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Introduction: In Cuba, 26% of men and 18% of women die between ages 35-69 years,mainly from vascular, cancer and respiratory causes. Studies are need of the main causes ofchronic diseases in middle age and their risk factors.Objectives: To determine mortality related to tobacco and alcohol in Cuba. 1999- 2011.Methods: 140,000 adults recruited 1997-2000 from 4 provinces in Cuba; 50, 000 men and60,000 women with no reported cancer or CVD at entry. Mean age 53 years. Mean follow-up for mortality 11 years. Specific causes of death were obtained from mortality statistics ofthe Ministry of Health Data matched by name and ID number. Variables: Name, IDnumber, sex, age, education, occupation, marital status, tobacco smoking, alcohol con-sumption, medical history, height, weight, blood pressure. Statistic analysis: Coxregression models, adjusted for age and alcohol.Results: In both men and women, tobacco smoking was more prevalent at younger agesand there was a strong positive association between all-cause mortality and the number ofcigarettes smoked. Mortality was strongly and inversely associated with age startedsmoking, so that male smokers who smoked 20 cigs/day and started before 15 years of agewere at 50% higher risk than never smokers, and female smokers who smoked 20 cigs/daywho started at 10 years of age were at twice the risk of never smokers, stopping youngworks. For those men who had given up before 45 years old there was no excess risk. After5 years the risks approach those of never smokers. Current smoking was associated with

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4-fold risk of lung cancer, upper aero-digestive cancer and chronic obstructive pulmonarydisease (COPD) 50% increased risk of IHD and stroke. There was a strong positive andcontinuous association among men so that the risk of death increased with increasingalcohol consumption.Conclusion: Smoking RRs are lower in Cuba than in US/UK studies for COPD, lungcancer, upper aero-digestive cancer and vascular disease. Starting young causes bigger risk,diminishes >5 years after stopping smoking and giving up before age 45 avoids most of therisk. Alcohol has minimal total mortality in light drinkers.Disclosure of Interest: None Declared

PT308

Networking and coalition buildings, challenges and opportunities: a case study

Wael Abd El Meguid*1,21Technical lead, Coalition For Tobacco Control, Cairo, Egypt, 2Technical lead, Coalition forTobacco Control Egypt, Beiruth, Lebanon

Introduction: Coalition building plays an important role in supporting the TC programms.Lessons learned from a case study from the Middle East region point out the role of anInternational organization in supporting the establishment of the two Coalitions in Egyptand Lebanon by variety of NGOs in collaboration with The MOHP-Egypt and TC, programin Lebanon.Objectives: Coalitions and Networks in Tobacco control, what works and what are theopportunities and challenges, how to overcome the challenges?Methods: Analysis of Strengths, weaknesses, Opportunities and Threats of the NationalTobacco Control Program in Egypt and Lebanon was conducted which identified the scarcefinancial recourses as well as the extreme lack of manpower within the MOH in bothcountries to effectively implement and monitor tobacco control policies in Egypt. Then thepotential members of the proposed coalition came together and agree on working togetherin a unified strategic plan. Netowrking and meetings was conducted for coalitions andpartners to exchange experiences and increase the outcome of the work.Results: Two coalitions developed and acting in different areas of TC to support theministries in their respective countries in fulfilling with TC requirements. The two co-alitions included new members with diverse spheres and geographical distribution to in-crease the outreach and outcome of the work. The coalitions are working on monitoringthe Tobacco Industry as well as identifying new areas of work TC as exploring andadvocating for NCDs.

Conclusion: Recognizing the important role the coalition can play in adding a momentumto the national tobacco control efforts, The Union Middle East office in collaboration withThe Tobacco Control Department Ministry of Health and Population in Egypt and Tobaccocontrol program in Lebanon have facilitated networking and planning by NGOs toestablish and build National Tobacco Control Coalitions. The NGOs members of the co-alitions are collaborating with the MOHP in both countries for implementation of tobaccocontrol polices as they have the needed human resources, wide geographical outreach aswell as the experience to work at the grass root levels.Disclosure of Interest: None Declared

PT312

Healthy Habits Education for Overweight Children Impacts Both Children andCaregivers: a Randomized Clinical Trial

Vanessa Minossi1, Fátima H. Cecchetto1, Lucia C. Pellanda*1,21Post-Graduation Program in Health Sciences: Cardiology, Instituto de Cardiologia / FundaçãoUniversitária de Cardiologia, 2Universidade Federal de Ciências da Saúde de Porto Alegre, PortoAlegre, Brazil

Introduction: Childhood obesity is consistently increasing. It is believed that good resultscan be achieved with the adoption of early strategies directed towards the promotion ofhealth through nutritional guidance and increased physical activity, in conjunction withhealthy lifestyle habits.Objectives: To access the effectivity of a program for healthy habits education for over-weight children in improving LDL-cholesterol and blood pressure both in children andtheir caregivers.

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Methods: Randomized clinical Trial with 93 children from 7 to 11 years. Interventiongroup (IG) received 10 weekly group encounters with children and parents or caregivers,including orientation and ludic activities about food, healthy family habits, physical activityand attitudes. In all activities resources were elaborated to address specific objectives and touse simple and low cost resources. Control group (CG) received usual individual outpatientmanagement with a multidisciplinary team. Outcomes included blood pressure and lipidprofile after intervention. Statistical analysis included ANOVA, repeated measures ANOVAand Mc Nemar test.Results: Mean age was 9.13 � 1.43 years, 52.7% were girls. LDL-cholesterol was abnormalin 17 (35.4%) of children in IG at baseline, reducing to 5 (10.4%) after intervention, whilein CG there was an increase of children with abnormal LDL(p < 0.002). The LDL levelswere abnormal in 8 (16.7%) of caregivers in IG and 7 (15.16%) of CG. After interventions,none of the caregivers of IG showed alterations, while in CG this number rose to 11(24.4%). Mean systolic blood pressure was significantly lower in children of IG comparedto CG after intervention.Conclusion: An education program based in simple and low cost resources may beeffective to reduce LDL-cholesterol both in children and their caregivers, showing thatintervention with children may have extended benefits to their families. The interventionwas also effective in reducing systolic blood pressure in children.Disclosure of Interest: None Declared

PT313

Knowledge About Healthy Habits and Risk Factors for Cardiovascular Disease: aRandomized Clinical Trial With Schoolchildren

Fátima H. Cecchetto1, Daniela B. Peña2, Vanessa Minossi1, Lucia C. Pellanda*1,31Post-Graduation Program in Health Sciences: Cardiology, 2Instituto de Cardiologia / FundaçãoUniversitária de Cardiologia, 3Universidade Federal de Ciências da Saúde de Porto Alegre, PortoAlegre, Brazil

Introduction: In recent decades, childhood obesity has been considered as a globalepidemic, present among all socioeconomic classes and ethnic groups. In this context, thereis an urgent need to focus on early prevention. Although genetic factors can influencesusceptibility to weight gain, the consensus is that a sedentary lifestyle, changes in dietarypractices and changes in family structures are factors that contribute to this epidemic. Newforms of interventions should be developed and improved.Objectives: To ascertain the impact of ludic workshops on children’s knowledge andself-care.Methods: This was a randomized, clinical trial with 79 students aged 7-11. Anthropo-metric measurements were collected and two questionnaires were applied at baseline, andagain after three months, just after eight ludic workshops were implemented. The twoquestionnaires were: the typical day of physical activity (TDPA) and a questionnaire aboutknowledge, healthy habits and risk factors for cardiovascular disease (QKHHRFCD), bothvalidated to portuguese.Results: The intervention group contained 40 students, while the control group contained39. The average age (10.03 � 1.1) was the same in both groups. The scores concerningknowledge and practice of physical activity were similar at the baseline evaluation. Aftertwo months, the intervention group showed significant improvement (p<0.005) in thescores for knowledge and increased physical activity. There was a reduction in the BMIpercentile of the intervention group, but there was no significant statistical difference be-tween the two groups.Conclusion: The data suggests that knowledge may be improved by . education and healthstrategies using ludical techniques. In the long term, these can be beneficial in helping tocontrol childhood weight and improve self-care when performed in conjunction with otherstrategies.Disclosure of Interest: None Declared

PT314

Motivating Indian youth to embrace walking – the Ground Miles Challenge

Radhika Shrivastav*1, Manjusha Chatterjee2, Nikunj Sharma1, Ima Chopra1,Prerna Bharadwaj1, Monika Arora21Hriday, 2PHFI, New Delhi, India

Introduction: Globally, more people die from CVDs than from any other cause. In 2008,CVDs claimed 17.3 million lives and, by 2030, it is expected that number will increase toover 23 million. Physical inactivity is the fourth leading risk factor for global mortality (afterhigh blood pressure, tobacco use and high blood glucose), and is a key risk factor forCVDs. In India, annual CVD-related deaths are projected to rise from 2.7 million to 4million in 2030. Effective health promotion strategies targeted at youth are much needed toencourage healthy lifestyles, including adequate physical activity. Campaigns that effec-tively engage youth have a strong potential to get amplified to reach families, schools andcommunities at large. HRIDAY is partnering with the Public Health Foundation of India(PHFI), WHF, Bupa and Max Bupa for an innovative walking campaign – GROUND MILES(GM), supported by a robust smartphone App which enables walkers to track the distancewalked and meet their walking goals.Objectives: Motivating youth to actively embrace walking as a sustainable medium formaintaining adequate levels of physical activity, tracking the distance they walk andadvocating for walking-friendly environment and policies.Methods: Nearly 5000 youth from three Indian cities (Delhi, Mumbai and Vishakha-patnam) will be mobilized to join the global GM challenge and participate in walking eventsorganized by Indian partners. Engagement with schools has already commenced and there

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is an enthusiastic response to the campaign, as well as the App. To ‘warm up’ the youngadvocates for the walking events scheduled in October-November 2013, interactive ses-sions, including intra-and inter-school poster making competitions on the theme ofwalking. These precursor activities will commence around World Heart Day 2013.Results: The GM Challenge will be evaluated through participation in walking events,download and usage of the App. Social media activities, digital engagement and mediacoverage will also be important measures of success for the overall campaign, coupled withkey advocacy initiatives to promote walking-friendly policies.Conclusion: The campaign which will run from October-December 2013, has the po-tential to pitch walking as a ‘youthful’ and fun activity and boost youngsters to adoptregular walking – which will potentially have significant impact on their heart health asadults.Disclosure of Interest: None Declared

PT315

Oil usage practices among small and medium sized vendors in South Delhi, India

Archna Singh*1, Aarti Srivastava2, Richa Bisht3, Anita Singh11Biochemistry, All India Institute of Medical Sciences, New Delhi, 2Indian Institute of PublicHealth, Gurgaon, 3UNICEF-ECHO, Shivpuri, India

Introduction: Policy and advocacy efforts are ongoing to minimize trans fatty acid con-sumption in India, in the context of the increasing chronic disease burden driven by un-healthy nutrition practices and choices. Trans fat consumption in India is considered to bechiefly through hydrogenated oils i.e. vanaspati. In addition, the fatty acid composition ofoils also affects its quality for consumption due to susceptibility to degradative processeslike peroxidation etc.Objectives: This study aimed to assess oil usage practices among small and medium sizedvendors in an area of Delhi, India. Such vendors are a substantial source of freshly preparedready-to-eat snacks in India.Methods: The study sites were selected from the census enumeration block list, mappedfor vendor numbers and location; participants were selected by a random number gen-eration . The survey was conducted amongst 50 vendors using a pretested questionnaire in2011-2012 after obtaining informed consent.Results: 19/26 (73.1%) of vendors had daily earnings of <2000INR. The mean number ofemployees in the establishments (n¼47; 3 had �20 employees) was 4. Soy bean oil (86%)was the most frequently reported frying medium (43/50). 60% of vendors (n¼30) wereusing vanaspati for cooking (shortening as well as deep frying). Availability (34%) was thecommonest reason cited for choice of oils followed by taste and health factors (20% each).11 types of freshly prepared deep fried snacks were reported being sold; common onesbeing bread pakora (n¼32) (bread savoury), samosa (potato filled flaky pastry; n¼30) andaloo tikki (potato cakes; n¼21). Cast iron utensils (Karahis) were most commonly used byvendors for deep frying. 42/50 (84%) vendors reported intermittent heating and re-heatingof oils during the workday; 20 vendors were reusing the leftover oil/fat on the followingday. None of the vendors were using any scientific method to check the temperature of thefrying medium. Only 5 /50 (10%) vendors surveyed were aware of the term “trans fattyacid” and its possible health impacts.Conclusion: Regular and frequent use of hydrogenated oils for preparing snacks was re-ported by food vendors with minimal knowledge about hydrogenated oils . Approaches tominimize unhealthy oil consumption should include targeted awareness campaigns amongvendors and promotion of optimal cooking/food preparation practices. Policy makerswould benefit from such evidence to formulate policies to facilitate the implementation ofthese strategies.Disclosure of Interest: None Declared

PT316

Bringing data to life – an interactive online mapping tool for clinicians and healthplanners

Harry Patsamanis*1, Greg Ford1, Steve Vander Horn2, Karen Page3, Hella Parker41Victorian Division, National Heart Foundation of Australia, 2University of Melbourne, 3NationalHeart Foundation of Australia, 4Victorian Department of Health, Melbourne, Australia

Introduction: The National Heart Foundation (HF) in collaboration with The University ofMelbourne and The Victorian Health Department developed an interactive online mappingtool that visually presents the rate of hospital separations for acute coronary syndrome(ACS) and heart failure at the local level. The tool takes hospital level data and presents it ina format that is engaging for both clinicians and health planners. Data on risk factors andsocio-economic status was included to assist with population health planning and chronicdisease prevention.Objectives: To take data that is already collected by government departments and make itmeaningful at a local level for agencies and health workers who deliver prevention andtreatment programs.Methods: Five years of hospital data and key risk factor and socio- demographic data wasanalysed to enable comparisons to be made between local populations, identifying trendsand patterns of presentation and risk. A software mapping program StatPlanet was used tovisually represent the data and allow for interactive search and discovery.Results: In total, 79 local government areas were mapped allowing for meaningful com-parisons at the local and regional level.The maps identified major differences in the distribution of heart disease across the state

of Victoria; these were most evident between metropolitan and regional areas and thoseliving in areas of greater social disadvantage; for example regional areas had a 37% higheradmission rate for ST elevation myocardial infarction than metropolitan areas.

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