., S272 (MON-P254) Pérez-Fernández, L., S114 (SUN-P164) Pol, R. A., S132 (SUN-P211)
Papadiamantis, P., S295 (MON-LB316) Pérez-Moreno, I., S290 (MON-LB303) Ponce, O. F., S303 (MON-LB336)
Papageorgiou, P., S295 (MON-LB316) Permana, H., S245 (MON-P182) Poorter, R., S174 (SUN-LB324)
Papanikolaou, A., S101 (SUN-P126) Perrier, M., S8 (OR19) Popadic, A., S23 (OR56), S181 (MON-P006)
Papapietro, K., S61 (SUN-P023) Perry, R., S282 (MON-P281) Popińska, K., S18 (OR44), S150 (SUN-P262)
Papet, I., S167 (SUN-LB306) Persiani, R., S152 (SUN-P267) Portheault, D., S273 (MON-P259)
Pape, U.-F., S85 (SUN-P086), S114 (SUN-P163), Pession, A., S50 (PT09.5) Postma, E. M., S171 (SUN-LB318)
S204 (MON-P067), S206 (MON-P073), Pessoa, A., S129 (SUN-P203) Potgëns, S., S273 (MON-P259)
S230 (MON-P139) Pestana, E. A., S267 (MON-P244), Poulia, K. A., S109 (SUN-P148)
Papier, I., S254 (MON-P206) S268 (MON-P245) Poulia, L., S111 (SUN-P153)
Papoutsakis, C., S295 (MON-LB315) Pestour, S., S3 (OR07) Poullenot, F., S5 (OR11)
Papovic, V., S82 (SUN-P077) Petelin, A., S141 (SUN-P236), Pourhassan, M., S190 (MON-P030)
Pappa, E., S59 (SUN-P018) S243 (MON-P176), S270 (MON-P249), Povedano, M., S119 (SUN-P178),
Paquot, N., S273 (MON-P259) S275 (MON-P264), S285 (MON-P290) S223 (MON-P120)
Paraiso, V.M.C., S122 (SUN-P185) Peters, A., S73 (SUN-P054) Power, L. C., S30 (PT01.3), S131 (SUN-P209),
Paraizo, V. C., S122 (SUN-P186) Petersen, A. H., S39 (PT05.3) S189 (MON-P027)
Pardo-Pacheco, B. R., S101 (SUN-P127) Petersen, J. H., S39 (PT05.3) Pramyothin, P., S272 (MON-P254)
Park, J. S., S95 (SUN-P110), S282 (MON-P283) Peters, S., S160 (SUN-P288) Prats, A., S223 (MON-P120)
Partridge, J., S168 (SUN-LB309), Petit, A., S200 (MON-P057), S244 (MON-P180) Preiser, J.-C., S62 (SUN-P028)
S300 (MON-LB327) Petit, L.-M., S265 (MON-P236) Prelous, I., S58 (SUN-P015)
Pasanisi, F., S40 (PT05.6), S44 (PT07.2), Petrolo, M., S71 (SUN-P049) Preux, P. M., S34 (PT03.1), S34 (PT03.3),
S103 (SUN-P131), S126 (SUN-P196) Petrova, M., S282 (MON-P282) S127 (SUN-P200)
Pascher, A., S85 (SUN-P086), S114 (SUN-P163), Pevny, S., S204 (MON-P067), S206 (MON-P073) Psachoula, C., S258 (MON-P219)
S206 (MON-P073) Pezzoli, G., S101 (SUN-P128) Psaltopoulou, T., S174 (SUN-LB326)
Pasqua, M., S101 (SUN-P128) Phattharayuttawat, S., S272 (MON-P254) Puffelen, E. V., S304 (MON-LB337)
Passos, C., S81 (SUN-P074) Piasecki, M., S29 (PT01.1) Puggioli, C., S50 (PT09.5)
Patel, P. S., S109 (SUN-P150), S215 (MON-P096), Pichard, C., S62 (SUN-P028), S113 (SUN-P159), Pugnaloni, S., S227 (MON-P131)
S215 (MON-P097) S129 (SUN-P205), S293 (MON-LB310), Puig Piña, R., S94 (SUN-P109)
Patel, P., S50 (PT10.2) S293 (MON-LB311) Puiggrós, C., S239 (MON-P165),
Patkova, A., S186 (MON-P019) Picot, D., S32 (PT02.2) S240 (MON-P166)
Pattinson, A., S259 (MON-P221) Pieters, R., S286 (MON-P293) Puiggros, C., S61 (SUN-P024)
Paulon, E., S96 (SUN-P114), S109 (SUN-P150), Pietka, M., S207 (MON-P074) Puig, R., S136 (SUN-P223)
S215 (MON-P096), S215 (MON-P097) Pijnappels, M., S72 (SUN-P051) Pusani, C., S101 (SUN-P128)
Author index S323
Q Riccardi, R., S276 (MON-P265) Rubio, M. Á., S271 (MON-P253)

Ricci, S., S221 (MON-P116) Rubio, M. A., S269 (MON-P247)
Queiroz, D.M.M., S202 (MON-P063) Riego Valledor, A., S233 (MON-P146) Rudka, T., S66 (SUN-P038)
Quero, M. Serrano, S226 (MON-P127) Riemslag Baas, S., S133 (SUN-P214) Ruggiero, A., S276 (MON-P265)
Quilliot, D., S5 (OR11) Rijksen, B., S169 (SUN-LB312) Rühlin, M., S141 (SUN-P234), S259 (MON-P220)
Quintano Pindado, A., S225 (MON-P124) Ri, M., S78 (SUN-P068), S201 (MON-P058) Ruiz Alonso, A., S214 (MON-P094)
Quintero-Osso, B., S290 (MON-LB303) Rimbert, A., S200 (MON-P057), Ruíz-Roso, G., S225 (MON-P126),
S244 (MON-P180) S228 (MON-P134)
R Rinninella, E., S87 (SUN-P091), Ruiz-Vico, M., S89 (SUN-P095), S89 (SUN-P096)
S152 (SUN-P267), S276 (MON-P265), Runau, F., S88 (SUN-P094), S93 (SUN-P106),
Rabito, E. I., S40 (PT05.4), S111 (SUN-P154) S281 (MON-P278) S93 (SUN-P107), S94 (SUN-P108),
Ræder, H., S46 (PT08.1) Risérus, U., S55 (SUN-P009) S214 (MON-P095)
Raffoul, W., S50 (PT10.1) Rivero, M.E.J., S185 (MON-P016) Runia, S., S112 (SUN-P158)
Ragusa, M., S293 (MON-LB311) Rizzo, O., S4 (OR09) Ruozi, G., S1 (OR01)
Rahman, F., S13 (OR32), S50 (PT10.2), Robalino, X., S277 (MON-P268) Ruperto Lope, M.D.M., S225 (MON-P126)
S96 (SUN-P114), S109 (SUN-P150), Roberts, H. C., S193 (MON-P037) Ruperto Lopez, M.D.M., S237 (MON-P160)
S130 (SUN-P207), S215 (MON-P096), Roberts, S., S169 (SUN-LB311), Ruperto, M.D.M., S228 (MON-P134)
S215 (MON-P097), S287 (MON-P294) S281 (MON-P279) Ruppen, W., S67 (SUN-P040)
Ramalho, A., S29 (PT01.2) Robins, R., S155 (SUN-P276) Rutten, M., S104 (SUN-P135)
Ramani, D., S284 (MON-P286) Rocha Junior, E. P., S283 (MON-P285) Ryan, M., S169 (SUN-LB311)
Ramel, A., S43 (PT07.1), S97 (SUN-P117) Rocha Junior, E.P.C., S267 (MON-P243) Rye, B., S76 (SUN-P063)
Ramesh, N., S220 (MON-P113) Rocha, G. A., S133 (SUN-P213), Ryttergaard, L., S228 (MON-P132)
Ramírez, L., S263 (MON-P231) S202 (MON-P063)
Ramirez, M., S61 (SUN-P023) Rocha, P., S296 (MON-LB319) S
Ramminger, S., S298 (MON-LB322) Rock, E., S156 (SUN-P278)
Ramos, A.P.A., S178 (SUN-LB334) Rodenas Esteve, I., S107 (SUN-P143) Saad, R., S84 (SUN-P083)
Ramos-Vázquez, A., S117 (SUN-P170) Rodenburg, I. L., S296 (MON-LB318) Sabatino, A., S182 (MON-P008)
Rascov, F., S181 (MON-P005) Rodrigues, A.L.C. C., S294 (MON-LB312) Sabbatinelli, J., S227 (MON-P131)
Rasic, I., S82 (SUN-P077) Rodrigues, C. S., S39 (PT05.2) Sáez, M. V., S271 (MON-P253)
Rasmussen, H. H., S40 (PT05.5), Rodrigues, C., S117 (SUN-P172) Safaz, I., S131 (SUN-P208)
S213 (MON-P091), S228 (MON-P132), Rodrigues, V. D., S29 (PT01.2), Saginova, E., S157 (SUN-P281)
S239 (MON-P164) S215 (MON-P098) Sagrado, M. Gonzalez, S224 (MON-P123)
Rasmussen, H., S13 (OR32) Rodriguez-Aguilera, J. C., S107 (SUN-P142) Sahin Kaya, A., S294 (MON-LB313)
Ratanapichayachai, D., S272 (MON-P254) Rodriguez-Elvira, M., S290 (MON-LB303) Sahin, A. O., S303 (MON-LB334)
Ratti, C., S74 (SUN-P056) Rodriguez, J., S2 (OR04), S273 (MON-P259) Sahin, M. A., S240 (MON-P168)
Rattray, M., S281 (MON-P279) Rodríguez-Mendiola, N., S225 (MON-P126), Şahin, M., S87 (SUN-P090)
Ravi, C., S5 (OR12) S228 (MON-P134) Saidijam, M., S164 (SUN-P300)
Raynaud-Simon, A., S285 (MON-P289) Rodriguez, R. E., S46 (PT08.3), S70 (SUN-P046), Saito, K., S139 (SUN-P229)
Raz, A., S254 (MON-P206) S156 (SUN-P277) Saito, S., S219 (MON-P110)
Razak, S., S223 (MON-P121) Rodriguez, S., S147 (SUN-P254) Sakai, P., S16 (OR40), S38 (PT04.6)
Razmpour, F., S121 (SUN-P183) Rogulska, J., S49 (PT09.3) Sakai, Y., S220 (MON-P111)
Reckman, G.A.R., S158 (SUN-P282) Rojas-Mandujano, A., S226 (MON-P129) Sakata, J., S55 (SUN-P008)
Reddy, A., S169 (SUN-LB311) Rolland, Y., S167 (SUN-LB306) Sakaue, H., S178 (SUN-LB335)
Reichart, S., S267 (MON-P244), Rollnik, J. D., S9 (OR22) Sakaue, M., S52 (PT10.5)
S268 (MON-P245) Romero, C., S61 (SUN-P023) Sakuramoto, S., S153 (SUN-P269)
Reijnierse, E. M., S29 (PT01.1), Romero, D., S16 (OR39) Sala, P. C., S12 (OR29)
S71 (SUN-P050), S72 (SUN-P051), Romero, E., S119 (SUN-P178), S223 (MON-P120) Sala, P., S16 (OR40), S38 (PT04.6),
S72 (SUN-P052), S195 (MON-P041) Romijn, J. A., S54 (SUN-P004) S124 (SUN-P190)
Reijven, P., S248 (MON-P190), Ronco, C., S64 (SUN-P032) Salas Lorenzo, I., S36 (PT04.1)
S249 (MON-P191), S250 (MON-P194) Roob, J. M., S3 (OR06), S156 (SUN-P278) Salas-García, I., S37 (PT04.3)
Reina-Ortiz, M., S120 (SUN-P180) Roodenburg, J. L., S131 (SUN-P210), Salazar, J. L., S102 (SUN-P130)
Reinders, I., S166 (SUN-LB305) S132 (SUN-P211), S160 (SUN-P289), Salehi, M., S76 (SUN-P061)
Renke, M., S105 (SUN-P139) S222 (MON-P119) Salentijn, A., S70 (SUN-P047)
Rensen, S. S., S47 (PT08.5) Rooijackers, O., S291 (MON-LB306) Salhab, N., S306 (MON-LB343)
Rettore, T. M., S283 (MON-P285) Roosenboom, B., S48 (PT09.1) Salpakoski, A., S29 (PT01.1)
Rey Fernández, L., S237 (MON-P158), Roque, R., S219 (MON-P109) Samaan, M., S50 (PT10.2)
S280 (MON-P276), S280 (MON-P277) Rosinhas, J., S129 (SUN-P203) Saman, R., S301 (MON-LB331),
Reyes Lopez, M. A., S238 (MON-P162), Rossi Fanelli, F., S96 (SUN-P115) S302 (MON-LB332)
S238 (MON-P163) Rossum, M. V., S104 (SUN-P135) Sammarco, R., S40 (PT05.6), S44 (PT07.2),
Reyes-Torres, C. A., S117 (SUN-P170) Rothenberg, E., S71 (SUN-P049) S126 (SUN-P196)
Rey, L., S229 (MON-P136) Rotovnik Kozjek, N., S62 (SUN-P028), Samur, F. G., S306 (MON-LB342)
Rey, V., S285 (MON-P291) S244 (MON-P178) Samur, F.G.Eroglu, S276 (MON-P267)
Rezaei, N., S164 (SUN-P300) Roustaee, R., S145 (SUN-P246), Samur, G., S17 (OR42), S45 (PT07.6),
Rezazadeh, A., S299 (MON-LB326) S159 (SUN-P287) S88 (SUN-P092), S98 (SUN-P118),
Rha, M. Y., S219 (MON-P108) Rowicka, G., S42 (PT06.5) S124 (SUN-P191), S289 (MON-P300)
Ribalta, J., S156 (SUN-P278) Rshidkhani, B., S299 (MON-LB326) Sanada, H., S299 (MON-LB325)
Ribeiro, A.A.F., S253 (MON-P202) Rubio Gambin, A., S234 (MON-P150), Sanches, L. M., S122 (SUN-P186)
Ribeiro, P. C., S127 (SUN-P199) S263 (MON-P231) Sanches, L.T.M., S122 (SUN-P185)
S324 Author index
Sánchez Romera, J. F., S234 (MON-P150) Schols, J., S74 (SUN-P055), S261 (MON-P225) Shimizu, T., S195 (MON-P043),
Sanchez Romera, J. F., S263 (MON-P231) Schönknecht, Y. B., S275 (MON-P262) S196 (MON-P045), S262 (MON-P229)
Sanchez Sequero, P., S234 (MON-P150) Schrader, E., S73 (SUN-P054) Shiozaki, M., S96 (SUN-P113)
Sánchez, C., S91 (SUN-P101) Schueren de van der, M., S49 (PT09.4) Shiozawa, Y., S189 (MON-P026)
Sánchez-López, M., S209 (MON-P081) Schug, B., S268 (MON-P245) Shirai, H., S14 (OR35), S39 (PT05.1),
Sánchez-Migallón Montull, J. M., Schulz, H., S73 (SUN-P054) S76 (SUN-P062), S153 (SUN-P270),
S94 (SUN-P109) Schunck, W.-H., S204 (MON-P067) S206 (MON-P072)
Sanchez-Migallon, J. M., S136 (SUN-P223) Schüssler, S., S71 (SUN-P048) Shiraishi, A., S66 (SUN-P036), S198 (MON-P049)
Sanchez-Torralvo, F. J., S89 (SUN-P095) Schuurman, C., S291 (MON-LB306) Shiraki, M., S170 (SUN-LB313)
Sanchez-Torralvo, F., S89 (SUN-P096) Schweitzer, L., S118 (SUN-P173) Shon, J., S282 (MON-P283)
Sancho, A., S197 (MON-P048), Scialanga, F., S152 (SUN-P267) Short, V., S305 (MON-LB339)
S239 (MON-P165), S240 (MON-P166) Scislo, L., S207 (MON-P074) Siahpoushi, E., S105 (SUN-P137)
Şanlıer, N., S200 (MON-P056) Sealy, M. J., S160 (SUN-P289), Sibilska, M., S18 (OR44), S150 (SUN-P262)
Santamaria-Orleans, A., S277 (MON-P269) S296 (MON-LB318) Sicchieri, J.M.F., S48 (PT08.6), S81 (SUN-P074),
Santana, M. S., S260 (MON-P223) Sebe, M., S178 (SUN-LB335) S95 (SUN-P111), S95 (SUN-P112),
Santarpia, L., S103 (SUN-P131), Seckiner, S., S270 (MON-P250) S177 (SUN-LB333)
S126 (SUN-P196) Sedef, E., S87 (SUN-P090) Sieber, C. C., S73 (SUN-P054)
Santini Sánchez, A. F., S126 (SUN-P197) Segal-Lieberman, G., S13 (OR31) Sierra Bracamonte, M., S214 (MON-P094)
Santo, M. A., S16 (OR40), S38 (PT04.6) Segura Moreno, M. T., S36 (PT04.1) Sierro, C., S129 (SUN-P205)
Santos, C. A., S128 (SUN-P202) Segura-Moreno, M. T., S41 (PT06.2) Silva Junior, J. M., S64 (SUN-P031)
Santos, C., S83 (SUN-P079), S163 (SUN-P296) Segurola, H., S16 (OR39), S197 (MON-P048), Silva, E.M.F. E., S143 (SUN-P241)
Santos, D. M., S64 (SUN-P031) S239 (MON-P165), S240 (MON-P166) Silva, F. M., S40 (PT05.4), S111 (SUN-P154)
Santos, K.G.D., S100 (SUN-P125) Seguy, D., S23 (OR57) Silva, F., S173 (SUN-LB321)
Santos, M. C., S219 (MON-P109) Seidner, D. L., S4 (OR10), S33 (PT02.5), Silva, F.D.F., S178 (SUN-LB334)
Santos, M.J.D., S60 (SUN-P022) S81 (SUN-P075), S230 (MON-P139) Silva, I.D.C. G., S16 (OR40), S38 (PT04.6)
Santoso, P., S245 (MON-P182) Seiva, D., S16 (OR40) Silva, L. D., S133 (SUN-P213), S202 (MON-P063)
Santos, R. L., S122 (SUN-P186) Sekine, R., S299 (MON-LB325) Silva, M. M., S16 (OR40), S179 (SUN-LB337)
Santulario, L., S61 (SUN-P024) Sekine, S., S189 (MON-P026) Silva, M., S17 (OR41)
Sanz-París, A., S114 (SUN-P164) Selimovic, N., S279 (MON-P275) Silva, S. G., S129 (SUN-P203)
Sanz-Valero, J., S107 (SUN-P143) Semolic, A., S1 (OR01), S6 (OR15) Silva, W. R., S260 (MON-P223)
Sapen, H. D., S62 (SUN-P027) Sendros Madroño, M. J., S94 (SUN-P109) Silveira, J., S129 (SUN-P203),
Sarantidou, M., S101 (SUN-P126) Sendros, M. J., S136 (SUN-P223) S296 (MON-LB319)
Saray, A., S82 (SUN-P077) Senkyrik, M., S139 (SUN-P231) Silvestre, S. C., S283 (MON-P285)
Sarer-Yurekli, B. P., S164 (SUN-P299) Seo, J. M., S174 (SUN-LB325) Silvestre, S., S267 (MON-P243)
Sarkut, P., S249 (MON-P193) Serel Arslan, S., S103 (SUN-P132) Simões, B. P., S48 (PT08.6)
Sarto, B., S239 (MON-P165), S240 (MON-P166) Seremet Kürklü, N., S146 (SUN-P249), Simões, B., S95 (SUN-P112)
Sasdelli, A. S., S202 (MON-P062) S146 (SUN-P250), S146 (SUN-P251), Sinai, T., S179 (SUN-LB338)
Sato, A., S168 (SUN-LB310), S299 (MON-LB325) S245 (MON-P183) Singer, P., S13 (OR32), S24 (OR60), S25 (OR63),
Sato, H., S153 (SUN-P269) Seremet Kurklu, N., S51 (PT10.4), S182 (MON-P008), S183 (MON-P012),
Sato, K., S78 (SUN-P066), S85 (SUN-P084), S123 (SUN-P188), S192 (MON-P034) S184 (MON-P013)
S219 (MON-P110) Sergentanis, I. N., S174 (SUN-LB326) Singh, N. A., S5 (OR12)
Sato, N., S292 (MON-LB309) Sergentanis, T. N., S174 (SUN-LB326) Sin, M., S117 (SUN-P171)
Sato, Y., S234 (MON-P151) Serlie, M. J., S54 (SUN-P004) Sio, C. A., S305 (MON-LB340)
Sattler, M. C., S3 (OR06) Serralde-Zúñiga, A. E., S117 (SUN-P170) Sipilä, S., S72 (SUN-P051)
Saunders, C., S215 (MON-P098) Serteser, M., S53 (SUN-P001) Sipila, S., S29 (PT01.1)
Saura, E., S288 (MON-P299) Seto, Y., S15 (OR36) Sirichindakul, B., S247 (MON-P187)
Sawyer, M., S47 (PT08.4) Sève, M., S157 (SUN-P279) Sisa, I., S120 (SUN-P181)
Scambia, G., S281 (MON-P278) Severine, A. N., S294 (MON-LB312) Sistanizad, M., S182 (MON-P010)
Schaap, F. G., S31 (PT02.1), S33 (PT02.6), Sevim, S., S118 (SUN-P174), S125 (SUN-P192), Siviero, J., S116 (SUN-P169), S136 (SUN-P222)
S54 (SUN-P004) S241 (MON-P170), S254 (MON-P204) Sivri, E., S245 (MON-P183)
Schaap, F., S22 (OR55) Sezer, T. Ö., S218 (MON-P107) Sjögren, P., S55 (SUN-P009)
Scheffer, H., S93 (SUN-P105) Shaaban, S. Y., S19 (OR47) Sjogren, P., S30 (PT01.4)
Scheike, T., S234 (MON-P149) Shabeer, L., S287 (MON-P296) Skadhauge, L. B., S213 (MON-P091)
Schindera, C., S17 (OR43) Shahar, D. R., S166 (SUN-LB305), Skoknova, M., S284 (MON-P287)
Schindler, K., S83 (SUN-P080), S263 (MON-P230) Sköldenberg, O., S2 (OR03)
S272 (MON-P255), S272 (MON-P256) Shahbazi Feshtali, S., S75 (SUN-P060), Skurk, T., S297 (MON-LB321)
Schippers, H.-J., S128 (SUN-P201) S78 (SUN-P067) Slaughter, S., S75 (SUN-P057)
Schluckebier, D., S265 (MON-P236) Shan, H., S149 (SUN-P259) Slavuta, H., S65 (SUN-P035)
Schmidt, S. B., S9 (OR22) Shelkunova, I., S188 (MON-P025) Small, M., S266 (MON-P240)
Schnabel, R. M., S25 (OR61) Shen, N., S61 (SUN-P025) Smeets, E. T., S166 (SUN-LB305)
Schneider, A., S147 (SUN-P254) Sheppard, C., S172 (SUN-LB320) Smeland, S., S46 (PT08.1), S91 (SUN-P100)
Schneider, S., S5 (OR11) Shestopalov, A., S82 (SUN-P078) Smith, O., S252 (MON-P201)
Schneiter, P., S285 (MON-P291) Shiga, M., S288 (MON-P297) Smith, T. R., S175 (SUN-LB328),
Schoen, E., S286 (MON-P293) Shi, H., S139 (SUN-P230) S217 (MON-P103)
Schols, A., S6 (OR13) Shih, Y.-L., S92 (SUN-P104), S210 (MON-P084) Smith, T., S7 (OR18)
Schols, A.M.W. J., S26 (OR66), Shiloah, M., S254 (MON-P206) Smit, T. C., S46 (PT08.3), S70 (SUN-P046),
S232 (MON-P145) Shimazu, S., S66 (SUN-P036), S198 (MON-P049) S156 (SUN-P277)
Schols, J. M., S9 (OR21) Shimizu, M., S170 (SUN-LB313) Soares, M.M.S., S202 (MON-P063)
Author index S325
Sobhanian, S., S201 (MON-P059) Stubelj, M., S141 (SUN-P236), Tanaka, H., S165 (SUN-P301), S189 (MON-P026)
Sobocki, J., S21 (OR52), S49 (PT09.3), S243 (MON-P176), S270 (MON-P249), Tanaka, S., S52 (PT10.5)
S91 (SUN-P102), S106 (SUN-P140), S275 (MON-P264) Tanaka, T., S78 (SUN-P066), S85 (SUN-P084),
S106 (SUN-P141), S153 (SUN-P271), Stuiver, M. M., S160 (SUN-P289) S165 (SUN-P301), S254 (MON-P207)
S179 (MON-P001), S207 (MON-P075) Stukan, M., S105 (SUN-P139) Tanaka, Y., S167 (SUN-LB307),
Sobolev, M., S282 (MON-P282) Sturm, A., S85 (SUN-P086), S114 (SUN-P163) S168 (SUN-LB310)
Soetedjo, N.N.M., S245 (MON-P182) Suárez-Lledó, A., S79 (SUN-P069) Tang, C.-H., S44 (PT07.3), S44 (PT07.4)
Soeters, M. R., S54 (SUN-P004) Suchkov, D., S61 (SUN-P025) Tan, H., S162 (SUN-P293)
Sohn, T. S., S174 (SUN-LB325), Sugama, J., S299 (MON-LB325) Taniguchi, H., S155 (SUN-P274),
S219 (MON-P108) Sugawara, L. M., S55 (SUN-P007) S278 (MON-P271)
Soja, A.M.B., S35 (PT03.5) Suhm, N., S67 (SUN-P040) Taniguchi, L. U., S127 (SUN-P199)
Soldatovic, I., S23 (OR56) Suker, M., S80 (SUN-P073) Tani, M., S52 (PT10.5)
Somers, A., S150 (SUN-P261) Sulmont Rosse, C., S167 (SUN-LB306) Tan, K. Y., S152 (SUN-P266)
Somlaw, N., S247 (MON-P187) Sulo, S., S168 (SUN-LB309), S300 (MON-LB327) Tan, M., S242 (MON-P174)
Song, H. J., S79 (SUN-P070), Suluhan, D., S149 (SUN-P257), S149 (SUN-P258) Tan, S., S14 (OR34)
S301 (MON-LB330) Sulz, I., S83 (SUN-P080), S272 (MON-P255), Tan, T. H., S59 (SUN-P019)
Sood, S., S169 (SUN-LB311) S272 (MON-P256) Tan, T. L., S162 (SUN-P293)
Sospedra Martínez, M., S94 (SUN-P109) Sümer, F., S241 (MON-P169), S243 (MON-P177) Tan, Z. H., S59 (SUN-P019)
Soto Celix, M., S233 (MON-P146) Sumi, Y., S154 (SUN-P273) Tapia-Valdés, S., S117 (SUN-P170)
Soto, C. Crespo, S224 (MON-P123), Summers, M., S180 (MON-P003) Tap, P., S107 (SUN-P144)
S225 (MON-P124) Sundaram, L., S249 (MON-P191), Tappy, L., S285 (MON-P291)
Sotoodeh Jahromi, A., S198 (MON-P051), S250 (MON-P194) Taura, K., S76 (SUN-P062)
S201 (MON-P059) Sundh, V., S71 (SUN-P049) Taus, M., S227 (MON-P131)
Souren, T., S295 (MON-LB316) Šundov, A., S198 (MON-P050) Tavolacci, M. P., S200 (MON-P057)
Sourisseau, H., S34 (PT03.1), S34 (PT03.3) Sundov, Z., S198 (MON-P050) Tayebinia, H., S105 (SUN-P137),
Sousa, A. S., S192 (MON-P035) Sungur, M., S287 (MON-P295) S164 (SUN-P300)
Sousa, A.G.D.M.R., S60 (SUN-P022) Sun, H., S138 (SUN-P228) Taylor, M., S10 (OR23), S108 (SUN-P145)
Souza, I.A.O., S127 (SUN-P199) Sun, L. C., S210 (MON-P084) Tchabashvili, L., S300 (MON-LB328)
Sparvoli, D., S193 (MON-P036) Sun, L.-C., S87 (SUN-P089), S92 (SUN-P104) Teh, R., S167 (SUN-LB306)
Speedy, A., S292 (MON-LB308) Sürer, I., S149 (SUN-P257) Teixeira, A., S81 (SUN-P074)
Speranza, E., S103 (SUN-P131), Suriano, F., S22 (OR54) Teixeira, R. T., S202 (MON-P063)
S126 (SUN-P196) Surowska, A., S285 (MON-P291) Teixeira, R., S133 (SUN-P213)
Spörri, A., S197 (MON-P047) Susam Şen, H., S217 (MON-P104), Tel Adıgüzel, K., S124 (SUN-P191),
Staessens, K., S62 (SUN-P027) S218 (MON-P105) S131 (SUN-P208), S146 (SUN-P249),
Stamou, A., S111 (SUN-P153) Sütcüoglu, O., S249 (MON-P193) S208 (MON-P078), S208 (MON-P079),
Stancari, A., S50 (PT09.5) Su, W.-C., S221 (MON-P114) S209 (MON-P080)
Stanga, Z., S37 (PT04.2), S120 (SUN-P179) Suzuki, H., S219 (MON-P110) Telessy, I. G., S105 (SUN-P138)
Stanislaus, A., S47 (PT08.4) Suzuki, K., S247 (MON-P188) Tengilimoglu Metin, M. M., S241 (MON-P170),
Stanton, C., S167 (SUN-LB306) Suzuki, N., S247 (MON-P188) S254 (MON-P204)
Stapel, S., S187 (MON-P021) Suzuki, T., S168 (SUN-LB310) Tengilimoglu Metin, M., S118 (SUN-P174),
Starodubova, A., S157 (SUN-P281) Suzuki, Y., S266 (MON-P241) S125 (SUN-P192)
Staun, M., S39 (PT05.3), S234 (MON-P149) Svobodova, I., S170 (SUN-LB314) Tennoune El hafaia, N., S285 (MON-P289)
Steele, C., S75 (SUN-P057) Sweeney, E., S252 (MON-P201) Teo, W. S., S162 (SUN-P293)
Steenackers, N., S270 (MON-P251) Swierblewski, M., S173 (SUN-LB323) ter Beek, L., S131 (SUN-P210),
Steenhagen, E., S112 (SUN-P158) Sytema, B., S84 (SUN-P082) S132 (SUN-P211), S222 (MON-P119),
Stefanoni, N., S285 (MON-P291) Szczepanek, K., S207 (MON-P074) S250 (MON-P195), S298 (MON-LB323)
Steffen, R., S37 (PT04.2) Teramoto, F., S266 (MON-P241)
Stehle, P., S73 (SUN-P054), S275 (MON-P262) T Teran, E., S102 (SUN-P130),
Steiber, A., S295 (MON-LB315) S120 (SUN-P180), S120 (SUN-P181)
Steinert, R. E., S303 (MON-LB335) Tabak, O., S303 (MON-LB334) Terashima, H., S154 (SUN-P273)
Stelmach, M., S167 (SUN-LB306) Tabak, S., S205 (MON-P071) Terhaard, C. H., S83 (SUN-P081)
Stenroth, L., S72 (SUN-P051) Tabbers, M., S42 (PT06.4) Terroba Larumbe, M. C., S225 (MON-P125)
Stoddard, L., S159 (SUN-P286) Tabei, I., S266 (MON-P241) Teruel, J. L., S224 (MON-P122),
Stoecklin, P., S183 (MON-P011) Taberna, M., S211 (MON-P085) S225 (MON-P126), S228 (MON-P134)
Stoffel-Wagner, B., S275 (MON-P262) Taddei, C. R., S185 (MON-P016) Tesinsky, P., S139 (SUN-P231),
Stollhof, L., S196 (MON-P046) Tagliaferri, S., S193 (MON-P038) S184 (MON-P014)
Stoppe, C., S26 (OR65) Taguchi, M., S278 (MON-P271) Tesser, A., S164 (SUN-P298)
Storchai, M., S282 (MON-P282) Takagi, H., S219 (MON-P110) Teubner, A., S10 (OR23)
Stover, C. M., S199 (MON-P054) Takagi, K., S14 (OR33) Teunis, M., S286 (MON-P293)
Stover, J., S267 (MON-P244), S268 (MON-P245) Takamasu, T., S278 (MON-P271) Theilla, M., S13 (OR32), S24 (OR60),
Strand, T. A., S260 (MON-P224) Takaori, K., S206 (MON-P072) S25 (OR63), S182 (MON-P008),
Stratton, R. J., S7 (OR18), S175 (SUN-LB328), Takemoto, H., S139 (SUN-P229) S183 (MON-P012), S184 (MON-P013)
S217 (MON-P103) Takenouchi, M., S155 (SUN-P274) Theodoro, H., S98 (SUN-P120),
Streicher, M., S167 (SUN-LB306), Tamai, K., S168 (SUN-LB310) S136 (SUN-P222), S143 (SUN-P241)
S189 (MON-P027) Tamai, Y., S14 (OR35) Thibault, R., S62 (SUN-P028), S143 (SUN-P242),
Streppel, M. T., S291 (MON-LB306) Tamanaha, É. M., S164 (SUN-P298) S209 (MON-P082)
Stubbe, J., S135 (SUN-P218), Tamayo-Serrato, J., S123 (SUN-P187) Thissen, J.-P., S2 (OR04), S273 (MON-P259)
S159 (SUN-P284) Tam, C. K., S15 (OR37) Thomas, A., S50 (PT10.1)
S326 Author index
Thomas, S., S282 (MON-P281), Tsuji, Y., S66 (SUN-P036) van Bodegraven, A., S93 (SUN-P105)
S305 (MON-LB339) Tsukizaki, H., S154 (SUN-P273) van Bokhorst, Q., S216 (MON-P101)
Thomas, T., S255 (MON-P208) Tsunoda, S., S220 (MON-P111) van de Bool, C., S6 (OR13), S232 (MON-P145)
Thompson, J., S23 (OR58), S93 (SUN-P106), Tsutsumi, R., S178 (SUN-LB335) Van De Maele, K., S151 (SUN-P263)
S93 (SUN-P107), S94 (SUN-P108) Tsutsumi, Y., S178 (SUN-LB335) van de Poll, M. C., S25 (OR61)
Thong, D., S130 (SUN-P207) Tůmová, J., S229 (MON-P135) van de Poll, M., S22 (OR55)
Thorand, B., S73 (SUN-P054) Tuncil, E., S138 (SUN-P227) Van de Rest, O., S69 (SUN-P045)
Thuler, L.C.S., S215 (MON-P098) Tupper, O., S35 (PT03.5) van den Berg, A., S11 (OR26)
Thurmann, D., S204 (MON-P067), Türkoğlu, I., S45 (PT07.5), S124 (SUN-P191), Van den Berghe, G., S20 (OR49)
S206 (MON-P073) S147 (SUN-P252), S165 (SUN-P302) Van Den Berghe, S., S220 (MON-P112)
Tian, F., S187 (MON-P022) Turri, A., S24 (OR59) van den Berghe, S., S68 (SUN-P043)
Tian, Z., S138 (SUN-P228) Twist, K., S160 (SUN-P288) van den Berg, M.G.A., S10 (OR24),
Ticha, A., S170 (SUN-LB314) Tylavsky, F. A., S12 (OR30) S84 (SUN-P082), S255 (MON-P210)
Ticinesi, A., S68 (SUN-P041), S193 (MON-P038) Tzanninis, I.-G., S111 (SUN-P153), Van der Flier, W., S69 (SUN-P045),
Tieland, M., S129 (SUN-P204), S174 (SUN-LB326) S73 (SUN-P053)
S159 (SUN-P284), S163 (SUN-P297), Tzouvekas, G., S300 (MON-LB328) van der Held-Horinga, G., S123 (SUN-P189)
S166 (SUN-LB305), S291 (MON-LB305) van der Linde, J., S181 (MON-P007)
Tierney, A. C., S169 (SUN-LB311) Van Der Meij, B. S., S46 (PT08.3),
U
Timmons, S., S167 (SUN-LB306) S70 (SUN-P046), S156 (SUN-P277)
Tincu, I. F., S60 (SUN-P020), S60 (SUN-P021) Uebaba, K., S168 (SUN-LB310) van der Meij, B., S47 (PT08.4)
Tincu, R. C., S60 (SUN-P020), S60 (SUN-P021) Ueda, R., S189 (MON-P026) Van Der Pant, K., S112 (SUN-P157)
Tiran, B., S3 (OR06), S156 (SUN-P278) Uehara, D., S78 (SUN-P066), S85 (SUN-P084), Van Der Putten, G.-J., S74 (SUN-P055)
Tirnova, I., S249 (MON-P193) S219 (MON-P110) van der Putten, G.-J., S9 (OR21)
Tlemsani, C., S90 (SUN-P098) Uehata, Y., S299 (MON-LB325) van der Schans, C. P., S131 (SUN-P210),
Tobota, K., S150 (SUN-P262) Uemoto, S., S14 (OR35), S21 (OR53), S132 (SUN-P211), S158 (SUN-P282),
Tognon, G., S71 (SUN-P049) S39 (PT05.1), S76 (SUN-P062), S160 (SUN-P289), S222 (MON-P119),
Toh, C. H., S152 (SUN-P266) S153 (SUN-P270), S206 (MON-P072) S250 (MON-P195), S298 (MON-LB323)
Toigo, G., S74 (SUN-P056) Ueno, H., S1 (OR02) Van der Schueren, B., S270 (MON-P251)
Toka, O., S88 (SUN-P092) Ueno, T., S219 (MON-P110) van der Sluis, G., S250 (MON-P195)
Tokarczyk, J., S49 (PT09.3), S207 (MON-P075) Ugur, E., S53 (SUN-P002), S54 (SUN-P003) van der Spek, A. H., S54 (SUN-P004)
Tokay, A., S114 (SUN-P162) Ukleja, A., S147 (SUN-P254) van der Steen, A., S163 (SUN-P297)
Toki, A., S276 (MON-P266) Ülfer, G., S200 (MON-P056) van der Vaart, H., S222 (MON-P119),
Toledo, D. O., S57 (SUN-P013), S64 (SUN-P031) Ülger Öztürk, N., S273 (MON-P258) S298 (MON-LB323)
Toledo, D., S181 (MON-P005) Ulmann, G., S90 (SUN-P098) Van Der Werf, A., S112 (SUN-P157),
Toloi, J., S57 (SUN-P013) Ulrik, C. S., S35 (PT03.5) S216 (MON-P101)
Tominaga, E., S78 (SUN-P068) Umeda, Y., S14 (OR33) van der Werf, A., S83 (SUN-P080)
Tonietto, T. A., S26 (OR64) Ünal, G., S245 (MON-P183) van Dijk, D. P., S25 (OR61)
Topal, G. G., S125 (SUN-P192), Ünal, N. G., S245 (MON-P181), Van Dijk, D.P.J., S47 (PT08.5)
S241 (MON-P170), S254 (MON-P204) S288 (MON-P298) van Dronkelaar, C., S163 (SUN-P297)
Topal, G., S118 (SUN-P174) Ünal, S., S273 (MON-P258) van Eijck, C., S80 (SUN-P073)
Torbahn, G., S167 (SUN-LB306) Unoura, J., S296 (MON-LB317) van Elsacker, T.J.E., S220 (MON-P112)
Torrego, M., S269 (MON-P247), Unsal, I., S53 (SUN-P001) van Galen, K. A., S54 (SUN-P004)
S271 (MON-P253) Urganci, N., S230 (MON-P138) van Gassel, R., S22 (OR55), S25 (OR61)
Torres, D., S231 (MON-P142) Urioste-Fondo, A., S115 (SUN-P165), Van Gossum, A., S66 (SUN-P037),
Torres, E., S102 (SUN-P130) S115 (SUN-P166), S116 (SUN-P167), S66 (SUN-P038), S67 (SUN-P039)
Torres, J., S151 (SUN-P264) S143 (SUN-P240) van Helvoort, A., S6 (OR13),
Torrinhas, R. S., S124 (SUN-P190) Ushigome, K., S155 (SUN-P274) S286 (MON-P293)
Torrinhas, R.S.M. M., S16 (OR40) Uslu, R., S81 (SUN-P076) Van Hoek, B., S75 (SUN-P060)
Torrinhas, R.S.M.D.M., S38 (PT04.6), Uthirapathy, J., S162 (SUN-P293) van Kanten, A., S123 (SUN-P189)
S164 (SUN-P298) Utrilla Navarro, M. P., S280 (MON-P276) van Kemenade, M. C., S133 (SUN-P214)
Torsy, T., S301 (MON-LB331), S302 (MON-LB332) Utrilla Navarro, P., S237 (MON-P158), Van Kralingen, M. A., S181 (MON-P007)
Totti, F. R., S122 (SUN-P185), S122 (SUN-P186) S280 (MON-P277) Van Laer, E., S63 (SUN-P030)
Tran, T., S161 (SUN-P292) Uzun, H., S303 (MON-LB334) van Lieshout, R., S84 (SUN-P082)
Trappenburg, M. C., S29 (PT01.1), van Loon, L. J., S2 (OR05)
S71 (SUN-P050), S72 (SUN-P051), V van Loon, L.J.C., S26 (OR66),
S72 (SUN-P052), S195 (MON-P041) S191 (MON-P031), S232 (MON-P145)
Tretyakova, E., S61 (SUN-P025) Vaez, I.D.A., S118 (SUN-P175) van Lummel, R. C., S72 (SUN-P051)
Tretyakov, D., S61 (SUN-P025) Vahidinia, A., S141 (SUN-P235) van Miert, L., S174 (SUN-LB324)
Triarico, S., S276 (MON-P265) Vaktskjold, A., S260 (MON-P224) van Norren, K., S286 (MON-P293)
Tribler, S., S13 (OR32), S39 (PT05.3), Valaitis, R., S125 (SUN-P193), S125 (SUN-P194) van Oort, A.G.C. M., S104 (SUN-P136)
S234 (MON-P149) Valentini, L., S298 (MON-LB322) van Orten-Luiten, A.C.B., S31 (PT01.6)
Trierweiler-Hauke, B., S264 (MON-P234) Valeriani, L., S132 (SUN-P212) Van Puffelen, E., S20 (OR49)
Trivin, F., S32 (PT02.2) Valladares, M., S133 (SUN-P215) Van Regenmortel, N., S290 (MON-LB304)
Tsai, H. L., S86 (SUN-P087) Val-Laillet, D., S143 (SUN-P242), van Rhenen, R., S135 (SUN-P218)
Tsai, H.-L., S90 (SUN-P099), S92 (SUN-P104), S209 (MON-P082) van Rijn, R. V., S135 (SUN-P218)
S221 (MON-P114) Van Aarle, D., S66 (SUN-P037) Van Schalkwyk, J., S117 (SUN-P171)
Tsuchida, J., S55 (SUN-P008) van Amerongen, A., S68 (SUN-P043) van Veen, M. R., S84 (SUN-P082)
Tsui, O. Y., S15 (OR37) van Beers, M., S6 (OR13) van Velzen, A., S163 (SUN-P297)
Author index S327
Van Vugt, J., S80 (SUN-P072), S80 (SUN-P073), Vinter-Jensen, L., S13 (OR32), Warnke, A., S267 (MON-P244)
S128 (SUN-P201) S228 (MON-P132) Wäsch, M., S11 (OR28), S240 (MON-P167)
van Vugt, J.L.A., S133 (SUN-P214) Virgili-Casas, M., S223 (MON-P120) Wassell, S., S176 (SUN-LB329)
Van Wijngaarden, J. P., S66 (SUN-P037), Virgili, M., S119 (SUN-P178) Watanabe, M., S109 (SUN-P149)
S67 (SUN-P039), S158 (SUN-P283) Virgili, N., S211 (MON-P085) Watanabe, T., S1 (OR02), S15 (OR36),
Van Wijngaarden, J., S66 (SUN-P038) Visakha, V., S226 (MON-P128) S46 (PT08.2), S78 (SUN-P068),
Van Winckel, M., S150 (SUN-P261) Visiedo Rodas, L., S237 (MON-P158), S85 (SUN-P085), S171 (SUN-LB316),
van Winckel, M., S42 (PT06.4) S280 (MON-P276), S280 (MON-P277) S201 (MON-P058), S220 (MON-P111)
Van Zwienen-Pot, J. I., S166 (SUN-LB305) Visser, J., S154 (SUN-P272), S251 (MON-P198) Watkins, A., S1 (OR02), S15 (OR36),
Vandewoude, M., S66 (SUN-P037), Visser, L., S132 (SUN-P211) S46 (PT08.2), S85 (SUN-P085),
S66 (SUN-P038), S67 (SUN-P039) Visser, M., S10 (OR25), S12 (OR30), S171 (SUN-LB316)
Vanhorebeek, I., S20 (OR49) S69 (SUN-P045), S73 (SUN-P053), Watokins, A., S201 (MON-P058)
Vargas, J.G.D., S98 (SUN-P120) S166 (SUN-LB305), S167 (SUN-LB306) Wearden, A., S160 (SUN-P288)
Varli, M., S166 (SUN-LB304) Vogt, L. J., S141 (SUN-P234), S259 (MON-P220) Weekes, C. E., S43 (PT07.1), S97 (SUN-P117),
Vasant, D., S108 (SUN-P145), S160 (SUN-P288) Voirin, N., S48 (PT09.2) S111 (SUN-P155)
Vasold, A. S., S9 (OR22) Volby, A. W., S155 (SUN-P275) Wegener, S., S130 (SUN-P206)
Vaudry, D., S97 (SUN-P116) Volkert, D., S73 (SUN-P054), S166 (SUN-LB305), Wehbe, A., S162 (SUN-P295)
Veen, K., S128 (SUN-P201) S167 (SUN-LB306), S189 (MON-P027), Wei, J., S243 (MON-P175), S300 (MON-LB327)
Velasco Gimeno, V., S212 (MON-P089) S190 (MON-P030) Weijs, P. J., S10 (OR25), S12 (OR30),
Velasco, C., S177 (SUN-LB332) von der Weid, N., S17 (OR43) S163 (SUN-P297), S186 (MON-P020),
Velasquez, M., S16 (OR39) Vonderbeck, D., S85 (SUN-P086), S187 (MON-P021), S232 (MON-P144),
Velázquez-Morales, U., S209 (MON-P081) S114 (SUN-P163) S291 (MON-LB305), S291 (MON-LB306)
Veley, E., S34 (PT03.2), S99 (SUN-P123) Vonk, R. J., S158 (SUN-P282) Weijs, P., S129 (SUN-P204), S135 (SUN-P218),
Velho, S., S151 (SUN-P264), S219 (MON-P109) Voogd, E., S286 (MON-P293) S159 (SUN-P284)
Veličkovic,́ J., S127 (SUN-P198) Voravud, N., S247 (MON-P187) Weijzen, M.E.G., S191 (MON-P031)
Venables, M., S176 (SUN-LB329) Vosooghinia, H., S76 (SUN-P061) Weimann, A., S37 (PT04.4)
Ventosa Viña, M., S225 (MON-P124), Vroomen, A., S249 (MON-P191), Weinel, L., S180 (MON-P003)
S225 (MON-P125) S250 (MON-P194) Weissbrod, R., S264 (MON-P234)
Ventura, G., S285 (MON-P289) Vroomen, L., S93 (SUN-P105) Wempe, J. B., S222 (MON-P119)
Ventura, J. C., S41 (PT06.1) Vucea, V., S75 (SUN-P057) Wempe, J., S298 (MON-LB323)
Venturini, C., S193 (MON-P036) Vukovic, N. D., S281 (MON-P280) Wenke-Zobler, J., S20 (OR50)
Verardi, A., S68 (SUN-P042), S135 (SUN-P219), Wen-Yi, C., S44 (PT07.3), S44 (PT07.4)
S189 (MON-P028) Wernio, E. W., S119 (SUN-P177)
W
Verbruggen, S. C., S20 (OR49) Wernio, E., S119 (SUN-P176)
Verdes, G., S37 (PT04.3) Wada, M., S278 (MON-P271) Wessel, I., S213 (MON-P093)
Verdes-Sanz, G., S114 (SUN-P164) Waeber, G., S262 (MON-P227) Weylandt, K.-H., S204 (MON-P067)
Verdijk, L. B., S2 (OR05), S26 (OR66), Wagener, N., S141 (SUN-P234), White, C., S252 (MON-P201)
S232 (MON-P145) S259 (MON-P220) Wiedswang, G., S46 (PT08.1)
Verhelle, K., S63 (SUN-P030) Waitzberg, D. L., S12 (OR29), S16 (OR40), Wierdsma, N., S93 (SUN-P105),
Verheul, H., S216 (MON-P101) S38 (PT04.6), S124 (SUN-P190), S112 (SUN-P157)
Verhoef, C., S80 (SUN-P073) S164 (SUN-P298) Wierzchowska-Mcnew, A., S227 (MON-P130)
Verlaan, S., S71 (SUN-P050), S158 (SUN-P283) Wakai, T., S55 (SUN-P008) Wigodski, S., S61 (SUN-P023)
Vernay, A., S183 (MON-P011) Waki, H., S168 (SUN-LB310) Wijnhoven, H. A., S166 (SUN-LB305)
Verreijen, A. M., S10 (OR25), S12 (OR30), Walewska, E., S207 (MON-P074) Wilcox, C. R., S193 (MON-P037)
S232 (MON-P144) Walker, D. K., S227 (MON-P130) Willemssen, F., S128 (SUN-P201)
Verschuren, M., S286 (MON-P293) Walker, D., S36 (PT03.6) Willschrei, H.-P., S190 (MON-P030)
Verspreet, J., S22 (OR54) Wallengren, O., S216 (MON-P099) Wilson, B., S108 (SUN-P147)
Verstraete, S., S20 (OR49) Walrand, S., S34 (PT03.1) Winklhofer-Roob, B. M., S3 (OR06),
Verté, D., S261 (MON-P225) Walsh, D., S252 (MON-P201) S156 (SUN-P278)
Viana, L. V., S26 (OR64) Walters, E. R., S175 (SUN-LB328) Winnicki, W., S25 (OR62)
Viana, M. V., S26 (OR64) Wanden-Berghe, C., S107 (SUN-P143) Winter, R., S9 (OR22)
Vicente De Sousa, O. L., S192 (MON-P035) Wang, J. Y., S86 (SUN-P087), S92 (SUN-P104) Wirth, R., S190 (MON-P030)
Vicente, C., S7 (OR17) Wang, J.-Y., S86 (SUN-P088), S87 (SUN-P089), Witkamp, R. F., S31 (PT01.6)
Vieira, D. A., S133 (SUN-P213), S90 (SUN-P099), S210 (MON-P084), Witkamp, R., S286 (MON-P293)
S202 (MON-P063) S221 (MON-P114) Witte, G., S286 (MON-P293)
Vieira, J., S128 (SUN-P202) Wang, L., S221 (MON-P115) Witteman, B., S107 (SUN-P144)
Vieira, T. S., S127 (SUN-P199) Wang, M., S213 (MON-P092) Witvliet-Van Nierop, J., S93 (SUN-P105)
Vignini, A., S227 (MON-P131) Wang, S., S138 (SUN-P228) Wodzig, W. K., S2 (OR05)
Vilajosana, E., S211 (MON-P085) Wang, X., S138 (SUN-P228), S187 (MON-P022), Woerdenbach, R., S272 (MON-P256)
Vílchez-López, F. J., S123 (SUN-P187) S222 (MON-P118) Wolters, M., S167 (SUN-LB306)
Viligorska, K., S140 (SUN-P233) Wang, Y., S299 (MON-LB324) Wong, K. Y., S15 (OR37)
Villagomez, V., S260 (MON-P222) Wang, Z., S243 (MON-P175) Wong, S. K., S144 (SUN-P245)
Villar, M., S260 (MON-P222) Wanten, G. J., S31 (PT02.1) Wong, S., S15 (OR38)
Viña, M. Ventosa, S224 (MON-P123) Wanten, G., S13 (OR32), S48 (PT09.1), Wong, V., S15 (OR38)
Viñas, M. Chimeno, S224 (MON-P123) S104 (SUN-P135), S108 (SUN-P146), Wood, C., S175 (SUN-LB328)
Vincent, J., S69 (SUN-P044) S126 (SUN-P195), S255 (MON-P209) Woollacott, A. E., S162 (SUN-P294)
Vinci, P., S1 (OR01) Wanten, G.J.A., S10 (OR24), S255 (MON-P210) Wouters, E., S6 (OR13)
Viniou, N.-A., S111 (SUN-P153) Ward, L., S305 (MON-LB341) Wouters, P. J., S20 (OR49)
S328 Author index
Wouters, Y., S13 (OR32), S48 (PT09.1) S85 (SUN-P085), S171 (SUN-LB316), Zajic, P., S25 (OR62)
Wright, L., S120 (SUN-P180) S201 (MON-P058) Zakrzewska, E., S91 (SUN-P102)
Wright, O., S305 (MON-LB341) Yasuoka, H., S85 (SUN-P084) Zaloudkova, L., S170 (SUN-LB314)
Wroczyński, P., S49 (PT09.3) Yavuz, B. B., S241 (MON-P169), Zaltz, Z., S254 (MON-P206)
Wu, A. H., S15 (OR37) S243 (MON-P177) Zamani, A., S105 (SUN-P137)
Wu, G., S14 (OR34) Yayla, A., S228 (MON-P133), S242 (MON-P174) Zanetti, E., S68 (SUN-P042), S135 (SUN-P219),
Wu, H., S208 (MON-P077) Yazıcı, K., S45 (PT07.5), S147 (SUN-P252), S189 (MON-P028)
Wu, J., S138 (SUN-P228) S165 (SUN-P302) Zanetti, M., S1 (OR01), S6 (OR15),
Wu, S.-C., S79 (SUN-P071) Yeh, Y. S., S86 (SUN-P087) S64 (SUN-P032), S74 (SUN-P056)
Wu, X., S138 (SUN-P228) Yeung, S.S.Y., S29 (PT01.1), S195 (MON-P041) Zani, M., S68 (SUN-P042), S135 (SUN-P219),
Yiannakouris, N., S137 (SUN-P224) S189 (MON-P028)
X Yiğit, P., S200 (MON-P056) Zarate, E., S107 (SUN-P142)
Yildiran, H., S256 (MON-P213) Zaremba, S.M.M., S274 (MON-P261),
Xia, J.-Z., S165 (SUN-P301) Yildiz, D., S149 (SUN-P257), S303 (MON-LB335)
Xi, Q., S14 (OR34) S149 (SUN-P258) Zec, S., S127 (SUN-P198)
Xiu, D., S243 (MON-P175) Yıldız, E., S124 (SUN-P191) Zhang, H., S54 (SUN-P006)
Xu, Y., S125 (SUN-P193) Yılmaz Işıkhan, S., S273 (MON-P257) Zhang, L., S138 (SUN-P228), S187 (MON-P022),
Yoca, G., S45 (PT07.5), S147 (SUN-P252), S222 (MON-P118)
Y S165 (SUN-P302) Zhang, P., S138 (SUN-P228)
Yokota, H., S292 (MON-LB309) Zhang, R. J., S161 (SUN-P290)
Yagi, S., S14 (OR35), S39 (PT05.1), Yoneda, J., S96 (SUN-P113) Zhang, X., S138 (SUN-P228)
S76 (SUN-P062), S153 (SUN-P270), Yoon, M.-O., S305 (MON-LB340) Zhang, Y., S168 (SUN-LB309), S208 (MON-P077),
S206 (MON-P072) Yoshida, M., S299 (MON-LB325) S300 (MON-LB327)
Yagi, T., S14 (OR33) Yoshida, R., S14 (OR33) Zheng, X., S278 (MON-P272)
Yagubyan, R., S282 (MON-P282) Yoshida, T., S189 (MON-P026) Zhigang, X., S299 (MON-LB324)
Yakoub-Agha, I., S23 (OR57) Yoshimura, Y., S66 (SUN-P036), Zhou, J., S187 (MON-P022)
Yalçın, T., S124 (SUN-P191) S198 (MON-P049) Zhou, Y., S188 (MON-P023),
Yamada, N., S78 (SUN-P068) Ystad, S. O., S32 (PT02.3), S221 (MON-P115)
Yamaguchi, M., S139 (SUN-P229) S207 (MON-P076) Zhuang, Q., S14 (OR34)
Yamaguchi, S., S153 (SUN-P269) Yuan, S., S187 (MON-P022) Zhu, C., S99 (SUN-P121),
Yamaguchi, Y., S167 (SUN-LB307) Yu, C., S14 (OR34) S99 (SUN-P122)
Yamaguti, A., S294 (MON-LB312) Yue, D., S278 (MON-P272) Zhu, M., S243 (MON-P175)
Yamamoto, J., S1 (OR02) Yu, J., S138 (SUN-P228), S299 (MON-LB324), Zijlstra, H., S135 (SUN-P218)
Yamamoto, M., S21 (OR53) S302 (MON-LB333) Zimmer, J., S199 (MON-P054)
Yamamoto, T., S109 (SUN-P149) Yun, E., S282 (MON-P283) Zimmermann, K., S20 (OR50)
Yamanaka-Okumura, H., S32 (PT02.4) Yung, M. Y., S15 (OR38) Ziółkowski, M., S100 (SUN-P124)
Yaman, F., S233 (MON-P147) Yürük, A. A., S124 (SUN-P191) Žnidaršič, M., S127 (SUN-P198)
Yamaniac, N. E., S46 (PT08.1) Yu, S. Y., S219 (MON-P108) Zoni, L., S132 (SUN-P212)
Yang, G., S243 (MON-P175) Yu, Z., S14 (OR34) Zukova, O., S138 (SUN-P226)
Yang, J., S166 (SUN-P303), S187 (MON-P022) Yüzbaşıoğlu Marangoz, F., Zusman, O., S183 (MON-P012),
Yang, X., S243 (MON-P175) S123 (SUN-P188) S184 (MON-P013)
Yang, Y., S243 (MON-P175) Zweers, H., S104 (SUN-P135), S126 (SUN-P195),
Yao, S., S39 (PT05.1), S76 (SUN-P062), S255 (MON-P209)
S153 (SUN-P270), S206 (MON-P072) Z
Zwinkels, I., S68 (SUN-P043)
Yassıbaş, E., S88 (SUN-P092) Zachria, A., S99 (SUN-P123) Żydak, J., S18 (OR44)
Yasuhara, H., S1 (OR02), S15 (OR36), Zadák, Z., S170 (SUN-LB314) Zydak, J., S150 (SUN-P262)
S46 (PT08.2), S78 (SUN-P068), Zadak, Z., S186 (MON-P019) Zyla-Pawlak, A., S18 (OR44)

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36 ISSUE 4

VOL. 36 SUPPLEMENT 1 AUGUST 20172017

Clinical Nutrition Vol. 36/4 (2017) 915–1186

Cover.indd All Pages 11-Aug-17 5:05:51 PM

Past Associate Editors

Editorial Advisory Board/ESPEN Faculty

Authors are responsible for content and language quality of abstracts

Clinical Nutrition has no page charges

Printed by Henry Ling Ltd, The Dorset Press, Dorchester, UK.

Available online at www.sciencedirect.com

Author index S309

Contents lists available at ScienceDirect

Time Friday 4 September 2015 Room

08:30 10:00 Nutritional

Contents lists available at ScienceDirect

References of 2 types of curcumin, the natural curcumin and a hydro-

and GSK3 was noted in aluminium-exposed rats, while these OR14

OR23 bedside following proactive advise from a nutritional assistant,

measured REE. Subgroup analyses were performed for type 2 OR27

Rationale: Both taurolidine 2% and saline 0.9% solution are

OR34 Rationale: Infection is the leading cause of death after liver

than in the non-sarcopenia group. Absence of enteral nutrition OR37

Reference Oral Communication V: Paediatrics

OR46 to define and document cerebral changes and abnormalities in

(OR = 1.06 [95% CI: 1.01–1.12]; p = 0.03) and triglycerides OR50

Rationale: Postoperative early oral or enteral intake is a crucial

OR56 amino-acid reflecting enterocyte health, in patients before

OR57 Rationale: Oesophagogastric carcinoma (OC) is a devastating

OR61 ‘obesity paradox’ has been described. In a large group of

83 ± 25 g/d protein, significantly more than G1 (n = 22) and G2 OR65

Contents lists available at ScienceDirect

PT02.2 Methods: Twenty patients with suspected NCGS (14F/6M, age

Aminoleban EN® as a LES with 14.1 g BCAA (BCAA-LES). The

PT04.2 Methods: A sample of T2D patients was prospectively and

PT06.4 Rationale: Measurements of bone mineral density (BMD)

comparing DNA damage in patients receiving chemotherapy Days Initial 15 25 35 45 Initial 15 25 35 45

Risk factors n Median survival p-Value Poster Tour 9: Nutritional techniques

Rationale: The key for prevention of Re-feeding Syndrome (RS)

Conclusion: In this study, no significant difference was found PT10.6

Contents lists available at ScienceDirect

−1.05 ∼ −0.73, p = 0.000), Modified Acetate Ringer’s Solutions SUN-P008

SUN-P020 in a patient with extensive burns and pneumonia successfully

Results: Digestive tract complications in patients with cardio- SUN-P024

SUN-P031 variability of plasma GLN levels in elderly septic patients is

Geriatrics 1 Methods: General practitioners and health care workers in the

Rationale: Prevalence of (risk of ) malnutrition is high in

phenylalanine, isoleucine, leucine and valine) calculated as

Results: Baseline characteristics, plasma TRP levels and TRP/ SUN-P049

Rationale: In clinical practice, optimization of physical and

SUN-P074 remnant bowel anatomy. Recently, the idea that grading

Rationale: Low carbohydrate-high fat diets (LCHFD) are

SUN-P087 Rationale: Enteral nutrition (EN) is preferable with immune-

SUN-P089 (3 × 1) were given in 22 patients, the others received Glt

SUN-P097 Methods: This was a cross-sectional case-control study on a

advanced/nourished GI cancer patients (19.16 ± 2.78 vs.19.79 ± SUN-P101

Rationale: Advanced pancreatic cancer (APC) is characterised