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MON-PP238: Changes in Body Mass Index After Heart Transplantation: A Three Year Cohort Study
S216
Poster presentations
MON-PP238 CHANGES IN BODY MASS INDEX AFTER HEART TRANSPLANTATION: A THREE YEAR COHORT STUDY R. Patel1 , N. Banner1 , A. Simon1 , A. Reed1 . 1 Royal Brompton and Harefield NHS Foundation Trust, Middlesex, United Kingdom Rationale: Increased Body Mass Index (BMI) is prevalent in our Advanced Heart Failure patients which has negative impact on health and surgical outcomes. At our centre we are seeing further weight gain post heart transplantation (HTx). We conducted an observational study to investigate the prevalence of obesity before and after transplantation. Methods: BMI was recorded pre HTx and regularly post transplantation between March 2010 and April 2013; at follow ups until April 2014. Results: There were 43 HTx performed of which 9 died (data excluded). 24% (n = 8) of patients were classed as obese pre transplantation increasing to 32% (n = 11) within the first year of HTx. 44% (n = 15) had a weight in the healthy range pre transplantation falling to 24% (n = 8) within 1 year. There was an overall trend of weight gain over 2 years post transplantation with mean(SD) BMI increasing from 25.8(4.4) to 29.4(6.7), however reduced to 25.4(6.5) at 3 years. The highest percentage weight gain was within the first year (7.4%). Table: Serial percentage BMI pre and post Heart Transplantation n
Pre HTx 3 month 6 month 9 month 1 year 2 year 3 year
34 34 34 34 34 15 6
Mean (SD)
25.8 25.8 26.8 27.6 27.8 29.4 25.4
(4.4) (4.6) (4.9) (5.5) (5.9) (6.7) (6.5)
Underweight (<18.5 kg/m2 )
Healthy
Overweight
(20 25 kg/m2 )
(25 30 kg/m2 )
Obese (30 35 kg/m2 )
Morbidly obese (>35 kg/m2 )
3% 9% 9% 9% 9% 0% 17%
44% 38% 21% 24% 24% 20% 33%
29% 35% 41% 32% 29% 33% 17%
24% 18% 29% 29% 32% 27% 17%
0% 0% 0% 6% 6% 20% 17%
Conclusion: Despite current guidelines, 24% of patients were obese pre HTx reflecting the changing BMI profile of our referral population. There were overall trends in weight gain over the first 2 years with most weight gain occurring in the first year after surgery. This suggests that early intervention will be necessary to reverse this trend. The Year 3 cohort was small (n = 6) however this will be continued to followed up to establish longer term trend. Disclosure of Interest: None declared
MON-PP239 SERUM BIOMARKERS OF PALMITIC ACID AND LINOLEIC ACID INTAKE ARE ASSOCIATED WITH ABDOMINAL OBESITY MEASURES IN A LARGE POPULATION-BASED COHORT STUDY OF 60-YEAR-OLD MEN AND WOMEN Z. Alsharari1 , U. Riserus1 , K. Leander2 , P. Sj¨ ogren1 , M. Vikstr¨ om2 , F. Laguzzi2 , B. Gigante2 , T. Cederholm1 , U. De Faire2 , M.-L. Hellenius2 , M. Marklund1 . 1 Public Health and Caring, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, 2 unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Rationale: Recent intervention trials report that dietary palmitic acid (PA, 16:0) and linoleic acid (LA, 18:2n-6) may play important roles in abdominal fat accumulation. Aim is to
investigate the associations between biomarkers of PA and LA intake with anthropometric measures of abdominal obesity in men and women. Methods: A population-based cross-sectional study of 3908 participants of 60-years-old living in Stockholm, Sweden. PA and LA in serum cholesterol ester (CE) were measured by gas chromatography. Abdominal anthropometric measures (AAM) were recorded and included waist circumference (WC), sagittal abdominal diameter (SAD), and waist-hip ratio (WHR). Relationships between serum fatty acids and AAM were investigated by calculation of Spearman’s rank correlation coefficients and in linear regression models. Results: In men, PA was positively correlated with WC, SAD, and WHR (r = 0.16, 0.15, and 0.14 respectively; all p < 0.001), whereas LA was inversely correlated with all AAM in both men (r = 0.22, 0.24, and 0.22 respectively; all p < 0.001) and women (r = 0.19, 0.15, and 0.19 respectively; all p < 0.001). These associations remained after adjustments for lifestyle factors. Conclusion: Our findings suggest that palmitic acid and linoleic acid may play an important role in abdominal adiposity and that relationships between serum fatty acid and abdominal anthropometric measures are partly sex-specific. Disclosure of Interest: None declared
Paediatrics MON-PP240 SENSORY EVALUATION OF NO FLAVOR SUPPLEMENT FOR CHILDREN AND ADOLESCENTS IN THE HOSPITAL P. Zamberlan1 , A.G. Servilha1 , M.A.C. Bonfim1 , V.L.B. Batista1 , R.H. Barnabe1 , D.G. Silva1 , K. Viani1 , A.G.Z. Leite1 . 1 Division of Nutrition, Instituto da Crian¸ca do Hospital das Clínicas da Faculdade de Medicina da Universidade de S˜ ao Paulo, Sao Paulo, Brazil Rationale: The oral supplementation therapy (OST) is an important nutritional strategy for patients who are at risk of malnutrition at admission. However, most nutritional supplements do not have a nice flavor Methods: During a day at a pediatric tertiary hospital, “no flavor” supplements were offered to children and adolescents for their breakfast and afternoon snack. The supplements were added in preferred liquids of them (coffee with milk, milk chocolate, milk thickener, yogurt or juice). The addition of the supplement was informed at the end of the study in order to avoid that that the responses of the patients were not influenced. For the evaluation we used a specific form designed for the study Results: Fifty-one patients ingested the supplement flavor (33 children and 18 adolescents). 72.5% did not feel the supplement flavor; 17.5% noted difference in food flavor and they mentioned “bitter”, “strange” or “sweeter” flavor. 10% of patients did not ingest the supplement for problems related to disease, such as pain, loss of appetite and fasting for procedures. Of the patients who received the supplement, 37% accepted all, 34.8% accepted half and 28.2% less than half offered Conclusion: Sensory evaluation of the supplement was considered satisfactory because over 70% of children did not
Poster presentations
MON-PP238 CHANGES IN BODY MASS INDEX AFTER HEART TRANSPLANTATION: A THREE YEAR COHORT STUDY R. Patel1 , N. Banner1 , A. Simon1 , A. Reed1 . 1 Royal Brompton and Harefield NHS Foundation Trust, Middlesex, United Kingdom Rationale: Increased Body Mass Index (BMI) is prevalent in our Advanced Heart Failure patients which has negative impact on health and surgical outcomes. At our centre we are seeing further weight gain post heart transplantation (HTx). We conducted an observational study to investigate the prevalence of obesity before and after transplantation. Methods: BMI was recorded pre HTx and regularly post transplantation between March 2010 and April 2013; at follow ups until April 2014. Results: There were 43 HTx performed of which 9 died (data excluded). 24% (n = 8) of patients were classed as obese pre transplantation increasing to 32% (n = 11) within the first year of HTx. 44% (n = 15) had a weight in the healthy range pre transplantation falling to 24% (n = 8) within 1 year. There was an overall trend of weight gain over 2 years post transplantation with mean(SD) BMI increasing from 25.8(4.4) to 29.4(6.7), however reduced to 25.4(6.5) at 3 years. The highest percentage weight gain was within the first year (7.4%). Table: Serial percentage BMI pre and post Heart Transplantation n
Pre HTx 3 month 6 month 9 month 1 year 2 year 3 year
34 34 34 34 34 15 6
Mean (SD)
25.8 25.8 26.8 27.6 27.8 29.4 25.4
(4.4) (4.6) (4.9) (5.5) (5.9) (6.7) (6.5)
Underweight (<18.5 kg/m2 )
Healthy
Overweight
(20 25 kg/m2 )
(25 30 kg/m2 )
Obese (30 35 kg/m2 )
Morbidly obese (>35 kg/m2 )
3% 9% 9% 9% 9% 0% 17%
44% 38% 21% 24% 24% 20% 33%
29% 35% 41% 32% 29% 33% 17%
24% 18% 29% 29% 32% 27% 17%
0% 0% 0% 6% 6% 20% 17%
Conclusion: Despite current guidelines, 24% of patients were obese pre HTx reflecting the changing BMI profile of our referral population. There were overall trends in weight gain over the first 2 years with most weight gain occurring in the first year after surgery. This suggests that early intervention will be necessary to reverse this trend. The Year 3 cohort was small (n = 6) however this will be continued to followed up to establish longer term trend. Disclosure of Interest: None declared
MON-PP239 SERUM BIOMARKERS OF PALMITIC ACID AND LINOLEIC ACID INTAKE ARE ASSOCIATED WITH ABDOMINAL OBESITY MEASURES IN A LARGE POPULATION-BASED COHORT STUDY OF 60-YEAR-OLD MEN AND WOMEN Z. Alsharari1 , U. Riserus1 , K. Leander2 , P. Sj¨ ogren1 , M. Vikstr¨ om2 , F. Laguzzi2 , B. Gigante2 , T. Cederholm1 , U. De Faire2 , M.-L. Hellenius2 , M. Marklund1 . 1 Public Health and Caring, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, 2 unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Rationale: Recent intervention trials report that dietary palmitic acid (PA, 16:0) and linoleic acid (LA, 18:2n-6) may play important roles in abdominal fat accumulation. Aim is to
investigate the associations between biomarkers of PA and LA intake with anthropometric measures of abdominal obesity in men and women. Methods: A population-based cross-sectional study of 3908 participants of 60-years-old living in Stockholm, Sweden. PA and LA in serum cholesterol ester (CE) were measured by gas chromatography. Abdominal anthropometric measures (AAM) were recorded and included waist circumference (WC), sagittal abdominal diameter (SAD), and waist-hip ratio (WHR). Relationships between serum fatty acids and AAM were investigated by calculation of Spearman’s rank correlation coefficients and in linear regression models. Results: In men, PA was positively correlated with WC, SAD, and WHR (r = 0.16, 0.15, and 0.14 respectively; all p < 0.001), whereas LA was inversely correlated with all AAM in both men (r = 0.22, 0.24, and 0.22 respectively; all p < 0.001) and women (r = 0.19, 0.15, and 0.19 respectively; all p < 0.001). These associations remained after adjustments for lifestyle factors. Conclusion: Our findings suggest that palmitic acid and linoleic acid may play an important role in abdominal adiposity and that relationships between serum fatty acid and abdominal anthropometric measures are partly sex-specific. Disclosure of Interest: None declared
Paediatrics MON-PP240 SENSORY EVALUATION OF NO FLAVOR SUPPLEMENT FOR CHILDREN AND ADOLESCENTS IN THE HOSPITAL P. Zamberlan1 , A.G. Servilha1 , M.A.C. Bonfim1 , V.L.B. Batista1 , R.H. Barnabe1 , D.G. Silva1 , K. Viani1 , A.G.Z. Leite1 . 1 Division of Nutrition, Instituto da Crian¸ca do Hospital das Clínicas da Faculdade de Medicina da Universidade de S˜ ao Paulo, Sao Paulo, Brazil Rationale: The oral supplementation therapy (OST) is an important nutritional strategy for patients who are at risk of malnutrition at admission. However, most nutritional supplements do not have a nice flavor Methods: During a day at a pediatric tertiary hospital, “no flavor” supplements were offered to children and adolescents for their breakfast and afternoon snack. The supplements were added in preferred liquids of them (coffee with milk, milk chocolate, milk thickener, yogurt or juice). The addition of the supplement was informed at the end of the study in order to avoid that that the responses of the patients were not influenced. For the evaluation we used a specific form designed for the study Results: Fifty-one patients ingested the supplement flavor (33 children and 18 adolescents). 72.5% did not feel the supplement flavor; 17.5% noted difference in food flavor and they mentioned “bitter”, “strange” or “sweeter” flavor. 10% of patients did not ingest the supplement for problems related to disease, such as pain, loss of appetite and fasting for procedures. Of the patients who received the supplement, 37% accepted all, 34.8% accepted half and 28.2% less than half offered Conclusion: Sensory evaluation of the supplement was considered satisfactory because over 70% of children did not