S98 Poster presentations

the intervention group or isocaloric, non-enriched bread (4 gof protein) and drinking yoghurt (8 g of protein) in thecontrol group as part of their daily meals. Food intake ofthe participants was measured and nutritional values werecalculated according to the Dutch Food Composition Table.An independent samples t-test was used to compare proteinintake between intervention and control group.Results: The use of enriched products resulted in a signif-icantly increased protein intake (table). Bread and drinkingyoghurt contributed almost equally to the increased intake ofprotein in the intervention group.

Control group(n = 25)

Intervention group(n = 22)

P-value

Protein intake (g) 58±15 75±33 0.039Protein intake (g/kg/day) 0.9±0.3 1.1±0.5 0.041Protein requirement a (%) 8% 36% 0.030

Data are presented as mean±SD, unless stated otherwise.a Percentage of patients reaching the minimum protein requirement of1.2 g/kg/day.

Conclusion: The use of protein-enriched bread and drinkingyoghurt, consumed as part of regular meals, is a promisingand feasible solution to increase the protein intake of acutelyill elderly. It needs to be confirmed whether a longer-term useof these products in larger groups of patients will also resultin better clinical outcomes.

Disclosure of Interest: None Declared.

PP209-SUNEVALUATION OF GUT MICROBIOTA AND FECAL SHORT CHAINFATTY ACIDS IN OBESE AND ANOREXIC PATIENTSL. Santarpia1, C. Iervolino2, C. Del Piano1, I. Torre2,F. Contaldo1, F. Pasanisi1. 1Department of Clinical Medicineand Surgery, Internal Medicine and Clinical Nutrition,2Department of Hygiene and Preventive Medicine, Federico IIUniversity, Naples, Italy

Rationale: Determining the variations of microbial communi-ties and Short Chain Fatty Acids (SCFA) levels in feces maybe beneficial to identify specific profiles in patients withabnormal body weight.Methods: Intestinal bacterial flora in 18 (3M, 15F; 22±4 years;14.1±1 kg/m2) patients with Anorexia Nervosa (AN), in 16(9M, 7F; 37±11 years; 45±7 kg/m2) obese (OB) and in 16(6M, 10F; 38±14 years; 22±3 kg/m2) healthy controls wasevaluated.Different bacterial divisions (Bacteroidetes, Firmicutes, Bifi-dobacterium, Lactobacillus and the methanogen M. smithii)were identified both with real-time PCR and microbiologicaltechniques; fecal SCFA were quantified with gaschromatogra-phy; caloric and macronutrient intakes were evaluated toowith food questionnaires.Results: The bacterial concentrations evaluated were not sig-nificantly different between the groups. A significantly lowerfecal SCFA content was observed in AN (butyric p < 0.001;propionic p = 0.001 and acetic acid p = 0.026) compared withOB patients.Conclusion: The strong reduction in fecal SCFA in AN comparedwith OB patients might represent an adaptive use of nutrientsin thess populations.

Disclosure of Interest: None Declared.

PP210-SUNIMPLEMENTATION OF A QUALITY MANAGEMENT SYSTEMACCORDING TO ISO 9001:2008 IN A NUTRITION UNITC. Velasco1, C. Cuerda1, L. Frías1, A. Alonso1, I. Breton1,M. Camblor1, I. Izquierdo2, R. Pla2, P. García-Peris1. 1Unidadde Nutricion Clínica y Dietetica. Instituto de InvestigacionSanitaria Gregorio Maranon., 2Servicio de MedicinaPreventiva y Gestion de la Calidad, Hospital GregorioMaranon, Madrid, Spain

Rationale: To describe the process of implementing a qualitymanagement system (QMS) according to the standard ISO9001:2008 in a Nutrition Unit.Methods: The implementation began in October 2012.Nutrition Unit was supported by Hospital Preventive Medicineand Quality Management Service (PMQM). Initially trainingsessions on QMS and ISO standards for staff were held. QualityCommittee (QC) was established with representation of themedical and nursing staff. Every week, meeting took placeamong members of the QC and PMQM to define processes,procedures and quality indicators.Results: A total of 4 processes were identified and docu-mented (Nutritional status assessment, Nutritional treatment,Monitoring of nutritional treatment and Planning and controlof oral feeding) and 13 operating procedures in which all theactivity of the Unit were described. The interactions amongthem were defined in the processes map. Each process hasassociated specific quality indicators for measuring the stateof the QMS, and identifying opportunities for improvement. Allthe documents associated with requirements of ISO 9001:2008were developed: quality policy, quality objectives, qualitymanual, documents and records control, internal audit,nonconformities and corrective and preventive actions.The unit was certified by AENOR in April 2013.Conclusion: The implementation of a QMS causes a reorgani-zation of the activities of the Unit in order to meet customer’sexpectations. Documenting these activities ensures a betterunderstanding of the organization, defines the responsibilitiesof all staff and brings a better management of time andresources. QMS also improves the internal communication andis a motivational element.Disclosure of Interest: None Declared.

PP211-SUNEARLY NUTRITIONAL FACTORS ASSOCIATED WITH BODYCOMPOSITION IN LATE ADOLESCENCE IN A BIRTH COHORTIN SOUTHERN BRAZILS.P. Orlandi1, D.A. Gonzalez-Chica2, M.C. Gonzalez3,R. Buffarini1, M.C.F. Assuncao1. 1Post-Graduate Program inEpidemiology, Federal University of Pelotas, Pelotas, 2Post-Graduate Program in Nutrition, Federal University of SantaCatarina, Florianopolis, 3Post-Graduate Program in Healthand Behavior, Catholic University of Pelotas, Pelotas, Brazil

Rationale: Recent studies have established the relationshipbetween nutritional status in adulthood with several early andcontemporary conditions. Thus, the present study aimed toevaluate the association between duration of breastfeedingand age at introduction of complementary feeding in the firstmonths of life with body composition at 18 19 years of age.Methods: A prospective cohort study with a subsample of 1438adolescents belonging to birth cohort in Pelotas, southernBrazil. Data related to breastfeeding and complementary

Nutritional epidemiology S99

feeding was obtained systematically from birth to 12 monthsof life. Fat Mass Index (FMI) and Fat-Free Mass Index(FFMI) were determined at ages 18 19 by plethysmography(BOD POD™). Analysis was stratified by sex and adjusted forpotential confounders using a linear regression model.Results: After adjusted no significant associations were foundbetween FMI and breastfeeding or age at introduction ofcomplementary foods for both sexes. A significant associationwas found between FFMI and breastfeeding for both male andfemale (p = 0.004 and p = 0.035, respectively). Three monthsof breastfeeding were sufficient to observe in girls beneficialeffect of breastfeeding on FFMI (b = 0.98, 95% CI: 0.18, 1.77),while for boys the significant increase in FFMI was onlyobserved from six months of breastfeeding (b = 1.20, 95% CI:0.39, 2.01). In females introducing complementary food afterfive months was associated with a lower FFMI (p = 0.036).Conclusion: The data presented suggest that, in bothsexes, breastfeeding influences the FFMI in early adulthood,determining a significant increase. The introduction of com-plementary food was only associated with FFMI in females. Nosignificant associations were found to FMI.

Disclosure of Interest: None Declared.

PP212-SUNMEDITERRANEAN DIETS BETWEEN EUROPE AND THE MIDDLEEAST: THE CASE OF LEBANONN. Hwalla1, L. Nasreddine1, A. Sibai1, L. Itani1, F. Naja1.1American University of Beirut, Beirut, Lebanon

Rationale: To propose a score for assessing adherence toa “Middle-Eastern” version of the Mediterranean diet asrepresented by the traditional Lebanese Mediterranean diet(LMD), to assess the correlation between the LMD score andselected scores of other Mediterranean diets (MD); to examinesocio-demographic and lifestyle determinants of adherence toMD including the LMD among Lebanese adults.Methods: Using nationally representative dietary intake dataof Lebanese adults, a score to measure adherence to theLMD was calculated. The choice of food groups used in thecalculation of the LMD score was based on results of previousfactor analyses conducted on the same dataset. These foodgroups included fruits, vegetables, legumes, olive oil, burghol,dairy products, starchy vegetables, dried fruits; eggs. OtherMD scores belonging to Greece, Spain, Italy, France, EPIC werealso calculated.Results: Fruits, vegetables and olive oil were common de-nominators to all MD scores. Food groups, specific to the LMD,included burghol and dried fruits. The LMD score significantlycorrelated with all the European MD indexes, while beingthe closest to the Italian (r = 0.57) and the farthest fromthe French (r = 0.21). Percent agreement between the scores’tertile distributions and Kappa statistics confirmed thesefindings. Multivariate linear regression showed that olderage, higher educational, female gender, and healthy lifestylecharacteristics were associated with increased adherence toall MD studied.Conclusion: By proposing a score for adherence to aMiddle-Eastern MD, the findings of this study complementinternational efforts to characterize the MD and its associationwith disease risk.

Disclosure of Interest: None Declared.

PP213-SUNSWALLOWING DISTURBANCES IN PARKINSON’S DISEASEE. Cereda1, C. Klersy2, R. Cilia3, M. Canesi3,A.L. Zecchinelli3, C.B. Mariani3, S. Tesei3, G. Sacilotto3,N. Meucci3, M. Zini3, I.U. Isaias3, E. Cassani3, S. Goldwurm3,M. Barichella3, G. Pezzoli3. 1Nutrition and Dietetics Service,2Fondazione IRCCS Policlinico San Matteo, Pavia, 3ParkinsonInstitute, Milano, Italy

Rationale: Swallowing disturbances are an important issuein Parkinson’s disease (PD) as several studies have shownthat they are associated with increased risk of aspirationpneumonia and mortality. Information about factors relatedto swallowing disturbances, such as disease duration, age atassessment and concomitant dementia, is limited and wouldbe useful for their management.Methods: All consecutive out-patients evaluated at a move-ment disorders clinic (Parkinson Institute, Milan) over a 7-yearperiod (2007 2014), meeting the UK Brain Bank criteria foridiopathic PD, were included in the present cross-sectionalretrospective study. Presence of swallowing disturbances wasassessed using the specific item of the Non Motor SymptomQuestionnaire.Results: In the whole PD population (N = 6,462), prevalenceof swallowing disturbances was 11.7% (95% CI, 10.9 12.5).Multivariable logistic regression analysis disclosed a significantinteraction between disease duration and gender (P= 0.009).In both gender strata, swallowing disturbances were sig-nificantly associated with older age at assessment, longerdisease duration and dementia (P< 0.005 for all). However,the associations with age and disease duration were morepronounced in male patients. In non-demented patients,swallowing disturbances were associated with male gender,age and disease duration (P< 0.001 for all). In dementedpatients an association was found only with male gender(P= 0.018) and disease duration (P< 0.001).Conclusion: Gender, age, disease duration and dementiaall seem to contribute to the occurrence of swallowingdisturbances independently. However, the role played bythese factors in sub-groups of patients stratified by gender andconcomitant dementia suggests that swallowing disturbancesare likely related to different neuro-degenerative patternswithin the brain. The underlying mechanisms deserve furtherinvestigation.

ReferencesBarichella M, Cereda E, Pezzoli G. Mov Disord 2009; 24: 1881 92.

Disclosure of Interest: E. Cereda Grant/Research Support from:Nutricia Italia, Speaker bureau of: Nutricia Italia, C. Klersy: NoneDeclared, R. Cilia: None Declared, M. Canesi: None Declared, A.Zecchinelli: None Declared, C. Mariani: None Declared, S. Tesei: NoneDeclared, G. Sacilotto: None Declared, N. Meucci: None Declared,M. Zini: None Declared, I. Isaias: None Declared, E. Cassani: NoneDeclared, S. Goldwurm: None Declared, M. Barichella: None Declared,G. Pezzoli: None Declared.