Day 1 :
Francois Andre Allaert, Cen Nutriment Dijon, France
Keynote: Grading nutritional health claims by weight of evidence would make for a better-informed public
Time : 09:35-10:15
Francois Andre Allaert is a Medical Doctor specialized in Public Health, completed his PhD in Biostatistics and Pharm D. He is strongly involved in the field of Medical Evaluation and especially in the evaluation of health claim. He is managing a human clinical center specifically approved by French health authorities for food supplement and enriched food evaluation. He is also managing the Chair for Health Claim Medical Evaluation at the Burgundy University of Dijon. He authored more than 1500 scientific oral communications and publications among which 210 are PubMed referred.
In the European Regulation 1924/2006 and especially its first recital; the evaluation of health claims (HC) by European Food Safety Agency (EFSA) was introduced so as “to ensure a high level of consumer protection, [and] give the consumer the necessary information to make choices in full knowledge of the facts…” Now, with 10 years of hindsight since the Regulation was adopted, it can be asked whether EFSA HC process of evaluation that led to a marginal number of accepted claims is consistent with this objective, not just for protecting consumers but for allowing them to decide freely and make informed choices. The aim of this paper is to demonstrate that the inclusion of a ranking of the weight of evidence in the assessment of EFSA’s scientific substantiation of HC would allow consumers to benefit from the very high standard of scientific evaluation performed by EFSA. The definition of standards of proof is a generalized practice and rests on the principle that evaluations of health practices should be understood in terms of descriptions ranging from formal proof from high-power double-blind placebo-controlled studies to rankings based on the consensus views of experts or even agreement among professionals. Grading of weight of evidence – not of scientific expertise – is pervasive in all the recommendations or consensus meetings of health authorities or learned societies. This approach would stimulate research and product innovation as industrials would see a positive return on investment. The transition from an all-or-nothing system of health claims to a system graded by weight of evidence would be an alternative to the current system. This approach would be more consistent with the rationale of European Regulation which aims both to provide consumers with the best possible information by giving them the opportunity to exercise their free will in full knowledge of the facts and to promote research that meets sound scientific and medical grounds providing a basis for such information.
ASL Cagliari, Italy
Keynote: Nutritional hypoproteic approach and phosphate control allows the Incremental Hemodialysis.
Time : 10:15-10:55
Piergiorgio Bolasco is Director of the Territorial Nephrology Department- Cagliari Italy from 20 years. His main vein researches are: New and advanced dialytic techniques, prevention of chronic renal diseases by nutritional and pre-dialysis teams and spending review of methodologies and pharmaco economy. Since 1998, he is using and improving combined nutritional and tailored dialysis, guidelines of water for dialysis, peritoneal dialysis. He is the Reviewer of international journals like: Kidney International, Nephron, Nephrology Dialysis and Transplantation, Journal of Nephrology, American Journal of Kidney Disease, Artificial Organs and BMC Nephrology. He is the Member of Editorial Board of Giornale Italiano di Nefrologia, Journal of Nephrology, Minerva Urologica e Nefrologica, Clinical Nephrology and International Journal of Artificial Organs. He is also a Member of Italian Society of Nephrology since 1980. He is author/co-author of 374 scientific publications and abstracts of Nephrology 68 in med-line.
It is largely agreed that preservation of Residual Kidney Function (RKF) has a directly proportional effect on general and in particular cardiovascular mortality. The prolongation of RKF depends on a rigorous hypoproteic regimen especially in phosphate contents because of a significant output urinary phosphate that continues despite of a severe decrease of residual kidney function. The RKF>3 ml/Kg/die 1.73 sm and nutritional compliance allows to choose a new hemodialytic strategy called Infrequent Hemodialysis (ID) as both are once-weekly (CDDP) or twice-weekly hemodialysis. The nutritional regimen and phosphaturia has been frequently underestimated. The excessive proteic charge and hyperphosphataemia load and damage the residual nephrons. We compared general survival, nutritional, clinical parameters, phosphate pool balance between three patient cohorts: 10 in thrice weekly, 10 in twice weekly and 9 in once weekly hemodialysis patients. We collected over 250 urine collections in patients with RKF. The hemodialysis patients on ID who adhere accurately to a low protein diet of 0.6-0.8 g/Kg/day and phosphate intake 800-1000 mg/day were opted for the study. In view of the significant impact produced by inadequate nutrition and poor phosphate control on both RKF and the frequency of even severe cardiovascular effects, infrequent dialysis with its negative or neutral weekly phosphate balance, may constitute a valid “bridging” treatment even in the long-term. Nutritional approach and neutral phosphate control improved wellbeing and the survival rates (fig.1) compared with respect to patients receiving conventional thrice-weekly hemodialysis.
- Clinical Nutrition| Nutrient related Chronic diseases | Food and Nutrition | Nutrition- Health and Choice | Diet in Obesity & Gastrointestinal Disorders | Nutrition in Pregnancy and Lactation | Vitaminology & Lipidology | Current Research in Nutrition and Dietetics
Francisco J. Senorans
Universidad Autonoma de Madrid, Spain
Mukogawa Womens University, Japan
Scripps Clinic, USA
Time : 11:15-11:45
Gauree G Konijeti is a Gastroenterologist specializing in Inflammatory Bowel Disease (IBD), including Crohn’s disease (CD) and Ulcerative Colitis (UC) at Scripps Clinic in San Diego, CA. She is the Head of the Scripps Clinic Inflammatory Bowel Disease Program as well as a KL2 Clinical-Translational Scholar at the Scripps Translational Science Institute and the Scripps Research Institute. She is trained in Gastroenterology and Hepatology at Massachusetts General Hospital and Harvard Medical School, and completed her Internal Medicine residency at Cedars-Sinai Medical Center and the UCLA West Los Angeles VA Hospital, and attended Medical School at the University of Pennsylvania. She holds a Master of Public Health degree from the University of California, Los Angeles. She conducts research evaluating the role of diet and nutrition for IBD, as well Genetics and Epigenetics, Epidemiology and cost-effective treatments for IBD. She is a member of the Crohn’s and Colitis Foundation of America, the American College of Gastroenterology and the American Gastroenterological Association.
Introduction: Recent data suggest that dietary modification can improve clinical responses in Inflammatory Bowel Disease (IBD). The goal of this study was to determine the tolerability and efficacy of an autoimmune protocol (AIP) diet in patients with Crohn's disease (CD) and ulcerative colitis (UC).
Methods: We have enrolled 18 adult patients with IBD with mild-moderate disease activity (HBI ≥ 5 or partial Mayo score ≥ 3), and objective evidence of active disease (endoscopy within 7 months and/or elevated fecal calprotectin (FC) within 1 month). Three patients withdrew prior to study start due to inability to commit to dietary change. Participants transitioned to the AIP diet over 6 weeks (elimination of grains, legumes, nightshades, dairy, eggs, coffee, alcohol, nuts and seeds, and refined/processed sugars, oils, and food additives) and then maintained the diet for 5 additional weeks. Serial laboratories, fecal calprotectin, microbiome and transcriptome analyses were performed. Endoscopy, radiology, and/or biomarker assessment were performed at study completion to assess for mucosal healing.
Results: The final cohort included 9 patients with CD and 6 with UC. Mean IBD duration was for 19 years (SD 14.6) and active biologic use is in 7 patients. Nutrient repletion was initiated for deficiencies in vitamin D (n=3) and iron (n=6). From week 0 to 6, mean partial Mayo score improved from 5.8 (SD 1.2) to 1.2 (SD 2.0) (p<0.01) Plasma 25-hydroxyvitamin d, vitamin d binding protein, and risk of colorectal cancer in the nurses' health study. Cancer Prev Res (Phila) 9(8): 664-72.for UC, and mean HBI score improved from 7 (SD 1.5) to 3.6 (SD 2.1) (p<0.01). At baseline, CRP was normal (<10) in 66% (10/15). Among those, with labs completed at baseline and week 6, mean CRP (n=11) improved from 8.3 to 7.0 (p=0.46), and mean FC (n=5) improved from 412 (range 80-1078) to 196 (range 0-758) (p=0.36). Among those with follow-up endoscopy at week 11 (n=7), improvements were noted in SES-CD (n=1), Rutgeerts score (n=1), and Mayo endoscopy subscore (n=4). No significant changes in lipid profile were observed at week 6. One patient with ileal CD with stricture withdrew due to worsening symptoms.
Discussion: From this study, it was known that dietary elimination has the potential to improve symptoms and endoscopic inflammation in patients with inflammatory bowel disease. And larger randomized trials are needed to validate these findings.
Universidad AutĂłnoma de Madrid, Spain
Title: Food enrichment with omega-3: New oilseed sources and algal oils for microencapsulation and delivery of healthy lipids
Time : 11:45-12:15
Francisco J Señoráns has developed his research and teaching career in Food Science and Technology in different Spanish and international institutions during the last 25 years. He served in Madrid (CSIC and UAM) and at Uppsala University (Sweden) as Researcher and Lecturer for two years. He has Chemical Sciences PhD and since 2002 he is Professor Titular (Associate Professor) at Universidad Autonoma de Madrid (Spain), where he has been responsible of several research projects and contracts with industry. He was In-charge of the management and creation of the Joint Institute in Food Science Research (CIAL) as a Co-director since its foundation in July 2007. He is co-author of more than 100 publications of international impact (SCI) with h index of 31 (Web of Science) and of several international patents transferred to industry. In 2001, he received the Prize "Archer Daniels" granted by the AOCS. At present, he directs a research team with a sound record of research contract with food and pharma industry, in projects related with healthy lipids, including omega-3 fractionation and enrichment of fish and marine oils, microalgae components extraction with compressed fluids and supercritical technology, and enzymatic technologies for structured lipids, hipocaloric oils, and phospholipids.
Omega-3 fatty acids like EPA and DHA play a vital role in health and correct nutrition, especially during fetal and infant growth. Omega-3 acids are also important for reducing the risk of cardiovascular diseases and prevention of nervous system and inflammatory diseases. Health authorities along the world have promoted the intake of foods that contain higher amounts of omega-3 fatty long chain acids and a favorably ratio ω6/ω3 essential fatty acids. Subsequently, in recent years, there has been a growing interest in alternative sources of omega-3 oils, like new oilseeds (chia (Salvia hispanica L.), camelina (Camelina sativa L.), etc.) and microalgae like Nannochloropsis, Isochrysis and others. Modern extraction techniques such as pressurized liquids extraction (PLE) with “green” solvents have advantages over traditional techniques for oil extraction and allow the replacement of hexane as solvent. At the same time, food enrichment with omega-3 oils requires the protection of the polyunsaturated fatty acids (PUFA) during all the process. Different strategies to this aim include use of synergic antioxidants and microencapsulation of oils. In recent years, there has been a growing interest in microencapsulation for a variety of applications in the food and pharmaceutical industries to protect the active substances, and simultaneously, provide a controlled release of the active substances, masking its unpleasant taste and smell and allowing new forms of delivery of bioactive compounds, such as in this case, healthy lipids with omega-3 in solid form. In addition, the new omega-3 oils are used to produce structured lipids by enzymatic modification, with improved health and nutritional properties that can also be microencapsulated for food enrichment, producing healthy lipids with desired characteristics to improve the lipid profile of final food products.
Mukogawa Womenâs University, Japan
Title: Association Between Functional Performance AbilityAnd Energy Intake In The First Seven Days of Patients after stroke
Time : 12:15-12:45
Noriko Kurokawa has expertise in Nutrition. She is doing Nutrition Management and Nutritional Guidance at Acute Brain Surgery Special Hospital based on Japanese Nutritionist's license. On the other hand, she is conducting research on clinical nutrition in educational institution (graduate school). This model was constructed after the experience of evaluation and management at the workplace brain surgery special hospital, and it is a study on the relation between the body function and energy intake in the acute period of stroke.
Background: The relation between energy intake and outcome in acute phase after onset of stroke, as risk indicators on adverse events are not fully studied, it was examined whether the Functional Independence Measure (FIM) score on admission is a risk indicator for energy intake during the first 7 days of acute phase.
Methods: Patients with stroke, admitted between January 2015 and March 2015, were enrolled. Data on characteristics and nutritional status of patients were collected from electronic medical record. The subjects were divided according to FIM score on admission and energy intake for the first 7 days. The outcome index was: length of stay in SCU, presence of serum C-reactive protein (CRP) ≥ 6mg/dl. The logistic-regression analysis was conducted to examine the length of stay in SCU.
Results: 192 patients were enrolled. (I) Comparing two groups divided by FIM scores on admission: (1) the energy intake in the first seven days was significantly lower in the group of <75 points (median: 75 points, P <0.001). (2) length of stay in SCU ≥ 5 days was significantly longer (median: 5 days, P <0.001), and (3) more patients with CRP ≥ 6mg/dl during the first week (median: 0.6 mg/dl, P=0.024). (II) Comparing two groups divided according to energy intake in the first seven days after admission by target energy intake <50% vs. ≥50% or <66% vs. ≥66%: In the group of <50% and <66%, (4) none of the patients had a FIM score of ≥ 75 points on admission, (5) length of stay in SCU ≥ 5 days was significantly longer, (6) presence of CRP ≥ 6 mg/dl after hospitalization was significantly larger. (III) In multivariate analysis on binary values of length of stay in SCU ≥ 5 days: (7) strongly related to item of energy intake in first seven days <66%, (8) length of stay in SCU ≥ 5 days group vs. <5 days group: odds ratio = 0.165, (0.032-0.845).
Conclusions: These results suggested that FIM score on admission could be a risk indicator of energy intake during stroke attack. In addition, it was suggested that the risk factor of the length of stay in SCU seemed an energy intake (< 66%) during the first seven days after admission.
Mukogawa Womenâs University, Japan
Title: A novel methodology system to educate patients with non-communicable diseases and to evaluate its effectiveness by outcome parameters
Time : 12:45-13:20
Teruyoshi Amagai has completed his MD and PhD from University of Tsukuba, Japan and Clinical Practice from the Birmingham Children’s Hospital in UK during 1993 and 1994. He is the Professor of Mukogawa Women’s University since 2007 and has been In-charge of drawing up member, “Dietary Reference Intakes for Japanese (2015), developed by the Ministry of Health Labor and Welfare, Japanese Government. He is the Editorial Member, Nutrition in Clinical Practice, academic journal of American Society for Parent and Enteral Nutrition (ASPEN).
Background: A number of patients and at risk with non-communicable diseases (NCDs) must be growing year by year. However, as media-mediated information is mixing evidence and non-evidence and it is not easy to identify which is true and vice versa, nutritional education methodology must be essential to cease the growth of number of patients with NCDs.
Aim: To examine an effectiveness of a novel methodology to educate patients with NCDs, such as diabetes (DM), hypertension (HT), dyslipidemia (DL), and chronic kidney disease (CKD), on outcome.
Methods: A novel methodology was developed to educate patients with NCDs using dietary behavior questionnaire (brief self-administered diet history questionnaire: BDHQ) among group-basis. Based on results of individual BDHQ, their reading and aim to resolve their individual problems were discussed among group-basis. Outcome indicators of this education were the clinical objective parameters measured at the first outpatient clinic visited within three months after education, including HbA1c (%), mean blood pressure (mmHg), T-cholesterol (mg/dl), and eGFR, for patients with DM, HT, DL, and CKD, respectively. Then, an effectiveness was evaluated by the changing rate of these parameters, definingă(pre-) – (post-) / (pre) parameterăX100 (%). An effectiveness was made when this rate was above zero among four NCDs. All consecutive patients who have got group education between Apr, 2016 and Mar, 2017 in a single institute, were enrolled.
Results: To be under analyzed and shown in presentation.
Conclusion: This novel diet and nutrition-related education methodology must be analyzed in their effectiveness by changing rate of individual parameters. To our knowledge, this is the first report to study an effectiveness of diet and nutrition-related education for patients with NCDs.
Cen Nutriment Dijon, France
Title: Observational study of the effect of consumption of a magnesium and B vitamins enriched gingerbread on cognitive well-being (mood, stress, sleep)
Time : 14:20-14:50
Medical doctor specialised in Public Health, PhD in biostatistics and Pharm D, Pr Francois-André Allaert is strongly involved in the field of medical evaluation and especially in the evaluation of health claim. He is managing a human clinical center specifically approved by French health authorities for food supplement and enriched food evaluation. He is also managing the chair for health claim medical evaluation at the burgundy university of Dijon. He is authors of more than 1500 scientific oral communications and publications among which 210 are pubmed referred.
Objective: According to European Commission Regulation No 432/2012, the incorporation into food of minerals and oligo-elements which are officially linked to a health claim allows also the “health claim” to the food. Nevertheless, their introduction into various food matrices can potentially influence their effectiveness. The objective of this study was to confirm the effect on daily mood, stress and sleep of a daily intake of magnesium and B-vitamin enriched gingerbread for 3 weeks at the required quantities determined by EFSA ( 30% of RDAs).
Materials: Selection criteria: men or women, aged over 18 years and under 70 years of age, complaining of a mood or stress rated by an MSP-9 scale. Evaluation criteria: MSP-9, Brief Mood Introspection Scale (BMIS) and Spiegel scale for sleep. Daily data collection for 7 days before the consumption of gingerbread and during the last week of consumption on a Smartphone CRF (NursTrial System).
Results: 185 persons aged 39 ± 12 years and mostly female were included in the study. The results show significant reductions in stress assessed by MSP-9, which significantly decreased from 42.6 ± 8.5 to 30.9 ± 8.4 (p <0.0001), a 26% improvement in BMIS-assessed mood from 38.6 6.6 to 47.2 ± 7.3 (p <0.0001), an improvement of 25% and quality of sleep evaluated by the Spiegel scale, which increased from 16.2 ± 3.5 to 19.3 ± 3.6 (p <0.0001) which corresponds to an improvement of 23% . 35.1% of the subject declared they were rather satisfied and 50.3% they were satisfied or very satisfied.
Conclusion: These results confirm that at the quantities required for EFSA health claims, the enrichment of a magnesium and B vitamin B of a gingerbread allows significant improvements in mood, stress and sleep of the subjects.
St. Scholasticaâs College-Manila, Philippines
Title: Factors associated to lifestyle-related diseases among selected call center agents of metro Manila
Time : 14:50-15:20
Christina Isabel F Santisteban has completed her Bachelor of Science degree in Nutrition and Dietetics at St. Scholastica’s College- Manila in 2015. In the same year she received her license as Registered Nutritionist Dietitian. She is currently working as a Wellness Coach/Nutritionist with LiveWell Corporate Solutions Inc.- a company dedicated to provide health and wellness programs to make employees happier and healthier which results to lower attrition and absenteeism among Business Process Outsourcing (BPO) Industries.
The study aimed to determine the prevalence of lifestyle-related diseases (DM, HPN and obesity) and identify the factors associated with it among selected call centre agents in Metro Manila. 310 selected call centre agents were included in the study. Primary data such as weight, height, and body circumference, dietary and physical activity were measured while secondary data were validated from existing records. Pearson correlation was computed for correlation between the independent variables and obesity while Chi-square test was used to determine the association of lifestyle diseases to independent variables. Of the 310 respondents, 8.7% are diabetic while 18.4% are hypertensive. Based on BMI, 61.3% are normal, 14.5% are underweight, and 34.2% are overweight to obese. Based on waist-hip-ratio, 65.2% were at risk and 34.8% have no risk. In terms of diet, majority have inadequate energy intake (71.3%) yet adequate protein intake (76.7%). For physical activity level, more than half (56.5%) were sedentary. For correlation of lifestyle-related diseases and risk factors, all are correlated to each other except for physical activity and energy and protein adequacy. With regards to association, diabetes is associated with age, weight, number of years as a call center agent, BMI and obesity. Hypertension is associated with age, number of years as a call center agent, weight, BMI, waist and hip circumferences, WHR and obesity. Obesity is associated with age, number of years as a call center agent, diabetes and hypertension. Factors associated to lifestyle-related diseases among respondents are age, gender, number of years as a call center agent, BMI, and WHR.
Hakodate Goryoukaku Hospital, Japan
Title: A Clinical advantage of thicken enteral formulae with acidic pH: From study on their effects on different pH in an intra-gastric dynamics
Time : 15:20-15:50
Background: An enteral nutrition (EN) formula has been chosen in clinical practice which varies in the characteristics. Recently the application thicken EN formulae (TEF) with medium viscosity (1000-5000 mPa/s) has been proved to have clinical advantages. TEFs, differ In the followings: 1) rapid rate to administer (400-500 ml/15-30 min) 2) minimal devices necessary 3) pH in an acid of them benefits in clinical practice and medical economic advantages are expected, such as pressure ulcer prevention due to time sparing and keeping sterile using ready-to-hang fashion.
Aims: The aim of the study is to examine TEF effects on gastrointestinal tract dynamics, especially on gastric pH environment.
Method: Healthy subjects ingested two different TEFs with acidic or neutral pH-over 15 minutes were enrolled and their amounts of TEF in the stomach were measured using external ultrasonography (US) method by every 5 minutes between 5 and 120 minutes after ingestion.
Results: There is favoring trend in acidic TEF compared with neutral one in faster excretion from stomach with no side effects, such as diarrhea, abdominal distension and/or pain, or vomiting.
Conclusion: This study could be concluded that acidic TEF seems to have advantages in time-sparing and nutritional effects with no enteral adverse events.
National Nutrition and Food Technology Research Institute, Iran
Title: The challenges and successes of salt, sugar and fat reduction program to prevent NCDs (Iran experiences)
Time : 15:50-16:20
Hajifaraji Majid is a Research Associate Professor in Nutritional Sciences of the National Nutrition and Food Technology Research Institute (NNFTRI), and has been served as Dean of Faculty of Nutritional Sciences and Food Technology (FNSFT) from 2010- 2015 and President of Iranian Nutrition Society (INS) from 2011-2015. He has a PhD in clinical nutrition program at Kings College, London University.
In January 2015, WHO released a global estimate report, which showed more than 1.9 billion overweight adults including 600 million obese people in 2014. Unbalanced diets and low physical activity can contribute to chronic diseases. 65% of Iranian adults 40-64Y are overweight and obese, 45% with hypercholesterolemia and 47% are hypertensive and 42% have low physical activity and 16% identified and non-identified diabetes in total. The studies show that 80% of CVD and Diabetes and 40% of cancers are preventable by controlling the above risk factors and dietary patterns have a pivotal role in the control of NCD's. Two main restrictive policies which performed by Iranian authority to minimize the consumption of fat, salt and sugar: The first one is putting the tax for unhealthy food products and the updated list of unhealthy food products are published every year by Ministry of Health. In this program, tax of unhealthy foods spends on healthcare system. The second strategy is designing of a food traffic light labeling system which easily helps to estimate amounts of fat, salt, sugar and trans-fatty acids in one serving of food products. This system of labeling is mandatory for all of the industrial food products. Within 3 years, we could succeeded to reduce 1- 2.5% salt in bread, snacks, cheeses and sauces. The standard of salt in bread decreased from 2.3% to 1.8% and then 1% in 2016. According to the legislations and operational plans SFA in oil products was reduced to <25% and in food products such as snacks, biscuits and confections <30%. TFA was reduced from >20% to <8% in food products and <2% in edible oils in 2016. As a future plan, the road map in the national nutrition policy and food security in Iran by 2025 is mainly emphasizing on NCDs.
Mukogawa Womenâs University, Japan
Title: A Cumulative Energy Deficit during 7 days is not a Predictor of Severity and Outcomes of Hospital â acquired Pressure Ulcer in Older Adult Patients
Time : 16:20-16:50
I have expertise of clinical nutrition. I am doing nutrition management and nutritional guidance at general hospital based on Japanese nutritionist license. On the other hand, I am conducting research on clinical nutrition in graduate school. This study investigated how nutrient intake before and after the onset of pressure ul participates in prevention and cure of pressure ulcer.
Background: Pressure ulcer (PU) is a financial and physio-psychological burden in hospital settings, especially in the super-aged society.
Aim: To examine an association between energy deficit in the 7 days before PU development and the severity of hospital-acquired PU developed after admission in older adult patients.
Methods: The study was conducted under a retrospective observational design in all consecutive patients admitted to a single general hospital between July 2014 and June 2016. Data collection: 1) demographics domain- sex, age, body weight, body mass index (BMI), Charlson comorbidity index (CCI), 2) PU domain- severity of PU scored by DESIGN-R score, NPUAP score, 3) blood test domain- hemoglobin (Hb), total lymphocyte count (TLC), serum albumin (Alb), C-reactive protein (CRP), Prognostic Nutritional Index (PNI), 4) nutrition domain- cumulative and daily energy and protein intakes 7 days before and 7 or 14 days after PU development, 5) outcome domain- survival status, length of hospital stay in hospital, length of days between admission and PU development. Then the follows were compared: Method 1-blood test data on admission and at development of pressure ulcers; Method 2-all data for subjects between energy sufficient and deficit groups: Method 3- energy intake between mild (NPUAP stage I,II) and severe (stage III, IV).
Results: Method 1: Serum Hb level (p <0.001), serum Alb level (p <0.001), and PNI (p <0.001) at PU development were significantly lower than that on admission. Method 2: no parameters showed a significant difference in energy sufficient and deficit group. Method 3: no significant differences in energy intake during 7 days before PU development and time-related clinical outcomes between mild and severe PU. (Table)
Conclusion: The results of the present study suggests that nutrition support for energy sufficiency during the 7 days before PU development had no impact on the PU severity and time-related outcomes.
San Diego State University, USA
Title: Rapid Improvement in Symptoms and Quality of Life among Patients with Inflammatory Bowel Disease Following an Autoimmune Protocol Diet
Time : 17:10-17:30
Shauna Leigh Groven, BS, is a graduate student currently obtaining a Master of Science in Nutritional Sciences at San Diego State University, as well as completing an ACEND-accredited Didactic Program of Dietetics at San Diego State University. She holds a Bachelor of Science in Biology from Oklahoma Christian University. In addition to her graduate studies, Shauna is participating in a research internship at Scripps Clinic in San Diego, CA, where she is studying the effects of diet and nutrition on the clinical course and outcomes in patients with inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD). She conducts research evaluating diet and vitamin repletion in patients diagnosed with IBD, and performs statistical analysis of patients’ data.
Introduction: Dietary modification can potentially improve clinical symptoms and quality of life in patients with Inflammatory Bowel Disease (IBD), including Crohn’s Disease (CD) and Ulcerative Colitis (UC). In this study of the efficacy of an Autoimmune Protocol (AIP) diet in patients with IBD we examined the effect of the AIP diet on symptoms and quality of life, and compared the efficacy of the AIP diet between CD and UC.
Methods: We enrolled 18 adult patients with IBD with mild-moderate disease activity (HBI ≥ 5 or partial Mayo score ≥ 3) and objective evidence of active disease (endoscopy within 7 months and/or elevated fecal calprotectin within 1 month). Three patients withdrew prior to study start due to inability to commit to dietary modification. In the 11 week uncontrolled trial, patients transitioned to an AIP diet over six weeks, and then maintained the diet for five weeks. By week three, patients eliminated grains, alcohol, legumes, and nightshades. Patients prospectively completed health surveys prior to study start, and at weeks three, six, nine, and 11. Rating scale questions were analyzed by mixed design ANOVA using SPSS 24.0.
Results: Results showed that the final cohort included 15 patients (nine CD, six UC), with mean IBD duration of 19 years (SD 14.6) and active biologic use in seven patients. Nine patients have completed surveys at both baseline and week three. Compared to baseline, there were significant improvements in bowel movement frequency (36%, p=0.04), state relaxation/free of tension (28%, p=0.01), and performance of leisure/sport activities (29%, p=0.02) at week three. Surveys indicated no significant improvements in fatigue (45%, p=0.07) and energy (24%, p=0.14), as well as no significant decrease in frequency of abdominal cramps (6%, p=0.53), worry of surgery (5%, p=0.17), fear of not finding a toilet (6%, p=0.39), and irritable mood (18%, p=0.13). Effects of the AIP diet were not significantly different between CD and UC patients, and yielded no significant interaction between time and IBD subtype.
Discussion: Based on prospective patient-reported health surveys, the AIP diet significantly improved clinical symptoms and quality of life of patients with active CD and UC within the first three weeks. Our data suggests dietary change as a feasible and efficacious adjunct to IBD therapy.
Mukogawa Womenâs University, Japan
Title: Influence of ative moisture balance on outcomes during 7 days after esophageal cancer surgery
Time : 17:30-17:50
Eri Miyamoto has expertise in clinical nutrition. While working at an educational institution, she has learned and guided knowledge of various fields concerning nutrition. Currently she is studying outcome after esophageal cancer surgery.
Background: Esophageal cancer surgery has many postoperative complications even in surgical gastroenterological surgery, and length of hospital stay and mortality rate are also high, mainly due to surgical stress and impairment of water excretion. However, few clear indicator for moisture balance after esophageal cancer surgery exists so far.
Aim: To investigate an effect of cumulative water balance on outcomes.
Methods: All consecutive patients admitted for radical surgery for esophageal cancer (SE) to a single institute January 2013 to December 2013 was enrolled. Exclusion criteria: liver and/or renal dysfunction. The cumulative water balance (WB) within 7 days after SE was calculated and subjects were divided according to the following method to examine outcome prediction factors:(1) WB >= vs. <5,000 ml, (2) WB >= vs. <2,500 ml, (3) average daily WB >= vs. <10ml /kg, (4) average daily WB >= vs. <5 ml /kg.
Results: (1) The group with water intake of >=10 ml /kg / day showed significantly longer antibiotic-free-days than that in another group (9 (5, 9) vs.9 (9, 9), p = 0.022). (2) The group with water intake of >=5 ml /kg/day showed significantly shorter Length of stay in ICU (days) than that in another group (5 (3.5, 6.5) vs. 7 (4.5, 7.5), p = 0.047)
Conclusion: An average water balance during 7 days after esophageal cancer surgery may be a predictor of outcome.