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PP163-MON: Metabolic Transformation of Apple Polyphenols in Human Body
Nutritional assessment the prevalence of overweight and obesity according to the criteria of the World Health Organization. Results: Among 148 pupils, 51 (34.45%) were males, while 97 (65.54%) were females, the mean and standard deviation of Z-score of BMI: 0.15±1.5 kg/m2 . The prevalence of overweight and obesity was 34.5% (95% CI [26.5%, 42.5%]) and 10.1% (95% CI [4.9%, 15.3%]) respectively; and 8.8% (95% CI [3.9%, 13.7%]) represented underweight children. The prevalence of overweight was higher in boys (52.9%; 95% CI [38.3%, 67.6%]) than girls (24.7%; 95% CI [15.6%, 33.8%]). Conclusion: This study found a relatively high prevalence of overweight and obesity among children of 13 years old in Algeria. Nutrition education is absent in Algerian school, we recommend to promote programs to prevent overweight including nutrition interventions at the national level in Algeria. Disclosure of Interest: None Declared.
PP161-MON THE ASSESSMENT OF NUTRITIONAL STATUS IN CHILDREN WITH CANCER USING ANTHROPOMETRY AND THE BIOELECTRICAL IMPEDANCE METHOD M.I. Chincesan1 , M. Oana1 , G. Alina1 . 1 Pediatric Department, University of Medicine and Pharmacy TG Mures, Romania Rationale: The measurement of body composition is important in assessing nutritional status in children with cancer. Besides of anthropometry, the bioimpedance analysis is a useful method in assessing body composition. Methods: We prospectively assessed 47 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided into two groups: Group I, 17 patients with cancer, and Group II, the control group consisting of 30 age- and gender-matched patients with different pediatric diseases. Weight, height, body mass index (BMI), middle upper arm circumference (MUAC), tricipital skinfold thickness (TST) were comparatively evaluated. Fat mass (FM; kg, %), fat free mass (FFM, kg), muscle mass (MM, kg) and total body water (TBW; kg, %) were measured using Tanita BC420 S MA Analyzer. Results: The weight, height and BMI of children in Group I were lower compared with Group II, without statistically significant difference. We also found a statistically significant difference among the MUAC ( 0.10 DS vs 1.31 DS; p = 0.01) and TST ( 0.01 DS vs 1.35 DS; p = 0.01). Group I had significantly lower percent FM (14.79±7.14 vs 21.56±9.06; p = 0.01) and significantly higher percent TBW (61.84±4.93 vs 57.45±6.64; p = 0.02) compared with Group II. No significant differences in any other body composition components between Group I and Group II were obtained. Conclusion: Compared with the control group, children with cancer had higher alterations of nutritional status. The assessment of nutritional status using the bioimpedance method provides important information on body composition and allows for a more careful monitoring of nutritional risk. Acknowledgment: This paper is supported by the project 14/30.01.2013: “The assessment of nutritional status in children with cancer” project financed by internal research grants from The University of Medicine and Pharmacy, TîrguMure¸s, Romania. Disclosure of Interest: None Declared.
S189 PP162-MON PREOPERATIVE NUTRITIONAL ASSESSMENT FOR PREDICTING COMPLICATIONS RISK IN PATIENTS UNDERGOING ABDOMINAL SURGERY D. Karayiannis1 , Z. Bouloubasi1 , D. Konstantinou2 , M. Chourdakis3 , D. Magganas2 , S. Drakopoulos2 . 1 Department of Clinical Nutrition and Dietetics, 2 1st Department of Surgery, Organ Transplatation Unit, Evangelismos General Hospital, Athens, 3 School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Rationale: Existence of malnutrition prior to a surgery comprises a risk factor for postoperative complications, prolonged hospitalization and increased morbidity. The aim of this study was to evaluate the predictive power of nutritional risk screening tools along with established medical and surgical parameters in a sample patients undergoing abdominal surgery. Methods: This was a prospective observational study of 214 adult patients (mean age 61.3±12.8 years; 52% female) who underwent abdominal surgery. Nutritional screening was performed with the use of the “Nutritional Risk Screening” (NRS 2002) and the “Malnutrition Universal Screening Tool” (MUST). The “Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity” (POSSUM), was used to predict morbidity. Multiple linear regression was used to assess variables predictive capability for the detection of postoperative complications. Results: A high prevalence of malnourished patients was detected with both NRS 2002 (59.4%, 127 patients) and MUST (Medium Risk: 43.9%, 94 patients and High Risk: 11.7%, 25 patients). Among the 86 patients with complications, 58 (68.2%) were detected as being malnourished (preoperative NRS score >3, p < 0.002). Malnutrition (OR 1.27, 95% CI 1.11 1.43), weight loss over the past 3 months (OR 1.58, 95% CI 1.11 1.43), comorbidity (OR 2.27, 95% CI 1.93 2.60), duration of hospitalization (OR 2.00, 95% CI 1.78 2.22), POSSUM Score (OR 2.21, 95% CI 1.81 2.83) and severity of surgery (OR 2.72, 95% CI 2.31 3.12) were indicated as the main factors significantly associated with postoperative complications. Conclusion: In a group of patients undergoing abdominal surgery, NRS 2002 but not MUST screening tool was associated with the risk of postoperative complications. Disclosure of Interest: None Declared.
PP163-MON METABOLIC TRANSFORMATION OF APPLE POLYPHENOLS IN HUMAN BODY K. Trost1 , M. Ulaszewska1 , J. Stanstrup1 , F. Natella2 , C. Scaccini2 , F. Mattivi1 . 1 Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all’Adige, 2 Food and Nutrition Research Center, Consiglio per la Ricerca e la sperimentazione in Agricoltura, Rome, Italy Rationale: Fruit and vegetables are claimed to have beneficial effect on human health mostly due to their high polyphenol (PP) content. (1) Regular consumption is protective against age related diseases and different forms of cancer (2). As PP are largely metabolized both by the human organism and gut
S190 microbiota, identification of the forms of metabolites and the kinetics of their appearance into the circulation is essential for understanding their possible bioactivity in humans. Methods: In order to evaluate absorption and transformation of apple polyphenols, a human single-dose crossover controlled blind experiment was designed. In 2 different sessions 12 subjects were supplemented with apple juice (1 g/l total PF) or polyphenol enriched apple juice (4 g/l total PF). Urine and plasma samples were collected at different time points and analyzed using an untargeted metabolomics approach. Results: Scarcely metabolized polyphenols were recognized as potential biomarkers. These compounds showed two different kinetic patterns. Epicatechin methyl sulfate, ferulic acid sulfate and phloretin glucuronide reached their maximal concentration 1 hour after apple juice supplementation. While, the methyl, sulfate and glucuronide conjugates of valerolactons had their peak concentration 5 hours after the supplementation. The concentration of the majority of the biomarkers showed an increase four times greater in high PP diet than in low. Conclusion: Untargeted metabolomics allowed identification of biomarkers of apple consumption and demonstrated that an increase in polyphenol intake corresponds to an increase of circulating metabolites within the limits of ‘normal’ consumption. Thus, if the beneficial effects of these compounds are confirmed, it might prove beneficial to increase their plasma concentration by increasing their intake or choosing polyphenols richer foods. References [1] Del Rio et al., 2013; ARS, 18: 1818 1892. [2] Gerhauser, 2008. Planta Med. 74: 1608 24. Disclosure of Interest: None Declared.
PP164-MON COMPARISON OF TWO NUTRITIONAL ASSESSMENT METHODS IN CANCER PATIENTS H.B. Abreu1 , G.D. Ceniccola1 , L.G. Barbosa1 , I.M. Wanderley1 , B.A.F. Toscano1 , M.S. Coelho1 , A.P.R. Silva1 . 1 Clinical nutrition, SES DF, Brasilia, Brazil Rationale: Malnutrition can occur in 60% to 80% of the cancer patients. Thus nutritional assessment should be performed early and nutritional intervention initiated when deficits are detected. The aim of this study was to investigate the correlation between Subjective Global Assessment (SGA) and the Nutritional Risk Index (NRI) in cancer patients. Methods: All cancer‘s patient, at least 18 years old, were evaluated at hospital admission. A trained dietitian performed assessments of nutritional status within 72 h of admission with ASG and NRI methods. Statistical analyses were performed with SPSS version 19. The study was approved by the local Ethics Committee and all patients signed an informed consent form. Sensitivity and specificity of the methods used to assess nutritional status were calculated considering SGA as the gold standard. Results: We assessed 118, these was enrolled 108 patients, 56 (51.9%) men, and total mean of age 55 years (±16.8). The frequency of cancer was 61.1% in the gastrointestinal tract, 12% gynecological, 15.7% blood related cancers, 4.6%urological; and 6.5% others. Malnutrition rate with ASG was 79.6%, Severe malnutrition was recognized in 29.6%. The NRI assessment
Poster presentations presented 86.1% of prevalence for malnutrition and 34.3% for severe malnutrition. In the present study, NRI showed the high sensitivity (91.9%) in the detection of malnutrition in cancer patients, but its specificity was low (63.6%). Conclusion: NRI presented good Sensibility with ASG, what works well for identifying undernourished patients. NRI may be another important assessment tool applied to oncologic hospitalized population, offering complementary information to ASG, because utilizes objective parameters also. The nutritional status of patients can be better accessed with a combination of evaluation methods during the hospitalisation period. Another studies with larger groups of patients are needed to establish a more solid evaluation. Disclosure of Interest: None Declared.
PP165-MON A NEW CHALLENGE OF THE EVALUATION OF MALNUTRITION USING TSF (TRICEPS SKINFOLD THICKNESS) AND AMC (ARM MUSCLE CIRCUMFERENCE) T. Ohta1,2,3,4 , T. Sugimoto1 , Y. Kiyasu1 , K. Hayashi1 , C. Kojima2 , M. Suzuki3 , A. Ohashi4 , Y. Ueta4 , T. Matsushita4 , H. Okuno4 . 1 Gastroenterogical Surgery, 2 Nursing, 3 Pharmacy, 4 Nutritional support, Kameda Medical Center, Kamogawa, Japan Rationale: The importance of physical measurement, such as triceps skinfold thickness (TSF) and arm muscle circumference (AMC) is often referred in many textbooks, but there are a few studies related to the significance of TSF and AMC. Methods: 122 patients (64 males and 54 females) of suffering surgical disease were selected for this study. We extracted six parameters (1, TP; 2 ALB; 3, CRP; 4, TLC; 5, BMI, 6, MNA-SF) from the patients and obtained an average value of each quadrants. We made a coordinate that the X axis is TSF and the Y axis is AMC and the average values of TSF and AMC in all patients at the first examination is zero points. The data for each patient was plotted. We classified the patients located in each quadrant into four types of malnutrition (1st: light malnutrition, 2nd: Marasmus, 3rd: Marasmus Kwashiorkor, 4th: Kwashiorkor). We performed the analysis of variance (ANOVA) of the average values and tested by the multiple comparison of Sheffe’s S analysis. We created a survival curve by Kaplan Meier method in each group, and performed a comparison of the survival rate by log rank test. Results: In males, the average values of BMI and MNA-SF were decreased significantly from first quadrant to third quadrant, but the average values of each quadrant in TP, ALB, TLC and CRP were not significantly different. Although we observed similar trends in females, there was a significant difference only between first quadrant and third quadrant in the average value of BMI. The survival rate of patients in third quadrant in man was significantly low and median survival time in third quadrant is 234 days. Conclusion: We can diagnose the type of nutritional disorders based on the concept of protein-energy malnutrition (PEM) by utilizing TSF and AMC for nutrition assessement. By estimating the severity of malnutrition and the mortality, it is possible to perform active intervention in more severe malnutrition patients. Disclosure of Interest: None Declared.
PP161-MON THE ASSESSMENT OF NUTRITIONAL STATUS IN CHILDREN WITH CANCER USING ANTHROPOMETRY AND THE BIOELECTRICAL IMPEDANCE METHOD M.I. Chincesan1 , M. Oana1 , G. Alina1 . 1 Pediatric Department, University of Medicine and Pharmacy TG Mures, Romania Rationale: The measurement of body composition is important in assessing nutritional status in children with cancer. Besides of anthropometry, the bioimpedance analysis is a useful method in assessing body composition. Methods: We prospectively assessed 47 consecutively hospitalized patients in a tertiary emergency pediatric hospital. The patients were divided into two groups: Group I, 17 patients with cancer, and Group II, the control group consisting of 30 age- and gender-matched patients with different pediatric diseases. Weight, height, body mass index (BMI), middle upper arm circumference (MUAC), tricipital skinfold thickness (TST) were comparatively evaluated. Fat mass (FM; kg, %), fat free mass (FFM, kg), muscle mass (MM, kg) and total body water (TBW; kg, %) were measured using Tanita BC420 S MA Analyzer. Results: The weight, height and BMI of children in Group I were lower compared with Group II, without statistically significant difference. We also found a statistically significant difference among the MUAC ( 0.10 DS vs 1.31 DS; p = 0.01) and TST ( 0.01 DS vs 1.35 DS; p = 0.01). Group I had significantly lower percent FM (14.79±7.14 vs 21.56±9.06; p = 0.01) and significantly higher percent TBW (61.84±4.93 vs 57.45±6.64; p = 0.02) compared with Group II. No significant differences in any other body composition components between Group I and Group II were obtained. Conclusion: Compared with the control group, children with cancer had higher alterations of nutritional status. The assessment of nutritional status using the bioimpedance method provides important information on body composition and allows for a more careful monitoring of nutritional risk. Acknowledgment: This paper is supported by the project 14/30.01.2013: “The assessment of nutritional status in children with cancer” project financed by internal research grants from The University of Medicine and Pharmacy, TîrguMure¸s, Romania. Disclosure of Interest: None Declared.
S189 PP162-MON PREOPERATIVE NUTRITIONAL ASSESSMENT FOR PREDICTING COMPLICATIONS RISK IN PATIENTS UNDERGOING ABDOMINAL SURGERY D. Karayiannis1 , Z. Bouloubasi1 , D. Konstantinou2 , M. Chourdakis3 , D. Magganas2 , S. Drakopoulos2 . 1 Department of Clinical Nutrition and Dietetics, 2 1st Department of Surgery, Organ Transplatation Unit, Evangelismos General Hospital, Athens, 3 School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece Rationale: Existence of malnutrition prior to a surgery comprises a risk factor for postoperative complications, prolonged hospitalization and increased morbidity. The aim of this study was to evaluate the predictive power of nutritional risk screening tools along with established medical and surgical parameters in a sample patients undergoing abdominal surgery. Methods: This was a prospective observational study of 214 adult patients (mean age 61.3±12.8 years; 52% female) who underwent abdominal surgery. Nutritional screening was performed with the use of the “Nutritional Risk Screening” (NRS 2002) and the “Malnutrition Universal Screening Tool” (MUST). The “Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity” (POSSUM), was used to predict morbidity. Multiple linear regression was used to assess variables predictive capability for the detection of postoperative complications. Results: A high prevalence of malnourished patients was detected with both NRS 2002 (59.4%, 127 patients) and MUST (Medium Risk: 43.9%, 94 patients and High Risk: 11.7%, 25 patients). Among the 86 patients with complications, 58 (68.2%) were detected as being malnourished (preoperative NRS score >3, p < 0.002). Malnutrition (OR 1.27, 95% CI 1.11 1.43), weight loss over the past 3 months (OR 1.58, 95% CI 1.11 1.43), comorbidity (OR 2.27, 95% CI 1.93 2.60), duration of hospitalization (OR 2.00, 95% CI 1.78 2.22), POSSUM Score (OR 2.21, 95% CI 1.81 2.83) and severity of surgery (OR 2.72, 95% CI 2.31 3.12) were indicated as the main factors significantly associated with postoperative complications. Conclusion: In a group of patients undergoing abdominal surgery, NRS 2002 but not MUST screening tool was associated with the risk of postoperative complications. Disclosure of Interest: None Declared.
PP163-MON METABOLIC TRANSFORMATION OF APPLE POLYPHENOLS IN HUMAN BODY K. Trost1 , M. Ulaszewska1 , J. Stanstrup1 , F. Natella2 , C. Scaccini2 , F. Mattivi1 . 1 Food Quality and Nutrition, Research and Innovation Centre, Fondazione Edmund Mach, San Michele all’Adige, 2 Food and Nutrition Research Center, Consiglio per la Ricerca e la sperimentazione in Agricoltura, Rome, Italy Rationale: Fruit and vegetables are claimed to have beneficial effect on human health mostly due to their high polyphenol (PP) content. (1) Regular consumption is protective against age related diseases and different forms of cancer (2). As PP are largely metabolized both by the human organism and gut
S190 microbiota, identification of the forms of metabolites and the kinetics of their appearance into the circulation is essential for understanding their possible bioactivity in humans. Methods: In order to evaluate absorption and transformation of apple polyphenols, a human single-dose crossover controlled blind experiment was designed. In 2 different sessions 12 subjects were supplemented with apple juice (1 g/l total PF) or polyphenol enriched apple juice (4 g/l total PF). Urine and plasma samples were collected at different time points and analyzed using an untargeted metabolomics approach. Results: Scarcely metabolized polyphenols were recognized as potential biomarkers. These compounds showed two different kinetic patterns. Epicatechin methyl sulfate, ferulic acid sulfate and phloretin glucuronide reached their maximal concentration 1 hour after apple juice supplementation. While, the methyl, sulfate and glucuronide conjugates of valerolactons had their peak concentration 5 hours after the supplementation. The concentration of the majority of the biomarkers showed an increase four times greater in high PP diet than in low. Conclusion: Untargeted metabolomics allowed identification of biomarkers of apple consumption and demonstrated that an increase in polyphenol intake corresponds to an increase of circulating metabolites within the limits of ‘normal’ consumption. Thus, if the beneficial effects of these compounds are confirmed, it might prove beneficial to increase their plasma concentration by increasing their intake or choosing polyphenols richer foods. References [1] Del Rio et al., 2013; ARS, 18: 1818 1892. [2] Gerhauser, 2008. Planta Med. 74: 1608 24. Disclosure of Interest: None Declared.
PP164-MON COMPARISON OF TWO NUTRITIONAL ASSESSMENT METHODS IN CANCER PATIENTS H.B. Abreu1 , G.D. Ceniccola1 , L.G. Barbosa1 , I.M. Wanderley1 , B.A.F. Toscano1 , M.S. Coelho1 , A.P.R. Silva1 . 1 Clinical nutrition, SES DF, Brasilia, Brazil Rationale: Malnutrition can occur in 60% to 80% of the cancer patients. Thus nutritional assessment should be performed early and nutritional intervention initiated when deficits are detected. The aim of this study was to investigate the correlation between Subjective Global Assessment (SGA) and the Nutritional Risk Index (NRI) in cancer patients. Methods: All cancer‘s patient, at least 18 years old, were evaluated at hospital admission. A trained dietitian performed assessments of nutritional status within 72 h of admission with ASG and NRI methods. Statistical analyses were performed with SPSS version 19. The study was approved by the local Ethics Committee and all patients signed an informed consent form. Sensitivity and specificity of the methods used to assess nutritional status were calculated considering SGA as the gold standard. Results: We assessed 118, these was enrolled 108 patients, 56 (51.9%) men, and total mean of age 55 years (±16.8). The frequency of cancer was 61.1% in the gastrointestinal tract, 12% gynecological, 15.7% blood related cancers, 4.6%urological; and 6.5% others. Malnutrition rate with ASG was 79.6%, Severe malnutrition was recognized in 29.6%. The NRI assessment
Poster presentations presented 86.1% of prevalence for malnutrition and 34.3% for severe malnutrition. In the present study, NRI showed the high sensitivity (91.9%) in the detection of malnutrition in cancer patients, but its specificity was low (63.6%). Conclusion: NRI presented good Sensibility with ASG, what works well for identifying undernourished patients. NRI may be another important assessment tool applied to oncologic hospitalized population, offering complementary information to ASG, because utilizes objective parameters also. The nutritional status of patients can be better accessed with a combination of evaluation methods during the hospitalisation period. Another studies with larger groups of patients are needed to establish a more solid evaluation. Disclosure of Interest: None Declared.
PP165-MON A NEW CHALLENGE OF THE EVALUATION OF MALNUTRITION USING TSF (TRICEPS SKINFOLD THICKNESS) AND AMC (ARM MUSCLE CIRCUMFERENCE) T. Ohta1,2,3,4 , T. Sugimoto1 , Y. Kiyasu1 , K. Hayashi1 , C. Kojima2 , M. Suzuki3 , A. Ohashi4 , Y. Ueta4 , T. Matsushita4 , H. Okuno4 . 1 Gastroenterogical Surgery, 2 Nursing, 3 Pharmacy, 4 Nutritional support, Kameda Medical Center, Kamogawa, Japan Rationale: The importance of physical measurement, such as triceps skinfold thickness (TSF) and arm muscle circumference (AMC) is often referred in many textbooks, but there are a few studies related to the significance of TSF and AMC. Methods: 122 patients (64 males and 54 females) of suffering surgical disease were selected for this study. We extracted six parameters (1, TP; 2 ALB; 3, CRP; 4, TLC; 5, BMI, 6, MNA-SF) from the patients and obtained an average value of each quadrants. We made a coordinate that the X axis is TSF and the Y axis is AMC and the average values of TSF and AMC in all patients at the first examination is zero points. The data for each patient was plotted. We classified the patients located in each quadrant into four types of malnutrition (1st: light malnutrition, 2nd: Marasmus, 3rd: Marasmus Kwashiorkor, 4th: Kwashiorkor). We performed the analysis of variance (ANOVA) of the average values and tested by the multiple comparison of Sheffe’s S analysis. We created a survival curve by Kaplan Meier method in each group, and performed a comparison of the survival rate by log rank test. Results: In males, the average values of BMI and MNA-SF were decreased significantly from first quadrant to third quadrant, but the average values of each quadrant in TP, ALB, TLC and CRP were not significantly different. Although we observed similar trends in females, there was a significant difference only between first quadrant and third quadrant in the average value of BMI. The survival rate of patients in third quadrant in man was significantly low and median survival time in third quadrant is 234 days. Conclusion: We can diagnose the type of nutritional disorders based on the concept of protein-energy malnutrition (PEM) by utilizing TSF and AMC for nutrition assessement. By estimating the severity of malnutrition and the mortality, it is possible to perform active intervention in more severe malnutrition patients. Disclosure of Interest: None Declared.