Book of abstracts 2017 by International Congress of Nutritionists

17th-19th November 2017 Zagreb, Croatia

IMPRESSUM: Organizatori / Organizators Hrvatski akademski centar primijenjenog nutricionizma / Croatian Academic Centre for Applied Nutritional Science Hrvatski Zbor Nutricionista / Croatian Association of Nutritionists Nutricionizam Balans / Association Nutrition Balance Partneri u organizaciji / Partners Američko društvo za parenteralnu i enteralnu prehranu / American Society for Parenteral and Enteral Nutrition Slovensko strukovno udruženje nutricionista i dijetetičara / Slovene Nutritionists and Dietitians Association Klinika za dječje bolesti Zagreb / Children’s Hospital Zagreb Klinički bolnički centar Split / Clinical Hospital Centre Split Udruga studenata Prehrambeno biotehnološkog fakulteta ‘’Probion’’ / Student Association of Faculty of Food Technology and Biotechnology ‘’’Probion’’ Nakladnik / Publisher Hrvatski akademski centar primijenjenog nutricionizma Croatian Academic Centre for Applied Nutritional Science Uredništvo / Editorial Board Hrvatski akademski centar primijenjenog nutricionizma Croatian Academic Centre for Applied Nutritional Science Grafička priprema i tisak / Graphic design and press Unikat grafika, Bibinje Naklada / Number of Copies 400 primjeraka / copies

Zagreb, 2017. ISBN 978-953-59317-1-3 CIP zapis je dostupan u računalnome katalogu Nacionalne i sveučilišne knjižnice u Zagrebu pod brojem 000975674 Mišljenja, nalazi, zaključci i preporuke iznesene u knjizi sažetaka ne reflektiraju nužno stavove uredništva i odgovornost su samih autora. Opinions, findings, conclusions, and recommendations outlined in the Book of abstracts do not necessarily reflect Editorial attitudes and are the responsibility of the authors themselves.

www.kongresnutricionista.com hacpn.hr@gmail.com info@udruga-hzn.com nutricionizam.os@gmail.com

Organizacijski odbor Organisation Commitee

Predsjednica / Chair Tena Niseteo Dopredsjednice / Vice Chairs Dora Bučan Andrea Gvozdanović Ostali članovi organizacijskog odbora / Other Members of Organisation Commitee Dora Babić, Valerija Bukvić, Hrvoje Centner, Sanja Ćosić, Maja Gradinjan Centner, Ana Ilić, Josipa Mađarić, Karmen Matković Melki, Marija Petras, Sara Sila, Nataša Šoštarić

ZNANSTVENI ODBOR Scietific Commitee

Predsjednica / Chair Irena Colić Barić Faculty of Food Technology and Biotechnology, University of Zagreb Članovi / Members Branislava Belović, Daniela Čačić Kenjerić, Nataša Fidler, Sanja Kolarić Kravar, Milica Martinović, Fuad Pašić, Milka Popović, Jasmina Ranilović, Ivana Rumbak, Mauro Serafini, Darja Sokolić, IrzadaTaljić, Miroslav Venus

Organizatori

Organizators

Hrvatski akademski centar primijenjenog nutricionizma

Croatian Academic Center for Applied Nutritional Science

Hrvatski zbor nutricionista

Croatian Association of Nutritionists

Nutricionizam Balans

Association Nutrition Balance

Partneri u organizaciji

Partners

Američko društvo za parenteralnu i enteralnu prehranu

American Society for Parenteral and Enteral Nutrition

Slovensko strukovno udruženje nutricionista i dijetetičara

Slovene Nutritionists and Dietitians Association

Klinika za dječje bolesti Zagreb

Children’s Hospital Zagreb

Klinički bolnički centar Split

Clinical Hospital Centre Split

Udruga studenata Prehrambeno biotehnološkog fakulteta ‘’Probion’’

Student Association of Faculty of Food Technology and Biotechnology ‘’’Probion’’

Udruga Nutricionizam Balans

Klinika za dječje bolesti Zagreb

TLOCRT DVORANA VENUE FLOOR PLAN PRIZEMLJE GROUND FLOOR

LOBBY

POLUKAT MEZZANINE

LOBBY

Sljeme

Cloakroom

Toilet facilities

LOBBY

ZLATNI SPONZOR GOLDEN SPONSOR

SREBRNI SPONZOR SILVER SPONSOR

Službena voda kongresa official congress water

SPONZOR GALA VEČERE GALA DINNER SPONSOR

BRONČANI SPONZOR BRONZE SPONSOR

SPONZOR ENO-GASTRO EVENTA OENO-GASTRO EVENT SPONSOR

SPONZORI RADIONICE WORKSHOP SPONSORS

SPONZOR NAGRADE ZA NAJBOLJE ZNANSTVENO ISTRAŽIVANJE Prize sponsor for best scientiffic research

SPONZOR SEKCIJE SESSION SPONSOR

SLUŽBENA KAVA KONGRESA OFFICIAL CONGRESS COFFEE

SPONZORI Sponsors

Dragi kolege i prijatelji

Dear Colleagues and Friends

U ime Organizacijskog odbora želim Vam dobrodošlicu na na 5. Međunarodni kongres nutricionista koji će se održati od petka 17. do nedjelje 19. studenoga 2017., u Zagrebu.

On behalf of the Organizing Committee I am delighted to welcome you to the 5th International Congress of Nutritionists to be held from Friday17 to Sunday 19November 2017, in Zagreb, Croatia.

Štoviše, željela bih zahvaliti svim posjetiteljima, predavačima, izlagačima sažetaka, moderatorima i partnerima, pokroviteljima, sponzorima i donatorima za postizanje velikog uspjeha 5. Međunarodnog kongresa nutricionista.

Moreover, I would like to thank all delegates, speakers, abstract presenters, chairs, and industry partners for making the 5th International Congress of Nutritionists a great success.

Međunarodni kongres Nutricionista pruža idealnu platformu za komunikaciju između nutricionista i zdravstvenih djelatnika, istraživača, inovatora te industrije i pružatelja usluga i proizvoda koji se odnose na prehranu i nutricionizam u širokom smislu riječi. Sve veći broj posjetitelja i bogati znanstveni sadržaj čine Međunarodni kongres nutricionista smislenim i snažnim susretom stručnjaka iz područja prehrane i nutricionizma diljem Europe, ali i šire!

International Congress of Nutritionists provides an ideal platform for communication between nutritionists and health care professionals, researchers, innovators and providers of products and services related to nutrition overall. Growing attendance rate, the rich scientific content and the worldwide interest turned International Congress of Nutritionists into a meaningful and strong meeting of nutrition experts all over the Europe and wider!

Ove smo godine postigli zapanjujuć i rekordan doprinos svih uključenih strana! 5. Međunarodni kongres nutricionista privukao je više od 400 posjetitelja iz više od 7 zemalja i više od 30 predavača iz Hrvatske i svijeta što ga čini najvećim regionalnim okupljanjem stručnjaka iz područja nutricionizma. Kongres nudi izlagačima sažetaka veliki prostor za objavljivanje svojih najnovijih rezultata istraživanja te s ponosom možemo reći da se svake godine broj podnesenih sažetaka udvostručuje. Čast mi je biti dio Organizacijskog odbora ovog rastućeg međunarodnog susreta te Vas pozivam da i u budućnosti sudjelujete u stvaranju ovog velikog događaja.

This year, we have reached an overwhelming and a record-breaking contribution of all involved parties! The 5th International Congress of Nutritionists has attracted more than 400 delegates from 7 countries and more than 30 presenters from Croatia and all over the world. The Congress offeres abstract presenters a stage to publish their latest research results and we are proud to say that every year there is a double number of submitted abstracts. I feel honored to be a part of Organization Committee of this growing international meeting therefore I invite you to be a part of it in the future.

Zahvaljujemo vam se što ste dio 5. Međunarodnog kongresa nutricionista i veselimo se sljedećem druženju u listopadu 2018. u našem glavnom gradu Zagrebu!

We thank you all for being a part of 5th International Congress of Nutritionists and look forward to welcoming you again in October 2018 in our capital city, Zagreb!

Dr.sc. Tena Niseteo, dipl.ing.preh.teh.

Predsjednica Organizacijskog odbora 5. Međunarodnog kongresa nutricionista Predsjednica Hrvatskog Saveza Nutricionista

Tena Niseteo, MSc, PhD,

Organizing Committee Chair of 5th International Congress of Nutritionists President of Croatian Federation of Nutritional Associations www.kongresnutricionista.com |

Hrvatski Savez Nutricionista

Hrvatski Savez Nutricionista (HSN) je krovno udruženje, odnosno nacionalna zajednica udruga nutricionista i dijetetičara u Republici Hrvatskoj. HSN je osnovan 03. lipnja 2017. godine u cilju ujedinjenja nutricionista i udruga nutricionista u jedinstvenu i snažnu skupinu koja zajednički djeluje u cilju promicanja, razvitka, unapređenja ali i očuvanja nutricionističke struke s jasno definiranim načinom i stupnjem obrazovanja. Hrvatski Savez Nutricionista organizator je Međunarodnog Kongresa Nutricionista koji se održava jednom godišnje. Kongres je poseban po tome što okuplja ne samo nutricioniste već i stručnjake različitih grana znanosti od prehrambenih tehnologa i inženjera preko agronoma,liječnika i ostalih zdravstvenih djelatinka, farmaceuta, kineziologa, svedo psihologa koji dijele iste interese, a sve s ciljem razmjene najnovijih znanstvenih saznanja povezanih s nutricionizmom kao znanosti. Vizija Hrvatskog Saveza Nutricionista jest kao krovno udruženje, odnosno nacionalna zajednica, ujediniti sve postojeće udruge nutricionista i/ili dijetetičara u cilju kvalitetnije suradnje i podrške među nutricionistima na području Republike Hrvatske, a sve u svrhu promicanja društvenog položaja nutricionistate stvaranja kvalitetnih uvjeta za rad, znanstvena istraživanja i međunarodnu suradnju.

Misija Hrvatskog Saveza Nutricionista je poboljšanje društvenog položaja nutricionista,ali i kompetencija nutricionista vođenjem brige o njihovim potrebama i interesima te cjeloživotnoj izobrazbi i trajnom usavršavanju,ali i osviješćivanje i edukacija javnosti o važnosti pravilne prehrane u skladu s kampanjama gradskih, državnih, europskih i svjetskih krovnih zdravstvenih i nezdravstvenih institucija te organizacija. Ciljevi Hrvatskog Saveza Nutricionista su: ▶ Organiziranje Međunarodnog Kongresa Nutricionista jednom godišnje ▶ Organiziranje savjetovanja, predavanja, seminara, tribina i drugih stručnih i promotivnih skupova struke ▶ Poticanje stručnog i znanstvenog rada na području nutricionizma ▶ Skrb o izobrazbi i trajnom usavršavanju nutricionista ▶ Informiranje javnosti i izdavanje stručnih mišljenja za javnost ▶ Suradnja sa zdravstvenim i nezdravstvenim ustanovama i zavodima na teritoriju Republike Hrvatske ▶ Suradnja s inozemnim i internacionalnim udruženjima i institucijama

| www.kongresnutricionista.com

Croatian Federation of Nutrition Associations The Croatian Federation of Nutrition Associations (CFNA) is a national organization which acts as an umbrella society of nutritionists and dieticians in Croatia. CFNA was founded on the 3rd of June 2017 in order to unite nutritionists and nutritionists’ associations into a unique and powerful association that works together to promote, develop, improve and preserve the nutritists’ and dietitian’ professions which have a clearly defined education. The Croatian Federation of Nutrition Associations is the organizer of the International Congress of Nutritionists which is held every year. This Congress is unique as it brings together not only nutritionists, but also experts from various fields of science with same interest and aim: food technologists and engineers, agronomists, medical doctors and other allied health professionals, pharmacists, kinesiologists, and psychologists and offers them the platform for exchanging the latest scientific knowledge related to nutritional science. The vision of the Croatian Federation of Nutrition Associations is to bring together all the existing associations of nutritionists and/or dieticians in order to improve cooperation and support among nutritionists on the territory of Croatia in purpose to promote the social status of nutritionists in Croatia and creating high quality conditions for work, scientific research and international cooperation. The mission of the Croatian Federation of Nutrition

Associations is to improve the social status of nutritionists and their competences by taking care of their professional needs and interests as well as lifelong education and training, but also to promote, raise awareness and educate the public on the importance of proper nutrition in line with the campaigns of City, State, European and World healthcare institutions and organizations as well as food industry and educational institutions. The general aims of Croatian Federation of Nutrition Associations are: ▶ An annually organization of the International Congress of Nutritionists ▶ Organizing consultations, lectures, seminars, forums and other professional and promotional meetings ▶ Encouraging professional and scientific work in the field of nutrition ▶ Taking care of lifelong education and continuous training of nutritionists ▶ Informing and communicate with public regarding expert position statements regarding nutrition in wide range ▶ Cooperation with health and other (nonhealth) institutions and on the territory of the Republic of Croatia ▶ Cooperation with foreign and international associations and institutions

www.kongresnutricionista.com |

HRVATSKI AKADEMSKI CENTAR PRIMIJENJENOG NUTRICIONIZMA

snovni cilj Udruge je ujediniti stručnjake koji se bave nutricionizmom te srodnim i komplementarnim djelatnostima i time stvoriti jedinstveni i složni milje koji će omogućiti promicanje, razvitak i unapređenje prehrambene svijesti, prevenciju razvoja bolesti i poboljšanje kvalitete života pojedinca i društva u cijelosti. Hrvatski akademski centar primijenjenog nutricionizma (HACPN) okuplja članove iz područja nutricionizma, prehrambene tehnologije, biotehnologije, agronomije, medicine, farmacije, psihologije, kineziologije i gastro-enologije u cilju cjelovitog pristupa prehrani i zdravlju. Od svog osnutka 2014. godine, rad i djelovanje HACPN-a uključuje niz uspješnih projekata poput suorganizacije 3. i 4. Međunarodnog kongresa nutricionista, partnerstvo na EU projektu „Slatka dijetetika“ s Pučkim otvorenim učilištem, vođenje projekta FoodRevolutionDay za Republiku Hrvatsku te izdavanje prvog nutricionističkog časopisa za stručnu i opću javnost „Hranologija“. Službena web stranica www.hacpn.hr

HRVATSKI ZBOR NUTRICIONISTA

rvatski Zbor Nutricionista (HZN) osnovan je 2011. godine kao prva strukovna Udruga nutricionista u Republici Hrvatskoj u cilju međusobnog povezivanja nutricionista te promoviranja i unaprjeđenja struke. Strukovnim povezivanjem, stručnim i profesionalnim usavršavanjem te suradnjom s drugim istovrsnim i sličnim udrugama i organizacijama u zemlji i inozemstvu, HZN potiče stručni i znanstveni rad na području nutricionizma.U svrhu promicanja društvenog položaja dipl. ing. nutricionizma, magistara nutricionizma i doktora nutricionizma HZN surađuje s državnim institucijama kao i drugim srodnim udrugama i savezima. U budućnosti je cilj i dalje poticati stručan i znanstveni rad kao i razvijati izdavačku djelatnost na području nutricionizma te nastaviti misiju edukacije javnosti o važnosti pravilne prehrane u održanju zdravlja i u potpori liječenju bolesti. Službena web stranica www.udruga-hzn.com Udruga Nutricionizam UDRUGA NUTRICIONIZAM BALANS Balans

druga Nutricionizam Balans osnovana je 2011. godine s ciljem promicanja zdravlja na znanstveno utemeljenim načelima. Iste godine udruga otvara vrata savjetovališta u Osijeku i Virovitici koje je namijenjeno osobama s pitanjima o pravilnoj prehrani i zdravom načinu života. Udruga surađuje sa brojnim srodnim udrugama i organizacijama (Hrvatski Cochrane ogranak, Hrvatski zbor nutricionista, ZZJZ “Sv. Rok”, HACPN, Medicinski fakultet Osijek, Hrvatska agencija za hranu,...).Prvi u Hrvatskoj su pokrenuli program koji uključuje multidisciplinarni pristup mršavljenju, pri kojem su u rad s klijentom uključeni liječnik, nutricionist i osobni trener. Udruga je od samog početka uključena u organizaciju Međunarodnog kongresa nutricionista. Službena web stranica www.nutricionizam-balans.com

| www.kongresnutricionista.com

CROATIAN ACADEMIC CENTER FOR APPLIED NUTRITIONAL SCIENCE

he main goal of Croatian Academic Centre for Applied Nutritional Science (CACANS) is to create a unique group of members who will work together on promotion, development and improvement of nutritional awareness, quality of life and disease prevention using integrated approach to nutrition and health. CACANS mission is to promote the development and improvement of nutritional and complementary professions, encourage further development of nutritional science in Croatia and its implementation in practice, and nutritional education of general and professional public in accordance to international, local and European Union standards. Our vision is to become and remain an institution whose work will result in concrete and clearly visible improvement in education, awareness and quality of life for the society. Since it was founded in 2014, CACANS was a part of a number of successful projects such as the co-organization 3rd and 4th International Congress of Nutritionist, partnership in the EU project “Sweet dietetics” with the POU Zagreb, project management of Croatian Food Revolution Day and publishing first nutritional magazine for professional and general public “Hranologija”. Official web page www.hacpn.hr

CROATIAN ASSOCIATION OF NUTRITIONISTS

he Croatian Association of Nutritionists (CroAN) was founded in 2011 as the first professional association of nutritionists in the Republic of Croatia in order to connect nutritionists and promote and improve the profession. Through professional connectivity, technical and professional training and cooperation with other similar associations and organizations within the country as well as internationally, CroAN promotes professional and scientific work in the field of nutrition. In order to promote the social position of bacc. of nutrition, MA Nutrition and PhD nutrition, CroAN cooperates with government institutions and other related organizations and associations. In the future, we aim to continue to encourage professional and scientific work as well as the development of publishing activities in the field of nutrition and will continue our mission to educate the public about the importance of adequate nutrition in order to maintain health and support of the treatment of diseases. Official web page www.kongresnutricionsta.com

Udruga Nutricionizam ASSOCIATION NUTRITION BALANCE Balans

he Association Nutrition Balance was established in 2011 with the aim of promoting health on a scientifically funded basis. In the same year, the association opens the door to the counselingcenter in Osijek and Virovitica, which is intended for people with issues of proper nutrition and healthy lifestyle. The association cooperates with numerous affiliated associations and organizations (Croatian Cochrane Branch, Croatian Association of Nutritionists, ZZJZ “Sv. Rok”, HACPN, Faculty of Medicine Osijek, Croatian Food Agency, ...).We were first in Croatia to launch a program that includes a multidisciplinary approach to client when considering weight loss, involving a doctor, a nutritionist, and a personal trainer. From the very beginning, the association has been involved in the organization of the International Congress of Nutritionists. Official web page www.nutricionizam-balans.com www.kongresnutricionista.com |

Partneri u organizaciji Partners

AMERIČKO DRUŠTVO ZA PARENTERALNU I ENTERALNU PREHRANU Razvoj parentalne prehrane 1968. godine omogućio je novi pristup liječenju te pružanje skrbi pacijentima u vidu brige o njegovom prehrambenom statusu. Nastankom nove terapije pokazala se potreba za osnutkom organizacije te je 1975. godine u Chicagu 35 zainteresiranih zdravstvenih djelatnika osnovalo Američko društvo za parenteralnu i enteralnu prehranu (ASPEN) s interdisciplinarnim karakterom. ASPEN je osnovan u svrhu pružanja optimalne prehrane svim ljudima u svim uvjetima u svakom trenutku. Pioniri ASPEN-a prepoznali su važnost istraživanja, obrazovanja, kliničke prakse, propagiranja i interdisciplinarnog pristupa u području nutritivne terapije. Društvo je počelo objavljivati znanstveni časopis 1977. godine, Journal of Parenteral and Enteral Nutrition i časopis za kliničku praksu 1985. godine, Nutricionizam u kliničkoj praksi, koji su indeksirani od strane Nacionalne knjižnice za medicinu. ASPEN Rhoads Research Foundation osnovana je 1992. godine u čast dr. Rhoadsa i nastavlja s financiranjem osnovnih i kliničkih istraživanja prehrane. ASPEN danas ima više od 6500 članova i nastavlja svoju ponosnu tradiciju koja se bori za najbolju prehrambenu podršku temeljenu na dokazima za naše pacijente. AMERICAN SOCIETY FOR PARENTERAL AND ENTERAL NUTRITION The development of parenteral (intravenous) nutrition in 1968, an innovative therapy to nourish individuals during illness and starvation, provided an option to healthcare clinicians concerned with their patients’ nutritional status. This newly developed therapy gave birth to an organization, the American Society for Parenteral and Enteral Nutrition (ASPEN) when in 1975, 35 dedicated healthcare professionals met in Chicago to create an interdisciplinary association. ASPEN was founded for the purpose of providing optimal nutrition to all people under all conditions at all times. The pioneers of ASPEN recognized the importance of research, clinical practice, advocacy, education, and an interdisciplinary approach to nutrition support therapy. The Society began publishing a scientific journal in 1977, the Journal of Parenteral and Enteral Nutrition, and a clinical practice journal in 1985, Nutrition in Clinical Practice, both of which are indexed by the National Library of Medicine. The ASPEN Rhoads Research Foundation was developed in 1992 to honor Dr. Rhoads and continues to fund basic and clinical nutrition research. ASPEN today has more than 6,500 members and continues its proud tradition of championing the best evidence-based nutrition support for our patients. 16

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SLOVENSKO STRUKOVNO UDRUŽENJE NUTRICIONISTA I DIJETETIČARA (SNDA) je neprofitna organizacija koja ima dugu tradiciju unutar lokalnog područja. SNDA predstavlja važnu poveznicu za svoje članove, promiče interese nutricionista i dijetetičara, promiče ugled i vještine svojih članova te organizira stručne sastanak, seminare i radionice. Štoviše, organizacija povremeno objavljuje stručni bilten pod nazivom Dietetikus te mnoge druge informativne publikacije. SNDA je član Europske federacije udruga dijetetičara (EFAD). SLOVENE NUTRITIONISTS AND DIETITIANS ASSOCIATION (in the following SNDA) is a nonprofit organisation with a long tradition within local area. SNDA represents interests of professional nutritionists and dieticians, provides a reputation as well as proficiency of their members, and organizes professional meeting, seminars, workshops, etc. Moreover, the organization periodically publishes a professional bulletin entitled Dieteticus and many other informative publications. SNDA is a member of European Federation of the Associations of Dietitians (EFAD).

KLINKA ZA DJEČJE BOLESTI ZAGREB Klinika za dječje bolesti osnovana je 1904. godine kao Dječji odjel Bolnice milosrdnih sestara u Zagrebu. To je bio prvi dječji odjel u našoj zemlji, a osnovao ga je i vodio do 1920. godine prvi hrvatski pedijatar, Dr. Radovan pl. Marković (1884. - 1920.). U drugoj polovici dvadesetog stoljeća Odjel postaje Klinika i jedna je od vodećih pedijatrijskih ustanova u zemlji. Danas, Klinika za dječje bolesti Zagreb se sastoji od Klinike za pedijatriju, Klinike za dječju kirurgiju te nekoliko zavoda i nemedicinskih odjela. Klinika za pedijatriju ima 2 zavoda i 3 klinička odjela s 3 referentna centra Ministarstva zdravstva i socijalne skrbi te kroz specijalističko-konzilijarnu i dijagnostičku službu godišnje se pregleda više od 25.000 djece. Klinika za dječju kirurgiju jedina je dječja kirurška klinika u Republici Hrvatskoj te okuplja gotovo polovicu hrvatskih dječjih kirurga na jednome mjestu, s mogućnošću izvođenja gotovo svih operacijskih zahvata na malom bolesniku. Osim domaćih kirurga, u proteklih 25 godina radilo je i boravilo dvadesetak multidisciplinarnih kirurških timova iz najboljih svjetskih dječjih bolnica iz SAD-a, Švedske, Švicarske, Njemačke, Francuske, Nizozemske i Engleske. Klinika za dječje bolesti Zagreb prepoznala je ulogu nutricionista u svojim timovima te danas zapošljava ukupno 5 nutricionista u sklopu Referentnog centra Ministarstva zdravstva za dječju gastroenterologiju i poremećaje prehrane, Zavoda za dječju onkologiju i hematologiju ”Dr. Mladen Ćepulić” te Odjela prehrane. CHILDREN’S HOSPITAL ZAGREB The University Department of Pediatrics was established in 1904 as Department of Pediatrics at Sestre milosrdnice Hospital in Zagreb, as the first pediatric department in Croatia, founded and headed until 1920 by Dr. Radovan Marković, the first Croatian pediatrician. In the second half of the 20th century, the Department grew into University Department and one of the leading pediatric institutions in Croatia. Today, Children’s Hospital Zagreb consists of the Pediatric Clinic, Clinic for Pediatric Surgery and several institutes and no-medical departments. The Pediatric Clinic has 2 institutes and 3 Clinical Departments with 3 Reference Centers of the Ministry of Health and Social Welfare. The Clinic for Pediatric Surgery is the only pediatric surgery clinic in the Republic of Croatia and brings together almost half of Croatian children’s surgeons in one place, with the ability to perform almost all surgical interventions on a small patient. Over the past 25 years, except domestic surgeons, twenty multidisciplinary surgical teams have stayed and worked in clinic from the world’s best children’s hospitals from United States, Sweden, Switzerland, Germany, France, the Netherlands and England. Children’s Hospital Zagreb has recognized the role of nutritionists in their teams and today employs a total of 5 nutritionists within the Ministry of Health’s Reference Center for Pediatric Gastroenterology and Dietary Disorders, the Institute for Pediatric Oncology and Hematology “Dr. Mladen Ćepulić “and the Department of Nutrition. www.kongresnutricionista.com |

KLINIČKI BOLNIČKI CENTAR SPLIT Klinički bolnički centar Split je javna ustanova koja obavlja specijalističko-konzilijarnu zdravstvenu zaštitu, bolničku djelatnost, znanstveno-istraživačku djelatnost iz područja medicinskih znanosti te organizira i pruža usluge za izvođenje nastave na Medicinskom fakultetu te višim i srednjim školama zdravstvenog usmjerenja. Klinički bolnički centar Split je najveći bolnički centar u Dalmaciji koji zapošljava približno 3200 djelatnika. Središnja je zdravstvena ustanova županije Splitsko-dalmatinske i cijelog južnog područja Hrvatske. U ovoj ustanovi, kao regionalnoj bolnici, gravitira oko 1 000 000 državljana Republike Hrvatske te oko 500 000 stanovnika južnog dijela susjedne Bosne i Hercegovine, kao i 500 000 turista tijekom turističke sezone. Centar ima 1500 akutnih i 30 kroničnih ugovorenih postelja te 24 operacijske dvorane. U sklopu bolnice djeluje 13 klinika, 5 kliničkih zavoda, te 8 odjela, uz Jedinicu za znanstveni rad. Za obavljanje ostalih poslova ustrojeno je ravnateljstvo i šest službi. U Kliničkom bolničkom centru Split godišnje se hospitalizira preko 50 000 pacijenata koji ostvaruju više od 450 000 dana bolničkog liječenja, dok se u polikliničko-konzilijarnoj zdravstvenoj zaštiti godišnje prima preko 600 000 pacijenata kojima se pruža više od 2.500 000 usluga. CLINICAL HOSPITAL CENTRE SPLIT Clinical Hospital Centre Split is a public institution that performs specialist health care, hospital activity, scientific research activities in the field of medical sciences and organizes and provides teaching services at the Faculty of Medicine and higher and secondary schools of health care studies. The Clinical Hospital Centre Split is the largest hospital center in Dalmatia that employs approximately 3200 people. It is the central health institution of the Split-Dalmatia County and the entire southern part of Croatia. There are about 1 000 000 citizens of the Republic of Croatia and about 500 000 inhabitants of the southern part of the neighbouring Bosnia and Herzegovina, as well as 500 000 tourists during the tourist season that gravitate to this institution as a regional hospital. The centre has 1530 beds and 24 operating rooms. Within the hospital there are 13 clinics, 5 clinical institutes and 8 departments, along with the Scientific Research Unit. Directorate and six services have been set up in order to carry out other tasks. Over 50,000 patients with over 450,000 hospital treatment days are hospitalized annually, while over 600,000 patients receive more than 2,500,000 services annually in polyclinic and consular healthcare.

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UDRUGA STUDENATA “PROBION” Udruga PROBION na Prehrambeno-biotehnološkom fakultetu djeluje od 2015. godine te okuplja studente biotehnologije, prehrambene tehnologije i nutricionizma. S ciljem dodatne edukacije studenata te omogućavanjem njihovog rasta kao znanstvenika i stručnjaka, Udruga organizira izvannastavne sadržaje u vidu predavanja, radionica i rasprava, redovno tijekom akademske godine. Zbog interdisciplinarnosti djelovanja Udruge, studenti nisu strogo usmjereni u jedno područje već su skloni stalnom otkrivanju novih činjenica koje će im omogućiti rješavanje problema u njihovim karijerama nakon diplome. Iako tek na početku, Probion iza sebe već ima nekoliko uspješnih projekata. Posebno ističemo projekt, ciklus radionica Stekni zdrave navike,u kojem je ostvarena suradnja sa studentima kineziologije i medicine. Kroz ciklus od četiri radionice, studenti su kolege educirali o pravilnoj prehrani, poticali ih na tjelesnu aktivnosti te promjenu načina života. Projekt je prepoznat i od strane Sveučilišta te nagrađen Rektorovom nagradom u ak.god. 2016./2017. Uz navedene, tu su i projekti Budi zmaj za 6. maj, Svjetski dan hodanja, Međunarodni kongres nutricionista i mnogi drugi. Prehrambeno- biotehnološki fakultet je povodom 60. obljetnice postojanja prepoznao rad i trud studenata članova te Udruzi dodijelio Povelju za posebne zasluge, Osim aktivnostima na samom Fakultetu, Probion također sudjeluje u raznim humanitarnim akcijama u vidu kojih je ostvarena suradnja s Nastavnim zavodom za javno zdravstvo Dr. Andrija Štampar, Ministarstvom zdravlja i mnogim institucijama čiji je cilj briga o građanima i njihovom zdravlju. Okupljeni entuzijasti volonterskim radom planiraju još više projekata u narednim godinama, kako bi se ostvarili ciljevi osnutka Udruge te educiralo sve okupljene o pravilnom načinu života i poboljšanju životnih navika. STUDENT ASSOCIATION PROBION The PROBION association at the Faculty of Food Technology and Biotechnology has been operating since 2015 and brings together students of biotechnology, food technology and nutrition. With the aim of further student education and facilitating their growth as scientists and experts, the Association organizes extracurricular activities in the form of lectures, workshops and discussions, regularly during the academic year. Due to the interdisciplinarity of the Association’s activities, students are not strictly focused on one area but are inclined to constantly discover new facts that will enable them to solve problems in their careers after graduation. Although only at the beginning, Probion behind itself has already had several successful projects. We particularly emphasize the project, the cycle of the workshop “Stekni zdrave navike”, where cooperation with kinesiology and medicine students was realized. Through a cycle of four workshops, students were educating their colleagues about proper nutrition, stimulating them on physical activity and changing lifestyles. The project was recognized by the University and was rewarded with Rector’s award in the past 2016/2017. Along with the above, there are also projects “Budi zmaj za 6. maj, World Walking Day, International Congress of Nutritionists and many others. On the occasion of the 60th anniversary of the existence of the Faculty of Food technology and Biotechnology, the work and effort of the student members was recognized and the Charter for Special Merit was given to the Association. In addition to activities at the Faculty itself, PROBION also participates in various humanitarian actions whereby cooperation is made with the State Institute of Public Health Dr. Andrija Štampar, the Ministry of Health and many other institutions aimed at addressing citizens and their health. Collected enthusiasts work voluntarily to plan more projects in the upcoming years to achieve the goals of setting up the Association and educate all gathered about the proper way of life and improving living habits. www.kongresnutricionista.com |

Zagreb

Zagreb – grad milijun srca – Top European destination in 2017

Zagreb – city with a million hearts – Top European destination in 2017

Grad Zagreb, smješten na zemljopisnom, kulturnom, povijesnom i političkom sjecištu istoka i zapada Europe, glavni grad Hrvatske, spaja kontinentalni i mediteranski duh u osebujnu cjelinu. Zagreb je kulturno, znanstveno, gospodarsko, političko i administrativno središte Republike Hrvatske sa sjedištem Sabora, Predsjednika i Vlade. Povoljan geografski položaj između Panonske nizine, ruba Alpa i Dinarida omogućio je spontani nastanak mjesta slobodne komunikacije. Grad sa sjeverne strane od hladnih sjevernih vjetrova štiti gora Medvednica, a prostrana ravnica i rijeka Sava otvaraju ga prema ostalim stranama svijeta. U Zagrebu živi četvrtina ukupnog stanovništva Hrvatske, što je u brojkama gotovo milijun. Građani su stoljećima stizali iz različitih krajeva Europe, a u novijoj povijesti iz svih krajeva Hrvatske te su svojim doprinosom obogatili kulturu grada. Zagreb je siguran velegrad otvorenih vrata, burne povijesti i zanimljivih ličnosti, koji srdačno poziva na upoznavanje i ispunjava očekivanja. U ovom se gradu lako sklapaju zanimljiva poznanstva, nova prijateljstva i proživljavaju nezaboravne dogodovštine. Stoga ne iznenađuje da je Zagreb osvojio prvo mjesto, kao najuzbudljivija europska destinacija, na listi Best in Europe 2017 koju objavljuje vodeći svjetski medij Lonely Planet.

The city of Zagreb, capital of Croatia, on the historic and political threshold between East and West, illustrates both the continental and Mediterranean spirit of the nation it spearheads. Zagreb is the cultural, scientific, economic, political and administrative centre of the Republic of Croatia, and is home to the Croatian Parliament, Government and President. Its favourable location between the Pannonian plain, the edge of the Alps and the Dinaric range has allowed it to become a crossing point for mass international communication. Everything you need is at hand – modern facilities, tradition, thriving business and a unique atmosphere, which is why this city attracts so many. Turn on the street lamps in the Upper Town, delve into mystical medieval history, learn about secrets from the past and enjoy the beauty of the present through interestingly created incentives. All this is within your reach, intertwined into a unique combination, and only minutes and a short stroll away from Zagreb’s convention halls, hotels and cultural institutions. Forget about tiring drives, stressful long-haul journeys and inevitable delays – in Zagreb your business ventures will be more successful, socialising will be more enjoyable, and your free time will be more pleasurable. So it’s no surprise that Zagreb took first place on the Best in Europe 2017 list, published by world’s leading tourist media Lonely Planet, as the most exciting European destination to visit.

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Hotel Panorama Zagreb

HUP-ZAGREB d.d. za hotelijerstvo, ugostiteljstvo i turizam najstarija je hotelijerska kompanija u Zagrebu, koja uspješno posluje preko šezdeset pet godina te se svojom visokom kvalitetom usluge, raznovrsnim proizvodima i kontinuiranim praćenjem, ali i postavljanjem trendova pozicionirala kao tržišni lider, čiji su hoteli središte najvažnijih gospodarskih, političkih i sportskih događanja Zagreba i Hrvatske. Bez obzira dolazite li u Zagreb poslom ili se želite odmoriti, dolazite li zaključiti posao ili razgledati zagrebačke atrakcije, Panorama Zagreb Hotel Vam stoji na raspolaganju udobnim i funkcionalno opremljenim sobama, restoranom Šestine s izvrsnom domaćom kuhinjom, višenamjenskim dvoranama za sve vrste događanja te iskusnim i profesionalnim osobljem.

HUP-ZAGREB INC – our hotel, catering and tourist company is the oldest hotelier company in Zagreb, operating successfully for over sixtyfive years. With its high quality service and a variety of products, HUP-ZAGREB is keeping pace with current global trends. The company is also setting trends as a market leader, with hotels in its portfolio that represent a focal point of economic, political and sporting events in Zagreb and Croatia. Whether you are coming to Zagreb for work or just to relax, whether you are coming to make a business deal or go for a Zagreb sightseeing tour, Panorama Zagreb stands at your disposal with its cosy and functionally equipped rooms, great local cuisine in the Šestine restaurant, as well as its multifunctional conference rooms and professional staff.

www.kongresnutricionista.com |

Tako kremasto

14,90 kn 500 g (1 kg / 29,80 kn)

PRIRODNO I JEDNOSTAVNO UZ dmBio. Otkrijte što dmBio čini posebnim.

42,90 kn 250 ml (1 l / 171,60 kn)

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� www.dm.hr � www.facebook.com/dm.Hrvatska.hr

PROGRAM KONGRESA / CONGRESS PROGRAMME PETAK 17.11.2017. / FRIDAY 17th November 2017

Događanje / Event

Predavač / Lecturer

STUDENTSKA SEKCIJA / STUDENT SECTION 13:00 - 14:00 14:00 - 14:45 Grupa A / Group A 15:00 - 15:45 Grupa B / Group B 16:00 - 16:45 Grupa C / Group C

Registracija studenata / Student registration Lokacija / Location: Predvorje dvorane Kaptol / Foyer of Room Kaptol

Radionica 1: Nutricionist u institucionalnoj kuhinji Workshop 1: Nutritionist in an insitutional kitchen Lokacija / Location: Kamelija

Irena Martinis Hrvatska / Croatia

Radionica 2: Nutricionist u privatnoj praksi Workshop 2: Nutritionist in private practice Lokacija / Location: Fortuna

Dragana Olujić Hrvatska / Croatia

Radionica 3: Psihološka radionica - kako pristupiti klijentu Workshop 3: Psychological workshop - how to approach the client Lokacija / Location: Sljeme

Iva Kantolić Hrvatska / Croatia

14:00 - 14:45 Grupa C / Group C 15:00 - 15:45 Grupa A / Group A 16:00 - 16:45 Grupa B / Group B 14:00 - 14:45 Grupa B / Group B 15:00 - 15:45 Grupa C / Group C 16:00 - 16:45 Grupa A / Group A

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Dragi studenti, prijavili ste se na radionice koje su dio studentskog edukacijskog programa 5. Međunarodnog kongresa nutricionista, molimo da pročitate navedene upute. Prilikom registracije biti ćete podijeljeni u tri grupe (A,B,C) te ćete pohađati sve tri radionice u razdoblju od 14:00 do 16:45h. Između svake radionice imati ćete pauzu u trajanu od 15 minuta. Na kraju ćete dobiti test koji uključuje po 10 pitanja sa svake radionice. Test će se održati u 17:00h u prostorijama u kojima ste pohađali radionice. Nakon testa dobit ćete Certifikate. Kolegice i kolege, molimo Vas da pratite raspored radionica s obzirom na grupu kojoj pripadate. Vaša kontakt osoba je Sara Sila, mag.nutr. www.kongresnutricionista.com |

j o b la k s r

! e eć

Nove Bebimil žitne kašice s mlijekom!

za dojenčad od 6. mjeseci i malu djecu

pripremaju se samo s vodom

sadrže mliječni pripravak prilagođen dobi djeteta

okus grisa, voća ili keksa

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potpun i uravnotežen obrok za doručak, ručak ili večeru praktično pakiranje

www.bebimil.hr

PROGRAM KONGRESA / CONGRESS PROGRAMME PETAK 17.11.2017. / FRIDAY 17th November 2017

Događanje / Event 16:00 - 18:00

17:00 - 18:00

18:00 - 18:30

18:30 - 19:30

20:00

Predavač / Lecturer

Registracija sudionika / Registration Lokacija / Location: Predvorje dvorane Kaptol / Foyer of Room Kaptol Radionica 1 (prethodna registracija): Sponzorirana kulinarska radionica Workshop 1 (prior registration): Sponsored Culinary Workshop Lokacija / Location: Fortuna

Drogerie Markt Plc. Hrvatska / Croatia

Radionica 2 (prethodna registracija): Skriveni svijet osoba s poremećajem hranjenja: komunikacija i nutricionistička intervencija Workshop 2 (prior registration): The hidden world of people with eating disorders: communication and nutrition intervention Lokacija / Location: Kamelija

Maja Žanko Hrvatska / Croatia

Radionica 3 (prethodna registracija): Uporaba ergogenih sredstava među sportašima rekreativcima Workshop 3 (prior registration): Use of ergogenic aids amongst elite athletes Lokacija / Location: Sljeme

Hrvoje Centner Maja Gradinjan Centner Daniela Čačić Kenjerić Hrvatska / Croatia

Pauza za kavu / Coffee break Lokacija / Location: Grič Radionica 4 (prethodna registracija): Sponzorirana kulinarska radionica Workshop 4 (prior registration): Sponsored Culinary Workshop Lokacija / Location: Fortuna

Zvijezda Plc. Hrvatska / Croatia

Radionica 5 (prethodna registracija): Bodyrecog - sustav za digitalno antropometrijsko mjerenje i procjenu zdravstvenih rizika Workshop 5 (prior registration): Bodyrecog - system for digital anthropometric measurement and risk factor assessment Lokacija / Location: Kamelija

Nika Jiroušek Luka Leško Hrvatska / Croatia

Radionica 6 (prethodna registracija): Sponzorirana radionica: 21-dnevni detox Mg program Workshop 6 (prior registration): Sponsored Workshop: 21-day Mg detox Lokacija / Location: Sljeme

Atlantic Trade Plc. Hrvatska / Croatia

Interaktivan koktel party / Interactive cocktail party Lokacija / Location: Restaurant Šestine - Dvorana 2 / Room 2 www.kongresnutricionista.com |

PROGRAM KONGRESA / CONGRESS PROGRAMME SUBOTA 18.11.2017. / SATURDAY 18th November 2017 Događanje / Event 8:30

09:00 - 09:15

09:15 - 10:40

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Predavač / Lecturer

Registracija sudionika / Registration Lokacija / Location: Predvorje dvorane Kaptol / Foyer of Room Kaptol

Svečano otvaranje kongresa / Opening ceremony Lokacija / Location: Kaptol I & II Plenarna predavanja / Plenary lectures Moderatori / Chairs: Dora Bučan, Andrea Gvozdanović Lokacija / Location: Kaptol I & II

09:15 - 09:30

Zdravija prehrana: zašto moramo podići glas? Healthier nutrition: why we must speak (up)?

Milka Sokolović Europsko udruženje za informacije o hrani / European Food Information Council (EFIC) Belgija / Belgium

09:30 - 09:45

Konzumacija hrane u Europi: dosadašnja postignuća i izazovi budućnosti European food consumption data: achievements made so far and future challenges

Davide Arcella Europska agencija za sigurnost hrane / European Food Safety Agency (EFSA) Italija / Italy

09:45 - 10:00

Eleonora Dupouy

Organizacija za hranu i poljoprivredu Ujedinjenih Naroda /Food Agriculture Organization of the United Nations (FAO) Mađarska / Hungary

10:00 - 10:15

Prehrana za održivu budućnost: Kako dalje? Feeding the planet for a sustainable future: How to proceed?

Mauro Serafini Sveučilište u Teramu / University of Teramo Italija / Italy

10:15 - 10:30

Znanost o ukusnosti i moguća klinička upotreba The science of deliciousness and its possible clinical uses

Ole G. Mouritsen Sveučilište u Kopenhagenu University of Copenhagen Danska / Denmark

10:30 - 10:40

Diskusija / Discussion

10:40 - 11:30

Pauza za kavu • Vođena poster sekcija / Coffee break • Guided poster section Moderatori / Chairs: Iva Kantolić, Petra Kučan, Ivana Linardić, Lidija Šoher Lokacija / Location: Zagreb ‣ Za detaljnije informacije pogledajte dio Vođena poster sekcija ‣ Please refer to the Guided poster walk section for full listings

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PROGRAM KONGRESA / CONGRESS PROGRAMME SUBOTA 18.11.2017. / SATURDAY 18th November 2017

Događanje / Event

11:30 13:10

▼

Predavač / Lecturer

PREHRANA U PREVENCIJI BOLESTI NUTRITION IN DISEASE PREVENTION Moderatori / Chairs: Karmen Matković Melki Lokacija / Location: Kaptol I

Predavač / Lecturer

Događanje / Event

PSIHOLOGIJA PREHRANE: ŠTO OBLIKUJE PREHRAMBENE PREFERENCE PSYCHOLOGY OF NUTRITION: WHAT DEFINES NUTRITIONAL PREFERENCES Moderatori / Chairs: Maja Žanko, Sanja Ćosić Lokacija / Location: Kaptol II

11:30 11:50

Komunikacija s bolesnicima o prehrani za oboljele od raka: Što davatelji skrbi moraju znati? Communicating with Patients about Cancer Diets: What do care providers need to know?

Nicole Erickson Njemačka / Germany

11:50 12:10

Javno zdravstvene i promotivne aktivnosti ZZJZ Istarske županije u prevenciji kardiovaskularnih bolesti-put do savjetovališta za prehranu Public health and promotional activities of Public Health Institute of Istra county in the prevention of cardiovascular diseases – the way to a nutrition counseling centre

Olga Dabović Rac Hrvatska / Croatia

Održivi obrasci ponašanja s naglaskom na prehranu Sustainable patterns of behaviour with focus on nutrition

Iva Kantolić Hrvatska / Croatia

12:10 12:30

Procjena prehrambenog unosa i utroška energije tijekom tjelesne aktivnosti u 15-godišnjaka različite kompozicije tijela Assessment of nutritional intake and energy consumption for physical activity in fifteenyear-olds with different body composition

Jerneja Kožar Slovenija / Slovenia

Komunikacija i rad nutricionista s osobama oboljelim od poremećaja hranjenja Communication and work of nutritionists with people suffering from eating disorders

Maja Žanko Hrvatska / Croatia

12:30 12:50

Sponzorirano predavanje / Sponsored lecture

Abela Pharm Ltd.

Sponzorirano predavanje / Sponsored lecture

Drogerie Markt Ltd.

13:00 14:10

Ručak / Lunch Lokacija / Location: Restaurant Šestine - Dvorana 2 / Room 2

Prihvaćanje i odbijanje hrane u ranom djetinjstvu Food acceptance and refusal in infancy and early childhood

Gillian Harris Ujedinjeno Kraljevstvo / United Kingdom

www.kongresnutricionista.com |

PROGRAM KONGRESA / CONGRESS PROGRAMME SUBOTA 18.11.2017. / SATURDAY 18th November 2017

Događanje / Event

14:15 15:35

▼

14:15 14:35

14:35 14:55

14:55 15:15

Predavač / Lecturer

KLINIČKA PREHRANA CLINICAL NUTRITION Moderatori / Chairs: Josipa Radić, Maja Gradinjan Centner Lokacija / Location: Kaptol I

Uloga prehrane u dugoročnom programiranju zdravlja i bolesti Role of nutrition in the early programming of long-term health

Prehrana i mikrobiom crijeva u pedijatrijskih bolesnika oboljelih od Crohnove bolesti Diet and the Gut Microbiome in Pediatric Crohn’s Disease

Prehrana kod bulozne epidermolize Nutrition in bullous epidermolisis

15:15 15:35

Proteinsko-energetska pothranjenost u bolesnika s kroničnom bolešću bubrega Protein energy wasting in patients with chronic kidney disease

15:35 16:00

Pauza za kavu / Coffee break Lokacija / Location: Grič

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Sanja Kolaček Hrvatska / Croatia

Charlene W. Compher Sjedinjene Američke Države United States of America

Događanje / Event

Predavač / Lecturer

Suplementacija u sportaša powered by GAZ

Supplementation in athletes powered by GAZ

Moderatori / Chairs: Eva Kavka, Josipa Mađarić Lokacija / Location: Kaptol II

Zamke u prehrani i suplementaciji sportaša Traps in nutrition and supplementation of athletes

Zoran Bahtijarević Hrvatska / Croatia

Tjelesna aktivnost i korištenje dodataka prehrani među adolescentima Physical activity and usage of dietary supplements among adolescents

Katja Zdešar Kotnik Slovenija / Slovenia

Petra Kučan Hrvatska / Croatia

Pregled unosa dodataka prehrani u elitnih slovenskih sportaša An overview of dietary supplementation in elite Slovenian athletes

Eva Kavka Slovenija / Slovenia

Josipa Radić Hrvatska / Croatia

Sponzorirano predavanje / Sponsored lecture

Garmin

PROGRAM KONGRESA / CONGRESS PROGRAMME SUBOTA 18.11.2017. / SATURDAY 18th November 2017

Događanje / Event

Predavač / Lecturer

Događanje / Event

Mlijeko i mliječni proizvodi Milk and dairy products Moderatori / Chairs: Irena Barukčić, Sara Sila Lokacija / Location: Kaptol I

Izazovi u prehrani starijih osoba Challenges in nutrition of the elderly population Moderatori / Chairs: Irena Keser, Marija Petras Lokacija / Location: Kaptol II

16:00 16:20

Sirutka i mlaćenica zanemarena funkcionalna hrana Whey and buttermilk neglected functional food

Irena Barukčić Hrvatska / Croatia

Važnost adekvatnog unosa i statusa vitamina D za starije osobe - rezultati istraživanja sa starijom ženskom populacijom The importance of adequate vitamin D intake and status in elderly – the results of the study with older women

Irena Keser Hrvatska / Croatia

16:20 16:40

Zastupljenost mlijeka i mliječnih proizvoda u prehrani adolescenata Milk and dairy products in adolescent diet

Irzada Taljić Bosna i Hercegovina Bosnia and Herzegovina

Vođenje pacijenta u Referentnom centru za dijabetes Management of a diabetes patient in the Reference clinic

Zvezdana Vražič Slovenija / Slovenia

16:40 17:00

Učestalost korištenja mlijeka i mliječnih proizvoda kod učenika osnovih i srednjih škola u gradu Splitu Frequency of use of milk and dairy products in primary and secondary school students in the city of Split

Katja Ćurin Hrvatska / Croatia

Upotreba komercionalnih i enteralnih prehrambenih proizvoda u institucijama za smještaj i brigu o starijim osoba u gradu Splitu The use of commercial and enteral food in institutions for care of elderly

Ivana Gjeldum Hrvatska / Croatia

17:15 19:15

Izlet / Excursion

20:30 21:00

Aperitiv / Aperitive Lokacija / Location: Restaurant Šestine - Dvorana 2 / Room 2

21:00 02:00

Gala večera / Gala dinner Lokacija / Location: Restaurant Šestine - Dvorana 2 / Room 2

16:00 17:00

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PROGRAM KONGRESA CONGRESS PROGRAMME NEDJELJA 19.11.2017. / SUNDAY 19th November 2017

Događanje / Event

Predavač / Lecturer

Šećer i sol Sugar and salt Moderatori / Chairs: Jasmina Ranilović, Nataša Šoštarić Lokacija / Location: Kaptol I

Prehrana opće populacije Nutrition of the general population Moderatori / Chairs: Leon Vedenik, Dora Babić Lokacija / Location: Kaptol II

09:30 09:50

Smanjenje soli: izazov i prilika za inovaciju u prehrambenoj industriji Salt reduction: challenge and opportunity for innovation in the food industry

Jasmina Ranilović Hrvatska / Croatia

Primjer uspješnoga promicanja zdravlja: promicanje pravilne prehrane na radnome mjestu An example of successful health promotion – healthy diet in the workplace

Leon Vedenik Slovenija / Slovenia

09:50 10:10

Prisutnost N-nitrozoamina u mesnim prerađevinama The presence of N-nitrosamines in meat products

Iva Pavlinić Prokurica Hrvatska / Croatia

Određivanje prehrambenih navika odrasle populacije Istre upotrebom upitnika s 14 pitanja pod nazivom Medas Determination of dietary habits of adults population from Istria using the 14-point questionnaire named Medas

Tamara Poklarac Vatovec Slovenija / Slovenia

10:10 10:30

Sponzorirano predavanje / Sponsored Lecture

Cromaris Plc.

Sponzorirano predavanje / Sponsored lecture

Jamnica Plc.

10:35 11:35

Panel rasprava Panel discussion Etika oglašavanja prehrambenih proizvoda Ethics in food marketing Moderator / Chair: Nataša Šoštarić

11:35 12:00

Pauza za kavu / Coffee break Lokacija / Location: Grič

09:30 11:30

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Predavač / Lecturer

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Dijana Kladar - legal consultant for "Potrošač" Association Sanja Musić Milanović - Croatian Institute of Public Health Kristina Petljak - Croatian Association for Consumer Protection Predstavnici prehrambene industrije / Food industry representatives

PROGRAM KONGRESA CONGRESS PROGRAMME NEDJELJA 19.11.2017. / SUNDAY 19th November 2017

Događanje / Event

12:00 - 12:40

12:40 - 14:20

▼

Predavač / Lecturer

Predstavljanje 5 najboljih postera prema izboru Znanstvenog odbora Presentation of best 5 posters as decided by the Scientific Committee Moderatori / Chairs: Valerija Bukvić, Hrvoje Centner Lokacija / Location: Kaptol I & II

Klinička prehrana Clinical nutrition Moderatori / Chairs: Zvezdana Vražić, Andrea Gvozdanović Lokacija / Location: Kaptol I & II

12:40 - 13:00

Nutritivne intervencije u osoba s Downovim sindromom Nutrition interventions in patients with Down syndrome

Milka Popović Srbija / Serbia

13:00 - 13:20

Dijetoterapijski pristup kod bolesnika na antikoagulantnoj terapiji Dietotherapy approach to patient on anticoagulation therapy

A lenka Brozina Hrvatska / Croatia

13:20 - 13:40

Problem rane postoperativne nutritivne podrške pacijenata nakon transplantacije jetre Early post-operative nutrition in patients after liver transplantation

Ivančica Delaš Hrvatska / Croatia

13:40- 14:00

Nutricionistički aspekti enteralne hrane Nutritional aspects of enteral food

Marijana Ceilinger, Helena Tomić-Obrdalj Hrvatska / Croatia

14:00 - 14:20

Podjela nagrada i zatvaranje Kongresa AWARD ceremony and Congress closure

14:30 - 15.30

Ručak / Lunch Lokacija / Location: Restaurant Šestine - Dvorana 2 / Room 2 www.kongresnutricionista.com |

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Vođena poster sekcija Guided poster walk Subota, 18. studeni Saturday, 18th November 10:40 - 11:30 Sekcija postera

Poster Walk Section

Naslov

Broj postera Poster Number

Topic

Unos žive, riba i metabolički sindrom Fish intake, mercury and metabolic syndrome: A review of the literature

KLIN01

Kontrola glikemije i prehrana tip 1 dijabetičara u HR

Glycemic control and nutrition among DMT1 patients in Croatia

Važnost prehrane za regulaciju simptoma oboljelih od Parkinsonove bolesti

The importance of nutrition for KLIN03 symptom management of Parkinson disease patients

Edukacija o prehrani kao neizostavni dio liječenja kronične boli – prikaz aktivnosti prvog multidisciplinarnog tima za liječenje kronične boli u Hrvatskoj

Education on nutrition as necessary part of chronic pain treatment – presentation of the first multidisciplinary team for chronic pain treatment in Croatia

KLIN04

Profil pacijenata u ambulanti za pretilu djecu i adolescente u Klinici za dječje bolesti Zagreb

Profile of patients in the clinic for obese children and adolescents in a Children’s hospital Zagreb

KLIN05

Energetski unos hospitaliziranih pedijatrijskih pacijenata

Energy intake of hospitalized pedriatic patients

KLIN06

Šećer i sol u proizvodima široke Industrija potrošnje

Sugar and salt in consumer product

IND01

Izabrane karakteristike hrane za posebne medicinske potrebe

Selected characteristics of food for special medical purposes

IND02

Sportska prehrana

Kvaliteta prehrane studenata programa za izobrazbu trenera kineziološke rekreacije

The quality of nutrition for students SPO01 of coach education in kinesiological recreation

Sport nutrition

Informiranost sportaša rekreativaca o korištenju dodataka prehrani (suplemenata)

Recreational athletes awareness of dietary supplements usage

Klinička prehrana Clinical nutrition

Industry

KLIN02

SPO02

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Sekcija postera

Poster Walk Section

Opće teme General topic

Naslov

Topic

Konzumacija vode studentske populacije u Mostaru

Water consumption among Mostar students

OP01

Izvori soli i šećera u prehrani studentske populacija Sveučilišta u Mostaru

Salt and sugar sources in diet among students population at University of Mostar

OP02

Utjecaj medijskih dijeta na prehrambeno ponašanje i širenje epidemije pretilosti

Influence of media available diets on eating behaviours and the spread of the obesity

OP03

Utjecaj prehrane majke i potomaka na površinu i broj adipocita bijelog masnog tkiva muških potomaka štakora

Effect of maternal and offspring diet on surface area and number of white adipose tissue adipocytes in male rat offspring

OP04

Prehrana trudnica i dojilja

Pregnancy and breastfeeding diet

OP05

Utjecaj dentalnog statusa na kakvoću prehrane i stupnja uhranjenosti ispitanika starije dobi

Influence of dental status on the quality of food intake and nutritional the status in eldery

OP06

Učinkovitost multidisciplinarnog programa na Sljemenu u smanjenju tjelesne mase i popravljanju sastava tijela pretilih osoba

Efficiency of the multidisciplinary OP07 program on Sljeme in reduced body weight and correcting composition body of obese people

Unapređenje prehrambenih navika zaposlenika

Improvement of dietary habits of employees

OP08

Prehrambene navike i stavovi studenata veterinarske medicine koji žive kod kuće ili daleko od kuće

Eating habits and attitudes of veterinary medicine students who live at home or away from home

OP09

Čimbenici koji utječu na količinu otpada hrane u kućanstvu

Factors which affect the amount of household food waste

OP10

Procjena nutritivne vrijednosti jelovnika u izviđačkim kampovima

Assessment of nutritional value of food menus in scout camps

OP11

Procjena kakvoće prehrane u ljetnim Assessment of food quality in izviđačkim kampovima menus of scout camps

Broj postera Poster Number

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OP12

Sekcija postera

Poster Walk Naslov Section

Javno zdravstvo Public health

Broj postera Poster Number

topic

JZ01

Znanje o kakvoći mlijeka i mliječnih proizvoda utječe na bolju konzumaciju mlijeka i mliječnih proizvoda obzirom na preporuke

Nutrition knowledge about milk and milk products affects better dairy products consumption according to recommendations

Prehrambene navike zdravstvenih djelatnika istočne Hrvatske

Nutritional habbits of health workers JZ02 in Eastern Croatia

Utjecaj edukacije na znanje djece osnovnoškolske dobi o zaslađenim napicima

The effect of the education on primary school children’s knowledge about sugar sweetened beverages

JZ03

Nevladine udruge kao značajan čimbenik u promicanju pravilne prehrane

Non-governmental organizations as a significant factor in promotion of healthy eating

JZ04

Savjetovalište za prehranu u ZZJZ Istarske županije

Nutrition counseling in Institute of public health county of Istria

JZ06

Model inovativnoga pristupa lokalnomu održivom razvoju – primjer dobre prakse iz Pomurja

A model of innovative approach to local sustainable development - an example of good practise from Pomurje

JZ07

Prehrambene navike Roma u Pomurju

Eating habits of the Roma population in Pomurje

JZ08

Inovativan način integriranja promicanja pravilne prehrane u institucionalnome liječenju ovisnika o alkoholu

An innovative way in integration encouraging of the proper nutrition in an institutional treatment of the alcoholics

JZ09

Implementacija Smjernica pravilne prehrane u odgojno-obrazovnim ustanovama: primjer smanjivanja konzumacije šećera u prehrani djece koja pohađaju vrtić Murska Sobota

Implementation of National dietary guidelines for healthy nutrition in kindergartens and schools: an example of reducing sugar in the nutrition of children enrolled in Kindergarten Murska Sobota

JZ10

Učestalost konzumiranja mlijeka i mliječnih proizvoda kod djece od 11.-14.godina na području SBK/ KSB-a

The frequency of consumption milk and milk products among children of 11.14.years in the field of Central Bosnia Canton

JZ11

Procjena unosa energije i hranjivih Nutritional status evaluation among tvari u osoba smještenih u domove residents in retirement homes za starije osobe

JZ12

Izvođenje mjere Shema školskog voća i povrća u slovenskim školama

Implementation of the School fruit and JZ13 vegetables scheme in Slovenian schools

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KNJIGA SAŽETAKA SADRŽAJ BOOK OF ABSTRACTS TABLE OF CONTENTS

1. Sažeci radionica.......................................................................................43 UPORABA ERGOGENIH SREDSTAVA MEĐU SPORTAŠIMA REKREATIVCIMA........................................................... 44 BODYRECOG - SUSTAV ZA DIGITALNO ANTROPOMETRIJSKO MJERENJE I PROCJENU ZDRAVSTVENIH RIZIKA.................. 45 SKRIVENI SVIJET OSOBA S POREMEĆAJEM HRANJENJA KOMUNIKACIJA I NUTRICIONISTIČKA INTERVENCIJA................. 46

2. Sažeci predavanja.....................................................................................47 POGREŠKE, ZAMKE I ZABLUDE U DOPINGU ............................................................................................... 48 SIRUTKA I MLAĆENICA – ZANEMARENA FUNKCIONALNA HRANA ..................................................................... 49 DIJETOTERAPIJSKI PRISTUP KOD BOLESNIKA NA ANTIKOAGULANTNOJ TERAPIJI.................................................. 50 NUTRICIONISTIČKI ASPEKTI ENTERALNE HRANE.......................................................................................... 51 PREHRANA I CRIJEVNI MIKROBIOM U CROHNOVOJ BOLESTI KOD PEDIJATRIJSKE POPULACIJE................................... 52 RANA POSTOPERATIVNA PREHRANA PACIJENATA NAKON TRANSPLANTACIJE JETRE............................................... 53 UČESTALOST KORIŠTENJA MLIJEKA I MLIJEČNIH PROIZVODA KOD UČENIKA OSNOVNIH I SREDNJIH ŠKOLA U GRADU SPLIT........ 54 UPORABA KOMERCIONALNIH I ENTERALNIH PREHRAMBENIH PROIZVODA U INSTITUCIJAMA ZA SMJEŠTAJ I BRIGU O STARIJIM OSOBAMA U GRADU SPLITU.......................................................................................... 55 JAVNO ZDRAVSTVENE I PROMOTIVNE AKTIVNOSTI ZAVODA ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJE U PREVENCIJI KARDIOVASKULARNIH – PUT DO SAVJETOVALIŠTA ZA PREHRANU..................................................... 56 SOL KAO FUNKCIONALNA NAMIRNICA....................................................................................................... 57 KOMUNIKACIJA S ONKOLOŠKIM PACIJETNTIMA VEZANO ZA PREHRANU: ŠTO MEDICINSKO OSOBLJE TREBA ZNATI?....... 58 PRIHVAĆANJE I ODBIJANJE HRANE U DOJENČADI I MALE DJECE....................................................................... 59 ODRŽIVI OBRASCI PONAŠANJA S NAGLASKOM NA PREHRANU......................................................................... 60 UPOTREBA DODATAKA PREHRANI KOD VRHUNSKIH SLOVENSKIH SPORTAŠA...................................................... 61 VAŽNOST ADEKVATNOG UNOSA I STATUSA VITAMINA D ZA OSOBE STARIJE DOBI – REZULTATI ISTRAŽIVANJA SA STARIJOM ŽENSKOM POPULACIJOM.................................................................................. 62 ULOGA PREHRANE U DUGOROČNOM PROGRAMIRANJU ZDRAVLJA I BOLESTI........................................................ 63 PROCJENA PREHRAMBENOG UNOSA I UTROŠKA ENERGIJE TIJEKOM TJELESNE AKTIVNOSTI U 15-OGODIŠNJAKA RAZLIČITE KOMPOZICIJE TIJELA............................................................................................................... 64 EPIDERMOLIZA BULOZA I VAŽNOST PREHRANE........................................................................................... 65 PRISUTNOST N-NITROZAMINA U MESNIM PRERAĐEVINAMA............................................................................ 66 ODREĐIVANJE PREHRAMBENIH NAVIKA ODRASLOG STANOVNIŠTVA ISTRE POMOĆU UPITNIKA S 14 BODOVA METODE MEDAS............................................................................................................... 67 NUTRITIVNE INTERVENCIJE U OSOBA SA DOWN SINDROMOM.......................................................................... 68 PROTEINSKO ENERGETSKA POTHRANJENOST U BOLESNIKA S KRONIČNOM BOLEŠĆU BUBREGA................................ 69 SMANJENJE SOLI: IZAZOV I PRILIKA ZA INOVACIJU U PREHRAMBENOJ INDUSTRIJI................................................ 70 MLIJEČNI PROTEINI U FUNKCIJI OPORAVKA NAKON TJELESNE AKTIVNOSTI.......................................................... 71 ZASTUPLJENOST MLIJEKA I MLIJEČNIH PROIZVODA U PREHRANI ADOLESCENATA................................................. 72 PRIMJER USPJEŠNOG PROMICANJA ZDRAVLJA: PROMICANJE PRAVILNE PREHRANE NA RADNOME MJESTU................... 73 VOĐENJE PACIJENTA U REFERENTNOM CENTRU ZA DIJABETES ........................................................................ 74 Tjelesna aktivnost i korištenje dodataka prehrani među adolescentima ............................................ 75 KAKO RAZUMJETI POREMEĆAJE HRANJENJA ULOGA NUTRICIONISTA U MULTIDISCIPLINARNOM PRISTUPU LIJEČENJU OSOBE S POREMEĆAJIMA HRANJENJA . ......................................................................... 76

3. Sažeci postera..........................................................................................78 EDUKACIJA O PREHRANI KAO NEIZOSTAVNI DIO LIJEČENJA KRONIČNE BOLI - PRIKAZ AKTIVNOSTI PRVOG MULTIDISCIPLINARNOG TIMA ZA LIJEČENJE KRONIČNE BOLI U HRVATSKOJ ........................................................................... 79 UTJECAJ DENTALNOG STATUSA NA KAKVOĆU PREHRANE I STUPNJA UHRANJENOSTI U ISPITANIKA STARIJE DOBI......... 80 PREHRAMBENE NAVIKE ROMA U POMURJU................................................................................................. 81

MODUL INOVATIVNOG PRISTUPA LOKALNOM ODRŽIVOM RAZVOJU – PRIMJER DOBRE PRAKSE IZ POMURJA................. 82 KVALITETA PREHRANE STUDENATA PROGRAMA ZA IZOBRAZBU TRENERA KINEZIOLOŠKE REKREACIJE........................ 83 IZABRANE KARAKTERISTIKE HRANE ZA POSEBNE MEDICINSKE POTREBE............................................................ 84 KONZUMACIJA VODE STUDENTSKE POPULACIJE U MOSTARU.......................................................................... 85 SAVJETOVALIŠTE ZA PREHRANU U ZAVODU ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJE........................................ 86 IZVOĐENJE MJERE SHEMA ŠKOLSKOG VOĆA I POVRĆA U SLOVENSKIM ŠKOLAMA................................................. 87 UNAPREĐENJE PREHRAMBENIH NAVIKA ZAPOSLENIKA.................................................................................. 88 PROCJENA UNOSA ENERGIJE I HRANJIVIH TVARI UOSOBA SMJEŠTENIH U DOMOVE ZA STARIJE OSOBE....................... 89 UČINKOVITOST MULTIDISCIPLINARNOG PROGRAMA NA SLJEMENU U SMANJENU TJELESNE MASE I POPRAVLJANJU SASTAVA TIJELA PRETILIH OSOBA....................................................................................... 90 PROCJENA NUTRITIVNE VRIJEDNOSTI JELOVNIKA U IZVIĐAČKIM KAMPOVIMA...................................................... 91 PROCJENA KAKVOĆE PREHRANE U LJETNIM IZVIĐAČKIM KAMPOVIMA................................................................ 92 INFORMIRANOST SPORTAŠA REKREATIVACA O UZIMANJU DODATAKA PREHRANI (SUPLEMENATA)............................ 93 PREHRAMBENE NAVIKE ZDRAVSTVENIH DJELATNIKA ISTOČNE HRVATSKE........................................................... 94 ZNANJE O KAKVOĆI MLIJEKA I MLIJEČNIH PROIZVODA UTJEČE NA BOLJU KONZUMACIJU MLIJEČNIH PROIZVODA S OBZIROM NA PREPORUKE.................................................................................................... 95 NEVLADINE UDRUGE KAO ZNAČAJAN ČIMBENIK U PROMICANJU PRAVILNE PREHRANE........................................... 96 VAŽNOST PREHRANE ZA REGULACIJU SIMPTOMA OBOLJELIH OD PARKINSONOVE BOLESTI...................................... 97 IMPLEMENTACIJA SMJERNICA PRAVILNE PREHRANE U ODGOJNO-OBRAZOVNIM USTANOVAMA: PRIMJER SMANJIVANJA KONZUMACIJE ŠEĆERA U PREHRANI DJECE KOJA POHAĐAJU VRTIĆ MURSKA SOBOTA.......................... 98 UTJECAJ MEDIJSKIH DIJETA NA PREHRAMBENO PONAŠANJE I ŠIRENJE EPIDEMIJE PRETILOSTI................................. 99 ENERGETSKI UNOS HOSPITALIZIRANIH PEDIJATRIJSKIH PACIJENATA............................................................... 100 PREHRANA TRUDNICA I DOJILJA............................................................................................................ 101 UČESTALOST KONZUMIRANJA MLIJEKA I MLIJEČNIH PROIZVODA KOD DJECE OD 11.-14.GODINA NA PODRUČJU SREDNJOBOSANSKOG KANTONA........................................................................................ 102 INOVATIVAN NAČIN INTEGRIRANJA PROMICANJA PRAVILNE PREHRANE U INSTITUCIONALNOME LIJEČENJU OVISNIKA O ALKOHOLU........................................................................................................ 103 KONTROLA GLIKEMIJE I PREHRANA TIP 1 DIJABETIČARA U HRVATSKOJ............................................................ 104 IZVORI SOLI I ŠEĆERA U PREHRANI STUDENTSKE POPULACIJE SVEUČILIŠTA U MOSTARU..................................... 105 PREHRAMBENE NAVIKE I STAVOVI STUDENATA VETERINARSKE MEDICINE KOJI ŽIVE KOD KUĆE ILI DALEKO OD KUĆE... 106 UTJECAJ EDUKACIJE NA ZNANJE DJECE OSNOVNOŠKOLSKE DOBI O ZASLAĐENIM NAPITCIMA................................ 107 ŠEĆER I SOL U PROIZVODIMA ŠIROKE POTROŠNJE..................................................................................... 108 PROFIL PACIJENATA U AMBULANTI ZA PRETILU DJECU I ADOLESCENTE U KLINICI ZA DJEČJE BOLESTI ZAGREB........... 109 UNOS RIBE, ŽIVA I METABOLIČKI SINDROM: PREGLED LITERATURE................................................................. 110 UTJECAJ PREHRANE MAJKE I POTOMAKA NA POVRŠINU I BROJ ADIPOCITA BIJELOG MASNOG TKIVA MUŠKIH POTOMAKA ŠTAKORA...................................................................................................... 111 ČIMBENICI KOJI UTJEČU NA KOLIČINU OTPADA HRANE U KUĆANSTVIMA.......................................................... 112

4. Lecture abstracts.................................................................................... 113 PITFALLS, TRAPS AND ERRORS ABOUT DOPING........................................................................................ 114 WHEY AND BUTTERMILK – A NEGLECTED FUNCTIONAL FOOD........................................................................ 115 DIETOTHERAPY APPROACH TO PATIENT ON ANTICOAGULATION THERAPY......................................................... 116 NUTRITIONAL ASPECTS OF FOOD FOR ENTERAL NUTRITION.......................................................................... 117 DIET AND THE GUT MICROBIOME IN PEDIATRIC CROHN’S DISEASE................................................................. 118 EARLY POSTOPERATIVE NUTRITION IN PATIENTS AFTER LIVER TRANSPLANTATION.............................................. 119 FREQUECY OF USE OF MILK AND DAIRY PRODUCTS IN STUDENTS OF PRIMARY AND SECONDARY SCHOOLS THE CITY OF SPLIT.... 120 USE OF COMMERCIAL AND ENTERAL FOOD PRODUCTS IN THE INSTITUTIONS FOR ACCOMMODATION AND CARE OF ELDERLY IN THE CITY OF SPLIT................................................................................................. 121

PUBLIC HEALTH AND PROMOTIONAL ACTIVITES FOR PREVENTION OF CARDIOVASCULAR DISEASES IN INSTITUTE OF PUBLIC HEALTH COUNTY OF ISTRIA – PATH TO NUTRITION COUNSELING......................................................... 122 SALT, AS A FUNCTIONAL FOOD – IODINE................................................................................................. 123 COMMUNICATING WITH PATIENTS ABOUT CANCER DIETS: WHAT DO CARE PROVIDERS NEED TO KNOW?................... 124 FOOD ACCEPTANCE AND REFUSAL IN INFANCY AND EARLY CHILDHOOD........................................................... 125 SUSTAINABLE FOOD.......................................................................................................................... 126 AN OVERVIEW OF DIETARY SUPPLEMENTATION IN ELITE SLOVENIAN ATHLETES................................................. 127 THE IMPORTANCE OF ADEQUATE VITAMIN D INTAKE AND STATUS IN ELDERLY – THE RESULTS OF THE STUDY WITH OLDER WOMEN................................................................................................................................. 128 ROLE OF NUTRITION IN THE EARLY PROGRAMMING OF LONG-TERM HEALTH...................................................... 129 ASSESSMENT OF NUTRITIONAL INTAKE AND ENERGY CONSUMPTION FOR PHYSICAL ACTIVITY IN FIFTEEN-YEAR-OLDS WITH DIFFERENT BODY COMPOSITION.......................................................................... 130 EPIDERMOLYSIS BULLOSA AND IMPORTANCE OF DIETARY INTAKE.................................................................. 131 THE PRESENCE OF N-NITROSAMINES IN MEAT PRODUCTS............................................................................ 132 DETERMINATION OF THE DIETARY HABITS OF ADULTS POPULATION FROM ISTRIA USING THE 14-POINT QUESTIONNAIRE NAMED MEDAS................................................................................................................................ 133 NUTRITIONAL INTERVENTIONS IN PEOPLE WITH DOWN SYNDROME................................................................ 134 PROTEIN ENERGY WASTING IN PATIENTS WITH CHRONIC KIDNEY DISEASE....................................................... 135 SALT REDUCTION: CHALLENGE AND OPPORTUNITY FOR INNOVATION IN THE FOOD INDUSTRY............................... 136 MILK AND DAIRY PROTEINS FOR EXERCISE RECOVERY................................................................................. 137 MILK AND DAIRY PRODUCTS IN ADOLESCENT DIET . .................................................................................. 138 AN EXAMPLE OF SUCESSFUL HEALTH PROMOTION – HEALTHY DIET IN THE WORKPLACE...................................... 139 MANAGEMENT OF A DIABETES PATIENT IN THE REFERENCE CLINICS............................................................... 140 Physical activity and usage of dietary supplements among adolescents.......................................... 141 UNDERSTANDING EATING DISORDERS THE ROLE OF REGISTERED DIETICIANS IN MULTIDISCIPLINARY TREATMENT OF ED PATIENTS............................................................................................................... 142

5. Poster section abstracts........................................................................... 143 EDUCATION ON NUTRITION AS NECESSARY PART OF CHRONIC PAIN TREATMENT – PRESENTATION OF THE FIRST MULTIDISCIPLINARY TEAM FOR CHRONIC PAIN TREATMENT IN CROATIA ......................................................... 145 EATING HABITS OF THE ROMA POPULATION IN POMURJE............................................................................. 146 A MODEL OF INNOVATIVE APPROACH TO LOCAL SUSTAINABLE DEVELOPMENT – AN EXAMPLE OF GOOD PRACTICE FROM POMURJE................................................................................................................... 147 INFLUENCE OF DENTAL STATUS ON THE QUALITY OF FOOD INTAKE AND THE NUTRITIONAL STATUS IN ELDERY.......... 148 THE QUALITY OF NUTRITION FOR STUDENTS OF COACH EDUCATION IN KINESIOLOGICAL RECREATION..................... 149 SELECTED CHARACTERISTICS OF FOOD FOR SPECIAL MEDICAL PURPOSES....................................................... 150 WATER CONSUMPTION AMONG MOSTAR STUDENTS................................................................................... 151 NUTRITION COUNSELING IN INSTITUTE OF PUBLIC HEALTH COUNTY OF ISTRIA.................................................. 152 IMPLEMENTATION OF THE SCHOOL FRUIT AND VEGETABLES SCHEME IN SLOVENIAN SCHOOLS.............................. 153 IMPROVEMENT OF DIETARY HABITS OF EMPLOYEES................................................................................... 154 NUTRITIONAL STATUS EVALUATION AMONG RESIDENTS IN RETIREMENT HOMES................................................ 155 EFFICIENCY OF THE MULTIDISCIPLINARY PROGRAM ON SLJEME IN REDUCED BODY WEIGHT AND CORRECTING COMPOSITION BODY OF OBESE PEOPLE.................................................................................................. 156 ASSESSMENT OF FOOD QUALITY IN MENUS OF SCOUT CAMPS...................................................................... 157 ASSESSMENT OF FOOD QUALITY IN MENUS OF SCOUT CAMPS...................................................................... 158 RECREATIONAL ATHLETES AWARENESS OF DIETARY SUPPLEMENTS USAGE...................................................... 159 NUTRITIONAL HABBITS OF HEALTH WORKERS IN EASTERN CROATIA............................................................... 160 NUTRITION KNOWLEDGE ABOUT MILK AND MILK PRODUCTS AFFECTS BETTER DAIRY PRODUCTS CONSUMPTION ACCORDING TO RECOMMENDATIONS................................................................................... 161

NON-GOVERNMENTAL ORGANIZATIONS AS A SIGNIFICANT FACTOR IN PROMOTION OF HEALTHY EATING................... 162 THE IMPORTANCE OF NUTRITION FOR SYMPTOM MANAGEMENT OF PARKINSON DISEASE PATIENTS........................ 163 IMPLEMENTATION OF NATIONAL DIETARY GUIDELINES FOR HEALTHY NUTRITION IN KINDERGARTENS AND SCHOOLS: AN EXAMPLE OF REDUCING SUGAR IN THE NUTRITION OF CHILDREN ENROLLED IN KINDERGARTEN MURSKA SOBOTA.............................................................................................................................. 164 INFLUENCE OF MEDIA AVAILABLE DIETS ON EATING BEHAVIOURS AND THE SPREAD OF THE OBESITY EPIDEMIC........ 165 ENERGY INTAKE OF HOSPITALIZED PEDIATRIC PATIENTS.............................................................................. 166 PREGNANCY AND BREASTFEEDING DIET.................................................................................................. 167 THE FREQUENCY OF CONSUMPTION OF MILK AND DAIRY PRODUCTS IN CHILDREN OF 11- 14 YEARS IN THE AREA OF CENTRAL BOSNIA CANTON....................................................................................................... 168 AN INNOVATIVE WAY IN INTEGRATION ENCOURAGING OF THE PROPER NUTRITION IN AN INSTITUTIONAL TREATMENT OF THE ALCOHOLICS.......................................................................................................... 169 GLYCEMIC CONTROL AND NUTRITION AMONG DMT1 PATIENTS IN CROATIA....................................................... 170 SALT AND SUGAR SOURCES IN DIET AMONG STUDENT’S POPULATION ATUNIVERSITY OF MOSTAR......................... 171 EATING HABITS AND ATTITUDES OF VETERINARY MEDICINE STUDENTS WHO LIVE AT HOME OR AWAY FROM HOME..... 172 THE EFFECT OF THE EDUCATION ON PRIMARY SCHOOL CHILDREN’S KNOWLEDGE ABOUT SUGAR SWEETENED BEVERAGES.................................................................................................................................... 173 SUGAR AND SALT IN CONSUMER PRODUCT.............................................................................................. 174 PROFILE OF PATIENTS IN THE CLINIC FOR OBESE CHILDREN AND ADOLESCENTS IN A CHILDREN’S HOSPITAL ZAGREB......175 FISH INTAKE, MERCURY, AND METABOLIC SYNDROME: A REVIEW OF THE LITERATURE......................................... 176 EFFECT OF MATERNAL AND OFFSPRING DIET ON SURFACE AREA AND NUMBER OF WHITE ADIPOSE TISSUE ADIPOCYTES IN MALE RAT OFFSPRING.................................................................................................... 177 FACTORS WHICH AFFECT THE AMOUNT OF HOUSEHOLD FOOD WASTE............................................................. 178

1. SaĹžeci radionica

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UPORABA ERGOGENIH SREDSTAVA MEĐU SPORTAŠIMA REKREATIVCIMA Hrvoje Centner1, Maja Gradinjan Centner1,2, Daniela Čačić Kenjerić3 Nutricionizam Balans, Š.P. Preradovića 7, 31000 Osijek Klinički bolnički centar Osijek, Odjel za prehranu, J. Huttlera 4, 31000 Osijek 3 Prehrambeno-tehnološki fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Franje Kuhača 20, 31 000 Osijek

Puno je čimbenika koji doprinose uspjehu u sportu. Oni uključuju predispozicije u građi tijela i funkcionalnim sposobnostima, trenažni proces, motivaciju i mnoge druge parametre. Korištenje dodataka prehrani široko je rasprostranjeno među sportašima. Sportaši uzimaju dodatke prehrani s ciljem brže adaptacije na trening, povišenja razine energije, bržeg oporavka s ciljem intenzivnijeg treniranja, sprječavanja prekida u fazi treninga ili natjecanja kao posljedice iscrpljenosti, bolesti ili ozljede, postizanja boljih rezultata ili osiguravanja nutrijenata u slučajevima kada nisu u mogućnosti konzumirati uobičajenu hranu. Provedeno je istraživanje među sportašima rekreativcima u kojoj mjeri istražuju prednosti, moguće nedostatke i rizike korištenja te koja su sve sredstva koristili. Rezultati istraživanja će biti predstavljeni kroz teorijski dio radionice. Nakon toga sudionici radionice bit će podijeljeni u nekoliko manjih skupina. Svakoj skupini bit će dodijeljen prikaz sportaša rekreativca različitih parametara i aktivnosti. Svaka skupina će na temelju prikaza slučaja preporučiti uvođenje ili ukidanje uporabe pojedinih dodataka prehrani te korigirati prehranu pojedinog sportaša rekreativca. U završnom dijelu radionice predstavnik svake grupe prezentirat će rezultate za promatrani slučaj. Cilj ove radionice podizanje svijesti sudionika o primjeni dozvoljenih i nedozvoljenih supstanci unutar populacije sportaša rekreativaca. Ključne riječi: sport, dodaci prehrani, sportske ozljede, prehrana sportaša

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BODYRECOG - SUSTAV ZA DIGITALNO ANTROPOMETRIJSKO MJERENJE I PROCJENU ZDRAVSTVENIH RIZIKA Nika Jiroušek, Luka Leško LiveGood d.o.o., Dragutina Golika 63, 10000 Zagreb (Tehnološki park Zagreb d.o.o.)

LIVEGOOD & BODYRECOG Live Good d.o.o., je zagrebačka start-up tvrtka posvećena razvijanju ICT rješenja na području Biomedicine. Njene glavne aktivnosti su promocija zdravih navika u svrhu poboljšanja zdravlja i produženja života kroz razvijanje inovativnih eHealth i mHealth rješenja za jednostavnu, ranu i brzu detekciju zdravstvenih rizika. Naš proizvod je BodyRecogTM – integrativna webmobilna platforma za digitalno mjerenje ljudskog tijela, analizu i praćenje zdravlja. BodyRecog sustav je zamišljen kao sistem potpore i motivacije ljudima, te kao alat za praćenje tjelesnih promjena osobe (gubitak masti, povećanje ili smanjenje mišićne mase i obujma pojedinih dijelova tijela) uzrokovanih promjenom životnog stila (prehrana, vježbanje), određene terapije ili lijekova. Sustav je namijenjen zdravstveno osviještenim ljudima, sportašima, ljudima koji pate od zdravstvenih problema vezanih uz pretilost, liječnicima, trenerima, nutricionistima i ostalim profesionalcima. RADIONICA 1.TEORIJSKI DIO Prezentacija BodyRecoga sustava – koncept, znanstvena podloga i kako funkcionira aplikacija. 2.PRIKAZ SLUČAJA Demonstracija skeniranja i BodyRecog analize/izvješća - sudionicima radionice će se objasniti proces upotrebe i skeniranja te će sami moći isprobati BodyRecog. Uz to će dobiti primjer jednog stvarnog “slučaja” s BodyRecog izvješćem koji će se kasnije analizirati. 3.ZADACI I DISKUSIJA Sudionicima će se zadati da ovisno o svojoj profesiji osobi iz primjera (slučaj) uz pomoć BodyRecoga daju savjete i slože koncept prehrane/vježbanja/terapije. Teme diskusije: korist Bodyrecog sustava u profesijama sudionika, korištene mjere, analiza i parametri (dali bi nešto dodali/oduzeli, poboljšali).

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SKRIVENI SVIJET OSOBA S POREMEĆAJEM HRANJENJA KOMUNIKACIJA I NUTRICIONISTIČKA INTERVENCIJA Maja Žanko Dnevna bolnica za poremećaje prehranje, Psihijatrijska bolnica “Sveti Ivan”, Jankomir 11, 10090 Zagreb; Centar za poremećaje hranjenja Bea, Ribnjak 38, 10000 Zagreb

Prema navodima APA-e (American Psychiatric Association), “poremećaji hranjenja su bolesti kod kojih osobe imaju ozbiljne poremećaje u prehrambenim navikama i pripadajućim mislima i emocijama”. Poremećaji u prehrambenim navikama mogu imati vrlo različite forme. Vanjskom promatraču, unutarnji svijet osoba s poremećajem hranjenja se istovremeno može činiti tajanstvenim, ali i vrlo zastrašujućim i teškim za shvatiti. Vrlo često, oboljele osobe imaju dvojake osjećaje prema svojim nutricionistima: dok se sjedne strane dive njihovom znaju o hrani i njenim svojstvima, s druge strane ih se boje i doslovno ih mrze, osobito kada im govore kada i što moraju jesti. Mržnja je nerijetko vrlo otvoreno pokazana, verbalno ili neverbalno. Stručnjaku s malo iskustva u radu s oboljelima ova činjenica može biti izuzetno frustrirajuća i teška za podnijeti. Upravo su navedeni primjeri glavni razlozi radi kojih se relativno malo nutricionista, ali i ostalih stručnjaka, odlučuje na rad s osobama s poremećajima hranjenja. Jedan od ciljeva ove radionice je pokušati, kroz raspravu kliničkog slučaja, razjasniti razloge tog često neshvatljivog i “nepristojnog” ponašanja pacijenata. Također, bit će predstavljene specifične tehnike komunikacije i savjetovanja pacijenata s ciljem da se stručnjak osjeća spremnijim za rad s oboljelima, bez straha i frustracije. Psihoterapija je preporučeni tretman za liječenje poremećaja hranjenja, međutim nutricionistička intervencija ima izuzetno važnu ulogu ne samo pri liječenju, veći i kod prevencije poremećaja hranjenja. Nutricionističko savjetovanje je zapravo vrlo često za oboljelu osobu prvi korak u traženju pomoći. Upravo je radi toga, poznavanje i prepoznavanje simptoma poremećaja hranjenja izuzetno važno. Krajnji cilj nutricionističke intervencije je smanjenje ili potpuno uklanjanje simptoma poremećaja hranjenja te regulacija prehrambenih navika koristeći tehnike intuitivnog i svjesnog jedenja. Zaključno će sudionici imati priliku sudjelovati u iskustvenoj vježbi svjesnog jedenja. Ključne riječi: poremećaj hranjenja, nutricionistička intervencija, simptomi poremećaja hranjenja, svjesno jedenje, intuitivno hranjenje

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2. SaĹžeci predavanja

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POGREŠKE, ZAMKE I ZABLUDE U DOPINGU Zoran Bahtijarević Klinika za dječje bolesti Zagreb, Klaićeva 16, Zagreb

Doping je jedno od najvećih zla suvremenog sporta. Svakodnevno se suočavamo s novim slučajevima pozitivnih nalaza nakon testiranja na doping. Veliki dio tih nalaza rezultat je pogrešaka i zabluda sportaša, ali i tima oko njega. Pravilna, uravnotežena prehrana osnov je velikih rezultata. Na žalost i u takovoj prehrani kriju se zamke, koje mogu rezultirati pozitivnim testom na doping. Također, suvremeni je sport nezamisliv bez dodataka prehrani. Upravo se u tom području događa najviše pogrešaka i zabluda, koje mogu za posljedicu mati velike kazne, pa u konačnici i završeak karijere. Cilj je ovog predavanja ukazati na neke od pogrešaka, zamki i zabluda o dopingu, te nutricioniste, koji se sve važniji dionici u sportu, ali i ostale članove tima oko sportaša, još jednom upozoriti na njihovu važnost u sprečavanju namjernog i nenamjernog dopinga u sportu.

Ključne riječi: doping, sport, prehrana

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SIRUTKA I MLAĆENICA – ZANEMARENA FUNKCIONALNA HRANA Irena Barukčić Prehrambeno-biotehnološki fakultet Sveučilišta u Zagrebu, Laboratorij za tehnologiju mlijeka i mliječnih proizvoda, Pierottijeva 6, 10000 Zagreb

Glavni sporedni proizvodi mljekarske industrije su sirutka i mlaćenica, a oba proizvoda sadrže visokovrijedne sastojke zbog kojih se mogu smatrati funkcionalnom hranom. Unatoč tomu, njihov potencijal daleko je od iskorištenog. Mlaćenica zaostaje u proizvodnji maslaca i sadrži laktozu, proteine, membrane masnih globula, nešto mineralnih tvari i lecitin. Brojne znanstvene studije pokazale su da membrane masnih globula sadrže biološki aktivne sastojke koji primjerice djeluju inhibitorno na Helicobacter pylori, antitumorno protiv nekih vrsta raka, snižavaju koncentraciju serumskog kolesterola, te preveniraju gastrointestinalne infekcije. Sirutka nastaje u procesu proizvodnje sira i izvor je visokovrijednih proteina sirutke, laktoze, mineralnih tvari (prije svega soli kalcija) te vitamina B skupine (poglavito riboflavina). Proteini sirutke sadrže visok udjel esencijalnih aminokiselina pa im je biološka vrijednost veća nego u ostalih proteina životinjskog i biljnog podrijetla, uključujući proteine jaja koje se dugo smatralo referentnim. β-laktoglobulin i α-laktalbumin su izvor brojnih bioaktivnih peptida s pozitivnim utjecajem na krvožilni, gastrointestinalni, imunološki i živčani sustav. Zdravstvena vrijednost sirutke poznata je još od doba starih Grka, a tradicionalno se koristila u terapiji tuberkuloze, žutice, dizenterije, dijareje, kožnih oboljenja, itd. Mlaćenica se obično prerađuje fermentacijom bakterijama mliječne kiseline, dok se u slučaju sirutke koristi uglavnom ona koja je kisela i pasterizirana. Međutim, obje vrste proizvoda se prerađuju i stavljaju na domaće tržište u zanemarivim količinama. Stoga je cilj ovog predavanja obrazložiti nutritivnu i zdravstvenu vrijednost pojedinih sastojaka mlaćenice i sirutke osvrtanjem na rezultate najnovijih znanstvenih i kliničkih ispitivanja. Osim toga, pružit će se uvid u mogućnosti njihove prerade i iskorištavanja u prehrambene svrhe. Ključne riječi: funkcionalna hrana, mlaćenica, sirutka, biološki aktivni sastojci

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DIJETOTERAPIJSKI PRISTUP KOD BOLESNIKA NA ANTIKOAGULANTNOJ TERAPIJI Alenka Brozina Dom zdravlja Rijeka, Park Nikole Hosta 4, 51 000 Rijeka

Uvod: Antikoagulantna terapija se koristi kod bolesnika s dubokom venskom trombozom i određenih srčanih oboljenja,kao što su poremećaji srčanog ritma (fibrilacija i undulacija atrija) te nakon kirurške zamjene srčanih zalistaka mehaničkom valvulom. Temelj antikoagulantne terapije je sprečavanje aktivacije koagulantne kaskadne reakcije i stvaranja ugruška (tromba). Antikoagulantna terapija je kronična i najčešće doživotna. Rasprava: U današnje doba se koriste dvije temeljne antikoagulantne terapije, terapija varfarinom i NOAC (novi antikoagulantni lijekovi). Osnovno djelovanje NOAC-a je inhibicija koagulantnog faktora Xa (riavroksiban) te direktna inhibicija trombina (dabigratan). Ovi lijekovi ne zahtijevaju modifikaciju prehrambenih navika niti redovnu kontrolu određenih krvnih parametara, puno su elegantniji za korištenje no financijski zahtjevniji. U Hrvatskoj se najčešće koristi antikoagulantni lijek varfarin (Martefarin, Marivarin) koji je antagonist vitamina K. Aktivnost samog lijeka se izražava i kontrolira putem vrijednosti PV (protrombinsko vrijeme) čije se vrijednosti izražavaju u postotku i INR (“International Normalized Ratio”) čije se vrijednosti izražavaju brojem, a terapeutska širina se kreće između 2 - 4, ovisno o inicijalnoj dijagnozi. Zaključak: S obzirom na to da je Martefarin antagonist vitamina K, nužna je modifikacija prehrambenih navika pacijenta kako bi aktivnost lijeka bila u terapijskom rasponu. Zeleno lisnato povrće (špinat, raštika, lišće maslačka, blitva, kupus) sadrži visoku količinu vitamina K (više od 200 µg kalija na 100 g), koje ako se konzumira više od jedne porcije dnevno može signifikantno mijenjati vrijednost PV/INR. Namirnice s nižim udjelom vitamina K (manje od 100 µg kalija na 100 g) se mogu koristiti raspodijeljene u dvije do tri dnevne porcije bez značajnijih promjena u PV/INR vrijednosti. Također je nužno educirati pacijente o korištenju biljnih pripravaka tipa soka grejpa, brusnica, zelenog čaja te biljnih suplemenata (Hypericum perforatum, Ginko biloba, Ginseng,…) zbog interakcije s jetrenim enzimima (CYP 1A2, CYP 2C9,…), zbog čega se mijenja farmakokinetika i farmakodinamika varfarina. Danas se ne obraća dovoljna pozornost na dijetoterapijski pristup ovim bolesnicima stoga je nužna suradnja liječnika i nutricionista kako bi se ostvario individualizirani pristup bolesniku u prosvjećivanju i promjenama prehrambenih navika. Ključne riječi: antikoagulantna terapija, varfarin, vitamin K, prehrana

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NUTRICIONISTIČKI ASPEKTI ENTERALNE HRANE Marijana Ceilinger1, Helena Tomić-Obrdalj2, Jelena Miličević2, Lenkica Penava1, Davorka Gajari2 1

Belupo lijekovi i kozmetika d.d., Ulica Danica 5, 48 000 Koprivnica Podravka d.d., A.Starčevića 32, 48 000 Koprivnica

Uvod: Enteralna ili hrana za posebne medicinske potrebe koristi se pod nadzorom liječnika u svrhu nutritivne potpore kao dopuna ili potpuna zamjena uobičajenoj prehrani. Malnutricija uzrokovana bolešću je stanje koje karakterizira nedostatan unos energije, proteina i-/ili mikronutrijenata kao posljedica brojnih bolesti, stanja ili pojedinih terapijskih postupaka. Brojne studije pokazuju benefite primjene enteralnih formula, uključujući smanjen pobol, manje komplikacija, porast mišićne mase, poboljšanje kvalitete života bolesnika, ali i smanjenje duljine hospitalizacije te troškova liječenja. Materijali i metode: Nutritivni probir putem NRS obrazaca (Nutritional Risk Screening 2002) jednostavna je i brza metoda za detektiranje nutritivnog rizika kod bolesnika. U slučaju nutritivnog rizika započinje se s nutritivnom potporom te se propisuje enteralna prehrana. Kod većine bolesnika primjenjuju se standardne, polimerne, nutritivno potpune formule. Potrebno je kontinuirano praćenje rezultata nutritivne potpore, a po potrebi i korigiranje plana potpore .Za uspješno provođenje terapije ključna su i dobra organoleptička svojstva enteralne formule te primjena različitih okusa u skladu s preferencijama bolesnika. U cilju što uspješnijeg provođenja nutritivne terapije u ovom radu izrađeni su prijedlozi recepata za korištenje enteralne hrane u pripremi raznih jela, pri čemu se ne mijenjaju svojstva enteralne formule. Pripremljen je 7-dnevni jelovnik temeljen na prehrambenim potrebama odrasle osobe, karakteriziran kao normokalorijski i visokoproteinski. Za pripremu jela korištena je enteralna formula uz svježe i prerađene namirnice, karakteristične za Hrvatsku kuhinju. Nutritivna analiza recepata izvršena je u programu Genesis (Genesis R&D® v 6.00, ESHA Research, USA). Rezultati: U pripremljenim jelovnicima ostvarena kalorijska raspodjela u jednom serviranju iznosila je za proteine minimalno 20%, masti 25-30% i ugljikohidrate 50-55%. Enteralna formula je aplicirana u količini koja je adekvatna za dopunu normalnoj prehrani, uz minimalan utjecaj na organoleptiku, stoga su jela zadržala svojstven i tradicionalni izgled, miris, okus i konzistenciju. Zaključak: Za uspješno provođenje nutritivne terapije vrlo je važna pravovremena primjena nutritivne potpore kao i dobra prihvatljivost enteralne formule. Poštivanje osobnih preferencija, prehrambenih navika i tradicija bolesnika važan je dio procjene, kao i poboljšanja nutritivnog statusa. Aplikacija enteralne formule u svakodnevne jelovnike jedna je od mogućnosti personaliziranog pristupa terapije koji doprinosi održavanju kvalitete života bolesnika. Ključne riječi: enteralna hrana, malnutricija, nutritivna potpora, jelovnik

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PREHRANA I CRIJEVNI MIKROBIOM U CROHNOVOJ BOLESTI KOD PEDIJATRIJSKE POPULACIJE Charlene Compher, 2Dale Lee, 2Robert N. Baldassano, 3Anthony R. Otley, 2Lindsey Albenberg, 4 Anne M. Griffiths, 5Eric Z. Chen, 5Hongzhe Li, 5Erin Gilroy, 5Lisa Nessel, 3Amy Grant, 5 Christel Chehoud, 6Frederic D. Bushman, 7Gary D. Wu, 5,7James D. Lewis

University of Pennsylvania School of Nursing Department of Pediatrics/Division of Gastroenterology, Children’s Hospital of Philadelphia 3 Department of Pediatrics, IWK Health Centre, Halifax, Novascotia 4 Department of Pediatrics/Division of Gastroenterology, Hospital for Sick Children, University of Toronto 5 Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennslylvania 6 Department of Microbiology, Perelman School of Medicine, University of Pennsylvania 7 Department of Medicine/Division of Gastroenterology, Perelman School of Medicine, University of Pennsylvania 1 2

Uvod: Terapeutski ciljevi u liječenju Crohnove bolesti kod djece uključuju poboljšanje simptoma, povećanje kvalitete života (QOL) i zacjeljivanje crijevne sluznice. Iako parcijalna enteralna prehrana (PEN), ekskluzivna enteralna prehrana (EEN) i terapija anti-tumorskim faktorom nekroze alfa (anti-TNF) poboljšavaju simptome, usporedba učinkovitosti ovih pristupa u cilju zacjeljivanja crijevne sluznice i poboljšanja QOL-a ostaju nejasni. Disbioza crijevne mikrobiote jedna je od karakteristika Crohnove bolesti, no doprinoseći faktori ostaju nejasni. Metode: U ovom opažajnom (prospektivnom) istraživanju kod djece s Crohnovom bolešću kod kojih je uvedena PEN, EEN ili anti-TNF terapija usporedili smo kliničke ishode koristeći “Pediatric Crohn’s Disease Activity Index” (PCDAI), QOL i zacijeljivanje crijevne sluznice procijenjene pomoću fekalnog kalprotektina (FCP). 24-satno prisjećanje prehrambenog unosa, PCDAI, QOL i FCP su bili određeni prije uvođenja te nakon 8 tjedana terapije. Uzorci stolice na početku i nakon 8 tjedana su bili testirani pomoću “shotgun” metagenomike i uspoređeni s uzorcima stolica zdrave kontrolne skupine. Rezultati: U istraživanje smo uključili 90 djece s aktivnom Crohnovom bolešću, od toga 52 na terapiji anti-TNF-om, 22 na EEN-u i 16 na PEN-u uz prehranu ad libitum. Klinički odgovor, definiran kao značajno poboljšanje PCDAI-a bio je postignut kod 64 % djece na PEN-u, 88 % na EEN-u i 84 % na anti-TNF-u (test za trend P=0.08). FCP < 250 mg/g bio je postignut na PEN-u kod 14 %, EEN-u kod 45 % i anti-TNF-u kod 62 % djece (test za trend p=0.001). Poboljšanje u ukupnom QOL-u se nije statistički razlikovalo među skupinama, ali je bio najveći kod skupine na EEN-u u domeni zadovoljstva izgledom (P=0.03), te kod skupine na terapiji anti-TNF-om u emocionalnoj domeni (p=0.04). Disbioza crijevne mikrobiote bila je značajna kod jedne trećine pacijenata te je bila nezavisno povezana s upotrebom antibiotika, upalom sluznice crijeva i prehranom. Disbioza mikrobiote smanjila se sa smanjenjem intestinalne upale. Zaključak: Iako je PEN poboljšala kliničke simptome, EEN i anti-TNF su bile efikasnije u smanjenju upale sluznice crijeva i poboljšanju specifičnih aspekata QOL-a. Rezultati analize mikrobiote mogu potaknuti otkriće biomarkera i budućih terapeutskih intervencija. Ključne riječi: Crohnova bolest, mikrobiom, perhrana, djeca 52

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RANA POSTOPERATIVNA PREHRANA PACIJENATA NAKON TRANSPLANTACIJE JETRE Maja Ćurić Delač1, Leda Borovac Štefanović2, Željko Vidas1, Branislav Kocman1, Stipislav Jadrijević1, Jasna Aladrović3, Ivančica Delaš2 Klinička bolnica Merkur, Zajčeva 19, 10 000 Zagreb, Hrvatska Medicinski fakultet, Sveučilište u Zagrebu, Šalata 3, 10 000 Zagreb, Hrvatska 3 Veterinarski fakultet, Sveučilište u Zagrebu, Heinzelova 55, 10 000 Zagreb, Hrvatska

Uvod: Transplantacija je prijenos (usađivanje) ljudskih stanica, tkiva ili organa od donora primaocu, s ciljem obnove funkcije/a u tijelu.Često je jedini tretman kod krajnjeg stanja zakazivanja organa, kao što su jetra i srce.Danas je transplantacija u svijetu i kod nas prihvaćen i uspješan način liječenja bolesnika, kod kojih je iz bilo kojih razloga došlo do nepovratnog zakazivanja funkcije pojedinog, za život potrebnog organa.Prehrana bolesnika predstavlja važan segment u procesu liječenja. Odgovarajući unos energije i nutrijenata osigurava komponente nužne u procesima zarastanja, imunološkom odgovoru i normalizaciji metabolizma, što čini sastavni dio liječenja i oporavka. Ispitanici i metode:U istraživanju je sudjelovalo 50 odraslih osoba (15 žena, 35 muškaraca) kojima je izvršena transplantacija jetre. Prosječna dob pacijenata bila je 55 godina, s rasponom godina od 48 do 59.Provedena su antropometrijska mjerenja i strukturiranim upitnikom prikupljeni podaci o socio-demografskim karakteristikama i životnim navikama ispitanika. Vođena je detaljna evidencija o količini i sastavu nutritivnog unosa tijekom 14 dana postoperativnokorištenjemstandardnih bolničkih normativa koji su napravljeni prema Odluci o standardu prehrane bolesnika u bolnicama Ministarstva zdravstva i socijalne skrbi RH.Podaci su obrađeniχ2 testom pomoću računalnog statističkog programa Statistica, verzija 12. Rezultati:Istraživanje je pokazalo da je prosječni dnevni nutritivni unos tijekom prvih 14 dana nedostatan u većine pacijenata. Tijekom prva tri dana nakon transplantacije ukupni energetski unos manji je od 2/3 minimalnih energetskih potreba (REE, engl. Resting Energy Expenditure) u svih pacijenata. Tijekom 7 dana energetski unos je nedostatan u 70,8 % bolesnika, a nakon 14 dana energetski unos još je uvijek nedostatan u 47,9 % pacijenata. Tijekom istraživanog razdoblja unos proteina ne zadovoljava potrebe u 50 % pacijenata. U istom razdoblju uočen je vrlo mali unos masnoća. Zaključak:Rezultati ovog istraživanja ukazuju na nedostatnu prehranu pacijenata u ranom postoperativnom periodu nakon transplantacije jetre. Zbog ograničenog unosa masnoća, povećan je rizik od nedostatka esencijalnih masnih kiselina, kao i vitamina topljivih u mastima. Sagledavanje nedostataka u postupku nutritivne podrške bolesnika otvara mogućnosti da se promjenama u prehrani i/ili korištenjem odgovarajućih pripravaka za enteralnu i parenteralnu prehranu pozitivno utječe na brzinu i tijek oporavka, te tako skrati vrijeme i smanje ukupni troškovi liječenja. Ključne riječi: jetra, transplantacija, nutritivni unos www.kongresnutricionista.com |

UČESTALOST KORIŠTENJA MLIJEKA I MLIJEČNIH PROIZVODA KOD UČENIKA OSNOVNIH I SREDNJIH ŠKOLA U GRADU SPLIT Katja Ćurin¹, Ivana Gjeldum² ¹ Nastavni zavod za javno zdravstvo Splitsko – dalmatinske županije, Vukovarska 46, 21000 Split ² Jurja Šižgorića 30, 21000 Split

Uvod: Mlijeko je namirnica koja u povoljnim omjerima sadrži sve potrebne prehrambene i zaštitne tvari te vodu u visokom postotku (približno 87%). Bjelančevine mlijeka sadrže sve esencijalne aminokiseline neophodne za rast i razvoj djece, a organizam ih iskorištava odlično (95%). Mlijeko je bogato mineralima (natrij, kalij, kalcij, magnezij, fosfor, željezo, cink, bakar, jod, kobalt i sumpor. Mlijeko sadrži određene količine vitamina B-skupine (tiamin B1, riboflavin B2, cijanokobalamin B12), te vitamine topive u mastima (A, D, E, K). Cilj rada je bio istražiti znanje i navike u vezi korištenja mlijeka i proizvoda kod školske djece i mlađih adolescenata u gradu Splitu. Uzorak i metode rada: Istraživanje je obavljeno tijekom šk.god 2016./2017. putem anonimnog, dobrovoljnog anketnog upitnika. Anketni upitnik se proveo kod učenika u dva sedma i dva osma razreda u dvije osnovne škole (N= 104). Anketni upitnik također su riješili učenici dva treća i dva četvrta razreda u dvije srednje škole (N = 98). Upitnik je kreiran za potrebe ovog istraživanja, a sastojao se od 25 pitanja u vezi znanja o zdravstvenoj dobrobiti korištenja mlijeka i proizvoda i već usvojenim navikama njihovog korištenja. Upitnik je statistički obrađen i interpretiran. Korišten je X²-test, a statistička značajnost se uvažavala ako je p< 0,05. Rezultati: Pokazalo se da učenici osnovnih škola više i učestalije piju mlijeko i koriste mliječne proizvode (80%), dok im je znanje o zdravstvenoj dobrobiti mlijeka i proizvoda zadovoljavajuće, ali skromnije od učenika iz srednjih škola što se i očekivalo. Učenici srednjih škola značajno manje piju mlijeko (35 do 40%), radije uzimaju gazirana i ponekad alkoholna pića. Znanje o zdravstvenoj dobrobiti mlijeka i proizvoda im je dobro. Navike konzumiranja mlijeka i proizvoda učenici osnovnih i srednjih škola najviše stječu u obitelji (više od 70% ) Zaključak: Potrebno je kod učenika osnovnih i srednjih škola povećati potrošnju mlijeka i mliječnih proizvoda te podići razinu zdravstvene kulture o zdravstvenoj važnosti ovih namirnica preko javnih medija (TV, radio, internet, dnevni tisak, tjedni tisak, brošure, radionice, tribine i sl.) Ključne riječi: mlijeko,mliječni proizvodi, učenici, adolescenti, promocija zdravlja

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UPORABA KOMERCIONALNIH I ENTERALNIH PREHRAMBENIH PROIZVODA U INSTITUCIJAMA ZA SMJEŠTAJ I BRIGU O STARIJIM OSOBAMA U GRADU SPLITU Katja Ćurin¹, Ivana Gjeldum² ¹ Nastavni zavod za javno zdravstvo Splitsko – dalmatinske županije, Vukovarska 46, 21000 Split ² Jurja Šižgorića 30, 21000 Split

Uvod: Fiziološke promjene vezane za starenje utječu na potrebe za nutrijentima. Energetske potrebe i potrebe za makronutrijentima se smanjuju, međutim potrebe za mikronutrijentima jednake su ili veće nego tijekom zrele dobi. Planiranje obroka važan je dio nutritivne njege osoba starije dobi, a važni su i dodaci prehrani te oralni nutritivni dodaci (enteralni pripravci) i komercijalni proizvodi koji se propisuju kod dijagnosticirane ili prijeteće malnutricije. Prisutnost kroničnih bolesti i uzimanje lijekova mogu uzrokovati neravnotežu između potrebe za nutrijentima i prehrambenog unosa, što vodi nastanku malnutricije ili lošeg statusa uhranjenosti.. Malnutricija sa svoja “tri lica” (sarkopenijom, kaheksijom i anoreksijom) često se javlja u osoba starije dobi koje su hospitalizirane ili su smještene u institucijama. Takav loš nutritivni status povećava pobol i smrtnost te negativno utječe na svakodnevne aktivnosti, funkcije i kvalitetu života. Cilj rada je bio istražiti utjecaj komercionalnih proizvoda i enteralnih pripravaka na poboljšanje zdravstvenog stanja i kvalitetu života korisnika usluga domova za smještaj i brigu o starijim osobama Uzorak i metode rada:Istraživanje utjecaja komercijalnih proizvoda i enteralnih pripravaka na poboljšanje zdravstvenog stanja starijih osoba je izvršeno u dvije institucije za smještaj i brigu o starijim osobama u gradu Splitu. Praćeno je poboljšanje stanja kod korisnika koji su uzimali komercijalne pripravke ili enteralnu prehranu tijekom dvije godine. Rezultati su uspoređeni s kontrolnom skupinom korisnika usluga domova za starije osobe. Podaci su statistički obrađeni i interpretirani. Korišten je X²- test i t-test. Statistička značajnost se uvažavala ako je p< 0.05. Rezultati: Najbolji rezultati ovog praćenja pokazali su se kod tri česta patološka zbivanja u gerijatriji (dekubitalnih ulkusa, disfagije i demencije). Kod gotovo 90% starijih osoba s dekubitalnim ulkusima stanje se znatno popravilo već nakon 3 do 6 mjeseci korištenja novog načina prehrane. Kod 15 do 20% dementnih bolesnika enteralna prehrana i komercijalni pripravci su doveli do primjetnog poboljšanja. Kod disfagičnih starijih osoba nutritivni status se poboljšao već nakon nekoliko tjedana uzimanja novog oblika prehrana. Kvaliteta života je poboljšana kod sve tri dijagnoze. Zaključak: Komercijalna prehrana i enteralni pripravci trebali bi se još više koristiti u institucijama za smještaj starijih osoba, i proširiti njihovo korištenje kod osoba koji su na kućnoj njezi. Ovi pripravci su zalog boljeg i kvalitetnijeg života starijih ljudi smještenih u društvenim i privatnim institucijama ili koji su na kućnoj njezi. Ključne riječi: komercijalna hrana, enteralni pripravci, stariji ljudi, domovi za smještaj starijih osoba, kvaliteta života starijih osoba www.kongresnutricionista.com |

JAVNO ZDRAVSTVENE I PROMOTIVNE AKTIVNOSTI ZAVODA ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJE U PREVENCIJI KARDIOVASKULARNIH – PUT DO SAVJETOVALIŠTA ZA PREHRANU Olga Dabović Rac, Sunčica Matanić Stojanović, Danijela Lazarić-Zec, Aleksandar Stojanović Zavod za javno zdravstvo Istarske županije - Istituto di sanità pubblica della Regione Istriana (ZZJZIŽ), Nazorova 23, 52100 Pula

Uvod: Stanovništvo Istarske županije (IŽ) je pod visokim rizikom obolijevanja i umiranja (odgovorne za 87 % smrti) od kroničnih nezaraznih bolesti (KNB) - kardiovaskularne bolesti (KVB), rak, kronične respiratorne bolesti i dijabetes. KVB su bile županijski prioritet 2003. 2016. godine. U Planu za zdravlje i socijalno blagostanje IŽ 2017. - 2020. godine jedan od javnozdravstvenih prioriteta je Promocija zdravlja, prevencija i rano otkrivanje KNB.KNB se mogu u velikoj mjeri prevenirati kroz učinkovite intervencije prema zajedničkim rizičnim čimbenicima za ove bolesti: pušenje duhana, nepravilna prehrana, tjelesna neaktivnost i štetna uporaba alkohola. Kroz zadano razdoblje organizirat će se rad Centra za prevenciju kroničnih nezaraznih bolesti pri ZZJZIŽ u sklopu postojećih djelatnosti Zavoda. Od početka 2017. godine, kao dio navedenog prioriteta, u ZZJZIŽ započelo je s radom Savjetovalište za prehranu. Materijali i metode: ZZJZIŽsustavno provodi primarnu prevenciju KVB i potiče usvajanje zdravih životnih navika provedbom sljedećih programa: programi analize kvalitete prehrane i higijensko sanitarnog nadzora u predškolskim ustanovama na području IŽ, programi unapređenja prehrane u osnovnim školama gradova i općina IŽ, edukacija kuhinjskog osoblja i edukativne radionice u osnovnim školama, suradnja s Medicinskom školom Pula na projektu „Pokretom do zdravlja“ i drugim projektima, suradnja s udrugom Zelena Istra i srednjim školama na projektu „Istarski zeleni pjat 2“, organizacija „Sajma zdravog života i ljepote“ u suradnji s Strukovnom školom Pula, projekt „Školski vrt“, suradnja s Lokalnim akcijskim grupama u cilju promocije i veće upotrebe domaćih proizvoda, sudjelovanje na brojnim manifestacijama, organizacija raznih javnozdravstvenih akcija, koordinacija i provedba aktivnosti nacionalnog programa „Živjeti zdravo“. Rezultati: Kontinuirani i dugogodišnji rad u provedbi brojnih programa rezultirao je prepoznavanjem uloge ZZJZIŽ kao vodeće zdravstvene preventivne ustanove u IŽ. U cilju prevencije i očuvanje zdravlja žitelja svih životnih dobi potrebna je suradnja Zavoda s raznim zdravstvenim i odgojnim institucijama, udrugama civilnog društva, angažiranjem multidisciplinarnih timova i uključivanje stručnjaka raznih profila uz neophodnu podršku jedinica regionalne i lokalne samouprave. Sve navedeno rezultiralo je organiziranjem rada Savjetovališta za prehranu kao integrirane djelatnosti ZZJZIŽ. Zaključak: Zbog sve većeg bremena kroničnih nezaraznih bolesti potrebno je i nadalje razvijati i unapređivati preventivne programe na lokalnoj razini. Ključne riječi: ZZJZIŽ, prevencija KNB, savjetovalište za prehranu, multidisciplinarni pristup, podrška lokalne samouprave 56

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SOL KAO FUNKCIONALNA NAMIRNICA Ševal Đulović1, Midhat Jašić2, Zana Đulović-Jusić3 Solana d.d. Tuzla, Soli 3, Tuzla, Bosna i Hercegovina Tehnološki fakultet Tuzla, Univerzitet u Tuzli, Univerzitetska 8, Tuzla, Bosna i Hercegovina 3 Dom zdravlja Tuzla, Albina i Franje Herljevića 1, Tuzla, Bosna i Hercegovina 1

Nedostatak joda i prekomjeran unos soli globalni su problem stanovništva Zemlje. U nutritivnom smislu kuhinjska sol je glavni izvor Na i Cl za ljude i životinje. Njezin pravilan unos bitan je za život. Sol ima značajnu ulogu kao hranjiva tvar neophodna za održavanje homeostaze ljudskog organizma. Osim u prehrani sol se koristi u medicini, kemijskoj i prehrambenoj industriji. Osobe trebaju različite količine soli, ovisno o dobi, tjelesnoj masi, klimi, vlažnosti, podneblju, fizičkoj aktivnosti, zdravstvenom statusu, količini unesenog kalija i drugim čimbenicima. Prosječna potrošnja soli po glavi stanovnika na globalnoj razini je 10g/ dan ili 3,5-4,5 kg godišnje. 20% dnevnog unosa soli ostvaruje se putem namirnica koje sadrže sol, 15% naknadnim dosoljavanjem a čak 70% je tzv „skrivena sol“. Industrijska proizvodnja soli, njena relativno niska cijena te suvremeni životni stil, stvorili su navike konzumiranja hrane s većim sadržajem soli što ima za posljedicu povećanje smrtnosti od moždanog i srčanog udara,hipertenzije i oboljenja srca, bubrega i želuca. Iz tog razloga WHO preporučuje potrošnju soli 5-6 g/dan. Preporučuje se i korištenje zamjena za sol među kojima prednjači korištenje KCl soli. Oko 2 milijarde ljudi ima nedostatak unosa joda. Nedostatak joda može dovesti do pojave gušavosti, retardacije i kretenizma. Ako se jod unosi u dovoljnim količinama sprečava razvoj karcinoma (dojke, jajnika, maternice, prostate i štitne žlijezde) te pojačava imunološki odgovor organizmu u borbi protiv bakterioloških, virusnih, parazitskih i gljivičnih infekcija. Nutritivnom fortifikacijom s jodom kuhinjska sol je postala glavni izvor joda. Jodiranje soli može se vršiti s KI, NaI i KIO3. Međunarodne institucije (WHO, UNICEF, ICCIDD) preporučuju dnevni unos joda 150 mcg i preporučuju da se sol na izvorištu jodira s 20-40 mg I/kg soli. Imajući u vidu sve ove probleme vezano uz prekomjeran unos soli s jedne strane ali i činjenicu da je ona jedan od najznačajnijih izvora joda čiji unos je često nedostatan s druge strane, preporuke unosa soli trebalo bi usuglasiti sa smjernicama za jodiranje soli kako rješavanje jednog problema ne bi rezultiralo ekspanzijom drugog. Ključne riječi: jodirana sol, potrošnja soli, nedostatak joda

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KOMUNIKACIJA S ONKOLOŠKIM PACIJETNTIMA VEZANO ZA PREHRANU: ŠTO MEDICINSKO OSOBLJE TREBA ZNATI? Nicole Erickson Comprehensive Cancer Center LMU am Klinikum der Universität München, Campus Großhadern Marchioninistr. 15, 81377 München

Prema dosadašnjoj literaturi do 70% pacijenata oboljelih od raka pribjegava alternativnom obrascu prehrane, odnosno vrsti dijete, i/ili uzima nadomjeske prehrani. Međutim, manje od polovice navedenih bolesnika ove promjene u prehrani prijavljuje svome liječniku, odnosno medicinskom timu koji brine o njima. Unatoč činjenici da ne postoje konkretni i jasni dokazi koji bi podupirali poseban režim prehrane, pacijenti i dalje vjeruju da prehrambene intervencije (često ekstremne) mogu imati čudotvoran učinak koji nadilazi učinak uobičajeno korištene i dokazane prakse liječenja. Stoga, ne samo da je važno da medicinski tim osvijesti široku primjenu alternativnih tipova prehrane i suplemenata, već i da prilagodi komunikaciju s pacijentom putem koje će usmjeriti pacijenta ka liječenju koje se temelji na dokazima temeljenoj medicini te s educirati pacijenta koliko i na koji način prehrana može utjecati na njihovo zdravstveno stanje. Ključne riječi: onkološki pacijenti, prehrana, komunikacija

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PRIHVAĆANJE I ODBIJANJE HRANE U DOJENČADI I MALE DJECE Gillian Harris School of Psychology, University of Birmingham, Velika Britanija

Većina roditelja zna da svojoj djeci kao dio svakodnevne prehrane trebaju davati raznoliko voće i povrće. No, čini se, da veliki broj djece ipak odbija konzumaciju istih te preferira hranu bogatu mastima ili slatkog okusa. Preferencija prema okusima i hrani se uči, pitanje je zašto su onda dojenčad i mala djeca izbirljivija od drugih, da li je ovo problem koji potječe od roditelja ili od djeteta? U ovom predavanju prodiskutirat će se razvojna putanja naučenih preferencija prema hrani i osnovni čimbenici koji predodređuju odbijanje pojedinih namirnica. Opisat će se kritični i najosjetljiviji periodi u djetinjstvu u kojima se dijete izlaže novim okusima i teksturama, te individualne razlike među djecom u kontekstu izbirljivosti, responzivnosti i senzorne hiperosjetljivosti. Ključne riječi: preferencija prema okusima, dojenčad, djeca, senzorna osjetljivost

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ODRŽIVI OBRASCI PONAŠANJA S NAGLASKOM NA PREHRANU Iva Kantolić1, Maja Obrovac Glišić1, Branko Ančić2 Hrvatski akademski centar primijenjenog nutricionizma, Supilova 7, Zagreb, Institut za društvena istraživanja u Zagrebu – Centar za istraživanje društvenih nejednakosti i održivosti, Amruševa 11/II, Zagreb 1

Uvod: Prehrambeno ponašanje je vrlo kompleksan sustav, određen brojnim ekonomskim, kulturalnim i okolišnim faktorima. Teme o supernamirnicama ili različitim trendovima u prehrani postale su neizostavni dio brojnih medijskih platformi. No osim same nutritivne vrijednosti hrane, hranu kao temu treba sagledati puno šire. Suočeni smo s izazovom vrlo velikih količina hrane koja na kraju dana završi kao otpad. Višak hrane je evidentno prisutan, a to dokazuje i trend porasta debljine kao bolesti i svojevrsnog novog kanala gubitka hrane. Hrana koja se konzumira u suvišku, može se promatrati kao suvišno trošenje resursa. Uz sve navedeno, u Hrvatskoj se i dalje rijetko govori o aktualnom problemu klimatskih promjena i važnosti održivih obrazaca ponašanja, u cilju očuvanja naših prirodnih obnovljivih resursa. Kada govorimo o održivosti u kontekstu prehrane, ona obuhvaća niz ponašanja povezanih s proizvodnjom, pripremom i konzumacijom hrane, kao i načine postupanja s otpadom. Metode: Cilj ovog istraživanja je ispitati temeljno znanje građana Republike Hrvatske o održivim obrascima postupanja s hranom, te u kojoj su mjeri takva ponašanja dio njihove navike. Upitnik je konstruiran za potrebe ovog ispitivanja, a sadrži pitanja o znanju i uključenosti u održive načine ponašanja kada je u pitanju hrana. Ispitani su i demografski podaci, te su sudionici odgovorili na pitanja o zadovoljstvu načinom prehrane te života u cijelosti. Uzorak je prigodan, a odgovori su prikupljani metodom papir-olovka, te putem elektroničkog obrasca za odgovore (CASI – Computer Assisted Self-Interview). Obuhvaćeni su građani iz različitih dijelova Hrvatske. Rezultati: Informiranost i uključenost u različite obrasce održivog ponašanja, kada je u pitanju postupanje s hranom, prikazani su na razini deskriptivne statistike. Rezultati su analizirani s obzirom na demografske karakteristike sudionika, poput dobi i spola, razine obrazovanja, mjesta prebivališta i nekih karakteristika kućanstva. Zaključak: Rezultate možemo smatrati vrijednima za osmišljavanje i provođenje daljnjih istraživanja ove teme u Republici Hrvatskoj, te mogu poslužiti kao baza za pokretanje različitih (psiho)edukativnih programa. Ključne riječi: održiva prehrana, svjesnost, ponašanje

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UPOTREBA DODATAKA PREHRANI KOD VRHUNSKIH SLOVENSKIH SPORTAŠA Eva Kavka1, Lovro Žiberna2, Janko Dvoršak3, Petra Golja4 University of Ljubljana, Biotechical Faculty, Department of Food Science and Technology, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia 2 University of Ljubljana, Medical Faculty, Institute of Pharmacology and Experimental Toxicology, Korytkova 2, SI-1000 Ljubljana, Slovenia 3 Slovenian Anti-doping Organization, Celovška 25, SI-1000 Ljubljana, Slovenia 4 University of Ljubljana, Biotechical Faculty, Department of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia 1

Uvod: U skladu s ranijim izvještajima, korištenje dodataka prehrani je rasprostranjeno među sportašima, iako razlozi za njihovo korištenje nisu utemeljeni na dokazima (Maughan et al., 2007). Naime, dokazano je, kako neki dodaci prehrani su tvari s nepotvrđenim ili čak negativnim utjecajem na sportsku uspješnost. Slovenačka antidoping organizacija (SLOADO) obavlja redovite doping kontrole slovenskih sportaša, gdje sportaši vode izvješće o njihovim uporabama dodataka prehrani. Budući da analiza tih podataka do sada nije bila izvedena, istraživanje je za zadatak imalo obaviti detaljnu anonimnu analizu dodatka prehrani vrhunskih slovenskih sportaša u razdoblju od 2012. do 2016. godine. Metode: Neidentificirani podaci bili su sakupljeni u elektroničku bazu podataka. Podaci o spolu sportaša, dobi, sportskoj disciplini i dodacima prehrani bili su zabilježeni i analizirani. Neparametrički podaci bili su uspoređeni s hi-kvadrat testom i parametrijski podaci s analizom varijacije (ANOVA) i t-testom. Rezultati: Vrhunski sportaši koriste prehrambene dodatke u velikoj mjeri, s prevalencijom 68% (N=530). Dodaci prehrani, koji su najčešće bili prijavljeni, bili su vitamini (s prevalencijom 38%), a slijede proteini (37%) i minerali (36%). Nasuprot tome, korištenje sportskih pića, masnih kiselina, stimulansa i drugih tvari bila je rjeđa, s prevalencijom ispod 6%. Konačno, postoji mogućnost da se pojavljuju specifični obrasci upotrebe prehrambenih dodataka između različitih sportskih kategorija. Zaključak: Naši rezultati pokazuju na visoku rasprostranjenost dodataka prehrani kod sportaša. Zbog nedovoljnog znanja o optimalnoj sportskoj prehrani među sportašima i njihovim trenerima (Couture et al., 2015), sportaši dodatke prehrani koriste iracionalno. Rezultati ovog istraživanja pozivaju na pozornost obrazovne organizacije, kao što je tema ciljano obrazovanje sportaša i njihovih trenera. To je jedini dugoročni pristup, koji može podići kritičko razmišljanje, te može dovesti do povećane suradnje sportaša s prehrambenim stručnjacima. Ključne riječi: prehrambeni dodatci, sport, vitamini, uspješnost, rasprostranjenost

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VAŽNOST ADEKVATNOG UNOSA I STATUSA VITAMINA D ZA OSOBE STARIJE DOBI – REZULTATI ISTRAŽIVANJA SA STARIJOM ŽENSKOM POPULACIJOM Irena Keser Laboratorij za znanost o prehrani, Prehrambeno-biotehnološki fakultet, Sveučilište u Zagrebu, Pierottijeva 6, 10 000 Zagreb

Uvod: Vitamin D je glavna odrednica crijevne apsorpcije kalcija i potreban je za normalan metabolizam kosti. Nizak status vitamina D se povezuje i s kroničnim bolestima kao što su neke vrste karcinoma, dijabetes tip 1 i bolesti srca. Nedostatak vitamina D je problem u starijih osoba zbog niza razloga. Unos tog vitamina je često nizak u starije populacije. Količina provitamina D, koji se formira u koži, je također reducirana u starijih osoba. To se javlja zbog toga što je kapacitet za sintezu provitamina D, kad je koža izložena sunčevom svijetlu, reduciran i zato što starije osobe provode manje vremena vani. Jedini dobri prehrambeni izvori vitamina D su masne ribe kao što su losos, skuša, sardine i tuna, ali su to rijetko glavni izvori u prehrani. Drugi korisni izvori su jaja i ovisno o zemlji, obogaćene namirnice kao što su mlijeko, jogurt, margarin i žitarice za zajutrak. Ispitanici i metode: Ispitanice su bile starije žene prosječne dobi 76,0 godina (n=105). Status vitamina D je procijenjen određivanjem koncentracije cirkulirajućeg 25-hidroksivitamina D [25(OH)D] enzimskom imunoanalizom. Unos vitamina D je procijenjen metodom 24-h prisjećanja tijekom 3 dana. Rezultati: Prosječna razina 25(OH)D je bila 44,9 nmol/L, što je niže od adekvatne. Nizak status vitamina D je imalo 58,1 % ispitanica (<47,7 nmol/L; Immunodiagnostic Systems Ltd, Boldon, UK). U skupini starijih žena dobi ≥75 godina je utvrđena statistički značajno niža razina vitamina D s obzirom na skupinu žena dobi 65-74 godine. Prosječan unos vitamina D je bio samo 1,42 µg/dan. Zaključak: Prikladni načini prevencije niskog statusa vitamina D u starije ženske populacije su povećano izlaganje suncu i uzimanje vitamina D u obliku dodataka prehrani i/ili obogaćenom hranom. Ključne riječi: žene starije dobi, 25-hidroksivitamin D, unos vitamina D

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ULOGA PREHRANE U DUGOROČNOM PROGRAMIRANJU ZDRAVLJA I BOLESTI Sanja Kolaček Klinika za dječje bolesti Zagreb, Klaićeva 16, Zagreb

Godine 2001 rasvijetljen je ljudski genom i svih 30.000 aktivnih gena; to se još uvijek smatra jednim od najznačajnijih znanstvenih dostignuća modernog doba koje je trebalo razjasniti podrijetlo mnogih dosad nerazjašnjenih bolesti modernoga doba. Riječ je poglavito o malignim bolestima, autoimunosnim i heredodegenerativnim poremećajima čija je učestalost u današnje vrijeme poprimila epidemijske obrise. Nažalost, sekvencioniranje našeg genoma nije ponudilo odgovor – globalna pandemija nezaraznih bolesti (kardiovaskularnih, dijabetesa tip 2, autoimunih, malignih, itd) ne može se pripisati isključivo nasljednim uzrocima, a nisu niti neposredna posljedica naglih promjena okoline i stila kojim živimo. Upravo zbog naglih promjena u morbiditetu koje su se odigrale u posljednjih nekoliko desetljeća, a koje su još uvijek nerazjašnjene, znanstvenici su ponudili nove hipoteze o podrijetlu modernih bolesti. Na prvom mjestu riječ je o hipotezi Davida Barkera, koju je izvorno nazvao “Fetalnim programiranjem”, a koja se danas naziva “Developmental Origins of Health and Disease DOHaD” ili “Razvojno podrijetlo zdravlja i bolesti”. Navedena teorija povezuje zdravlje i bolesti u starosti s promjenama koje su se dogodile tijekom fetalnog razvoja – čak i prije koncepcije, te postulira da su moderne bolesti posljedica dvije grupe rizičnih čimbenika – prve koja se zbiva u najranijoj razvojnoj fazi dok smo drugoj skupini okolišnih rizičnih čimbenika izloženi tijekom kasnijeg života. Riječ je poglavito o različitim metaboličkim i imunološkim prilagodbama koje nastaju kao odgovor na promjene u okolini koje se odvijaju “in utero” i u prvih nekoliko godina života, a utiru put kardiovaskularnim, autoimunosnim i malignim bolestima. Glede mogućih mehanizama najčešće se spominju epigenetske promjene, utjecaj oksidacijskog stresa na skraćivanje telomere i promjene u strukturi mitohondrija, dok se ulogu okolišnog rizičnog čimbenika najčešće pripisuje promjenama u prehrani. Ciljevi ovog predavanja jesu: a. razjasniti DOHaD hipotezu; b. definirati pojmove razvojne plastičnosti, anticipirajuće prilagodbe i razvojne nepodudarnosti; c. razložiti potencijalne mehanizme koji mogu posredovati utjecaje okoline u programiranju budućeg zdravlja; d. raspraviti ulogu prehrane u dugoročnom programiranju Ključne riječi: dugoročno programiranje, prehrana, dijete

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PROCJENA PREHRAMBENOG UNOSA I UTROŠKA ENERGIJE TIJEKOM TJELESNE AKTIVNOSTI U 15-OGODIŠNJAKA RAZLIČITE KOMPOZICIJE TIJELA Jerneja Kožar1, Katja Zdešar Kotnik2, Gregor Starc3, Matej Gregorič4, Petra Golja2 1 University of Ljubljana, Biotechical Faculty, Department of Food Science and Technology, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia 2 University of Ljubljana, Biotechical Faculty, Department of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia 3 University of Ljubljana, Faculty of Sports, Laboratory for physical and motor development diagnosis, Gortanova 22, SI-1000 Ljubljana, Slovenia 4 National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia

Uvod: Trend nepravilnog načina prehrane i nedostatka fizičke aktivnosti među adolescentima raste u nekoliko posljednjih godina. Taj podatak je jako zabrinjavajuć, ne samo zbog trenutnog zdravstvenog stanja mladih već i zbog zdravstvenih rizika tih istih pojedinaca u odrasloj dobi. U dosadašnjim studijama, autori su se većinom fokusirali na individualne učinke prehrambenih navika ili na posljedice (ne)dovoljne tjelesne aktivnosti. Kako bismo uvidjeli koji od navedenih čimbenika ima veći utjecaj na kompoziciju tijela mlađe populaciji, oba smo čimbenika promatrali na istom uzorku ispitanika, što je ujedno i cilj ovog rada. Materijali i metode: Podatke za istraživanje smo prikupili u sklopu istraživanja „Analiza razvoja djece u Sloveniji“ (ARDS). Prikupljeni su antropometrijski podaci, podaci o prehrambenim navikama te podaci o tjednoj razini tjelesne aktivnosti. Ispitanici su podijeljeni u tri skupine (pothranjenost, optimalna (poželjna) tjelesna masa, prekomjerna tjelesna masa). Za svakoga od pojedinaca određen je tjedni utrošak energije koristeći Husky indeks, baziran na unosu hrane te razine tjelesne aktivnosti. Parametarski podaci analizirani su koristeći analizu varijance, a ne-parametarski podaci s hi-kvadrat testom. Rezultati: Predstavit ćemo postotak adolescenata koji imaju (nemaju) pravilne prehrambene navike, kao i one koji su (ne)dovoljno tjelesno aktivni. Detaljno ćemo raspraviti čimbenike koji utječu na kompoziciju tijela, pa tako i tjednu razinu tjelesne aktivnost te prehrambene faktore. Zaključak: Dobiveni podaci naglašavaju ključne čimbenike koje je potrebno razmotriti kada je u pitanju (ne)poželjna kompozicija tijela kod adolescenata. Kao takvi, podaci igraju veliku ulogu pri pripremi preventivnih strategija (aktivnosti). Ključne riječi: prehrana, tjelesna aktivnost, adolescenti, sastav tijela

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EPIDERMOLIZA BULOZA I VAŽNOST PREHRANE Petra Kučan Odjel za dijetetiku i prehranu, Klinika za dječje bolesti Zagreb, Klaićeva 16, Zagreb

Uvod: Epidermoliza buloza (EB) skupina je nasljednih bolesti karakteriziranih pojavom mjehura na koži i sluznicama kao posljedica genetskih poremećaja u strukturnim proteinima kože. Međutim, ovisno o kliničkoj slici, mogu biti zahvaćeni različiti sustavi, a često i ektodermalne strukture, kao nokti, kosa i zubi.Potrebe za energijom povećane su zbog metabolizma bolesti, opterećenog imunološkog sustava i konstantnog procesa zarastanja ožiljaka, a simptomi uzrokovani bolešću ometaju unos i adekvatnu apsorpciju hranjivih tvari. Nutritivni plan koji uključuje adekvatnu prehranu za djecu i adolescente s EB ključna je strategija liječenja, koja nažalost nerijetko izostaje. Rasprava: Razlikujemo četiri glavna tipa EB, ovisno o lokalizaciji zahvaćenog proteina i mjestu odvajanja kože: EB simpleks, junkcijski EB, distrofični EB i Kindlerov sindrom. Svaki od tipova razlikuje više podtipova bolesti. Klinička slika gotovo uvijek uključuje gastrointestinalne (GI) probleme, a komplikacije se mogu promatrati u različitim dijelovima GI trakta. Često su pogođena područja usta i jednjaka. Zubi su nerijetko strukturno neispravni i propadaju uz gingivitis, što uzrokuje probleme sa žvakanjem. Među komplikacijama valja istaknuti stenozu jednjaka, koja ograničava unos namirnica koje se mogu progutati. Konstipacija je jedna od najčešćih klinički značajki kod svih oblika EB. Anemija, snižene vrijednosti albumina i poremećaj apsorpcije česte su komplikacije kod težih oblika. Nutritivne potrebe pacijenata s minimalnim ranama i malo ili bez GI problema vjerojatno će biti više u odnosu na zdrave vršnjake, dok jekod težih oblika teško kvantificirati potrebe zbog multisistemske prirode bolesti.Važno je usmjeriti pažnju na unos energije, proteina, željeza, cinka, i vitamina D te vlakana. Zaključak:Iako se EB primarno predstavlja kao kožna bolest, ovisno o tipu, pokazuje kliničke značajke koje često imaju negativan utjecaja na rast i nutritivni status pacijenata. Također, djeca i adolescenti s EB imaju povećanu potrebu za energijom i hranjivim tvarima zbog rasta, uz stalno zarastanje rana i upalne procese. Stoga, istovremeno neadekvatan unos hrane i povećani zahtjevi za hranjivim tvarima dovode do lošeg nutritivnog statusa i posljedično usporenog rasta i razvoja. Zbog čega je izuzetno važno da liječenje svakog pacijenta s EB uključuje nutritivni plan uz redovito praćenje stanja pacijenta. Ključne riječi: epidermoliza buloza, gastrointestinalni problemi, prehrana, nutritivni status

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PRISUTNOST N-NITROZAMINA U MESNIM PRERAĐEVINAMA Iva Pavlinić Prokurica1, Sandra Pavičić Žeželj2, Danijel Brkić3, Dario Lasić3 Hrvatski centar za poljoprivredu, hranu i selo, Rim 98, Zagreb Nastavni Zavod za javno zdravstvo Primorsko-goranske županije, Krešimirova 52a,Rijeka 3 Nastavni Zavod za javno zdravstvo „dr Andrija Štampar“, Mirogojska cesta 16, Zagreb, Croatia 1

Uvod: Nitrozamini su kancerogeni i toksični spojevi koji mogu nastati u mesu i mesnim proizvodima kao produkt reakcije nitrita s proteinima mesa nakon što se mesu ili mesnim proizvodima dodaju nitriti, odnosno nitrati. Nitriti, odnosno soli nitrita koriste se u prehrambenoj industriji kao konzervansi u mnogim namirnicama. Dodaju se tako mesu i mesnim prerađevinama kako bi očuvali karakterističnu crvenu boju mesa i specifični okus prerađenog mesa i suhomesnatih proizvoda.Štetnost nitrozamina dokazana je u mnogim objavljenim znanstvenim radovima tijekom zadnjih 40.-ak godina te je stoga sve veći pritisak na proizvođače hrane, odnosno mesnu industriju da se reducira količina dodanih nitrita i nitrata kako bi se smanjila izloženost ljudi nitrozo spojevima. Unatoč tome, potrebna je stalna sustavna kontrola na prisutnost N-nitrozamina, obzirom da meso i mesni proizvodi kao glavni izvor proteina, čine veliki udio u prehrani kako odrasle populacije tako i djece. Metode: U sklopu ovog istraživanja ispitivana je prisutnost 6 različitih spojeva hlapivih N-nitrozamina u uzorcima industrijski proizvedene jetrene paštete 2 različita proizvođača na tržištu u Republici Hrvatskoj. Uzorci su do analize čuvani na 3 različite temperature, a prisutnost N-nitrozamina utvrđivana je u određenim vremenskim intervalima. Nakon pripreme uzorka destilacijom vodenom parom te ekstrakcije redestilata diklormetanom, obrađeni i pročišćeni ekstrakti uzoraka analizirani su praćenjem karakterističnih iona u vezanom sustavu plinske kromatografije i spektrometrije masa (GC-MS-SIM). Rezultati: Dobiveni rezultati kretali su se u rasponu od 0.0002 mg/kg – 0.996 mg/kg, ovisno temperaturi i vremenskom intervalu čuvanja uzoraka. Zaključak: Ovim istraživanjem utvrđeno je da je temperatura skladištenja doista povezana sa razvojem N-nitrozamina u mesnim proizvodima. To osobito dolazi do izražaja ako su proizvodi skladišteni na višim temperaturama, odnosno na sobnoj temperaturi i na temperaturi od 37°C kroz 5-10 dana. Potvrđeno je također da je nastajanje N-nitrozamina usko povezano s količinom dodanih nitrita u mesne proizvode i načinom čuvanja proizvoda. Ključne riječi: N-nitrozamini, mesni proizvodi, jetrena pašteta, skladištenje

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ODREĐIVANJE PREHRAMBENIH NAVIKA ODRASLOG STANOVNIŠTVA ISTRE POMOĆU UPITNIKA S 14 BODOVA METODE MEDAS Tamara Poklar Vatovec, Zala Jenko Pražnikar, Mojca Stubelj, Ana Petelin University of Primorska, Faculty of Health Sciences, Polje 42, SI-6310 Izola

Uvod: Mediteranska prehrana smatra se model prehranom za dobro zdravlje. Mediteranske zemlje pripadaju područjima u kojima su kronične neinfektivne bolesti, u usporedbi s drugim razvijenim zemljama, znatno rjeđe. Razlog za to treba tražiti u prehrani koja uključuje mediteransku hranu bogatu mononezasićenim masnim kiselinama, dijetskim vlaknima, antioksidantima, vitaminima i elementima. Uravnotežena i zdrava prehrana predstavljaju temelje dobrog zdravlja i ključni su elementi razvoja tijekom cijelog životnog ciklusa. Iz tih razloga, cilj ovog istraživanja bio je proučiti njihov utjecaj na odabrane odrednice zdravlja, s naglaskom na prevenciju kardiovaskularnih bolesti. Ispitanici i metode: Pomoću MEDAS upitnika s 14 bodova, na slučajnom uzorku od 159 odraslih stanovnika Istre (33% muškarci i 67 % žena, svi zaposleni), procijenjene su prehrambene navike te istraženo u kolikoj su mjeri u skladu s profesionalnim preporukama za zdravu prehranu. Upitnik MEDAS omogućuje verifikaciju pridržavanja mediteranske prehrane i učinaka takve prehrane na ljudsko zdravlje. Rezultati su dobiveni statističkom analizom pomoću SPSS računalnog programa. Rezultati: Dobiveni rezultati pokazuju da više od polovine ispitanih osoba konzumira preporučeni sadržaj povrća, voća, maslinovog ulja, nemasnog bijelog mesa, dok manje od polovine odraslih konzumira adekvatni sadržaj mahunarki (42,1 %), ribe (39,6 %) i orašastog voća (46,5 %). Maksimalan broj bodova MEDAS upitnika nije postignut, većina ispitanika ostvarila je 8 bodova (18.2 %). Ključni nalaz istraživanja je veza između višeg postotka visceralnog masnog tkiva i višeg unosa ribe i vina, što ne potvrđuje blagotvoran učinak ribe kao dio mediteranske prehrane na zdravlje. Zaključak: Mediteranska prehrana ima pozitivan utjecaj na zdravlje pojedinca. Integracija mediteranske prehrane na slovenskom prostoru je izazov u postizanju ciljeva prehrambene politike. Ključ je sigurno učinkovita edukacija potrošača o pravilnoj prehrani te promocija zdrave lokalno proizvedene hrane, što mediteranska dijeta svakako i jeste. Ključne riječi: Prehrambene navike, mediteranska prehrana, antropometrija, promocija zdravlja

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NUTRITIVNE INTERVENCIJE U OSOBA SA DOWN SINDROMOM Milka Popović1, 2, Jelena Bjelanović1, 2, Radmila Velicki1, 2, Violeta Popović2, 3 Medicinski fakultet, Univerzitet u Novom Sadu, Novi Sad, Srbija Institut za javno zdravlje Vojvodine, Novi Sad, Srbija 3 Udruženje za podršku osobama s Daun sindromom, Novi Sad, Srbija 1

Uvod: Down sindrom (DS) je genetski poremećaj koji nastaje kao posljedica trisomije kromosoma 21, koji se javlja kod 1 od 700 živorođene djece. Osim karakterističnog fizičkog izgleda, karakteriziraju ga poteškoće u intelektualnom razvoju, oslabljen mišićni tonus, niži rast i brojne strukturne malformacije i metabolički poremećaji koji mogu imati snažan utjecaj na njihov nutritivni status (NS). Najčešće se javljaju: malformacije zuba i donje vilice, veliki jezik, malformacije gastrointestinalnog trakta (konstipacija, GERD, Hirschsprungova bolest), srčane mane, poremećaji koštano-zglobnog sistema, kao i različite alteracije imunog sustava s učestalom pojavom diabetes mellitusa, Hashimoto tireoiditisa, hipofunkcije štitne žlijezde i celijakije. U visokom postotku kod osoba s DS se utvrđuje gojaznost. Cilj istraživanja je bio utvrditiraspoloživemetode za rano otkrivanje nutritivnih poremećaja (NP) i predložiti protokole za utvrđivanje NS i ranu nutritivnu intervenciju (NI) kod osoba afektiranih DS. Materijali i metode: Izrada protokola na osnovu dostupne literature te educiranje timova za primjenu protokola za rano otkrivanje NP i ranu NI kod osoba s DS. Rezultati: U suradnji s Udruženjem za podršku osobama s DS-om izrađeni su protokoli za utvrđivanje NS i ranu NI koji su prilagođeni okruženju, raspoloživom kadru i resursima te predstavljeni timovima u razvojnim savjetovalištima. NI obuhvaća: ranu edukaciju roditelja i podršku dojenju, procjenu mogućnosti dojenja/dohrane/prehrane, medicinsku nutritivnu terapiju utvrđenih nutritivnih poremećaja sa stalnim praćenjem napretka, kirurško liječenje, farmakološko liječenje, bihevioralne intervencije u vezi s prehranom i hranjenjem, edukaciju o pravilnoj prehrani i pravilnim prehrambenim navikama, kao i brojne socio-ekonomske intervencije. Edukacija započinje u obitelji uz značajnu stručnu podršku liječnika/pedijatra i nutricionista. Zaključak: Rano otkrivanje rizika za razvoj NP kod osoba s DS zahtjeva kontinuiran interdisciplinarni rad na praćenju rasta, NS, skrining poremećaja kao što su hipotireoidizam, celijakija, diabetes mellitus ili malformacije koje zahtijevaju kirurško liječenje. NI su često veoma složene, a ujedno moraju biti prilagođene potrebama svakog djeteta. Primjena protokola za rano otkrivanje NP i ranu NI predstavljaju dio kompleksnog sistema podrške osobama sa DS i njihovim obiteljima koji omogućava dostizanje punog kapaciteta za rast u okviru genetski određenih mogućnosti, usvajanje poželjnih oblika ponašanja i spriječavanje sekundarnih smetnji u razvoju. Ključne riječi: Down sindrom; nutritivni status; prehrana; intervencija 68

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PROTEINSKO ENERGETSKA POTHRANJENOST U BOLESNIKA S KRONIČNOM BOLEŠĆU BUBREGA Josipa Radić Zavod za nefrologiju i dijalizu, Klinički bolnički centar Split, 21000 Split

Proteinsko energetska pothranjenost (PEP) je česta pojava među bolesnicima s kroničnom bolešću bubrega (KBB) te je povezana je s nastankom neželjenih kliničkih ishoda. Čest i važan uzrok PEP u bolesnika s KBB je nedostatan unos proteina i energije. Glavni čimbenik odgovoran za ovaj nedostatan unos proteina i energije je anoreksija. Anoreksija dovodi do nedostatnog unosa proteina i energije te direktno pridonosi pogoršanju kvalitete života ovih bolesnika. Učestalost anoreksije među bolesnicima sa završnim stadijem KBB je 30-50 %. Anoreksija se može razviti kao posljedica porasta koncentracije uremijskih toksina, samoga postupka dijalize, pridruženih akutnih bolesti, stanja kronične upale, acidoze i /ili kao posljedica pridruženih kardiovaskularnih bolesti. Nedostatan unos prehrambenih tvari može nastati i kao posljedica drugih pridruženih bolesti koje imaju utjecaj na funkciju gastrointestinalnog sustava, pridružene depresije, poremećaja kognitivnih funkcija, lošeg stanja usne šupljine, loših socijalno-ekonomskih uvjeta, osjećaja nadutosti zbog prisutne peritonejske otopine u peritonejskoj šupljini bolesnika liječenih peritonejskom dijalizom (PD) ili pak kao posljedica osjećaja sitosti zbog absorbcije glukoze iz peritonejske otopine. Absorpcijom glukoze iz peritonejske otopine unosi se 300-600 kcal/dan što stvara osjećaj sitosti bez kvalitetnog unosa potrebnih nutrijenata. Također, bolesnici liječeni PD gube 5-7 g proteina na dan u peritonejsku otopinu, a ovaj gubitak proteina se višestruko povećava tijekom epizode akutnog peritonitisa. Zbog povećanog gubitka proteina u peritonejsku otopinu bolesnici liječeni PD često imaju niže serumske vrijednosti albumina i imaju veće potrebe za unosom proteina u usporedbi s bolesnicima liječenim hemodijalizom. Prisutnost peritonejskog dijalizata usporava pražnjenje želuca i stvara osjećaj sitosti koji može dovesti do neadekvatnog oralnog unosa nutrijenata te lošije podnošljivosti oralnih nadomjesnih preparata u bolesnika liječenih PD. Gubitak bjelančevina i aminokiselina tijekom postupka hemodijalize zajedno sa neadekvatnim unosom pridonosi manjku nutrijenata potrebnih za adekvatan mišićni status. Također, gubitak i drugih nutrijenata tijekom hemodijaliznog postupka (vitamina, elemenata u tragovima, krvi i glukoze) čine ovu skupinu bolesnika podložnim za razvoj PEP. U bolesnika, KBB stadij 3-5 preporučuje se dnevni unos proteina od 0.6-0.8 g/kg idealne tjelesne mase te dnevni unos energije 30-35 kcal/kg idealne tjelesne težine. Ovaj unos se mora prilagoditi stanjima povećanog katabolizma tijekom akutne bolesti i/ili hospitalizacije bolesnika. U bolesnika liječenih dijalizom preporučeni dnevni unos proteina je 1.2 g/kg idealne tjelesne težine, a energije 30–35 kcal/kg idealne tjelesne težine. Unos energije treba prilagoditi fizičkoj aktivnosti bolesnika. Kako mnogi čimbenici pridonose razvoju i progresiji PEP, potrebni su različiti terapijski pristupi s ciljem prevencije razvoja i liječenja PEP. Ključne riječi: proteinsko energetska pothranjenost, kronična bubrežna bolest, hemodijaliza, peritonejska dijaliza www.kongresnutricionista.com |

SMANJENJE SOLI: IZAZOV I PRILIKA ZA INOVACIJU U PREHRAMBENOJ INDUSTRIJI Jasmina Ranilović, Sašenka Vugrinec, Tanja Cvetković, Davorka Gajari Podravka, Istraživanje i razvoj, A. Starčevića 32, Koprivnica

Uvod: Unos soli uglavnom potječe od prerađene hrane. Uloga soli u prehrambenim proizvodima je višestruka: utječe na okus i teksturu, kao konzervans inhibira ili smanjuje razvoj neželjenih mikroorganizama, sprečava kvarenje, utječe na aktivnost vode i fermentacijske procese. Uzimajući u obzir ulogu soli u prehrambenim proizvodima i važnost njezinog preporučenog dnevnog unosa, ciljevi ovog rada su opisati taktike u smanjenju soli i prikazati rezultate razvoja novih proizvoda sa smanjenom udjelom soli, kroz inovativan sastojak. Materijali i metode: U prvoj fazi novi i inovativan sastojak sa smanjenim udjelom natrija je najprije teoretski zamišljen, zatim praktično razvijen i organoleptički ocijenjen. U drugoj fazi, inovativan sastojak je korišten kao rješenje za razvoj novih juha sa smanjenim udjelom soli/natrija. Testovi prihvatljivosti i preferencija novih proizvoda sa smanjenim udjelom natrija, provedeni su na značajnom broj potrošača kroz period od dvije godine. Za testove preferencija, korištene su klasične i inovativne metode. Rezultati: Razvijen je patentibilan sastojak, kao rješenje za razvoj i inovaciju novih prehrambenih proizvoda sa smanjenom količinom soli/natrija, prihvaćenih od potrošača i spremnih za komercijalizaciju. Zaključak: Prije odabira najbolje taktike za razvoj proizvoda sa smanjenim udjelom soli, važno je znati ulogu soli u njima, a da se ne naruši okus i trajnost. S time u vezi, postoje brojne prilike za inovaciju u sastavu proizvoda. Prehrambeni proizvodi sa smanjenim udjelom soli/natrija pomažu potrošaču u zdravim prehrambenim navikama. Međutim, radi postizanja dugoročnih ciljeva u smanjenju prekomjernog unosa soli na nacionalnoj razini, pozitivne medijske kampanje usmjerene na osvještavanje potrošača o dnevnom unosu soli i stvaranju potrebe za proizvodima s niskom razinom soli, značajno mogu doprinijeti promjeni ponašanja ka zdravim prehrambenim navikama. Zajedničko djelovanje svih dionika (državne institucije, prehrambena industrija, mediji, sveučilišta, potrošači) čini se najboljim rješenjem u stvaranu poželjnog okoliša za održivu prehranu tijekom cijelog života. Ključne riječi: smanjenje soli, inovacija, razvoj novih proizvoda, zdravlje, ponašanje potrošača

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MLIJEČNI PROTEINI U FUNKCIJI OPORAVKA NAKON TJELESNE AKTIVNOSTI Emma Stevenson Human Nutrition Research Centre, Newcastle University, United Kingdom

Određeni broj sportaša trenira ili se natječe svakodnevno ili više puta dnevno, te su stoga maksimiziranje i ubrzanje oporavka ključni za poboljšanje njihove izvedbe (Betts & Williams, 2010). Nutritivni dodaci prehrani, ako se konzumiraju tijekom perioda oporavka nakon intenzivnog treninga, mogu značajno utjecati na uspješnost oporavka. Veliki fokus se stavlja na primjenu mlijeka i mliječnih proteina (posebno sirutke) u oporavku kako od treninga izdržljivosti tako i od treninga snage. Ovo predavanje će se fokusirati na ulogu mlijeka i mliječnih proteina u ubrzanju oporavka te će objasniti dostupne znanstvene činjenice koje govore u prilog korištenju mlijeka nakon tjelesne aktivnosti. Također će spomenuti istraživanja koja su pratila ulogu mlijeka u sintezi proteina mišića, rehidraciji i oporavku mišićnih vlakana nakon tjelesne aktivnosti. Ključne riječi: mliječni proteini, regeneracija, sportska aktivnost

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ZASTUPLJENOST MLIJEKA I MLIJEČNIH PROIZVODA U PREHRANI ADOLESCENATA Irzada Taljić Univerzitet u Sarajevu, Pedagoški fakultet, Skenderija 72, 71000 Sarajevo, Bosna i Hercegovina

Uvod: U adolescenciji dolazi do ubrzanog rasta, povećanja mišićne mase, sazrijevanja i povećane fizičke aktivnosti. Tijekom adolescencije dobije se 50,0% ukupnog prirasta težine i više od 20,0% visine (Spear, 2002). Mlijeko je kompletna namirnica koja sadrži brojne nutrijente i zadovoljava potrebe organizma za kalcijem, magnezijem, selenom, riboflavinom, vitaminima B12 i B5. Proteini u kravljem mlijeku su visoke kvalitete (definirani kao proteini koji podržavaju maksimalan rast), sadrže dobro uravnotežen sastav svih esencijalnih aminokiselina, uključujući i lizin. Ljudskoj prehrani često nedostaje nekih esencijalnih aminokiselina. Na primjer, dijete na bazi pšenice i kukuruza sadrže samo 58 % preporučene količine lizina (WHO, FAO i UNU, 2007). S obzirom na prethodno navedeno, zadani cilj istraživanja odnosi se na zastupljenost mlijeka i mliječnih proizvoda u prehrani adolescenata i vanjskih čimbenika, koji su u ovom istraživanju definirani kroz mjesto boravka (ruralno/urbano). Ispitanici i metode: Studija je obuhvatila 630 ispitanika; 60 dječaka i 73 djevojčice iz ruralnog i 264 dječaka i 233 djevojčice (13-15 godina) iz urbanog dijela Kantona Sarajevo. Provedena je anketa u školama što je odobreno od strane nadležnog ministarstva obrazovanja i znanosti Kantona Sarajevo. Korištena anketa je klasificirana kao semikvantitativna i predstavlja modificirani upitnik korišten u sličnom istraživanju među adolescentima na području kantona Sarajevo (Taljić, 2015; Hodžić i Smajić, 2012). Podaci su statistički obrađeni pomoću programa SPSS 13.0. Rezultati: U segmentu utjecaja mjesta boravka adolescenata na učestalost konzumacije pojedinih namirnica, statistička značajna razlika utvrđena jeza dnevnu konzumacije mlijeka/ jogurta (p=0,014, χ2=5,819), a kod adolescentica za dnevne konzumacije mlijeka/jogurta (?=-0,211, p<0,005) i dnevne konzumacije mlijeka/jogurta izražene količinski (?=0,135, p=0,04). Zaključak: Mlijeko je najčešći izbor napitka za doručak (adolescenti: urbano vs ruralno: 44,80%: 36,70%; adolescentice: ruralno vs urbano: 32,90%:43,35%). Mlijeko konzumiraju više adolescenti iz urbanog i adolescentice iz ruralnog područja; isto je i kod dnevne konzumacije izražene količinski; tjedna konzumacija mlijeka je više prisutna kod adolescenata iz urbanog i adolescentica iz ruralnog područja (tjedna konzumacija u količini većoj od 4 šalice); Adolescenti u najvećem postotku konzumiraju sir 1-2 puta tjedno (dječaci: ruralno vs urbano: 58,30%:47,00%; djevojčice: ruralno vs urbano: 48,65:57,10%). Ključne riječi: adolescenti, konzumacija, rast i razvoj, mliječni proizvodi

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PRIMJER USPJEŠNOG PROMICANJA ZDRAVLJA: PROMICANJE PRAVILNE PREHRANE NA RADNOME MJESTU Leon Vedenik1, Ilonka Feher1, Branislava Belović2 Policijska uprava Murska Sobota, Ulica arhitekta Novaka 5, 9000 Murska Sobota, Slovenija, Pomursko društvo za boj proti raku, Ulica arhitekta Novaka 2b, 9000 Murska Sobota, Slovenija

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Uvod: Zdrav životni stil, uključujući i pravilnu prehranu, važan je dio promicanja zdravlja na radnome mjestu. Ključ je do uspjeha cjelovit pristup (permanentno informiranje i edukacija, poticajno okruženje, aktivna uključenost zaposlenika, naklonjena politika radne organizacije, povezanost sa zajednicom, inovativni pristupi). Metode: Prikazani program smisleno povezuje zaštitu zdravlja na radnome mjestu i promicanje zdravlja u Policijskoj upravi (PU) Murska Sobota, koja ima 537 zaposlenika. Program je 2016. uvršten među najuspješnije programe u Republici Sloveniji, a ujedno je i dobitnik međunarodnoga priznanja Europske agencije za zaštitu i zdravlje na radu. U okviru promicanja zdravlja naglasak je na pravilnoj prehrani, tjelesnoj aktivnosti, stresu te sudjelovanju u nacionalnim preventivnim programima. Kako bismo potaknuli što zdravije prehrambene navike kod zaposlenika, provodimo informiranje i edukaciju organizirajući radionice/predavanja, izložbe i ponudu informativnih sadržaja. Ponuda informativnih i edukativnih sadržaja, koji uključuju i recepte za zdrava jela, vrlo je bogata. Na raspolaganju su tiskani sadržaji dostupni na info-točkama i intranetu. Istovremeno, poboljšali smo ponudu obroka u kantini tako što smo u jelovnik uvrstili jela s nacionalnim certifikatom „zdravlju korisno jelo“. Kao inovativan i atraktivan pristup u motivaciji održava se natjecanje kuhara amatera (zaposlenika) u pripremi zdravih jela. Recepti natjecatelja objavljeni su u e-publikaciji te su na internetskim stranicama dostupni svim zaposlenicima. Natjecanje kuhara amatera postalo je tradicionalno. Rezultati: Povećanje informiranosti, znanja i svijesti o pravilnoj prehrani. Poboljšana ponuda jela u kantini PU Murska Sobota (jela s certifikatom „zdravlju korisno jelo“) te istovremeno za 40 % povećana potrošnja povrća. Razmjena informacija, iskustava i recepata postali su kod zaposlenika dio svakodnevice. Zaključak: Kontinuirano informiranje i podizanje svijesti o pravilnoj prehrani, mogućnost konzumacije zdravih jela u kantini ustanove te atraktivni načini motivacije uvelike mogu pridonijeti zdravijem načinu života, boljem zdravlju, kvaliteti života i produktivnosti zaposlenika. Ključne riječi: promicanje zdravlja na radnome mjestu, promicanje pravilne prehrane, certifikat „zdravlju korisno jelo“, natjecanje kuhara amatera u pripremi zdravih jela, Policijska uprava Murska Sobota

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VOĐENJE PACIJENTA U REFERENTNOM CENTRU ZA DIJABETES Zvezdana Vražič Zdravstveni centar "dr. Adolfa Drolca Maribor ", Ulica talcev 9, 2000 Maribor

Prema podacima iz sustava lijekova na recept u Sloveniji, broj korisnika lijekova za dijabetes se svake godine povećava za 3% (oko 2500 ljudi). Prema podacima Europske studije o zdravlju i zdravstvenoj zaštiti iz2014. godineprevalencija dijabetesa procjenjuje se na 6,9% populacije (interval pouzdanosti: 6,3-7,6%) među ljudima u dobi od 15 i više godina. U 2014. godini u Sloveniji, više od 104.550 bolesnika s dijabetesom uzimalo je lijekove za smanjenje šećera u krvi. Također, podaci iz Studije o zdravlju i bihevioralnom istraživanju koje je proveo Nacionalni institut za javno zdravstvo u razdoblju od 2001. do 2012. među stanovnicima Slovenije u dobi od 25 do 64 godine, pokazuju povećanje broja oboljelih od dijabetesa. Modelu FINDRISC detektirao jevisoki ili vrlo visoki rizik za oboljenje od dijabetesa tipa 2 u sljedećih 10 godina među 28% ispitanika u dobi od 55 do 64 godine. U ovoj dobnoj skupini šećerna bolest se povećava i gotovo je dvostruko češća među ženama. Među oboljelima od dijabetesa, 69% ima visok krvni tlak, 67% dislipidemiju, 41% ih je pretilo, a 19% su pušači. Trećina pacijenata ne hrani se pravilno, a samo polovina je fizički aktivna. Udio pretilosti među odraslima u 2012. bio je 17,4%. Nezdravi način života koji pridonosi nastanku šećerne bolesti, osobito nezdrava prehrana, prekomjeran unosu hrane, pretilosti i nedostatna tjelesna aktivnost, imali su trend rasta u tom razdoblju. Rana dijagnoza dijabetesa i pravodobno liječenje mogu spriječiti komplikacije bolesti, što predstavlja veliki teret za pojedinca i bližnje, te za zdravstveni sustav i za društvo. Uspostavljanjem sustavnog pregleda identificiraju se osobe s visokim rizikom za oboljenje od dijabetesa tipa 2 pri čemu se smanjuje učestalost bolesti. (1). Značaj referentnog centra (RA) odražava se u sustavnom i protokolarnom pristupu aktivnog prepoznavanja pacijenata oboljelih od dijabetesa. Multidisciplinarni pristup upravljanja kroničnim pacijentima, uključujući i oboljele od dijabetesa, preusmjerava se na primarnu razinu s novim zdravstvenim sustavom. Stoga je važno da svi govorimo istim jezikom i zajedno radimo u svrhu optimiziranja posla. Ključne riječi: referentni centar , odabrani osobni liječnik, šećerni bolesnik

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Tjelesna aktivnost i korištenje dodataka prehrani među adolescentima Katja Zdešar Kotnik1, Gregor Jurak2, Gregor Starc2, Martina Puc3, Petra Golja1 1 Sveučilište u Ljubljani, Biotehnički fakultet, Katedra za biologiju, Večna pot 111, 1000 Ljubljana, Slovenija 2 Sveučilište u Ljubljani, Fakultet sporta, Gortanova 22, 1000 Ljubljana, Slovenija 3 Institut za istraživanje i razvoj kvalitete, Parmova 14, 1000 Ljubljana, Slovenija

Uvod: Iako je korištenje prehrambenih dodataka (PD) među adolescentima opsežno istraživano, i to kako u sportaša tako i u ne-sportaša, gotovo ne postoje studije koje bi ispitivale prevalenciju korištenja PD u općoj populaciji adolescenata u odnosu na opseg njihove fizičke aktivnosti (FA). Stoga je cilj našeg istraživanja bio utvrditi prevalenciju i učestalost korištenja prehrambenih dodataka među adolescentima u odnosu na opseg FA. Materijali i metode: Podaci su bili dobiveni iz slovenske studije adolescenata ACDSi (14-19 godina) koji su bili upisani u 15 javnih srednjih škola u Sloveniji te su uključeni u nacionalno reprezentativnom uzorku istraživanja (N=1463). Prosječna dnevna potrošnja energije za FA (DEEFA) utvrđeni su pomoću standardnog upitnika SHAPES (School Health Action, Planning and Evaluation System) s dodatnim pitanjem u vezi članstva u sportskim klubovima (članovi sportskih klubova su bili klasificirani kao sportaši (N=365), ne-članovi kao ne-sportaši (N=640)). Podaci o PD su prikupljani nacrtnim upitnikom. Statistička analiza je bila izvršena testom Hi-kvadrat (X2) i neovisnim t-testom ili analizom varijance. Rezultati: Naši rezultati su pokazali da više od dvije trećine (69%) adolescenata koristi PD u primjeru da su korisnici PD definirani kao svatko tko koristi PD barem nekoliko puta godišnje. Međutim, ako su korisnici PD klasificirani prema učestalosti upotrebe PD, prevalencija se značajno promijenila, naime 52%, 40% i 14% za one koji koriste PD barem jednom mjesečno, tjedno ili dnevno, Multivitaminsko-multimineralni PD su najpopularniji u muškaraca (49%), a vitaminski u žena (45%). Vrlo značajan porast korištenja PD uočen je s višim prosječnim DEEFA i s članstvom u sportskom klubu; značajno veća učestalost korištenja PD zabilježena je u grupi sportaša (76%) u usporedbi s ne-sportašima (66%). Zaključak: Prehrambeno korištenje dodataka je rašireno među adolescentima, kako među sportašima tako i ne-sportašima, te je pozitivno korelirano s većim opsegom FA i članstvom u sportskim klubovima. Procjena prevalencije korištenja PD mnogo ovisi od učestalosti tog korištenja, te tako postoji hitna potreba po metodološkoj standardizaciji prikupljanja podataka u vezi s PD. Ključne riječi: prehrambeni dodaci, tjelesna aktivnost, članstvo u sportskom klubu, standardizacija

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KAKO RAZUMJETI POREMEĆAJE HRANJENJA ULOGA NUTRICIONISTA U MULTIDISCIPLINARNOM PRISTUPU LIJEČENJU OSOBE S POREMEĆAJIMA HRANJENJA Maja Žanko Dnevna bolnica za poremećaje prehranje, Psihijatrijska bolnica “Sveti Ivan”, Jankomir 11, 10090 Zagreb; Centar za poremećaje hranjenja Bea, Ribnjak 38, 10000 Zagreb

Prema navodima APA-e (American Psychiatric Association), “poremećaji hranjenja su bolesti kod kojih osobe imaju ozbiljne poremećaje u prehrambenim navikama i pripadajućim mislima i emocijama”. Trenutne procjene broja oboljelih osoba u Hrvatskoj jesu negdje između tridesetpet i četrdesetpet tisuća. Dijagnostički priručnici ICD-10 i DSM 5 navode tri osnovna poremećaja hranjenja: anoreksija nervoza, bulimija nervoza i poremećaj kompulzivnog prejedanja. Od navedenih poremećaja, anoreksija nervoza je mentalni poremećaj s najvišom stopom smrtnosti. Psihoterapija je preporučeni tretman za liječenje osoba koje boluju od poremećaja hranjenja. Može li poremećaj hranjenja biti uspješno liječen koristeći samo psihoterapiju? Rastući broj istraživanja sugerira da je multidisciplinaran pristup najefikasniji pristup u liječenju poremećaja hranjenja. U kontekstu multidisciplinarnog pristupa, nutricionistička intervencija ima izrazito važnu ulogu. Ovaj rad će posebno naglasiti bitnu ulogu nutricionista u ranom prepoznavanju i grupnom tretmanu osoba oboljelih od svih tipova poremećaja hranjenja te će istaknuti važnost obostrane suradnje s ostalim stručnjacima na području poremećaja hranjenja. Kao dio multidisciplinarnog timskog pristupa, nutricionističko savjetovanje u kombinaciji s principima kognitivno-bihevioralne terapije (KBT) i intuitivnog jedenja pokazuje značajne rezultate u smanjenju simptoma poremećaja hranjenja.Zaključno, bit će predstavljene metode rada i testovi koji mogu pomoći u identifikaciji osoba oboljelih od poremećaja hranjenja te koji su sljedeći bitni koraci u procesu liječenja nakon same identifikacije. Ključne riječi: poremećaj hranjenja, multidisciplinarni pristup, nutricionističko savjetovanje, kognitivno bihevioralna terapija

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EDUKACIJA O PREHRANI KAO NEIZOSTAVNI DIO LIJEČENJA KRONIČNE BOLI - PRIKAZ AKTIVNOSTI PRVOG MULTIDISCIPLINARNOG TIMA ZA LIJEČENJE KRONIČNE BOLI U HRVATSKOJ Jelena Balkić1, Maja Gradinjan Centner1, Ivan Radoš2, Ivana Lubina3, Ines Banjari4 Odjel za dijetetiku i prehranu, Klinički bolnički centar Osijek, J. Huttlera 4, 31000 Osijek, Hrvatska Sveučilište J.J.Strossmayera u Osijeku, Medicinski fakultet Osijek, Katedra za anesteziologiju, reanimatologiju i intenzivno liječenje, Ulica Cara Hadrijana 10E, 31000 Osijek, Hrvatska 3 Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Zavod za liječenje boli, Klinički bolnički centar Osijek, J. Huttlera Osijek, Hrvatska 4 Sveučilište J.J. Strossmayera u Osijeku, Prehrambeno-tehnološki fakultet Osijek, Katedra za prehranu, F. Kuhača 20, 31000 Osijek, Hrvatska 1

Kronična bol je bol koja traje duže od 3 do 6 mjeseci od uobičajenog vremena zacjeljenja ozljede ili liječenja bolesti, a opisuje se kao kontinuirana ili ponavljajuća. Europsko udruženje za istraživanje boli u Deklaraciji o boli (2001.) navodi kako kronična bol, za razliku od akutne, predstavlja sama za sebe poseban zdravstveni problem. Svaka peta osoba u Europi boluje od kronične boli. Ona često negativno utječe na sve aspekte čovjekova života izazivajući ozbiljne fizičke, psihološke i psihosocijalne poteškoće te bitno narušava kvalitetu života pojedinca. Suvremena medicina, nažalost, još nije pronašla lijek za učinkovito liječenje kronične boli. Cilj je opisati multidisciplinarni četverotjedni program za liječenje kronične boli koji se provodi u KBC Osijek u sklopu Zavoda za liječenje boli pod vodstvom doc.dr.sc.prim. Ivana Radoša, dr.med.. Radi se o prvom takvom programu u Hrvatskoj kroz koji je do sada prošlo 300 pacijenata. Program je osmišljen s ciljem smanjenja kronične boli i povećanjem ukupne kvalitete života osoba primjenom strogo individualnog pristupa. Članovi multidisciplinarnog tima su anesteziolog, viša medicinska sestra, fizijatar, fizioterapeut, endokrinolog, gastroenterolog, nutricionist, radni terapeut, psiholog, te psihijatar koji educiraju pacijente o lijekovima i ostalim nefarmakološkim postupcima liječenja boli. Edukacijom se želi smanjiti ovisnost pacijenata o zdravstvenom sustavu, te poboljšati svakodnevno tjelesno i emocionalno funkcioniranje. Veza između prehrane i kronične boli očituje se u razini proupalnih (npr. brza hrana, zaslađeni napitci i sl.), odnosno protuupalnih citokina (npr. maslinovo ulje, riba, tamno zeleno lisnato povrće i sl.) nakon konzumacije određene hrane kojima se bol pojačava odnosno smanjuje. Mediteranska prehrana se ističe kao najbolji princip prehrane za osobe koje boluju od kronične boli. Nutricionist je u tim uključen od rujna 2016. godine, a do sada je o prehrani educirano 70 pacijenata. Cilj je prikazati prehrambene navike i znanje o prehrani prilagođenoj zdravstvenom stanju osoba prije i nakon programa. Ključne riječi: kronična bol, multidisciplinarni tim stručnjaka, edukacija, prehrana

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UTJECAJ DENTALNOG STATUSA NA KAKVOĆU PREHRANE I STUPNJA UHRANJENOSTI U ISPITANIKA STARIJE DOBI Inga Beganović1, Irena Keser2, Ivana Rumbak2, Ivana Rumora Samarin2, Darko Kantoci3, Lorena Honović4, Vedrana Fontana5, Adnan Ćatović6, Irena Colić Barić2 Dentalna Klinika H-dent, Andree Amoroso 6, 52210 Rovinj, Hrvatska Laboratorij za znanost o prehrani, Prehrambeno biotehnološki fakultet, Sveučilište u Zagrebu, Pierottieva 6, 10000 Zagreb, Hrvatska 3 KanDar Enterprises, Inc., 250 Commercial Street, Suite 3005F, Manchester, NH 03101, USA 4 Odjel za laboratorijsku dijagnostiku, Opća bolnica Pula, Zagrebačka 34, 52100 Pula, Hrvatska 5 Savjetovalište za prehranu, Zavod za javno zdravstvo Istarske župnije, Nazarova 23, 52100 Pula, Hrvatska 6 Zavod za fiksnu protetiku i gerantostomatologiju, Stomatološki fakultet, Sveučilište u Zagrebu, Gundulićeva 5, 10000 Zagreb, Hrvatska

Uvod: U osoba starije životne dobi dolazi do narušavanja dentalnog statusa što posljedično narušava i prehrambene navike što se odražava na kakvoću prehrane i stupanj uhranjenosti. Smanjena oralna funkcija povezana je sa smanjenim indeksom tjelesne mase. Bezubi ispitanici imaju značajno niži unos povrća, vlakana i karotenoida, te visok unos kolesterola i zasićenih masti. Metodologija: U istraživanju je regrutirano ukupno 118 ispitanica sa područja Republike Hrvatske starosne dobi od 55 godina i više. Svim ispitanicama prikupljeni su podaci o kakvoći prehrane putem validiranih kvantitativnih anketa FFQ (Food Frequency Questionare) i MNA (Mini Nutritional Assessment), napravljena su antropometrijska mjerenja, izvađena krv za biokemijsku analizu koncentracije serumskog folata, vitamina B12 i lipidnog profila te obavljen stomatološki pregled za utvrđivanje dentalnog statusa. Standardizirani upitnici bazirani su na strukturi pitanje/potpitanje, te sadrže različite skale od 2 do 11. Da bi mogli statistički analizirati pitanje, svi podaci su normalizirani na raspon između 0 i 1.Većina odgovora normalizirana su izračunavanjem prosječne vrijednosti odgovora te dijeljeni sa brojem odgovora. Rezultati: Najveći izazov je bio normalizirati dentalni status sa plakom i protetskim statusom, prilikom čega je razvijen poseban algoritam da poveže ta tri svojstva kako bi se zajedno opisali u dentalnom statusu. Za dentalni status određeni su težinski faktori od 0 do 1 pojedinačno za zdrav zub, zub koji nedostaje, karijes, ispun, zaostali zubni korijen, krunicu, međučlan, zub u protezi. Analizom prikupljenih podataka dobivena je snažna korelacija između indeksa tjelesne mase (ITM) i dentalnog statusa (0.412). Također se pokazala značajna korelacija između dentalnog statusa i kakvoće prehrane (0.317). Zaključak: Statističkom analizom koja je provedena na normaliziranom dentalnom statusu i čimbenicima prehrambene kakvoće utvrđena je snažna korelacija između dentalnog statusa, kakvoće prehrane i stupnja uhranjenosti u starije populacije. Rezultati ovog istraživanja su prvi ovakvog tipa unutar hrvatske znanstvene bibliografije. Ključne riječi: dentalni status, prehrana, indeks tjelesne mase, starija populacija

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PREHRAMBENE NAVIKE ROMA U POMURJU Branislava Belović1, Lijana Zaletel Kragelj2, Jerneja Farkaš Lainščak3, Staša Tkalec4 Pomursko društvo za boj proti raku, Ulica arhitekta Novaka 2b, 900 Murska Sobota, Slovenija Medicinska fakulteta Univerze v Ljubljani, Vrazov trg 5, 1104 Ljubljana, Slovenija 3 Splošna bolnišnica Murska Sobota, Ulica dr. Vrbnjaka 6, 9000 Murska Sobota, Slovenija 4 Državni zbor Republike Slovenije, Poslanska skupina Stranke modernega centra Šubičeva ulica 4, 1000 Ljubljana, Slovenija 1

Uvod: Prehrana i zdravlje usko su povezani, kao što to potvrđuju rezultati brojnih istraživanja. Pravilna je prehrana zaštitni faktor, a nezdrava prehrana predstavlja faktor rizika za razvoj kroničnih nezaraznih bolesti. Nezdrav način života, odnosno nepravilna prehrana te rani oblici kroničnih nezaraznih bolesti učestaliji su među siromašnijim i manje obrazovanim skupinama stanovništva. Zbog toga je potrebno posebnu skrb namijeniti upravo tim skupinama na području istraživanja, kao i na području promicanja zdravlja i izvođenja preventivnih programa. Među ranjivim je skupinama stanovništva i romska populacija. Metode i ispitanici: U istraživanju smo se koristili upitnikomCINDI Health Monitor, koji se u Sloveniji koristi u istraživanjima životnog stila stanovništva povezanoga sa zdravljem. To nam omogućava usporedbu životnoga stila Roma i ostaloga stanovništva. Istraživanje se temelji na prigodnom uzorku od 258 pripadnika romske populacije koji žive u Pomurju. Dobiveni podaci uspoređeni su s rezultatima istovjetnoga istraživanja stanovništva Slovenije/ Pomurja. Rezultati: U rezultatima prikazujemo dio istraživanja koji se odnosi na prehrambene navike: učestalost konzumacije doručka, konzumaciju povrća, voća, masnoća – biljnih ulja, aromatiziranih gaziranih i negaziranih pića te dosoljavanje hrane. Doručak kao najvažniji obrok u danu konzumira 50,6% anketiranih Roma. Podaci se bitno ne razlikuju od onih u populaciji Pomurja. Svježe povrće svaki dan konzumira 36,2% Roma te 65,2% stanovništva Pomurja. Romi također rjeđe svakodnevno konzumiraju svježe voće (31 % svaki dan) za razliku od ostaloga stanovništva (54,8%). Biljnim uljima za pripremu hrane koristi se 80,9% Roma i 70,8 % stanovništva Pomurja. Aromatizirana gazirana i negazirana pića svakodnevno konzumira 45,6% Roma i 28,7% ostaloga stanovništva. Hranu za stolom ne dosoljava 68,6% Roma i 41,2% stanovništva Pomurja. Zaključak: Prevalencija nezdravih prehrambenih navika viša je kod Roma u Pomurju u usporedbi s prehrambenim navikama ostaloga stanovništva. Rezultati istraživanja služe kao osnova za pripremu politika i programa za zaštitu i unaprjeđenje zdravlja romske populacije te njihovu implementaciju s ciljem smanjivanja nejednakosti u zdravlju. Ključne riječi: prehrambene navike, Romi, stanovništvo Pomurja upitnik CINDI Health Monitor

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MODUL INOVATIVNOG PRISTUPA LOKALNOM ODRŽIVOM RAZVOJU – PRIMJER DOBRE PRAKSE IZ POMURJA Branislava Belović1, Staša Tkalec2, Andreja Počič1 Kmetijsko turistična zadruga Žitek Petanjci 19a, 9251 Tišina, Slovenija Državni zbor Republike Slovenije, Poslanska skupina Stranke modernega centra Šubičeva ulica 4, 1000 Ljubljana, Slovenija 1

Uvod: Pomurje spada među najnerazvijenije regije u Sloveniji s najlošijim socijalnoekonomskim statusom i posljedično slabijim zdravstvenim stanjem i zdravljem stanovništva. Lokalna opskrba hranom jedna je od mogućnosti koje mogu pridonijeti lokalnomu gospodarstvu, zaštiti okoliša, zdravlju stanovništva te razvoju ruralnoga prostora i demografskoj obnovi društva. Metode: Lokalnom inicijativom osnovana je Kmetijsko turistična zadruga Žitek (Poljoprivrednoturistička zadruga Žitek). Posebnost djelovanja zadruge u pomurskoj regiji očituje se u integraciji znanja priznatih stručnjaka (članovi zadruge); korištenju tradicionalnih vještina i lokalnoga znanja (članovi zadruge – poljoprivrednici i lokalni stanovnici); povezivanju s različitim institucijama u Pomurju. Zadruga uključuje sljedeće aktivnosti: promicanje i omogućavanje lakše prodaje viška poljoprivrednih proizvoda/prerađevina proizvedenih na tradicionalan način na ekonomski slabim poljoprivrednim gospodarstvima dopunskom djelatnošću; poticanje samoopskrbe lokalno proizvedenom hranom; informiranje, osvješćivanje i educiranje poljoprivrednika ekonomski slabih poljoprivrednih gospodarstava o proizvodnji, razvoju novih proizvoda i zaštiti okoliša te motiviranje stanovništva za konzumaciju lokalno proizvedene hrane. Rezultati: Rezultati uključuju mrežu 25 poljoprivrednih proizvođača s ekonomski slabih poljoprivrednih gospodarstava, koji u zadruzi nude viškove svojih proizvoda; uspostavljenu prodaju preko mreže potrošača; proizvodnju i prodaju prvih većih količina autohtonoga slovenskog češnjaka te velik medijski odaziv na nacionalnoj i lokalnoj razini koji je potaknuo masovnu proizvodnju autohtonoga slovenskog češnjaka; povećanje informiranosti, podizanje svijesti i znanja poljoprivrednih proizvođača i potencijalnih članova zadruge te doprinos popularizaciji i potražnji lokalno proizvedenih poljoprivrednih proizvoda. Zaključak: Zadruga u suštini predstavlja model inovativnoga pristupa, koji podupire održiv razvoj ruralnoga područja. Time se pridonosi većoj kvaliteti života ruralnoga stanovništva, posebice stanovništva s ekonomsko slabijih gospodarstava. Poticanjem samoopskrbe i opskrbe lokalno proizvedenom hranom, uglavnom povrćem, voćem i žitaricama, zadruga pridonosi zdravijem načinu prehrane i većoj kvaliteti života stanovništva. Isto tako, prodajom viškova, pridonosi ekonomiji spomenutih poljoprivrednih gospodarstava te ujedno podupire lokalnu ekonomiju i razvoj. Ključne riječi: Kmetijsko turistična zadruga Žitek (Poljoprivredno-turistička zadruga Žitek), lokalna opskrba/samoopskrba hranom, ekonomski slaba poljoprivredna gospodarstva, lokalna ekonomija 82

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KVALITETA PREHRANE STUDENATA PROGRAMA ZA IZOBRAZBU TRENERA KINEZIOLOŠKE REKREACIJE Leda Borovac Štefanović1,2, Iva Karla Crnogorac1, Čučević Đivo1, Petra Jagarinec1, Ivančica Delaš1 1

Medicinski fakultet, Sveučilište u Zagrebu, Zagreb, Hrvatska Prolife, Marulićev trg 12, Zagreb

Uvod: Dnevne energetske potrebe predstavljaju količinu energije koja je nužna da bi se pokrila energetska potrošnja bazalnog metabolizma, tjelesne aktivnosti kao i popravka oštećenih tkiva. Trening ili sportska natjecanja općenito povećavaju dnevne zahtjeve za energijom, ovisno o trajanju, vrsti i intenzitetu aktivnosti. Prava dijeta će optimizirati razinu energije i pomoći sportašu da se učinkovitije oporavi. Cilj ovog istraživanja bio je istražiti kvalitetu prehrane među trenerima kineziološke rekreacije. Ispitanici i metode: Studija je obuhvatila 16 studenata (3 žene, 13 muškaraca) obrazovanja trenera u kineziološkoj rekreaciji. Provedena su antropometrijska mjerenja i prikupljeni podaci o načinu života. Utrošak potrošnje energije (REE) izračunat je prema Harris-Benedict formuli i uspoređen s ukupnim unosom hranjivih tvari na temelju dnevnika prehrane vođenog kroz tri dana. Rezultati: Srednja dob sudionika bila je 36,5 godina (raspon od 27 do 48), s prosječnim indeksom tjelesne mase (BMI) od 26,3 kg/m2 (raspon od 21,0 do 29,9). Pedeset posto sudionika navodi najmanje 30 minuta tjelesne aktivnosti dnevno, dok ostali redovito vježbaju 1-2 sata dnevno. Prosječni dnevni energetski unos ispitanika dovoljan je da pokrije REE i sjedilačku aktivnost. Međutim, intenzivnije tjelesne aktivnosti nisu uvijek pokrivene odgovarajućim prehrambenim unosom. U nekoliko je slučajeva utvrđen vrlo nizak unos proteina. Također, potrošnja voća i zelenog povrća bila je prilično niska. Zaključak: Studenti programa za trenere u kineziološkoj rekreaciji svjesni su važnosti odgovarajuće prehrane i redovite tjelesne aktivnosti u očuvanje zdravlja. Međutim, potrebno je dodatno obrazovanje kako bi se poboljšale njihove vještine u pravilnom planiranju prehrane. Ključne riječi: prehrana, kineziološka rekreacija, energetski unos, proteini

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IZABRANE KARAKTERISTIKE HRANE ZA POSEBNE MEDICINSKE POTREBE Marijana Ceilinger1, Valerija Bukvić2, Nina Puhač Bogadi2, Jelena Miličević2, Lenkica Penava1, Vesna Popijač2, Davorka Gajari2 , Helena Tomić-Obrdalj2 Belupo lijekovi i kozmetika d.d., Ulica Danica 5, 48 000 Koprivnica Podravka d.d., A. Starčevića 32, 48 000 Koprivnica

1 2

Uvod: Pristup razvoju hrane za posebne medicinske potrebe bazira se na multidisciplinarnom pristupu i umrežavanju tehnoloških, nutricionističkih i medicinskih ekspertiza. Cilj je s više različitih aspekata osigurati i potvrditi prikladnost prehrambenog proizvoda za primjenu u nutritivnoj terapiji bolesnika. Hrana za posebne medicinske potrebe je posebno oblikovana hrana za dijetalnu prehranu bolesnika i koristi se pod liječničkim nadzorom. Materijali i metode: Odabrane karakteristike i zahtjevi proizvoda obrađeni u ovom radu su: nutritivni sastav, označavanje proizvoda, senzorska procjena, potvrda nutritivnih karakteristika te sustavi osiguranja kvalitete. Rezultati: Kako bi sastav proizvoda odgovarao nutritivnim potrebama bolesnika, a označavanje proizvoda jamčilo adekvatnu informiranost bolesnika i zdravstvenih djelatnika, primjenjuju se odredbe opće i specifične prehrambene legislative, koriste se smjernice stručnih udruženja, opće prihvaćena nutricionistička i medicinska načela te rezultati istraživanja iz područja kliničke prehrane.Senzorska ispitivanja i testiranja potrošača podliježu istom metodološkom pristupu kao i sva ostala hrana. Trening panela podrazumijeva upoznavanje sa svojstvenim karakteristikama proizvoda visoko obogaćenog nutritivnog sastava kako bi se spriječila diskriminacija proizvoda. Sudjelovanjem laboratorija Kontrole kvalitete u testovima sposobnosti (engl. Proficiency test) dokazana je vanjska ocjena kvalitete rezultata ispitivanja nutritivnih karakteristika proizvoda.Iz aspekta sigurnosti hrane ova hrana proizvodi se prema načelima Zakona o hrani i pratećim pravilnicima tako da se proizvodnja može certificirati prema prihvaćenim standardima od strane Global Food Safety Initiative - GFSI (Globalna inicijativa za sigurnost hrane). S obzirom na višu razinu rizika ovog tipa proizvodnje, primjenjuje se IFS kao jedan od strožih standarda sigurnosti i kvalitete hrane. Zaključak: Sastav hrane za posebne medicinske potrebe određen je zakonskim propisima, ali značajan je i utjecaj prehrambenih smjernica, preporuka i rezultata kliničkih ispitivanja. Senzorska testiranja s korisnicima proizvoda su potencijalno ograničena, ali s dobro osposobljenimpanelima senzorskih ocjenjivača i potrošača osiguravaju se kvalitetni rezultati koji pomažu u razvoju i kontroli kvalitete proizvoda.Testovi sposobnosti čine esencijalni dio postupka laboratorijske kontrole, te sudjelujući u njima laboratoriji osiguravaju povjerenje u korištenu laboratorijsku opremu, metode i osoblje, ali i dokaz vjerodostojnih rezultata ispitivanja.Certificiranje proizvodnje od strane GFSI prihvaćenih standarda garantira svima u lancu hrane dodatnu sigurnost u zdravstvenu ispravnost proizvoda. Ključne riječi: hrana za posebne medicinske potrebe, nutritivne karakteristike, označavanje proizvoda, senzorska procjena, sustavi osiguranja kvalitete 84

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KONZUMACIJA VODE STUDENTSKE POPULACIJE U MOSTARU Daniela Čačić Kenjerić1,2, Marija Leko2, Ivana Flanjak1, Marizela Šabanović3 1 Prehrambeno-tehnološki fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Franje Kuhača 20, 31 000 Osijek, Hrvatska 2 Agronomski i prehrambeno-tehnološki fakultet Sveučilišta u Mostaru, Biskupa Čule bb, 88 000 Mostar, Bosna i Hercegovina 3 Tehnološki fakultet, Univerzitet u Tuzli, Univerzitetska 8, 75000 Tuzla, Bosna i Hercegovina

Uvod: Voda je esencijalna sastavnica hrane i pića koja u ljudskom tijelu čini čak 60 % ukupne mase. Najzastupljenija je u tjelesnim tekućinama, slini i urinu. Najvećim dijelom potrebe za vodom se osiguravaju putem različitih vrsta tekućine i hrane, dok se male količine vode osiguravaju i iz metaboličkih procesa. Ipak, primarno se pri procjeni unosa vode razmatra sama konzumacija vode. Adekvatan unos vode za odrasle osobe prema preporukama Svjetske zdravstvene organizacije iznosi 30 ml/kg tjelesne težine, što prosječno iznosi 2,0 L/dan za žene i 2,5 L/dan za muškarce. Zadatak rada bio je utvrditi naviku konzumacije vode u studentskoj populaciji u Mostaru. Ispitanici i metode: Presječnim istraživanjem obuhvaćeno je 97 studenata (35 studenata i 62 studentice) dobi 19 do 26 godina. Za prikupljanje podataka korišten je u tu svrhu posebno koncipiran anonimni upitnik koji su ispitanici popunjavali kroz intervju. Upitnikom su prikupljeni opći podaci o ispitanicima, podaci o životnim navikama te podaci o učestalosti konzumacije odabranih vrsta tekućina i hrane, a koji u značajnoj mjeri doprinose unosu vode. Prikupljanje podataka provedeno je tijekom lipnja 2016. godine. Za potrebe ovog rada izdvojeni i obrađeni su podaci koji se odnose na konzumaciju vode. Rezultati: Rezultati su uz prikaz na cijelu ispitivanu populaciju predstavljeni i obzirom na spol, status uhranjenosti (iskazan kao BMI), bavljenje fizičkom aktivnošću te naviku pušenja. Utvrđeno je da najveći dio studenata konzumira vodu u količini do 1 L dnevno (43 %) te 1-2 L dnevno (30 %). Adekvatan unos vode ima tek 6 % studentica i potencijalno 20 % studenata. Utvrđen je trend većeg unosa vode kod ispitanika s normalnom tjelesnom masom u odnosu na one s povećanom tjelesnom masom i pretile, kod ispitanika koji se bave fizičkom aktivnošću u odnosu na neaktivne te kod nepušača u odnosu na pušače. Zaključak: S obzirom na to da većina studenata ne zadovoljava preporuke unosa vode potrebno je provesti edukaciju o njezinom značenju u hidraciji organizma te prednostima u odnosu na ostale vrste tekućine. Ključne riječi: voda, studenti, Mostar

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SAVJETOVALIŠTE ZA PREHRANU U ZAVODU ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJE Olga Dabović Rac, Klaudija Blarežina, Helena Mitrović, Kristina Jelenić, Lara Meden, Vedrana Fontana, Aleksandar Stojanović Zavod za javno zdravstvo Istarske županije - Istituto di sanità pubblica della Regione Istriana (ZZJZIŽ), Nazorova 23, 52100 Pula

Uvod: U Planu za zdravlje i socijalno blagostanje Istarske županije (IŽ) 2017. - 2020. godine jedan od javnozdravstvenih prioriteta je Promocija zdravlja, prevencija i rano otkrivanje kroničnih nezaraznih bolesti (KNB). Kroz zadano razdoblje organizirat će se rad Centra za prevenciju kroničnih nezaraznih bolesti pri ZZJZIŽ u sklopu postojećih djelatnosti Zavoda. Od početka 2017. godine, kao dio navedenog prioriteta, u ZZJZIŽ započelo je s radom Savjetovalište za prehranu čije su usluge besplatne za sve žitelje IŽ. Materijali i metode: Savjetovalište za prehranu je integrirana djelatnost ZZJZIŽ u čijem radu sudjeluje nutricionist, liječnici specijalisti epidemiologije, liječnici specijalisti školske medicine i psiholozi. Aktivnosti Savjetovališta za prehranu posebno su usmjerene prema djeci i njihovim roditeljima, adolescentima, studentima i mladima, ali mogu ga koristiti i svi ostali žitelji IŽ. Rad Savjetovališta je organiziran u jutarnjim i popodnevnim terminima. Pristup u Savjetovalištu je individualan i grupni, a moguće je i e - savjetovanje. U individualnom radu koristi se procjena nutricioniste (dijetetičke i antropometrijske metode) te po potrebi procjena liječnika specijaliste školske medicine i psihologa. U grupnom radu daje se naglasak na usvajanju zdravih životnih navika kroz razne radionice unutar zajednice (suradnja s odgojno - obrazovnim ustanovama, klubovima umirovljenika, sportskim klubovima, udrugama i medijima). Korisnicima nije potrebna uputnica za usluge Savjetovališta, a naručuju se putem telefona, e-maila ili Facebook stranice. Rezultati: U individualnom radu pratit će se poboljšanje životnih navika i smanjenje rizika obolijevanja od KNB kod korisnika. Očekuje se da će rezultati ovog projekta dugoročno utjecati na unaprjeđenje životnih navika s naglaskom na unaprjeđenje kvalitete prehrane žitelja IŽ. Zaključak: Kroz kontinuirani i dugogodišnji rad Službe za javno zdravstvo na preventivnim programima ukazala se potreba za osnivanjem Savjetovališta za prehranu. Također kroz redovne preglede liječnika školske medicine u IŽ pokazalo se da je pojavnost prekomjerne tjelesne mase i pretilosti djece školske dobi u kontinuiranom porastu što dodatno potvrđuje potrebu za ovim tipom Savjetovališta. Navedeno je prepoznala Istarska županija koja financira projekt Savjetovališta za prehranu u razdoblju 2017.-2020. godine. Kroz rezultate projekta Savjetovališta za prehranu pokazat će se potreba za njegovim kontinuiranim radom. Ključne riječi: ZZJZIŽ, prevencija KNB, savjetovalište za prehranu, multidisciplinarni pristup, podrška lokalne samouprave

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IZVOĐENJE MJERE SHEMA ŠKOLSKOG VOĆA I POVRĆA U SLOVENSKIM ŠKOLAMA Vida Fajdiga Turk1, Matej Gregorič1, Katja Zdešar Kotnik2, Marcel Kralj1, Mitja Vrdelja1 1 2

Nacionalni institut za javno zdravlje, Trubarjeva 2, Ljubljana, Slovenija Univerzitet u Ljubljani, Biotehnički fakultet, Odjel za biologiju, Večna pot 111, Ljubljana, Slovenija.

Uvod: Rastući trend pretilosti i negativan trend konzumacije voća i povrća (VP) među djecom i mladeži veliki je javnozdravstveni problem u EU, koji može dovesti do negativnih zdravstvenih rezultata. Namjera studije je bila utvrditi koliko je uspješna i učinkovita mjera Shema školskog voća i povrća (SŠVP) u Sloveniji. Materijali i metode: Podatke smo prikupili u okviru studije vrednovanja SŠVP koja se na osnovnoj razini provodi svake godine, a detaljnije svakih pet godina. U istraživanje su, u periodu od 2011. do 2016. godine, svake godine bili uključeni učitelji koordinatori i učenici 4., 6. i 8. razreda svih uključenih škola. Korištena je metoda anketnoga upitnika na početku i kraju školske godine. Detaljno vrednovanje je bilo provedeno na reprezentativnom uzorku 10 škola, a obuhvaćalo je metodu detaljnog anketnog upitnika, 24-satno prisjećanje za ocjenu unosa hrane i pića tijekom dva neuzastopna dana i antropometrijskog mjerenja za ocjenu BMI. Podatke smo statistički obradili pomoću programa SPSS. Rezultati: Mjera se pokazala učinkovitom na razini škola koje raznoliko VP kontinuirano dijele kroz cijelu godinu, najčešće jednom tjedno, uključujući lokalnu i sezonsku ponudu. Većina škola je izvela planirane aktivnosti koje su vodile do promjena, a koje su donijele i nova znanja o koristima VP. Na razini učenika učinci mjere su najvidljiviji u okviru jedne školske godine. Konzumacija VP postaje češća, konzumacija povrća se povećala i količinski, a poboljšalo se i znanje o zdravim životnim navikama. Jednako tako, trend u godinama izvođenja sheme upućuje na povećanu konzumaciju povrća, prije svega kod dječaka, kod starijih učenika i kod učenika s višim socio-ekonomskim statusom. Zaključak: Mjera ima različite učinke, kako na razini škola, tako i na različite skupine učenika, kako tijekom jedne godine, tako i na razini više godina. Najviše poticaja i u narednom periodu je najbolje usmjeriti prema ranjivim skupinama i za te skupine prilagoditi načine djelovanja. Rezultati su pokazali da SŠVP ima dugoročan učinak na povećanu konzumaciju VP. S obzirom na činjenicu da su mjere SŠVP bitno doprinijele i razini znanja, smisleno ih je nadograditi i u što većoj mjeri uključiti u kurikulum. Ključne riječi: voće, povrće, škola, Shema školskog voća i povrća

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UNAPREĐENJE PREHRAMBENIH NAVIKA ZAPOSLENIKA Davorka Gajari, Helena Tomić-Obrdalj, Jasmina Ranilović, Maja Vidaković Podravka, Istraživanje i razvoj, Ante Starčevića 32., Koprivnica

Uvod: Pravilna prehrana ključna je za očuvanje dobrog zdravlja. S druge strane, neuravnotežena i jednolična prehrana nutritivno siromašnom hranom uz nedostatak tjelesne aktivnosti, rizični su čimbenici za razvoj kroničnih nezaraznih bolesti koje ugrožavaju zdravlje, opterećuju zdravstveni sustav i utječu na gospodarski razvoj. Društveno odgovorno ponašanje neke kompanije obuhvaća i brigu o vlastitim zaposlenicima koji su temeljni čimbenik stvaranja njezinih vrijednosti i razvoja. Ispitivanje prehrambenih navika može pomoći uutvrđivanju kritičnih elemenata prehrambenog ponašanja i razvoju programa edukacije koji bi pomogao njihovom unapređenju. Materijali i metode: U ispitivanju putem online ankete naziva „Ispitivanje prehrambenih navika zaposlenika“ je sudjelovalo 784 zaposlenika. Anketa s 27 pitanja je izrađena na internet servisu Survey Monkey (SurveyMonkey Inc, San Mateo, California, USA), a poveznica na anketu distribuirana je putem e-maila. Ispitivanje je bilo anonimno i provodilo se u srpnju 2016. godine. Analiza podataka provedena je uz pomoć Survey Monkey-a te statističkog programa SPSS (IBM SPSS Statistics for Windows, v 19.0. Armonk, NY, USA). Na osnovu rezultata ankete postavljene su mjere i osnovni principi edukacije u radnoj organizaciji koji su analizirani s 10 zaposlenika u 2 fokusne grupe. Rezultati: Otkriveno je 8 kritičnih navika zaposlenika. Ispitanici uglavnom ne provode posebne režime prehrane. Samo polovina ispitanika pridaje važnost energetskom unosu, pazi na unos šećera i svakodnevno jede voće. Trećina svakodnevno jede povrće i pazi na unos soli i masti.Trećina jednom tjedno jede ribu. Na deklaraciji se najčešće čita rok trajanja, zemlja podrijetla, popis sastojaka te upute za upotrebu. Tablicu nutritivnih vrijednosti redovito čita petina ispitanika. Redovito se tjelovježbom sukladno preporuci bavi petina ispitanika, a petina nikad nije tjelesno aktivna. Rezultati kvalitativnog ispitivanja u dvije fokusne grupe potvrdili su potencijalnu učinkovitost postavljenih mjera za poboljšanje ponašanja zaposlenika u vezi sa zdravljem i ukazali na potrebu provođenja pilot programa prema definiranom planu edukacije. Zaključak: Osnovne prehrambene navike većine ispitanika nisu odgovarajuće. Riječ je o odrasloj, radno aktivnoj populaciji koja u teoriji razumije termin pravilne prehrane, ali o tome u praksi ne vodi računa. Pridržavanjem osnovnih principa edukacije u radnoj organizaciji kojoj to nije dio primarnog poslovanja, uz inovativne metode i alate, dugoročno se može djelovati na promjenu stavova o prehrani svojih zaposlenika. Indirektno se može očekivati i djelovanje na promjenu prehrambenog ponašanja članova kućanstva. Ključne riječi: zaposlenici, ispitivanje prehrambenih navika, edukacija, zdravlje

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PROCJENA UNOSA ENERGIJE I HRANJIVIH TVARI UOSOBA SMJEŠTENIH U DOMOVE ZA STARIJE OSOBE Matej Gregorič1, Katja Zdešar Kotnik2, Igor Pigac3 Nacionalni institut za javno zdravlje, Trubarjeva 2, Ljubljana, Slovenija Univerzitet u Ljubljani, Biotehnički fakultet, Odjel za biologiju, Večnapot 111, Ljubljana, Slovenija

1 2

Sveučilište u Ljubljani, Biotehnički fakultet, Odjel za znanost o hrani, Jamnikarjeva 101, Ljubljana, Slovenija

Uvod: Osobe smještene u domove za starije osobe su među najosjetljivijim populacijskim skupinama s obzirom na fizičko zdravlje i pojavnost kroničnih bolesti. Njihove prehrambene navike i odabir hrane uglavnom se razlikuje od prehrambenih potreba i prehrambenih navika u mlađoj dobi. Cilj ovog istraživanja bio je utvrditi unos energije i hranjivih tvari u osoba smještenih u domove za starije osobe. Materijale i metode: Dobiveni podaci prikupljeni su u sklopu PANGeA (Tjelesna aktivnost i prehrana za bolje starenje) presječnog istraživanja. U reprezentativnom uzorku koji je uključivao tri doma za starije osobe regrutirane su zdrave osobe starije od 65 godina, dobrih kognitivnih funkcija, te su svi ispitanici dragovoljno sudjelovali u istraživanju. Unos energije i hranjivih tvari ispitanika procijenjen je 24-satnim prisjećanjem unosa hrane i pića tijekom dva neuzastopna dana i metodom trodnevnog dnevnika prehrane, dok je stupanj uhranjenosti procijenjen indeksom tjelesne mase (BMI). Za izračun unosa energije i hranjivih tvari korištena je aplikacija Otvorena platforma za kliničku prehranu (OPEN). Rezultati su uspoređeni s prehrambenim smjernicama za starije osobe i D-A-CH preporučenim vrijednostima za unos energije i hranjivih tvari. Rezultati: Rezultati ovog istraživanja pokazali su da je dnevni unos energije u ispitanika bio 19-34% niži od preporučenih vrijednosti. Servirani obroci sadržavali su samo 70%, 76%, 77% i 53% od preporučene vrijednosti za proteine, ukupne masti, ugljikohidrate i prehrambena vlakana. Unos tekućine, određenih mineralnih tvari (I, Se, Mg, Ca) i većine vitamina (vitamina D, vitamina C, vitamina E i vitamina B skupine) nije bio adekvatan. Najniži unos utvrđen je za vitamin D. Unos hranjivih tvari u osoba smještenih u domove za starije osobe bio je adekvatniji u žena nego u muškaraca. Obje provedene dijetetičke metode dale su usporedive rezultate. Osim toga, 50% žena i 40% muškaraca su bili pretili s obzirom na izračunati BMI. Zaključak: Rezultati ovog istraživanja pokazali su da prehrana osoba smještenih u domove za starije osobe nije adekvatna s obzirom na energijsku vrijednost, ali ni nutritivnu vrijednost. Rezultati ovog istraživanja ukazuju na potrebu za preventivnim javnozdravstvenim akcijama i intervencijama usmjerenim na ovu osjetljivu populacijsku skupinu. Metoda 24-satnog prisjećanja o unosu hrane i pića tijekom dva neuzastopna dana pokazala se prikladnom za procjenu unosa energije i hranjivih tvari u starijih osoba dobrih kognitivnih funkcija u usporedbi s referentnom metodom trodnevnog dnevnika prehrane. Ključne riječi: prehrana, starije osobe, domovi za starije osobe, referentne vrijednosti, energijski i nutritivni unos www.kongresnutricionista.com |

UČINKOVITOST MULTIDISCIPLINARNOG PROGRAMA NA SLJEMENU U SMANJENU TJELESNE MASE I POPRAVLJANJU SASTAVA TIJELA PRETILIH OSOBA Jasmina Hasanović1,2, Andrea Bilandžija1,2, Zvonimir Šatalić2 1

Udruga za prevenciju prekomjerne težine, Marulićev trg15, 10000 Zagreb, Hrvatska Prehrambeno-biotehnološki fakultet, Pierottijeva 6, 10000 Zagreb, Hrvatska

Uvod: Prilikom liječenja pretilosti postoji visoka stopa neuspjeha te se ulaže znatan trud u razvoj djelotvornih programa. Iako je jednako važno obratiti pažnju i na smanjen unos energije i na povećanje energetske potrošnje tj. iznimno je važan multidisciplinarni pristup koji će po mogućnosti utjecati i na druge životne navike. Cilj: Cilj ovog posebno osmišljenog multidisciplinarnog programa na Sljemenu, bio je educirati pretile odrasle pojedince o rizicima koji nastaju kao posljedica prekomjerne tjelesne mase, o osnovnim načelima pravilne prehrane i važnosti tjelesne aktivnosti. Ispitanici i metode: U ovom programu je uključeno ukupno 127 pretilih ispitanika, od toga 104 ispitanika ženskog spola, te 23 ispitanika muškog spola, starosne dobi iznad 45 godina. Program se odvijao u malim grupama od 10 do 15 polaznika. Rezultati: Ispitanici koji su završili desetodnevni program su izgubili 3,39±1,15kg, tj. 3,27±1,12% izgubljene tjelesne mase. Indeks tjelesne mase (ITM) na kraju programa, deseti dan, je iznosio 34,71±7,66kg/m2, u odnosu na indeks tjelesne mase prvog dana koji je iznosio 35,91 ±8,00. Ispitanicima se ITM u prosjeku smanjio za 1,20jedinica. Prosječna vrijednost masnog tkiva u postotku i kilogramima na početku programa je iznosila 42,47±7,59% (42,08±14,69kg), a na kraju programa prosječna vrijednost postotka masnog tkiva je iznosila 40,91±8,31% (41,36±15,34kg). Zaključak: Statistički značajna razlika prvog i desetog dana je utvrđena za sve ispitivane parametre: tjelesna masa, indeks tjelesne mase (ITM) i postotak masnog tkiva. Grupni rad stvara pozitivnu atmosferu i omogućuje međusobnu potporu, što olakšava lakše uvođenje novih prehrambenih i životnih navika, a ispitanicima su sudjelovanje u programu motivacija i poticaj za daljnju promjenu tih navika u cilju smanjenja rizika za pretilost. Ključne riječi: pretilost, tjelesna masa, sastav tijela, indeks tjelesne mase, multidisciplinarni program

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PROCJENA NUTRITIVNE VRIJEDNOSTI JELOVNIKA U IZVIĐAČKIM KAMPOVIMA Ana Ilić, Anamarija Švagelj, Sabina Barbiš Hrvatski akademski centar primijenjenog nutricionizma, Supilova 7, 10000 Zagreb

Uvod: Unutar ljetnih izviđačkih kampova, u trajanju od 10 do 15 dana, izviđačke udruge samostalno vrše posluživanje hrane.Prema tome svaka udruga za sebe izrađuje svoje jelovnike i normative, a često u to nisu uključene osobe educirane o nutritivnim potrebama djece i mladih. Cilj ovog istraživanja je procijeniti nutritivnu vrijednost jelovnika te u kojem udjelu su zadovoljene dnevne prehrambene potrebe članova s obzirom na njihovu dob i spol. Materijali i metode: U istraživanju su se koristili jelovnici i njihovi normativi izrađeni za potrebe ljetnih kampova izviđačkih udruga. Sama procjena nutritivne vrijednosti napravljena je pomoću danskih i američkih tablica s kemijskim sastavom hrane. Dobiveni rezultati za unos makronutrijenata prikazani su unutar prihvatljivog raspona unosa makronutrijenata (Acceptable Macronutrient Distribution Range), a za preporučeni dnevni unos mikronutrijenata s obzirom na dob i spol uzete su vrijednosti referentnog prehrambenog unosa (Dietary Reference Intakes). Analiza podataka provedena je pomoću računalnog programa Microsoft Office Excel 2010. Rezultati: Iz dobivenih rezultata vidljivo je da se energetske vrijednosti jelovnika razlikuju među udrugama. S obzirom na dob i spol unos energije muških članova (9–13 godina) kreće se u rasponu 91–161%, muških članova (14–18 godina) 68–120%, ženskih članova (9– 13 godina) 99–175% te ženskih članova (14–18 godina) 91–161% preporuka. Unos svih makronutrijenata je unutar prihvatljivog raspona. U jelovnicima svih udruga primijećen je značajno niži unos vitamina D (<19%), kalija (<69%), kalcija (<56%), joda (<68%) i selena (<88%) od preporučenog dnevnog unosa. Unos magnezija pokazao se deficitaran s obzirom na preporuke u muških (<67%) i ženskih (<76%) članova u dobi 14–18 godina. Također, vidljiv je i smanjeni unos željeza u ženskih članova u dobi 14–18 godina (<69%). U jelovniku udruge u kojem je primijećen smanjeni unos energije, vidljiv je i deficit drugih mikronutrijenata. Zaključak: Nutritivna vrijednost jelovnika razlikuje se unutar pojedinih udruga. Unatoč tome što je unos makronutrijenata unutar prihvatljivog raspona, primijećen je deficitarni unos pojedinih mikronutrijenata. Stoga je potrebno educirati voditelje i kuhare kampova te im osmisliti unificirane normative kako bi se lakše snalazili prilikom kreiranja jelovnika. Ključne riječi: nutritivna vrijednost, jelovnici, izviđački kamp

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PROCJENA KAKVOĆE PREHRANE U LJETNIM IZVIĐAČKIM KAMPOVIMA Ana Ilić, Sara Sila, Anamarija Švagelj Hrvatski akademski centar primijenjenog nutricionizma, Supilova 7, 10000 Zagreb

Uvod: Na kvalitetu jelovnika u izviđačkim kampovima utječe nekoliko čimbenike poput mogućnosti pohrane kvarljivih namirnica, odlaska u kupovinu, cijene obroka, tradicije kuhanja na logoru, prehrambenih navika djece te educiranosti osoba koji izrađuju jelovnike o potrebama djece i mladih. Cilj ovog istraživanja bio je procijeniti kakvoću prehrane u izviđačkim kampovima te zastupljenost pojedinih skupina namirnica u jelovnicima. Materijali i metode: U istraživanju su se koristili jelovnici i njihovi normativi izrađeni za potrebe ljetnih kampova izviđačkih udruga. Sama procjena nutritivne vrijednosti napravljena je pomoću danskih i američkih tablica s kemijskim sastavom hrane. Nakon procjene nutritivne vrijednosti korišten je HEI-2010 za procjenu kakvoće prehrane te HEI-1995 za procjenu raznovrsnosti namirnica. Analiza podataka provedena je pomoću računalnog programa Microsoft Office Excel 2010. Rezultati: Pomoću HEI-2010 ustanovljeno je da se jelovnici dviju udruga (udruga 1, udruga 2) svrstavaju u kategoriju neprikladne prehrane (39 i 42 boda), dok jedna udruga (udruga 3) spada u kategoriju prehrane koju treba popraviti (56 boda). Iz HEI-1995 preuzet je parametar koji se odnosi na raznovrsnost prehrane te je ustanovljeno da udruga 1 i udruga 2 imaju manje raznovrsnu prehranu (5 i 6 bodova), dok udruga 3 ima izrazito raznovrsnu prehranu (10 bodova). U svim udrugama potrebno je povećati unos cjelovitih žitarica, mlijeka i mliječnih proizvoda, plodova mora i izvora biljnih proteina poput mahunarki, sjemenki i orašastog voća te smanjiti unos rafiniranih žitarica i natrija. Međutim, dobiveni rezultati ukazuju na to da udruga 3, usprkos ranije navedenim problemima, ima veći unos voća, zelenog lisnatog povrća i leguminoza, cjelovitih žitarica, izvora proteina animalnog podrijetla, plodova mora i izvora biljnih proteina te manji unos natrija, rafiniranih žitarice i praznih kalorija od udruge 1 i 2. Također, vidljivo je da udruga 3 ima i bolje izbalansirani unos nezasićenih i zasićenih masnih kiselina. Ovakav rezultat postignut je time što je jelovnik udruge 3 izradila osoba educirana o potrebama djece i mladih. Zaključak: Usprkos problemima vezanim uz planiranje i izvedbu prehrane u ljetnim izviđačkim kampovima, izradom normativa i jelovnika od strane educiranih osoba poput nutricionista i kuhara, kakvoća prehrane u izviđačkim ljetnim kampovima može se poboljšati. Ključne riječi: kakvoća prehrane, HEI, raznolikost prehrane, izviđački kamp, jelovnici

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INFORMIRANOST SPORTAŠA REKREATIVACA O UZIMANJU DODATAKA PREHRANI (SUPLEMENATA) Martina Jakovljević2, Josipa Mađarić1, Martina Pavlić2, Lidija Šoher1 1

Nutricionizam Balans, Šetalište P. Preradovića 7, 31 000 Osijek, Hrvatska Prehrambeno-tehnološki fakultet Osijek, Franje Kuhača 20, 31 000 Osijek, Hrvatska

Uvod: Dodaci prehrani uključuju širok raspon različitih proizvoda od vitamina i minerala do pripravaka za nadoknadu makronutrijenata. Suplementi se koriste kod opće populacije u različite svrhe i dostupni su bez recepta. Kod sportaša rekreativaca poznata je upotreba različitih dodataka prehrani ovisno o cilju kojeg žele postići tjelovježbom, osobnim potrebama i znanju o suplementima. Cilj rada bio je utvrditi učestalost i razloge korištenja dodataka prehrani kod sportaša rekreativaca. Specifičan cilj ovog rada bio je ispitati informiranost o korištenju dodataka prehrani. Ispitanici i metode: Opažajno istraživanje provedeno je online upitnikom na skupini sportaša rekreativaca. Istraživanje je obuhvatilo 746 ispitanika dobi od 15 do 55 godina. Upitnik je kreiran isključivo za potrebe ovog istraživanja. Rezultati su obrađeni Microsoft Excel 2016 programom. Rezultati: Ukupno je anketu ispunilo 746 osoba, a 12 ispitanika isključeno je zbog nepotpunih odgovora. 52 % ispitanika bili su muškarci. 69% ispitanika izjavilo je kako suplemente uzimaju uvijek, dok njih 23 % uzima ponekad. Najveći dio ispitanika (52 %) trenira 3 do 4 puta tjedno. 89,3 % sportaša rekreativaca konzumira proteinske suplemente, pojedinačno ili u kombinaciji s drugim dodacima. Najčešći razlozi za uzimanje suplemenata su poboljšanje sportske izvedbe, povećanje mišićne mase ili kombinacija tih odgovora (83 %). 33,7 % ispitanika informacije dobiva isključivo od sportskih trenera, 37,1 % putem medija dok samo 6,4 % njih informacije dobiva od nutricionista. S druge strane, na pitanje od koga žele dobivati informacije 31,4 % odgovorilo je isključivo od sportskog trenera, 10,5 % putem medija, a 29,6 % ispitanika od nutricionista. Zaključak: Većina sportaša rekreativaca uzima dodatke prehrani. Kada je riječ o informiranosti o korištenju dodataka, najveći dio njih informacije dobiva putem medija ili od sportskog trenera, dok mali broj njih od nutricionista. Rezultati pokazuju da dio njih ipak želi provjerene informacije dobiti od stručne osobe što upućuje na potrebu uključivanja nutricionista u edukaciju sportaša rekreativaca o korištenju dodataka prehrani. Ključne riječi: dodaci prehrani, suplementacija, sportska prehrana, sportaši rekreativci

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PREHRAMBENE NAVIKE ZDRAVSTVENIH DJELATNIKA ISTOČNE HRVATSKE Darija Kajtar, Betilija Fadi Sekošan ZU Ljekarne Tripolski, Osijek, J.J. Strossmayera 14, Hrvatska

Uvod: Zdravstveni djelatnici imaju veliku ulogu u podizanju svijesti o zdravim prehrambenim i drugim životnim navikama populacije. Pretpostavka je da su svjesniji važnosti zdrave prehrane od ostatka populacije i da svojim primjerom služe kao uzor. Cilj ovog ispitivanja bio je utvrditi kakve su prehrambene i druge navike zdravstvenih djelatnika te njihova svjesnost o sastavu i kalorijskoj vrijednosti namirnica. Materijali i metode: Ispitivanje je provedeno na području istočne Hrvatske, a obuhvatilo je 304 osobe zaposlene u zdravstvu u dobi od 19 do 70 godina. Među ispitanicima njih 223 boravi na području grada i 81 na području sela. Anketirano je 248 ženskih i 56 muških ispitanika. 96 ispitanika ima visoku stručnu spremu (liječnici, magistri farmacije, magistri medicinske biokemije, doktori stomatologije). 60 ispitanika ima višu stručnu spremu (prvostupnici raznih područja zdravstva) i 148 ispitanika srednju stručnu spremu (medicinske sestre i tehničari, farmaceutski tehničari, laboratorijski tehničari, fizioterapeuti). Anonimni upitnik sadržavao je pitanja o prehrambenim navikama ispitanika, pušenju, učestalosti korištenja alkohola i svjesnosti o kalorijskom i nutritivnom sastavu prehrambenih proizvoda. Rezultati: Od ispitanih zdravstvenih djelatnika njih 58,88% doručkuje svaki dan. Međutim, čak 31,91% ispitanika jede samo jedan obrok dnevno. 77,63% ispitanika ima barem 1-2 obroka ribe tjedno. Brzu hranu uopćene ne konzumira 33,88 % ispitanika. Iako ispitanici često čitaju deklaracije na prehrambenim proizvodima (23,36% uvijek i 54,93% ponekad), njih 52,30% ipak ne obraća pozornost na kalorijsku vrijednost hrane. 39,47% ispitanika jede i nakon što osjeti sitost. Pušača je 35,20%. Nisu se pokazale značajne razlike u navikama u odnosu na stručnu spremu, zanimanje, dob, spol ili prebivalište. Zaključak: Zdravstveni djelatnici imaju dobre navike doručka i u visokom postotku konzumiraju ribu i morske plodove, 1-2 puta tjedno. Veliki postotak ispitanika čita deklaracije na proizvodima i ne jede brzu hranu. Unatoč tome, ne obraćaju pozornost na kalorijsku vrijednost hrane te jedu i nakon što osjete sitost. Udio pušača je također velik. Zaključak je da su zdravstveni djelatnici većinom dobri u odabiru namirnica, ali često nemaju dobro raspoređene obroke. Vjerojatno uzrok tome nije manjak svijesti o zdravim navikama, već manjak vremena za provođenje istih. Ključne riječi: zdravstveni djelatnici, kalorijska vrijednost, prehrambene navike, pušenje

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ZNANJE O KAKVOĆI MLIJEKA I MLIJEČNIH PROIZVODA UTJEČE NA BOLJU KONZUMACIJU MLIJEČNIH PROIZVODA S OBZIROM NA PREPORUKE Gordana Kenđel Jovanović1, Sandra Pavičić Žeželj1, Greta Krešić2 Nastavni Zavod za javno zdravstvo Primorsko-goranske županije, Zdravstveno ekološki odjel, Krešimirova 52a, Rijeka; Medicinski fakultet Sveučilišta u Rijeci, Katedra za zdravstvenu ekologiju, Braće Branchetta 20/1, Rijeka 2 Fakultet za menadžment u turizmu i ugostiteljstvu Sveučilišta u Rijeci, Katedra za hranu i prehranu, Primorska 42, p.p. 97, Opatija 1

Uvod: Mlijeko i mliječni proizvodi imaju mnoge zdravstvene dobrobiti, a njihova konzumacija predstavlja dobre prehrambene navike važne za svako životno doba. Studenti, zbog karakterističnog načina života, mogu imati zdravstvene koristi konzumacijom, ali kao potrošači, njihovo znanje i mišljenjao mliječnim proizvodima može utjecati na odabir mliječnih proizvoda. Cilj ovog rada bio je utvrditi kako znanje o kakvoći utječe na konzumaciju mliječnih proizvoda. Ispitanici i metode: Među 1005 studenata Riječkog sveučilišta utvrđene su navike bavljenja tjelesnom aktivnosti i pušenja te prosječni mjesečni unos mlijeka i mliječnih proizvoda pomoću FFQ upitnika, dok su znanje i mišljenja o kakvoći mliječnih proizvoda ispitana pomoću 5 pitanja. Studenti su podijeljeni s obzirom na ukupno znanje, na one sa dobrim znanjem – SDZ (ukupni score 4 i 5) te na one sa lošim znanjem – SLZ (ukupni score 1,2 i 3). Rezultati: Trećina studenata (30,1%) je imala dobro znanje o kakvoći mliječnih proizvodameđu kojima je58,7% studenata zadovoljilo preporuke dnevne konzumacije mlijeka i mliječnih proizvoda, statistički značajno više nego među SLZ studentima gdje je 41,6% studenata zadovoljilo preporuke dnevne konzumacije mlijeka i mliječnih proizvoda (p<0,0001). Među SDZ studentima bilo je statistički značajno više tjelesno aktivnih (61,4%SDZ, 50,9% SLZ; p=0,0027), dok je bilo gotovo podjednako nepušača u obje skupine (67,9% SDZ, 64,5% SLZ). Statistički značajno više SDZ studenata odabire mliječne proizvode sa manje od 1% mliječne masti (38,6% SDZ, 6,5% SLZ; p<0,0001). Prilikom odabira mliječnog proizvoda statistički značajno više SDZ studenata ne smatra bitnim udio mliječne masti (13,5% SDZ, 7,3% SLZ; p<0,0001). Studenti najčešće i u većoj količini konzumiraju fermentirane mliječne proizvode, a SDZ studenti (48,59g±29,50SD) statistički značajno više od SLZ studenata (39,85g±37,89SD; p=0,004). Zaključak: Rezultati ovog rada pokazali su da bolje znanje o kakvoći i važnosti mliječnih proizvoda utječe na bolju konzumaciju mliječnih proizvoda s obzirom na preporuke, no bolje znanje nije prediktor za odabir vrste mliječnog proizvoda među ispitanim studentima. Dobiveni rezultati mogu pomoći u oblikovanju javnozdravstvenih poruka i promocije konzumacije mliječnih proizvoda među mlađim populacijskim skupinama. Ključne riječi: studenti, mlijeko i mliječni proizvodi,znanje, javno zdravstvo, zdravstvena dobrobit www.kongresnutricionista.com |

NEVLADINE UDRUGE KAO ZNAČAJAN ČIMBENIK U PROMICANJU PRAVILNE PREHRANE Albina Knapp, Branislava Belović, Anica Benkovič Območno združenje RKS Murska Sobota, Staneta Rozmana 3, 9000 Murska Sobota, Slovenija

Uvod: Nevladine udruge značajan su čimbenik u promicanju zdravoga načina života, odnosno pravilne prehrane. Brojne udruge, naime, u svoje djelovanje uključuju tematiku zdravlja i zdravoga načina života. Nevladine udruge, osim toga, raspolažu iljudskim resursima – stručnjacima (radno aktivni i umirovljeni stručnjaci) te vrlo razvijenom mrežom na terenu. Među takve udruge spada i humanitarna organizacija Crvenoga križa. Metode: U Območnom združenju RKS Murska Sobota (Gradsko društvo CKS Murska Sobota) koje pokriva 12 općina Pomurja, pored drugih programa, projekata i aktivnosti već nekoliko godina provodimo tečajeve laičke njege starijih i bolesnih osoba. Posjećuju ih odrasle osobe koje vode skrb za starije osobe u svojoj obitelji ili kao dobrovoljci pomažu svojim rođacima, prijateljima, susjedima odnosno stanovnicima lokalnih zajednica. Sam tečaj uključuje sljedeća područja: posebne potrebe starijih osoba, brigu za starije osobe i bolesnike, laičku njegu bolesnika, tjelesnu aktivnost, pravilnu prehranu, komunikaciju i upravljanje stresom. Tijekom tečaja polaznici stječu potrebna znanja i praktične vještine za provedbu skrbi o starijim osobama i opću njegu bolesnika kod kuće. U sklopu pravilne prehrane polaznici tečajeva upoznaju prehrambene smjernice, skupine namirnica, pravilnu kombinaciju namirnica, pravilan način pripreme jela te osnovne značajke prehrane starijih osoba. Polaznici osim priručnika Laička njega starijih i bolesnih osoba u kojem je i poglavlje o pravilnoj prehrani dobivaju knjižice i brošure sa savjetima o pravilnoj prehrani i receptima. Rezultati: Tečajeve laičke njege do sada je pohađalo više od 500 odraslih osoba. Rezultati provjere usvojenih informacija, znanja i vještina na kraju svakoga tečaja pokazali su, između ostaloga, povećanje znanja i informiranosti o pravilnoj prehrani te uporabu recepata za pripremu zdravih jela u obiteljima polaznika. U razgovorima s polaznicima tečajeva doznajemo da usvojene informacije i znanja polaznici šire u svoju okolinu (rođaci, prijatelji, susjedi, znanci). Zaključak: Nevladine udruge, koje u svoje djelovanje uključuju zdravlje, odnosno zdrav životni stil, mogu biti značajan čimbenik u promicanje pravilne prehrane – posebice udruge s dobro razvijenom mrežom na samome terenu. Tako programi i aktivnosti stižu i do onih stanovnika koji bi inače bili isključeni. Ključne riječi: promicanje pravilne prehrane, nevladine udruge, tečajevi laičke njege starijih i bolesnih osoba

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VAŽNOST PREHRANE ZA REGULACIJU SIMPTOMA OBOLJELIH OD PARKINSONOVE BOLESTI Barbara Kolarić1, Svetlana Tomić2, Danijela Skelac2, Anja Bašnec1, Ines Banjari1 Sveučilište Josipa Jurja Strossmayera u Osijeku, Prehrambeno-tehnološki fakultet Osijek, Franje Kuhača 20, 31000 Osijek, Hrvatska 2 Klinika za neurologiju, Klinički bolnički centar Osijek, Josipa Huttlera 4, 31000 Osijek, Hrvatska 1

Uvod: Parkinsonova bolest je kronična degenerativna bolest mozga koja nastaje kao rezultat oštećenja brojnih živčanih stanica u mozgu. Rizik za obolijevanje raste s dobi i od nje danas boluje 1% osoba starijih od 60 godina. Uzrok bolesti još uvijek nije u potpunosti razjašnjen no etiologija uključuje teške metale, toksine, insekticide i herbicide te nasljedne genske mutacije. Kao jedan od prvih znakova javlja se poremećaj osjeta njuha i okusa. Bolest prati cijeli niz motoričkih i nemotoričkih simptoma, koji značajno utječu na kvalitetu života oboljelih. Osim potrebe za povećanim unosom nezasićenih masnih kiselina ne postoje jasne smjernice vezano uz prehranu oboljelih. Ipak, uzimajući u obzir prateće simptome, posebice one vezano uz smetnje probave (npr. konstipacija) jasno je kako bi se konzumacijom određenih skupina hrane u značajnoj mjeri moglo utjecati na kvalitetu života oboljelih. Osim toga, novija istraživanja pokazuju visok rizik od pothranjenosti i malnutricije oboljelih. Ispitanici i metode: Provedeno je opažajno istraživanje na oboljelima od Parkinsonove bolesti Klinike za neurologiju KBC Osijek (N=30) s ciljem utvrđivanja znanja oboljelih o važnosti prehrane prilagođenoj njihovoj bolesti te utvrditi postoji li potreba za edukaciju o istoj. Prosječna dob ispitanika je 66 godina (46 do 83 godine), 48% muškaraca 52% žena, s prosječnom dužinom trajanja bolesti od 6 godina (tek dijagnosticirano do 16 godina). Rezultati: Od simptoma koji prate Parkinsonovu bolest, kao najveći problem u svakodnevnom životu ispitanici ističu konstipaciju (31,7%), zatim promjene raspoloženja (24,4%), probleme s gutanjem (22,0%) te probleme sa spavanjem i krvnim tlakom (21,9%). 36% oboljelih smatra da se ne hrane adekvatno s obzirom na njihovu bolest, dok njih 68% smatra da o prehrani prilagođenoj njihovoj bolesti znaju vrlo malo. Čak je 96% ispitanika izjavilo kako žele naučiti više o prehrani prilagođenoj njihovoj bolesti. Zaključak: Rezultati jasno pokazuju potrebu za edukacijom oboljelih s primarnim ciljem ublažavanja simptoma koji u značajnoj mjeri utječu na svakodnevni život oboljelih. Ključne riječi: Parkinsonova bolest, simptomi, edukacija, znanje oboljelih, prehrana prilagođena bolesti

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IMPLEMENTACIJA SMJERNICA PRAVILNE PREHRANE U ODGOJNOOBRAZOVNIM USTANOVAMA: PRIMJER SMANJIVANJA KONZUMACIJE ŠEĆERA U PREHRANI DJECE KOJA POHAĐAJU VRTIĆ MURSKA SOBOTA Nataša Kučan1, Zdenka Sočič Tkalec1, Staša Tkalec2 Vrtec Murska Sobota, Talanyijeva ulica 6, 9000 Murska Sobota, Slovenija Državni zbor Republike Slovenije, Poslanska skupina Stranke modernega centra Šubičeva ulica 4, 1000 Ljubljana, Slovenija 1

Uvod: Odgojno-obrazovne ustanove identificirane su kao okruženja u kojima je moguće sustavnim mjerama utjecati na prehrambene navike i zdravlje djece. Zbog toga prehrana u odgojno-obrazovnim ustanovama ima posebno mjesto u Sloveniji te je organizacijski i zakonski dobro uređena. Posebna je pažnja posvećena nacionalnim strateškim dokumentima, među kojima su i Smjernice pravilne prehrane u odgojno-obrazovnim ustanovama koje se implementiraju od 2006. godine. Metode: Prikazan je primjer dobre prakse u svakodnevnoj prehrani djece u Vrtiću Murska Sobota s naglaskom na smanjivanje količine šećera u hrani, a uključuje javno naručivanje lokalno proizvedene hrane, prilagodbu receptura, edukacija djece o pravilnoj prehrani (redoviti i skriveni kurikul) te osvješćivanje roditelja. Budući da zakonodavstvo omogućuje javne nabave u kojima se prednost daje hrani/namirnicama uključenima u sheme kvalitete (sezonski proizvedena hrana, sezonske namirnice organski uzgojene…), u Vrtiću Murska Sobota koristimo se tom mogućnošću. Lokalni proizvođači, primjerice, za naše potrebe pripremaju voćne prerađevine bez/s manje šećera. Također odabiremo prehrambene proizvode bez ili s manje dodanoga šećera. Iz prehrane u Vrtiću isključili smo aromatizirana pića te voćne sirupe. Razvili smo recepte za jela prilagođena prehrambenim smjernicama, koja uključuju i slatkiše pripremljene na osnovi voća i povrća. U pripremi se koristimo minimalnim količinama meda. Kod proslave rođendana nudi se isključivo voće. Kod uvođenja novih jela/namirnica odgojiteljice prate reakciju djece (prihvaćaju/otklanjaju jelo, pojedu manje/uobičajeno), a kuharsko osoblje prati količinu ostavljene hrane. Rezultati: Promjenom jelovnika, uključivanjem jela pripremljenih po prilagođenim i suvremenim receptima te smanjenjem nabave gotovih proizvoda poboljšali smo ponudu hrane u Vrtiću Murska Sobota (otprilike 750 djece) u razdoblju od 2013. do 2016. godine. Potrošnja šećera u pripremi hrane smanjena je za 11 %, a meda za 28 %. Također je smanjena potrošnja proizvoda koji sadrže velike/veće količine šećera: pekarski proizvodi za 39 % te mliječni proizvodi s dodatkom voća, pudinzi i slični proizvodi za 77 %. Postupno uvođenje novih (prilagođenih) jela djeca su dobro prihvatila. U izvješćima o praćenju prehrane u vrtićima/ školama Nacionalni institut za javno zdravstvo (Nacionalni inštitut za javno zdravje) pozitivno ocjenjuje prehranu u Vrtiću Murska Sobota. Zaključak: Uspješna implementacija smjernica pravilne prehrane u vrtićima ovisna je ne samo o organizacijski i zakonski uređenoj prehrani već je potrebno stručno znanje i motiviranost voditelja prehrane, kuhinjskoga osoblja, kao i potpora uprave ustanove, kolektiva i roditelja te povezivanje odgoja i ponude jela. Ključne riječi: Smjernice pravilne prehrane u odgojno-obrazovnim ustanovama, vrtići, smanjivanje konzumacije šećera, odgoj i osvješćivanje o pravilnoj prehrani 98

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UTJECAJ MEDIJSKIH DIJETA NA PREHRAMBENO PONAŠANJE I ŠIRENJE EPIDEMIJE PRETILOSTI Snježana Longin– Merle du Bourg1, Silvestra Kolega2 1

Privatna nutricionistička ordinacija, 291, rue de l’Abbé Bonpain, 59700 Marcq, Francuska Privatna specijalistička ordinacija obiteljske medicine, Trg Bratski Dvor 1, 23272 Kali, Hrvatska

Medijske dijete na tržištu izgledaju opravdane i očigledne jer smo suočeni s galopirajućom epidemijom pretilosti i raširenom željom za mršavljenjem (posljedica društvenog pritiska). Ali, isto je tako očigledan dugoročan neuspjeh većine takvih dijeta (mršavost ne predstavlja sreću). Brojne studije strogoprotokolnih dijeta, provedene zadnjih 20 godina, pokazuju stopu neuspjeha od preko 95%. Kako objasniti taj fenomen? Hipotalamus, središnja zona mozga, uglavnom je odgovoran za našu energijsku ravnotežu jer brojne neurotransmitere stavlja u funkciju u složenoj tjelesnoj komunikaciji. Svi ti hormoni i neuro-signali utječu na normalan odnos prema hrani: jedemo kad ogladnimo, zatim se hranimo zbog apetita (koji nas kroz užitak vodi prema određenim namirnicama) i na kraju prestajemo unositi hranu jer smo postigli ugodnu sitost. Povećanje kilograma rezultat je poremećene i neučinkovite prirodne regulacije tjelesne mase. Dijeta iz javnih medija ili trgovina, osmišljena za svakog, ne može optimalno odgovarati ni osobnoj povijesti ni životnim uvjetima pojedinca. Stroga i kruta kontrola unosa hrane suprotna je spontanoj i nesvjesnoj prilagodbi pri prehrani. Zbog dijeta jedemo po točno određenom protokolu ili programu, zanemarujući naš osobni ukus i situaciju. Malo po malo, prestajemo pratiti svoje prehrambene reflekse i osjećaje. Kognitivni dio mozga preuzima funkciju hipotalamusa i isključuje spontanu regulaciju. Neadekvatne dijete uzrok su znatnih fizičkih i psihičkih šteta kod mnogih populacija. Unatoč tomu, nove dijete koje obećavaju lako i brzo mršavljenje neprestano privlače nove pobornike. No, često su učinkovite, ali samo na određeno vrijeme (često 3 do 9 mjeseci). Što je pravo rješenje kod patologije pretilosti? Postupno mijenjanje prehrambenih navika i štetnog načina života. Pronaći prave, često višestruke i zamršene, uzroke debljanja. Bitno je dokučiti razloge koji dovode do psihičke napetosti i razjasniti kako time osoba ulazi u emocionalno konzumiranje hrane. Pretile ili osobe s povišenim masom često su u shemi “kognitivne restrikcije” čak i kada prestanu slijediti dijetu. Zato se preporučuje dugoročna terapija uz pomoć obučenih zdravstvenih radnika (nutricionista, liječnika, psihijatara, psihologa) specijaliziranih za liječenje patologije pretilosti kao višefaktorske bolesti. Krajnji je cilj povratak normalnog odnosa prema hrani i percepciji tijela, te povećano samopouzdanje. Rezultati se ne vide u nekoliko tjedana ili čak mjeseci, ali strpljenje je temelj. Iako, mogućnost uspjeha takvog pristupa uvijek postoji.

Ključne riječi: medijske dijete, prehrambeno ponašanje, epidemija pretilosti

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ENERGETSKI UNOS HOSPITALIZIRANIH PEDIJATRIJSKIH PACIJENATA Marinela Mamić, Petra Kučan, Diana Vukman Odjel za dijetetiku iprehranu, Klinika za dječje bolesti Zagreb, Klaićeva 16, Zagreb

Uvod: Pravilna prehrana u ranoj fazi života ključna je za osiguranje normalnog rasta i razvoja. Zbog ograničenih zaliha energije i većih energetskih potreba kod djece je prisutan visok rizik od pojave pothranjenosti. Prehrambeni unos ima važnu ulogu u prevenciji i liječenju pothranjenost kod djece. Točna procjena prehrambenog unosa u djece i adolescenata je iznimno važna jer prehrambene navike formirane u ranoj životnoj dobi mogu imati značajan učinak na dugoročno zdravlje. Ispitanici i metode: Jednodnevnim presječnim istraživanjem 4 godine za redom (2013.2016.) utvrđivao se energetski unos hospitaliziranih pedijatrijskih pacijenata kako bi se procijenila razlika između preporuka i stvarnog unosa tijekom hospitalizacije. U istraživanje je uključeno 370 pacijenata primljenih u Kliniku za dječje bolesti Zagreb u dobi od 0 mjeseci do 18 godina. Provedena je anketa kojom su se prikupile demografske karakteristike te točan dnevni energetski unos pacijenata koji je zatim uspoređivan s hrvatskim Standardom prehrane bolesnika u bolnicama. Rezultati: U 4 godine istraživanja 37% svih ispitanih pacijenata unijelo je između 60 % i 90 % preporučenih dnevnih potreba. Prosječni dnevni energetski unos bio je ispod 60 % preporuka u 30 % pacijenata i iznad 90 % preporučenih vrijednosti u 33 % pacijenata. Prosječni dnevni energetski unos djece mlađe od 1 godine bio je unutar preporučenih vrijednosti, osim u 2014. (energetski unos djece u dobi od 0 do 4 mjeseca bio je iznad preporuka) i 2015. godini (energetski unos djece u dobi od 4 do 12 mjeseci bio je ispod preporuka). Također, prosječni dnevni energetski unos djece od 10 do 13 godina bio je unutar preporuka, osim u 2014. godini gdje je unos ispod preporučenih vrijednosti. U svim ostalim dobnim skupinama prosječni dnevni energetski unos bio je ispod preporučenih vrijednosti. Zaključak: Ključni elementi u poboljšanju energetskog unosa su kombinacija odgovarajuće nutritivne procjene, daljnjeg praćenja pacijenata i unaprjeđenja bolničkih jelovnika. Unaprjeđenje bolničkih jelovnika i omogućavanje ugodnijeg okruženja tijekom konzumiranja obroka mogu poboljšati unos hrane i zadovoljavanje energetskih potreba. Izdavanje hrane mora biti fleksibilno i individualizirano, a svi pacijenti trebaju imati mogućnost naručivanja dodatne hrane u bilo kojem trenutku i biti obaviješteni o toj mogućnosti. Ključne riječi: energetski unos, preporuke, hospitalizirana djeca, bolnički jelovnici

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PREHRANA TRUDNICA I DOJILJA Monika Novak1, Ivana Tkalec2, Monika Vidović3 Županijska bolnica Čakovec, I. G. Kovačića 1E, Čakovec Hrvatski Zbor Nutricionista, Ilica 134, Zagreb 3 Županijska bolnica Čakovec, I. G. Kovačića 1E, Čakovec 1

Uvod: Trudnoća je fiziološki proces u kojem dolazi do brojnih promjena u organizmu. Želja svake trudnice je roditi živo i zdravo dijete te se mnoge buduće majke informiraju o pravilnoj prehrani i ponašanju u trudnoći. Uravnotežena i pravilna prehrana trudnica ima utjecaj na rast i razvoj ploda jer dijete dobiva sve važne nutrijente od majke. Novija istraživanja ukazuju da vitaminski nadomjesci nemaju učinak na poboljšanje zdravlja u trudnoći izuzev vitamina D i folne kiseline. Britanski znanstvenici ukazuju da je pravilna i raznovrsna prehrana tijekom trudnoće najvažnija za trudnicu i nerođeno dijete dok nepravilna prehrana i nedostatak vitamina iz hrane mogu uzrokovati trudničke probleme poput visokog krvnog tlaka, komplikacije koje uključuju indukciju poroda, smanjeni rast fetusa, nisku porođajnu masu, deformacije u rastu kostiju, razna oštećenja mozga te kralježnice kod beba. Materijal i metode: Sudjelovalo je 35 ispitanica prosječne starosti 28 godina. Od toga 24 trudnice i 11 dojilja Međimurske županije prilikom pohađanja tečaja o pravilnoj prehrani u trudnoći i razdoblju dojenja te boravka u Županijskoj bolnici Čakovec. Upitnik otkriva prehrambene navike i fizičku aktivnost te je dopunjen s pitanjem o suplementima. Rezultati: Preko 50% trudnica i dojilja obavlja sjedeći posao, dok 46% obavlja srednje naporan, a 3% fizički zahtjevan posao. Sve trudnice i dojilje se svakodnevno bave fizičkom aktivnošću, njih 86% svakodnevno pješači minimalno 30 min. 20% ima 5 obroka u danu. 21% preskače međuobroke, dok 54% preskače kasni obrok. 29% popije 1 litru vode dnevno, 23% popije 1,5 litru, 31% popije 2 litre. 31% konzumiranja mlijeko i mliječne proizvode 2 i više puta na dan, dok 34% 1 puta dnevno. 23% konzumira cjelovite žitarice 4-6 puta tjedno. Voće i povrće konzumiraju najčešće jedanput dnevno, njih 48% voće, dok 46% povrće. Meso konzumiraju najčešće jedanput dnevno (njih 43%). Ribu konzumiraju najčešće 1 tjedno (njih 48%). Jaja konzumiraju najčešće 1 tjedno (njih 40%). 56% uzima suplemente. Zaključak: Istraživanje je pokazalo da se većina trudnica i dojilja nepravilno hrani. Sve trudnice i dojilje imaju minimalno tri obroka u danu. Pokazao se da većina ne unosi dovoljno voća, povrća, cjelovitih žitarica i ribe. Većina uzima suplemente. Ključne riječi: trudnice, dojilje, upitnik, obroci

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UČESTALOST KONZUMIRANJA MLIJEKA I MLIJEČNIH PROIZVODA KOD DJECE OD 11.-14.GODINA NA PODRUČJU SREDNJOBOSANSKOG KANTONA Mateja Paklarčić, Ermina Kukić, Sead Karakaš Zavod za javno zdravstvo SBK/KSB Bolnička 1, 72270 Travnik, Bosna i Hercegovina

Uvod: Mlijeko i mliječni proizvodi imaju važnu ulogu u prehrani djece i predstavljaju najvažniji prehrambeni izvor kalcija koji je djeci potreban za rast i razvoj. Adekvatan unos kalcija iz mlijeka i mliječnih proizvoda posebno u djetinjstvu i adolescenciji jedan je od najbitnijih faktora za stvaranje maksimalne koštane mase i prevenciju osteoporoze. Cilj ovoga rada bio je utvrditi učestalost konzumiranja mlijeka i mliječnih proizvoda u odnosu na spol, dob, mjesto prebivališta na prehrambene navike/ životni stil i status uhranjenosti kod djece dobi 11-14 godina na području SBK/KSB-a. Materijali (Ispitanici) i metode: Ispitivanjem su obuhvaćeni školarci s područja SBK/ KSB-a. Istraživanjem je obuhvaćeno ukupno 51 škola, tj. ukupno 1804 učenika. Prikupljanje podataka provedeno je primjenom prilagođenog anonimnog jednokratnog upitnika, koji je obuhvatio opće informacije o ispitaniku, kao i pitanja vezana uz prehrambene navike/ životni stil. Rezultati: Kada je u pitanju konzumiranje mlijeka i mliječnih proizvoda od ukupnog broja ispitanika, veći je udio dječaka 953 (52,82%) koji konzumiraju navedene proizvode u odnosu na djevojčice 769 (42,62%). Što se tiče konzumiranja mlijeka i mliječnih proizvoda u odnosu na mjesto stanovanja, veći je udio onih koji konzumiraju iste u ruralnoj sredini 905 (50,16%) u odnosu na one iz urbane sredine 817 (45,29%). Na pitanje o učestalosti konzumiranja mlijeka i mliječnih proizvoda u odnosu na broj glavnih obroka, od ukupnog broja ispitanika, najveći je udio onih koji konzumiraju iste među onim ispitanicima koji imaju tri glavna obroka dnevno 1383 (76,66%), dok je najveći udio onih koji ne konzumiraju mlijeko i mliječne proizvode među ispitanicima koji imaju samo jedan glavni obrok dnevno, tj. 65 (3,6%). Od ukupnog broja ispitanika koji konzumiraju mlijeko i mliječne proizvode, njih 1466 (81,26%) se bavi sportom, dok njih 255 (14,13%) se ne bavi sportom, ali konzumira spomenute proizvode. Zaključak: Budući da je rana adolescencija osjetljivo razdoblje u kojem dolazi do naglog smanjenja dnevnog unosa mlijeka, upravo to razdoblje treba i postati težište javnozdravstvenog djelovanja. Postoji pogrešno mišljenje među mladima da se od mlijeka deblja, a socijalni pritisak koji od mladeži traži vitkost, često utječe na smanjenje pijenja mlijeka, što je osobito izraženo kod djevojaka. Smatramo kako naši rezultati mogu predstaviti polazne točke za pokretanje preventivnih programa kojima bi cilj bio povećanje konzumacije mlijeka među mladima. Ključne riječi: mliječni proizvodi, djeca, spol, dob, status uhranjenosti

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INOVATIVAN NAČIN INTEGRIRANJA PROMICANJA PRAVILNE PREHRANE U INSTITUCIONALNOME LIJEČENJU OVISNIKA O ALKOHOLU Zoltan Pap1, Branislava Belović2 1

Odjel za psihijatriju, Univerzitetni klinični center Maribor, Ob železnici 30, 2000 Maribor, Slovenija

Pomursko društvo za boj proti raku, Ulica arhitekta Novaka 2b, 9000 Murska Sobota, Slovenija

Uvod: Suvremen pristup liječenju ovisnosti o alkoholu temelji se na poticanju brze integracije bolesnika u njihovo svakodnevno okruženje. Program liječenja zahtijeva raznolike terapeutske sadržaje, koji omogućuju razvoj bolesnikovih sposobnosti na svim važnijim područjima života. Odjel za psihijatriju Univerzitetskoga kliničkog centra Maribor provodi program liječenja ovisnosti o alkoholu koji uključuje različite socioterapeutske aktivnosti, a jedna od njih na inovativan način uključuje pravilnu prehranu. Metode: Program institucionalnoga liječenja ovisnika o alkoholu uključuje inovativan pristup, koji je istovremeno socioterapeutska metoda liječenja te podizanja svijesti o pravilnoj prehrani i zdravom načinu života. Program uključuje praktični rad u demonstracijskoj kuhinji po principu skupine za samopomoć, uzgoj povrća, ljekovitoga bilja i začina u demonstracijskom vrtu te predavanja/radionice o pravilnoj prehrani. Tako bolesnici usvajaju informacije, znanja i vještine o pravilnoj prehrani, čime ih se potiče na integraciju zdravih životnih navika u svakodnevni život. Istovremeno, razvijaju radne navike, discipliniranost, sposobnost djelovanja, organizaciju slobodnoga vremena i zdravoga načina opuštanja. Rad u demonstracijskoj kuhinji uključuje izbor i pripremu jela, degustaciju i skrb za održavanje higijene u kuhinji. Izbor jela uzima u obzir tradicionalna jela prilagođena pravilnoj prehrani, godišnja doba te aktualne praznike, pri čemu se koriste recepture priznatih stručnjaka za prehranu. U aktivnostima od 2016. godine sudjeluje 40 bolesnika. Uspjehu pridonosi i uključivanje stručnjaka iz primarne zdravstvene zaštite i nevladinih udruga. Rezultati: Rezultati provjere znanja o pravilnoj prehrani pomoću intervjua te stečenih vještina demonstracijom pripreme jela, uzgoja povrća i začinskoga bilja ukazuju na poboljšanje spomenutih znanja i vještina. Pacijenti konzumiraju sva jela koja pripremaju u demonstracijskoj kuhinji, a time i više zdravih namirnica (povrće, voće, integralno žito, manje masni mliječni proizvodi itd.). Pojedini pacijenti prenose znanja i vještine u domaće okruženje tijekom vikend-izlaska, kao i nakon otpusta iz bolnice (intervjui nakon izlazaka i kod kontrolnih pregleda). Metodom promatranja radni terapeuti ocjenjuju da se poboljšala odgovornost i sposobnost djelovanja pacijenata. Pacijenti također izvješćuju o pozitivnim doživljajima (osjećaj sposobnosti, korisnosti, doprinos općem dobru). Zaključak: Prikazani inovativni način uključivanja promicanja pravilne prehrane u institucionalno liječenje ovisnika o alkoholu predstavlja primjer dobre prakse, koji se može uspješno prenijeti i u druge institucije. Ključne riječi: institucionalno liječenje, promicanje pravilne prehrane, demonstracijska kuhinja, demonstracijski vrt www.kongresnutricionista.com |

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KONTROLA GLIKEMIJE I PREHRANA TIP 1 DIJABETIČARA U HRVATSKOJ Martina Pavlić1, Nevena Valić Marjanac2, Igor Marjanac3, Zvonimir Barišić1, Ines Banjari1 Sveučilište Josipa Jurja Strossmayera u Osijeku, Prehrambeno-tehnološki fakultet Osijek, Franje Kuhača 20, 31000 Osijek, Hrvatska 2 Dom zdravlja Osijek, Park kralja Petra Krešimira IV. 6, 31000 Osijek, Hrvatska 3 Klinika za pedijatriju, Klinički bolnički centar Osijek, Josipa Huttlera 4, 31000 Osijek, Hrvatska 1

Uvod: Kontrola glikemije kod oboljelih od dijabetesa ključ je sprječavanja akutnih komplikacija, odgađanja pojave kroničnih komplikacija te utječe na ukupnu kvalitetu života. S druge strane, prehrana bazirana na dijabetičkim jedinicama ključ je dobre regulacije glikemije. Ovo je posebice važno kod oboljelih od dijabetesa tipa 1 (DMT1). Cilj rada bio jeutvrditi razinu (samo)kontrole DMT1 i pridržavanja prehrambenih principa za dijabetičare. Metoda: Opažajno istraživanje provedeno na oboljelima od DMT1 s područja Hrvatske online upitnikom. Upitnik je kreiran specifično za potrebe ovog istraživanja. Istraživanje je obuhvatilo 101 oboljelog od DMT1 starosti od 6 do 50 godina. Rezultati: Lošu kontrolu glikemije promatranu kao glikozilirani hemoglobin (HbA1c)iznad 6,5 % ima čak 2/3 ispitanika. Pozitivna obiteljska anamneza prisutna je kod 6,9 % ispitanika. Ketoacidoza je bila zastupljena kod 44,5 % ispitanika, dok se kod 40,0 % njih pojavljivala više od jednom. Kronične komplikacije su razvijene kod 20,8 % ispitanika. Principa dijabetičke dijete i brojanja ugljikohidratnih jedinica se uopće ne pridržava 17,8 %, a dodatnih 67,3 % se pridržava samo brojanja ugljikohidratnih jedinica. Polovica ispitanika brzu hranu konzumira jednom mjesečno, a 71,3 % njih konzumira slatkiše više od 2 puta tjedno. Trećina ispitanika smatra da nije dovoljno educirana o dijabetičkoj prehrani, a interesantno je kako 44,5 % njih smatra da je dijabetička prehrana znatno skuplja od uobičajene prehrane. Zaključak: Rezultati pokazuju zabrinjavajuće podatke o lošoj (samo)kontroli glikemije kao i loše poznavanje i pridržavanje principa dijabetičke prehrane oboljelih od DMT1. Potrebno je intenzivirati aktivnosti u smislu pojačane i kontinuirane edukacije svih oboljelih od dijabetesa, kroz zdravstvene ustanove i udruge. Ključne riječi: dijabetes tip 1, prehrambene navike, prehrana, kontrola glikemije

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IZVORI SOLI I ŠEĆERA U PREHRANI STUDENTSKE POPULACIJE SVEUČILIŠTA U MOSTARU Marija Pehar1, Marijana Palac1, Katarina Marušić1, Daniela Čačić Kenjerić1,2 Agronomski i prehrambeno-tehnološki fakultet Sveučilišta u Mostaru, Biskupa Čule bb, 88 000 Mostar, Bosna i Hercegovina 2 Prehrambeno-tehnološki fakultet Osijek, Sveučilište Josipa Jurja Strossmayera u Osijeku, Franje Kuhača 20, 31 000 Osijek, Republika Hrvatska 1

Uvod: Prekomjeran unos energije i različitih nutrijenata jedan je od čimbenika kroničnih nezaraznih bolesti. Suvremene prehrambene navike dovele su do toga da je dnevni unos soli hranom viši od preporučenoga. Veći dio soli unosi se konzumacijom gotovih i polugotovih jela (tzv. skrivena sol). Najčešće se uz slanu hranu konzumiraju zaslađeni napitci koji sadrže velike količine dodanog šećera (tzv. skriveni šećer). Cilj rada bio je među studentima Sveučilišta u Mostaru utvrditi učestalost konzumacije odabranih vrsta hrane i pića te koji su od njih najznačajniji izvori soli i šećera. Ispitanici i metode: Istraživanje je provedeno prema načelima prosječnog. Obuhvaćeno je 146 studenata uz jednaku zastupljenost oba spola. Podaci su prikupljeni primjenom jednokratnog anonimnog upitnika, a sudjelovanje u istraživanju bilo je isključivo na dobrovoljnoj bazi. Upitnik je pored općih podataka o ispitaniku i prehrambenim navikama obuhvatio i podatke o učestalosti konzumacije odabranih vrsta hrane i pića. Rezultati: Prikupljeni podaci obrađeni su primjenom tabličnog alata Excel te izraženi na cjelokupnu ispitivanu populaciju te podskupine s obzirom na spol i status uhranjenosti. S obzirom da najveći dio ispitivanih studenata (49%) svakodnevno doručkuje, pri čemu su peciva i sendviči (52%) te žitarice za doručak (26%) najčešće zastupljeni, upravo oni su utvrđeni i kao najznačajniji izvori soli odnosno šećera, u svakodnevnoj prehrani. Uz njih, odnosno njihove sastavnice, značajan doprinos unosu soli utvrđen je i za tzv. brzu hranu, dok je značajan utjecaj na ukupan unos šećera utvrđen za puding. Zaključak: S obzirom da se većina ispitanika izjasnila da konzumira umjereno slanu hranu, a rezultati ukazuju na povećan unos soli evidentno je da je percepcija ispitanika iskrivljena te je potrebno provesti edukaciju studenata o izvorima skrivene soli. Ključne riječi: sol, šećer, studentska populacija, prehrambeni unos, prehrambeni izvori

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PREHRAMBENE NAVIKE I STAVOVI STUDENATA VETERINARSKE MEDICINE KOJI ŽIVE KOD KUĆE ILI DALEKO OD KUĆE Loredana Pincan, Marina Prišlin, Ozren Šiftar, Lana Vranković, Jasna Aladrović Veterinarski fakultet Sveučilišta u Zagrebu, Heinzelova 55, 10000 Zagreb

Uvod: Upisivanjem na fakultet studenti su suočeni s rastućim brojem obaveza i znatno većim opterećenjem. Zbog toga može doći do promjene prehrambenih i životnih navika. Kvaliteta prehrane tada ovisi o navikama stečenim u obitelji te o namirnicama koje su im dostupne pri pripremi obroka ili u obrocima koje konzumiraju u restoranima studentske prehrane. Cilj istraživanja bio je utvrditi utjecaj odvajanja od obitelji na prehrambene i životne navike studenata veterinarske medicine. Materijal i metode: Istraživanje je provedeno od 2014. do 2017. godine te je u njemu sudjelovalo 265 studenata. Ispitanici su podijeljeni u dvije skupine, u skupinu studenata koji prebivaju u Zagrebu (N=127) i studente koji borave u Zagrebu tijekom akademske godine (N=138). Istraživanje je provedeno putem anketnog listića koji je sadržavao 20 pitanja. Statistička analiza provedena je u računalnom programu Statistica v. 12. Rezultati: Najveći broj ispitanika jede i kod kuće i u restoranu studentske prehrane (81%). Pri tome značajno veći broj studenata koji ima boravište u Zagrebu jede u studentskom restoranu (p≤0,05). Većina studenata (58%), neovisno o mjestu stanovanja, kvalitetu studentskog restorana ocjenjuje dobrom i vrlo dobrom ocjenom. Značajno veći broj studenata koji prebiva u Zagrebu jede svakodnevno svježe obroke (p≤0,05) i u većem postotku jedu pet i više obroka na dan (p≤0,05). Studenti koji prebivaju u Zagrebu u značajno većem postotku svakodnevno doručkuju (p≤0,05) te svakodnevno jedu mlijeko i mliječne proizvode (p≤0,05). Sportom se od ukupnog broja studenata rekreativno bavi 47%, a aktivno 7% studenata. Većina studenata, neovisno o mjestu stanovanja, nije bila na dijeti u posljednjih godinu dana (81%) i ne smatra da su pretili (84%). Polovica ispitanika smatra da se hrani nezdravo (50%). Zaključak: Rezultati ukazuju na važnost života s roditeljima jer je doručkovanje i konzumiranje mlijeka i mliječnih proizvoda kod ovih studenata učestalije što može utjecati na kognitivne sposobnosti i brzinu protoka informacija u radnoj memoriji pri učenju te unos kalcija potrebnog za rast i razvoj koji je u ovoj dobi još intenzivan. Ključne riječi: studenti, prehrambene navike, stavovi, stanovanje kod kuće, stanovanje daleko od kuće

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UTJECAJ EDUKACIJE NA ZNANJE DJECE OSNOVNOŠKOLSKE DOBI O ZASLAĐENIM NAPITCIMA Juliana Lana Prah1, Ivana Rumbak2, Irena Colić Barić2 Studentica diplomskog studija Molekularna biotehnologija, Sveučilište u Zagrebu, Prehrambeno – biotehnološki fakultet, Pierottijeva 6, 10000 Zagreb, Hrvatska 2 Sveučilište u Zagrebu, Prehrambeno – biotehnološki fakultet, Pierottijeva 6, 10000 Zagreb, Hrvatska 1

Uvod: Ograničavanje unosa zaslađenih napitaka (ZN) jedna je od temeljnih preventivnih strategija za borbu protiv epidemije pretilosti. Visoki unos ZN kod djece povezan je sa smanjenim unosom hranjivijih napitaka poput mlijeka, ali i s neadekvatnim unosom vitamina i mineralnih tvari. Dugoročno, takav obrazac prehrane povezuje se osim s pretilošću i s drugim kroničnim nezaraznim bolestima. Cilj ovog istraživanja bio je procijeniti učinkovitost kratke edukacije na znanje djece o sadržaju šećera u različitim vrstama ZN i njihovom mogućem djelovanju na zdravlje. Materijali i metode: U istraživanju su sudjelovali učenici 5. razreda osnovne škole u Karlovcu (n=42). Edukacija u trajanju od 45 minuta, sastojala se od niza aktivnosti prilagođenih djeci tog uzrasta. Neposredno prije edukacije učenici su ispunjavali upitnik znanja o unosu dodanih šećera odnosno poželjnom odabiru napitaka. Isti upitnik znanja učenici su ispunili neposredno nakon edukacije. Upitnik znanja ponovljen je i 9 mjeseci nakon edukacije. Za prikaz rezultata korištene su standardne metode deskriptivne statistike, a za usporedbu frekvencija točnih odgovora hi-kvadrat test. Rezultati: Najbolje znanje učenici su pokazali na pitanju o preporučenom dnevnom unosu vode, a najslabije na pitanje o preporukama za unos šećera. Utvrđeno je poboljšanje u broju točnih odgovora nakon edukacije (p<0,05). Nakon 9 mjeseci, nije vidljivo statistički značajno poboljšanje u broju točnih odgovora u odnosu na odgovore prije edukacije, no usporedimo li ukupan broj točnih odgovora prije edukacije, s brojem točnih odgovora 9 mjeseci nakon edukacije vidljivo je da se broj točnih odgovora poboljšao za 5,75%. Odnosno, prije edukacije više od 50% točnih odgovora ostvarilo je 14 učenika, dok je 9 mjeseci nakon edukacije više od 50% točnih odgovora ostvarilo 22 učenika (n=42). Zaključak: S obzirom na cilj istraživanja, može se zaključiti da je neposredno nakon edukacije došlo do statistički značajnog poboljšanja u broju točnih odgovora. Iako nije vidljiv statistički značajan pozitivan dugoročan učinak edukacije, vidljivo je poboljšanje u broju točnih odgovora kod učenika. Buduća istraživanja trebala bi uključiti veći broj ispitanika te češće intervencije koje bi potaknule učenike na primjenu stečenog znanja u svrhu promjene prehrambenih navika, odnosno na smanjenje unosa ZN, a samim time i dodanih šećera. Ključne riječi: zaslađeni napitci, edukacija, djeca, dodani šećer

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ŠEĆER I SOL U PROIZVODIMA ŠIROKE POTROŠNJE Marija Prčić, Milica Bećir Marija Prčić, Dr Babović Anti Aging Centar, Krunska 80, 11000 Beograd, Republika Srbija

Uvod: Kronične nezarazne bolesti već desetljećima dominiraju u svjetskoj patologiji. Vodeći uzroci umiranja u Srbiji gotovo su identični onima u razvijenim dijelovima svijeta. U Srbiji godišnje od kroničnih nezaraznih bolesti umre približno 100.000 ljudi. Gotovo svaki drugi stanovnik Srbije umre od bolesti srca i krvnih žila, svaki peti od malignih tumora, dijabetesa. U Srbiji oko 710.000 osoba ili 12,4% stanovništva ima dijabetes, 465.000 ili 8,1% odraslog stanovništva zna za svoju bolest i još 245.000 osoba nema postavljenu dijagnozu bolesti i ne liječi se. Jedan od faktora rizika za obolijevanje od kroničnih nezaraznih bolesti je nepravilna, neadekvatna prehrana. Redovan odabir namirnica koje su izvor skrivenih šećera (“praznih kalorija”) i soli, mogu biti okidač bolesti iz spomenute grupe. Materijali i metode: Relevantni podaci prikupljeni su tehnikom analize tržišta konditorskih proizvoda, proučavanjem deklaracije i specifikacije samih proizvoda. Rezultati: Analizirano je preko 100 prehrambenih proizvoda, podijeljenih u tri statističke grupe - keksi, žitarice i orašasto voće te sjemenke. Dobiveni podaci ukazuju na povećan sadržaj šećera i soli u proizvodima. Zaključak: Na temelju prikazanih rezultata, uočena je potreba za edukacijom stanovništva u vezi s pravilnom prehranom i promjenama prehrambenih navika, čitanjem i razumijevanjem deklaracija i nutritivnih izjava na prehrambenim proizvodima. Pravilnom edukacijom je moguće osigurati povećanje unosa složenih ugljikohidrata koji su uvijek deficitarni, a smanjenje udjela “praznih kalorija” i soli. Ovakvim promjenama bi se posredno utjecalo na smanjenje obolijevanja od kroničnih bolesti koje su posljedica nepravilne prehrane. Ključne riječi: sol, šećer, KNO, edukacija

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PROFIL PACIJENATA U AMBULANTI ZA PRETILU DJECU I ADOLESCENTE U KLINICI ZA DJEČJE BOLESTI ZAGREB Sara Sila, Tena Niseteo Klinika za dječje bolesti Zagreb, Klaićeva ulica 16, 10000 Zagreb

Uvod: Pretilost u djece i adolescenata predstavlja jedan od najvećih javnozdravstvenih problema u 21. stoljeću. Činjenica je da preko 80% pretile djece postaju pretili adolescenti, a 20% pretilih adolescenata pretili odrasli. Pretilost kod djece može uzrokovati mnoge zdravstvene problem, od hipertenzije, preko dijabetesa tipa 2, inzulinske rezistencije, dislipidemije i psihosocijalnih posljedica. Cilj ovog istraživanja bio je procijeniti profil djece i adolescenata u ambulanti za pretile u Klinici za dječje bolesti Zagreb. Materijali i metode: U istraživanju su se koristili antropometrijski podaci pacijenata koji su posjećivali ambulantu za pretilu djecu i adolescente od 2013. godine, a kojima su osim tjelesne mase i tjelesne visine bili određeni i postotak masnog tkiva, mišićne mase i ostale antropometrijske mjere. Analiza podataka provedena je pomoću računalnog programa Microsoft Office Excel 2010. Rezultati: Analizom podataka procijenjeno je da od ukupno 53 pacijenata, veći broj njih čini muška populacija (60,4%) te djeca koja žive u gradu (58,5%). Prosječna dob (medijan) pacijenata je 14 godina. Njih 24 (45,2%) pohađa osnovnu školu, odnosno njih 29 pohađa srednju školu (54,8 %). Povećanu tjelesnu masu među ispitivanom populacijom ima 37,7% ispitanika te je 58,4% ispitanika pretilo i to 50,9% pretilosti I stupnja (ITM od 25,0 do 29,9) te 7,5% pretilost II stupnja (ITM od 30,0 do 34,9%). Ne postoji statistički značajna razlika u stupnju pretilosti između djece koja žive u gradu i u selu. Od njih 53, samo se 16 djece odazvalo na prvi kontrolni pregled. Od onih koji su došli na prvi kontrolni pregled 8 ih je imalo manji indeks tjelesne mase (ITM) u usporedbi s prvim pregledom, dok je njih 8 povećalo tjelesnu masu od prvog savjetovanja. Na drugi kontrolni pregled došlo je 6 ispitanika, te su svi povećali tjelesnu masu od posljednje kontrole. Zaključak: Liječenje pretilosti kod djece i adolescenata je vrlo zahtjevan i dugotrajan proces koji značajno ovisi o motivaciji pacijenata i njihovih roditelja. Vrlo mali broj pacijenata uspije izgubiti na tjelesnoj masi, a još manji broj uspije zadržati dostignutu tjelesnu masu. Stoga je vrlo bitno raditi na prevenciji pretilosti među djecom i adolescentima, edukaciji o važnosti pravilne prehrane. Ključne riječi: povećana tjelesna masa,pretilost, djeca, adolescenti, indeks tjelesne mase

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UNOS RIBE, ŽIVA I METABOLIČKI SINDROM: PREGLED LITERATURE Tamara Sorić1, Ivona Dragičević2 1

Psihijatrijska bolnica Ugljan, Otočkih dragovoljaca 42, 23 275 Ugljan, Hrvatska Omnipharma d.o.o., Radnička cesta 54, 10 000 Zagreb, Hrvatska

Uvod: Dobro je poznato da živa, kao toksični metal, može izazvati oksidativni stres, inaktivirati određene antioksidativne mehanizme, izazvati kroničnu upalu niskog stupnja te naposljetku dovesti do povećanog rizika od razvoja metaboličkog sindroma. Iako se unos ribe uglavnom povezuje s blagotvornim učincima na zdravlje, sve vrste ribe sadrže metil živu koja može imati toksični učinak na ljudski organizam. Uzimajući u obzir utjecaj unosa ribe na koncentraciju žive u organizmu te utjecaj izloženosti živi na razvoj metaboličkog sindroma, cilj ovog rada bio je dati pregled do sada publicirane znanstvene literature o povezanosti ovih triju čimbenika. Rezultati i rasprava: Brojne studije ispitivale su ulogu žive u razvoju pojedinih komponenti metaboličkog sindroma, ali samo se manji broj istraživanja bavio utjecajem žive na metabolički sindrom u cijelosti. Prema vlastitim saznanjima, samo su četiri studije istraživale povezanost koncentracije žive i metaboličkog sindroma, uzimajući u obzir unos ribe. Tri od četiri studije dokazale su da je izloženost živi, čak i u niskim dozama, povezana s metaboličkim sindromom ili barem nekim njegovim komponentama. Dvije su studije utvrdile da ukupan unos ribe ili unos pojedinih vrsta koje sadrže relativno visoke doze metil žive, doprinosi ukupnoj koncentraciji žive u organizmu. Zaključak: Radi boljeg razumijevanja povezanosti unosa ribe, žive i metaboličkog sindroma potrebno je provesti veće prospektivne kohortne ili randomizirane kontrolirane studije. Buduća bi se istraživanja trebala provoditi na širem geografskom području te bi trebala rasvijetliti sve čimbenike utjecaja na razinu žive. Ključne riječi: unos ribe, živa, metabolički sindrom

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UTJECAJ PREHRANE MAJKE I POTOMAKA NA POVRŠINU I BROJ ADIPOCITA BIJELOG MASNOG TKIVA MUŠKIH POTOMAKA ŠTAKORA Darija Šnajder1,2, Željka Perić Kačarević1, Matija Fenrich3, Nikola Bijelić4, Marina Bakula5, Radivoje Radić1 1 Katedra za anatomiju i neuroznanost, Medicinski fakultet, Sveučilište J.J. Strossmayera u Osijeku, Osijek, Hrvatska 2 Klinički zavod za nuklearnu medicinu i zaštitu od zračenja, Klinički bolnički centar Osijek, Osijek, Hrvatska 3 Medicinski fakultet, Sveučilište J.J. Strossmayera u Osijeku, Osijek, Hrvatska 4 Katedra za histologiju i embriologiju, Medicinski fakultet, Sveučilište J.J. Strossmayera u Osijeku, Osijek, Hrvatska 5 Klinički zavod za patologiju i sudsku medicinu, Klinički bolnički centar Osijek, Osijek, Hrvatska

Uvod: Kod sisavaca masno tkivo može se podijeliti na dvije glavne vrste masnoga tkiva, bijelo i smeđe, pri čemu je bijelo masno tkivo predominantno i specijalizirano za čuvanje energije. Kako bi se moglo prilagoditi prekomjernom dotoku energije bijelo se masno tkivo remodelira na nekoliko načina: 1. povećanjem volumena (hipertrofijom) i/ili broja adipocita (hiperplazijom), 2. infiltracijom upalnih stanica i 3. remodeliranjem vaskulature i ekstracelularnog matriksa kako bi se omogućila ekspanzija tkiva. No, kada su stanja upale i pretilosti neprekidna, homeostatski mehanizmi podbace uzrokujući tkivnu disfunkciju. Materijali i metode: Deset ženki Sprague Dawley štakora starosti 9 tjedana su nasumično podijeljene u dvije skupine i hranjene standardnom laboratorijskom hranom ili hranom bogatom zasićenim masnim kiselinama tijekom 5 tjedana i zatim parene s genetički srodnim mužjacima. Nakon poroda i laktacije muški potomci štakora su podijeljeni u četiri podgrupe ovisno o prehrani kojom su hranjeni do 22. tjedna starosti. Nakon žrtvovanja uzeti su uzorci bijelog masnog tkiva iz subkutanog kompartmenta i dva kompartmenta visceralnog masnog tkiva: epididimalnog i perirenalnog. Presjeci tkiva su fiksirani formalinom, uklopljeni u parafin, rezani, bojani hemalaunom i eozinom te slikani, a histomorfometrijska analiza se provela putem programa CellProfiler v. 2.1.1. Rezultati: Srednja vrijednost površine adipocita subkutanog i epididimalnog masnog tkiva bila je veća u skupinama muških potomaka štakora s promijenjenom pre- i postnatalnom dijetom nego u skupinama kod kojih dijeta nije bila mijenjana te sukladno tome u navedenim skupinama je izmjeren manji broj adipocita po jedinici površine. U visceralnom su masnom tkivu najmanje srednje površine i najveći broj adipocita izmjereni u skupini gdje su i majka i potomci hranjeni dijetom bogatom zasićenim masnim kiselinama. Zaključak: Promjena dijete nakon rođenja i laktacije dovodi do hiperplazije adipocita subkutanog i epididimalnog masnog tkiva, a masna prehrana uzorkuje hiperplaziju adipocita perirenalnog bijelog masnog tkiva. Ključne riječi: masna prehrana, masno tkivo, histomorfometrija, štakori

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ČIMBENICI KOJI UTJEČU NA KOLIČINU OTPADA HRANE U KUĆANSTVIMA Anamarija Švagelj1, Irena Colić Barić2 Hrvatski akademski centar primijenjenog nutricionizma, Supilova 7, 10000 Zagreb Prehrambeno-biotehnološki fakultet Sveučilišta u Zagrebu Laboratorij za znanost o prehrani, Pierottijeva 6, 10 000 Zagreb 1

Uvod: Otpad hrane u kućanstvima u najvećem udjelu pridonosi ukupnom otpadu hrane, stoga je potrebno posebnu pozornost obratiti na ovu vrstu otpada hrane pri osmišljavanju mjera prevencije i smanjenja ukupne količine otpada hrane, te utvrditi čimbenike koji utječu na njegov nastanak. Istraživanja provedena na ovu temu otpad hrane povezuju sa socioekonomskim čimbenicima te bihevioralnim čimbenicima koji se odnose na opskrbu, pripremu, skladištenje hrane te prehranu i životni stil. Ispitanici i metode: Istraživanje je provedeno pomoću on-line upitnika. Prikupljeno je 252 ispitanika starijih od 16 godina u razdoblju od 24. lipnja 2015. do 31. kolovoza 2015. godine. Podaci su obrađeni u statističkom paketu SPSS v. 20.0. Provedena je analiza određenih pitanja vezanih za sociodemografske čimbenike i postupke rukovanja hranom i količine otpada hrane. Korišten je kriterij statističke značajnosti manji od 5% (p<0,05). Test korišten za utvrđivanje statistički značajne povezanosti svih relevantnih parametara je Hi-kvadrat test. Rezultati: Postoji povezanost (p=0,006) između veličine kućanstva i količine otpada hrane te vrste kućanstva i količine otpada hrane (p=0,002). U kućanstvima s više članova te u kućanstvima s djecom baci se više otpada hrane. Postoji povezanost (p=0,006) između količine otpada hrane i učestalosti obavljanja spontane kupovine ili kupovine kojom se obnavljaju zalihe hrane i pića. Ispitanici koji rjeđe obavljaju ovakvu vrstu kupovine bacaju manje hrane nego ispitanici koji ju obavljaju češće. Ispitanici koji kupuju hranu u supermarketima i lokalnim trgovinama bacaju više hrane nego oni koji hranu kupuju na tržnici ili ju sami uzgajaju (p<0,001). Pokazana je povezanost (p=0,039) između količine otpada hrane i utvrđivanja potreba za kupovinom hrane prije odlaska u kupovinu. Ispitanici koji su bacali veće količine otpada hrane kao glavni razlog navodili rok trajnosti hrane, a sljedeći razlog je kupovina, priprema ili serviranje veće količine hrane od stvarnih potreba u obitelji (p<0,001). Neplaniranje obroka povezuje se s većim količinama otpada hrane u kućanstvima (p=0,028). S većim količinama otpada hrane povezuje se i nepravilno skladištenje hrane (p=0,013), dok se s manjim količinama povezuje konzumiranje ostataka jela čuvanih u hladnjaku ili zamrzivaču (p<0,001) te prije bacanja provjeravanje okusa, mirisa i/ili izgleda hrane kojoj je istekao rok trajnosti (p=0,005). Zaključak: Vidljivo da se određeni postupci tijekom opskrbe, pripreme i skladištenja hrane povezuju s nastankom otpada hrane u kućanstvima stoga je potrebno uvrstiti ih u plan edukacije stanovništva. Također je potrebno prilikom posebnu pozornost obratiti na kućanstva s više ukućana te kućanstva s djecom budući da se u takvim kućanstvima baci više otpada hrane. Ključne riječi: otpad hrane u kućanstvima, bihevioralni čimbenici 112

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4. Lecture abstracts

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PITFALLS, TRAPS AND ERRORS ABOUT DOPING Zoran Bahtijarević University Children’s Hospital Zagreb, Croatia

Doping is one of the most widespread evils in modern sport. New cases of adverse analytical findings in athletes arise almost every day. Great portion of these «positive» findings are result of pitfalls, errors and misunderstanding of doping present in athletes and their team. Balanced nutrition is one of the basics of the great sport results. Unfortunatelly, even such nutrition is full of traps that can result in adverse analytical finding. Modern sport is almost unthinkable without food suplements. But it is exactly the field in which most errors occur and the consenquence could be longterm ban or even end of career. The aim of this lecture is to, once again, point out some of the most often pitfalls, traps and errors about doping. Moreover, its aim is to emphasise the role of nutricionists and other members of the team surronding the athletes in prevention of intentional and uninentonal doping in sports. Keywords: doping, sport, nutrition

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WHEY AND BUTTERMILK – A NEGLECTED FUNCTIONAL FOOD Irena Barukčić Faculty of Food Technology and Biotechnology, Laboratory for Technology of milk and dairy products, Pierottijeva 6, 10000 Zagreb

The main by- products of the dairy industry are whey and buttermilk, both containing highly valuable constituents which make them a potential functional food. Despite, their potential is as raw materials for the development of new products is not used at all. Buttermilk originates from butter production and contains lactose, proteins, milk fat globule membrane (MFGM), minerals and lecithin. Numerous studies have shown that MFGM contain bioactive compounds with antitumor and cholesterol lowering impact, and which act inhibitory on Helicobacter pylori or prevent gastrointestinal infections. Whey originates from cheese production and contains highly valuable whey proteins, lactose, minerals and vitamin B. Whey proteins are rich in essential amino acids, which makes their biological value higher in comparison to other proteins of animal and vegetable origin, including egg proteins which were regarded as a referent for a long period of time. β-lactoglobulin and α-lactalbumin are a source of several bioactive peptides with positive effects on coronary, gastrointestinal, immune and nervous system. Therapeutic value of whey is familiar since the era of the ancient Greeks and was used for treatments of tuberculosis, hepatitis, diarrhoea, skin eczema, etc. Buttermilk has usually been processed by fermentation with lactic acid bacteria, while whey is placed on the market most commonly as pasteurised acid whey. However, the quantities of buttermilk and whey which are available on the market are negligible. Thus, the aim of this lecture is to present into the nutritional and the health promoting value of specific buttermilk and whey constituents by relating to the results of recent scientific and clinical research. Further, possibilities of whey and buttermilk processing and utilisation in human nutrition are to be presented to. Keywords: functional food, buttermilk, whey, bioactive compounds

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DIETOTHERAPY APPROACH TO PATIENT ON ANTICOAGULATION THERAPY Alenka Brozina Dom zdravlja, Rijeka, Park Nikole Hosta 4, 51 000 Rijeka

Anticoagulation therapy is used in patients with deep vein thrombosis (DVT) and some coronary heart diseases like cardiac arrhythmias (atrial fibrillation/undulation) and as the therapy after heart valve replacement with mechanical valves. The basis of anticoagulation therapy is to prevent the coagulation mechanism and formation of the thrombus (cloth). Anticoagulation therapy is often chronic and lifelong. Today we are using two different anticoagulation approaches; one is with NOAC (“novel oral anticoagulant”) and warfarin therapy. NOAC acts as a direct inhibitor of coagulation factor Xa (rivaroksiban) and as direct inhibition of thrombin (dabigratan). The action of this medication does not need to be monitored or does not need any nutrition modification, they are elegant to use, but they are expensive. In Croatia the most prescribed anticoagulant medicines are still Warfaine (Martefarin, Marivarin) which is a vitamin K antagonist. The activity of this medication has to be monitored by PT (prothrombotic time), which is expressed in percentage and in INR (“International Normalized Ratio”) which values are expressed by number in therapeutic range of 2-4, depending on initial diagnosis. Considering that Martefarin is a vitamin K antagonist, it is necessary to modify patient’s dietary habits, so that the activity of the medication could be in the therapeutic range. Today, we need to be more careful about the dietotherapeutic approach to patients on anticoagulation medication, so the need for collaboration on the pathway doctor- nutritionist (dietitian) is of great importance for planning and individual dietotherapeutic approach and changing their nutritional habits.

Keywords: anticoagulation therapy, varfarin, vitamin K, nutrition

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NUTRITIONAL ASPECTS OF FOOD FOR ENTERAL NUTRITION Marijana Ceilinger1, Helena Tomić-Obrdalj2, Jelena Miličević2, Lenkica Penava1, Davorka Gajari2 1

Belupo lijekovi i kozmetika d.d., Ulica Danica 5, 48 000 Koprivnica Podravka d.d., A.Starčevića 32, 48 000 Koprivnica

Introduction: Food for enteral nutrition (EN) or dietary food for special medical purposes is used for nutritional support as a supplement to normal food or as a sole source of nourishment. Disease-related malnutrition is a state characterized by deficiency in intake of energy, protein and/or micronutrients as a result of different diseases, conditions or medical treatments. A great number of studies show benefits of using formulae for EN, including lower morbidity and complications rates, increase of muscle mass, improved quality of life and also shorter hospital stay and lower healthcare costs. Materials and methods: Using NRS 2002form is a simple and rapid method for screening patients for nutritional risk. In case of nutritional risk, nutritional support is initiated and formulae for EN are usually prescribed. Standard,polymeric, nutritionally complete formulae are sufficient for the majority of patients. Continuous monitoring of the results of nutritional support and, if necessary, correction of nutritional plan is required. Good organoleptic characteristics of the EN formulae and selection of flavors according to patient preferences are key to successful therapy. For better nutritional plan implementation, meal recipes were created with EN formulae included in preparation of various dishes, without altering the properties of EN formula. A 7-day menu was created on the basis of nutritional needs of an adult, characterized as normocaloric and high-protein. Recipes were created using EN formulae, fresh and processed foods traditional for the Croatian cuisine. Nutritive analysis was performed in Genesis program (Genesis R&D® v 6.00, ESHA Research, USA). Results: Prepared meals had minimally 20% of proteins, 25-30% fat and 50-55% carbohydrates. Enteral food formulae was added in the amount adequate for the supplementation therapy with the minimal influence on organoleptic profile, therefore meals had the traditional appearance, odor, taste and texture. Conclusion: For the successful implementation of nutritional therapy, the timely application of nutritional support as well as the good acceptability of enteral food formulas is crucial. Respecting personal preferences, along with diet habits of the patient is important aspect of evaluation and improvement of nutritional status. Applying enteral food formulae in everyday meals is one of the approaches in personalized therapy beneficial for the maintaining the quality of life of the patient. Keywords: enteral food, malnutrition, nutritional support, menu

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DIET AND THE GUT MICROBIOME IN PEDIATRIC CROHN’S DISEASE Charlene Compher, 2Dale Lee, 2Robert N. Baldassano, 3Anthony R. Otley, 2Lindsey Albenberg, 4 Anne M. Griffiths, 5Eric Z. Chen, 5Hongzhe Li, 5Erin Gilroy, 5Lisa Nessel, 3Amy Grant, 5 Christel Chehoud, 6Frederic D. Bushman, 7Gary D. Wu, 5,7James D. Lewis

Background: Therapeutic targets in pediatric Crohn’s disease include symptoms, quality of life (QOL), and mucosal healing. Although partial enteral nutrition (PEN), exclusive enteral nutritional (EEN), and anti-tumor necrosis factor alpha (anti-TNF) therapy all improve symptoms, the comparative effectiveness of these approaches to achieve mucosal healing and improve QOL remains unclear. Dysbiosis of the intestinal microbiota is a characteristic of Crohn’s disease, but the contributing factors remain unclear. Methods: In a prospective study of children initiating PEN, EEN, or anti-TNF therapy for Crohn’s disease, we compared clinical outcomes using the Pediatric Crohn’s Disease Activity Index (PCDAI), QOL, and mucosal healing as estimated by fecal calprotectin (FCP). Dietary intake by 24-hour recalls, PCDAI, QOL, and FCP were assessed at baseline and after 8 weeks of therapy. Stool samples from baseline and week 8 were assayed using shotgun metagenomics, and compared to a sample of healthy control children. Results: We enrolled 90 children with active Crohn’s disease, 52 treated with anti-TNF, 22 with EEN, and 16 with PEN plus ad lib diet. Clinical response, defined as significant improvement in PCDAI, was achieved by 64% on PEN, 88% EEN, and 84% anti-TNF (test for trend P = 0.08). FCP <250 mg/g was achieved with PEN in 14%, EEN 45%, and anti-TNF 62% (test for trend P = 0.001). Improvement in overall QOL was not statistically significantly different between the groups, but was greatest with EEN in the body image (P= 0.03) domain and with anti-TNF in the emotional domain (P=0.04). Dysbiosis was apparent in one-third of the patients, and was independently associated with antibiotics, inflammation, and diet. Dysbiosis was reduced with reduction in intestinal inflammation. Conclusions: Although PEN improved clinical symptoms, EEN and anti-TNF were more effective for decreasing mucosal inflammation and improving specific aspects of QOL. The microbiota results may facilitate biomarker discovery and future therapeutic interventions. Key words: gut microbiome, Crohn's disease, children

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EARLY POSTOPERATIVE NUTRITION IN PATIENTS AFTER LIVER TRANSPLANTATION Maja Ćurić Delač1, Leda Borovac Štefanović2, Željko Vidas1, Branislav Kocman1, Stipislav Jadrijević1, Jasna Aladrović3, Ivančica Delaš2 University Hospital Merkur, Zajčeva 19, 10 000 Zagreb, Croatia School of Medicine, University of Zagreb, Šalata 3, 10 000 Zagreb, Croatia 3 Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10 000 Zagreb, Croatia

Transplantation is a procedure where human cells, tissues or organs from a donor are implanted into the body of a recipient with the purpose of improving the function of the recipient’s failing tissue or organ. It is an accepted therapeutic intervention for patients whose vital organs have sustained irreversible loss of function, regardless of etiology. Nutrition represents an important component in the success of the operative intervention itself and the patient’s postoperative recovery. Adequate energy and nutritional intake represent elements which are essential for the successful healing process, immune response and optimization of metabolism during acute treatment and recovery phase. The study included 50 adults (15 women and 35 men) with the liver transplant. The average age of the participants was 55 years, with the range of 48 to 59 years. They all underwent anthropometric analysis. We used a targeted questionnaire to gather information about social and demographic characteristics and lifestyle habits of the subjects. Their total nutritional intake was monitored for two weeks by using hospital food normative that was made according to the Decision on the standard of nutrition for patients in hospitals by the Ministry of Health and Social Welfare of the Republic of Croatia. Data were analyzed by the χ2 test using statistical program Statistica 12. Research has shown that the average daily nutritional intake during the first 14 postoperative days is insufficient in most patients. The total energy intake in the first 3 postoperative days was less than ⅔ of minimal energy requirements (REE, Resting Energy Expenditure) in all of the patients. During 7 days, energy intake was inadequate in 70.8 % of patients and after 14 days energy intake was still inadequate in 47.9 % of patients. Protein intake was low in 50% of all patients. Very low fat intake was registered in all of the participants. The results have demonstrated significant deficiencies in nutritional intake in liver transplant recipients during the early postoperative period. Low fat intake raises the risk for the essential fatty acids and fat soluble vitamin deficiency. Better nutritional support during the early postoperative period, and/or the introduction of appropriate supplements for enteral or parenteral nutrition, would improve the recovery process and thus shorten the time and reduce the overall costs of the medical treatment. Key words: liver, transplantation, nutritional intake

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FREQUECY OF USE OF MILK AND DAIRY PRODUCTS IN STUDENTS OF PRIMARY AND SECONDARY SCHOOLS THE CITY OF SPLIT Katja Ćurin1, Ivana Gjeldum² ¹ Education Institute for Public Health of the Split - Dalmatia CountyVukovarska 46, 21000 Split ² Jurja Šižgorića 30, 21000 Split

Milk is a foodstuff that in a favorable ratio contains all the necessary nutritional and protective substances and water at a high percentage - approximately 87%. Milk proteins contain all the essential amino acids necessary for the growth and development of the baby, and the organism exploits them abundantly (95%). Milk is rich in minerals (sodium, potassium, calcium, magnesium, phosphorus, iron, zinc, copper, iodine, cobalt and sulfur.) Milk contains certain amounts of vitamin B (grup-amin B, riboflavin B2, cyanocobalamin B12) and in fats vitamins A, D, E and K. The aim of the paper was to explore the knowledge and habits related to the use of milk and products in schoolchildren and adolescents in the city of Split. The research was conducted during the academic year 2016/2017. Through an anonymous, voluntary questionnaire. The survey questionnaire was conducted with two-seventh and two eighth grade students in two primary schools (N = 104). Questionnaire was also solved by the students. Two third and two fourth grades in two high schools (N = 98). The questionnaire was created for the purpose of this research and consisted of 25 questions related to knowledge of the health benefits of using milk and products and the already adopted habits of their use. The questionnaire was statistically processed and interpreted. X²-test, t-test was used, and statistical significance was observed if p <0.05. It has been shown that elementary school students drink milk more and more frequently and use dairy products (80%), while the knowledge about the health benefits of milk and products is satisfactory but modest than the high school students expected. High school students drink significantly less milk (35-40%), rather take carbonated and sometimes alcoholic beverages. Knowledge about the health benefits of milk and products is good. Milk and products consumption habits in primary and secondary school students are most familiar (more than 70%). It is necessary to increase the consumption of milk and dairy products for elementary and high school students and to raise the level of knowledge about the health benefits of these foods through public media (TV, radio, internet, daily press, weekly press, brochures, workshops, stands etc.) Keywords: milk, dairy products, students, adolescents, health promotion

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USE OF COMMERCIAL AND ENTERAL FOOD PRODUCTS IN THE INSTITUTIONS FOR ACCOMMODATION AND CARE OF ELDERLY IN THE CITY OF SPLIT Katja Ćurin¹, Ivana Gjeldum² ¹ Institute for Public Health of Split - Dalmatia County Vukovarska 46, 21000 Split ² Jurja Šižgorića 30, 21000 Split

Physiological changes associated with aging affect the need for nutrients. Energy demand and need for macronutrients are reduced, however, the need for micronutrients are equal to or greater than during adulthood. Meal planning is an important part of the nutritional care of older persons, and is important food supplements and oral nutritional supplements (enteral compositions) and commercial products are administered for threatening malnutrition. The presence of chronic diseases and medication may cause an imbalance between the need for nutrient and food intake, leading to the emergence of malnutrition or poor nutritional status. Malnutrition with their “three persons” (sarcopenia, cachexia and anorexia) often occurs in elderly people who are hospitalized or placed in institutions. Such poor nutritional status increased morbidity and mortality and a negative impact on daily activities, functions and quality life. The aim of the study was to investigate the influence of commercial products and enteral preparations to improve the health and quality of life for service users’ homes for accommodation and care of the elderly. The influence of commercial products and enteral preparations to improve the health status of the elderly was carried out in two institutions for accommodation and care of the elderly in the city of Split. Accompanied by the improvement of the situation with users taking out commercial preparations or enteral feeding for two years. The results were compared with the control group of home service users. The data were statistically processed and interpreted. X² and t-test were used, and statistical significance was observed if p <0.05. The best results of this review have proven in three common pathological events in geriatrics (decubitus ulcers, dysphagia, and dementia). In almost 90% of older people with ulcers of pressure condition has improved considerably already after 3-6 months of using a new way of eating. In 15-20% of dementia patients enteral nutrition and commercial products have led to noticeable improvements. In dysphagic elderly nutritional status has improved after a few weeks of a new form of nutrition. Quality of life was improved in all three diagnoses. The commercial nutrition and enteral preparations should be more use in institutions for accommodation of elderly people, and expand their use in people who are at home care. These preparations are stocks higher and better quality of life of older people placed in social and private institutions or who are on home care. Keywords: the commercial foods, enteral preparations, older people, hostels for accommodation of older people, quality of life of older people www.kongresnutricionista.com |

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PUBLIC HEALTH AND PROMOTIONAL ACTIVITES FOR PREVENTION OF CARDIOVASCULAR DISEASES IN INSTITUTE OF PUBLIC HEALTH COUNTY OF ISTRIA – PATH TO NUTRITION COUNSELING Olga Dabović Rac, Sunčica Matanić-Stojanović, Danijela Lazarić-Zec, Aleksandar Stojanović Institute of public health County of Istria – Istituto di sanità pubblica della Regione Istriana (ZZJZIŽ), Nazorova 23, 52100 Pula

Introduction: The population of Istria County (IC) is at high risk of morbidity and mortality (responsible for 87% of mortality) of chronic non-communicable diseases (CND) - cardiovascular disease (CVD), cancer, chronic respiratory diseases and diabetes. CVD were county priority from 2003 to 2016. In the Plan for Health and Social Well Being for IC from 2017 to 2020 one of the public health priorities is Health Promotion, Prevention and Early Detection of CND.CND can be greatly prevented through effective interventions towards common risk factors for these diseases: tobacco smoking, poor nutrition, physical inactivity and harmful use of alcohol.Through a given period it will be organized work of the Center for the prevention of chronic non-communicable diseases in Institute within the existing activities of the Institute. Since the beginning of 2017, as a part of this priority, in Institute started working Nutrition Counseling. Materials and Methods:Institute is systematically implementing the primary prevention of CVD and encourages the implementation of healthy lifestyles trough the following programs: food quality analysis programand hygienic sanitary supervision in kindergartens in IC, nutrition improvement programsin primary schools, education for kitchen staff and educational workshops in primary schools, collaboration with the Medical School Pula in theproject “Movement to Health” and other projects, cooperation the NGO Green Istria and secondary schools in the project “Istrian Green Plate 2 “, organization of “Fair of Healthy Living and Beauty” together with the Vocational School Pula, project “School Garden”, cooperation withLocal Action Groups in order to promote greater use of local products, participation in numerous events, organization of various public health actions, coordination and implementation of the activities of the national program “Living healthy”. Results: The continuous and longtime work in implementing numerous programs has resulted inthe recognition of the role ofInstitute as leading health preventive institutions in the County. In order to prevent and preserve thehealth of citizens of all ages the cooperation betweenthe Institute andvarious health and educational institutions, civil society organizations, employing multidisciplinary teams and involvement of various profileexperts with the necessary support of regional and local governments is required and of ultimate priority. All this resulted in the organization of Nutrition Counseling as an integrated activity in Institute. Conclusion:It is necessary to continue to grow and develop preventive programs locally due to the increasing burden of chronic non-communicable diseases. Keywords: Institute of Public Health County of Istria, prevention of chronic non-communicable diseases, nutrition counseling, multidisciplinary approach, support of local government 122

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SALT, AS A FUNCTIONAL FOOD – IODINE Ševal Đulović1, Midhat Jašić2, Zana Đulović-Jusić3 Solana d.d. (Salt Factory) Tuzla, Soli 3, Tuzla, Bosnia and Herzegovina Faculty of Technology, University of Tuzla, Univerzitetska 8, Tuzla, Bosnia and Herzegovina 3 Health Centre Tuzla, Albina i Franje Herljevića 1, Tuzla, Bosnia and Herzegovina 1

Iodine deficiency and excessive salt intake are global problems for the population of the Earth. In terms of nutrition, table salt is the main source of Na and Cl ions for humans and animals. Its proper intake is vital for life. Salt plays a significant role as a nutrient necessary to maintain homeostasis of the human body. Except in diet, salt is also used in medicine, chemical and food industry. Every person needs a different amounts of salt depending on the age, weight, climate, humidity, physical activity, health status, the amount of the potassium intake and others. Average consumption per capita on a global scale is 10 grams per day or 3.5-4.5 kg per year. Out of total daily salt intake, 20 % are from foods that contain salt, 15 % is from subsequent adding salt to the food and 70 % is from so called „hidden salt“. Industrial production of salt, its relative low cost and modern lifestyle have created habits of consuming foods with increased amounts of salt which results in increased death rates by stroke and heart attack, hypertension and heart, kidney and stomach diseases. All of which are reasons why WHO recommends consuming no more than 5-6 grams of salt per day. Salt substitution is also recommended, among which the use of KCl salts is preferred. About 2 billion people have insufficient iodine intake. Low iodine intake can lead to goiter, retardation and cretinism. Sufficient iodine intake prevents the development of cancer (breast, ovary, uterus, prostate, and thyroid) and enhances the immune response of the body to fight bacteriological, viral, parasitic and fungal infections. By nutritional fortification with iodine, the table salt has become the main source of iodine. Chemical compounds used for ordination are KI, NaI and KIO3. Daily iodine intake, recommended by International institutions (WHO, UNICEF and ICCIDD), is 150 mg and they also recommend to add 20-40 mg I per kilogram of salt during donation. Bearing in mind all these problems with excessive salt intake on the one hand, and the fact that it is one of the most important sources of iodine whose intake is often insufficient on the other hand, the recommendation of salt intake should be in line with the donation guidelines of salt so that solving one problem does not result in the expansion of the other. Keywords: iodinated salt, salt consumption, iodine deficiency

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COMMUNICATING WITH PATIENTS ABOUT CANCER DIETS: WHAT DO CARE PROVIDERS NEED TO KNOW? Nicole Erickson Comprehensive Cancer Center LMU am Klinikum der Universität München, Campus Großhadern Marchioninistr. 15, 81377 München

According to the literature up to 70% of cancer patients follow some sort of diet or take some sort of supplement. However, less than half of these patients share this information with their medical team. Despite the fact that no robust evidence exists to support these diets, patients still cling to the belief that (often extreme) nutrition practices can provide miracles that go well beyond that of the proven supportive care measures. Therefore, it is not only important for medical teams to acknowledge that these practices are widespread but to adapt communication skills that help steer our patients back into the realm of evidence based medicine and provide the patient with an understanding of what nutrition can and can’t achieve for cancer patients. Keywords: oncology patients, nutrition, comunication

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FOOD ACCEPTANCE AND REFUSAL IN INFANCY AND EARLY CHILDHOOD Gillian Harris School of Psychology, University of Birmingham, UK

Most parents know that they should give their child fruit and vegetables as part of their daily diet. Most children seem, however, to refuse to eat fruit and vegetables, and prefer to eat high fat or sweet foods. Food preferences are learned, so why donâ&#x20AC;&#x2122;t infants and young children easily learn to like the foods that we would like them to eat? Also some infants and young children are fussier than others; is this problem the fault of the parent, or something about the child? The developmental trajectory of learned food preferences and underlying factors predicting food rejection will be discussed. Sensitive and critical periods for exposure will be described; and individual differences between children in terms of fussiness, responsiveness and sensory hypersensitivity outlined. Keywords: food preferences, infants, children, sensory hypersensitivity

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SUSTAINABLE FOOD Iva Kantolić1, Maja Obrovac Glišić1, Branko Ančić2 Croatian Academic Centre for Applied Nutritional Science, 7 Supilova Street, Zagreb Institute for Social Research in Zagreb – Centre for Research in Social Inequalities and Sustainability, 11/II Amruševa Street, Zagreb

1 2

Food behaviour is a very complex system determined by several economic, cultural and environmental factors. Topics on superfood and trends in nutrition have become unavoidable, but, apart from its pure nutritional value, food has a greater context. We are faced with food wasting, the excess of food and the resulting obesity trend seen as a disease and a new foodwasting channel. Excessively consumed food can definitely be objected as resource wasting. However, the current problem of climate change and the importance of sustainability, in order to preserve our natural, renewable resources is being marginally discussed in Croatian society. The topic of sustainable food encompasses a range of behaviours associated with the production, preparation and consumption of food, as well as waste management. The aim of this study is to examine the basic knowledge of Croatian citizens on sustainable food, and to what extent is it related to their habits. The questionnaire was designed for the purpose of this research, and contains questions about knowledge and involvement in sustainable modes of behaviour in regard to food. Demographic information is gathered, and participants responded to questions concerning satisfaction with their own nutrition and life in general. Based on the non-probability sampling, responses were collected with paperpencil method and through the on-line system (CASI – Computer Assisted Self-Interview). The sample includes people from different parts of Croatia. Awareness and involvement in different forms of sustainable food are presented at the level of descriptive statistics. The results were analysed with regard to the demographic characteristics of the respondents, such as age and gender, level of education, place of residence and some of household features. The results can be seen as a valuable source in designing and implementing further research on this topic in Croatia, and can provide a basis for launching of different (psycho) educational programs. Keywords: sustainable food, awareness, behavior

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AN OVERVIEW OF DIETARY SUPPLEMENTATION IN ELITE SLOVENIAN ATHLETES Eva Kavka1, Lovro Žiberna2, Janko Dvoršak3, Petra Golja4

1 University of Ljubljana, Biotechnical Faculty, Department of Food Science and Technology, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia 2 University of Ljubljana, Faculty of Medicine, Institute of Pharmacology and Experimental Toxicology, Korytkova 2, SI-1000 Ljubljana, Slovenia. 3 Slovenian Anti-doping Organization, Celovška 25, SI-1000 Ljubljana, Slovenia 4 University of Ljubljana, Biotechnical Faculty, Department of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia

According to previous reports, use of dietary supplementation is widespread in athletes (Maughan et al., 2007), although the rationale for their use is far from being evidence-based. Namely, several dietary supplements have been proven to include substances with unconfirmed or even negative effects to sports performance. Slovenian Anti-doping Organization (SLOADO) performs regular doping controls of Slovenian athletes, where athletes also report their use of dietary supplements. As analysis of these data has not been performed so far, the present study aimed to perform a detailed anonymised analysis of dietary supplementation data of elite Slovenian athletes for the period from including 2012 to 2016, to provide evidencebased overview of this topic. Anonymous data were collected in an electronic database. Data on athletes’ gender, age, sports, discipline, and dietary supplement use were noted and analyzed. Non-parametric data were compared with Chi-square test and parametric data with analysis of variance (ANOVA) or unpaired t-test. The results demonstrate that dietary supplements are used on a large scale in elite athletes, with the prevalence of 68 % (N=530). Dietary supplements that were reported most often were vitamins (with the prevalence of 38 %), followed by proteins (37 %) and minerals (36 %). In contrast, dietary supplementation with sports drinks, fatty acids, stimulants (such as caffeine), and other substances (such as alkalizing agents, probiotics, hormones etc.) was less common, with prevalence smaller than 6 %. Finally, we identified sport discipline-specific patterns of dietary supplement use. Our results provide firm data about the high prevalence of dietary supplementation in athletes. Due to insufficient knowledge about optimal sports diet of athletes and their coaches (Couture et al., 2015), dietary supplements are most often not routinely used. The results of this study call for the attention of educational organizations, as topic targeted education of athletes and their trainers is the only long-term approach that can raise critical thinking and lead to increased cooperation of athletes with nutritional experts. Keywords: dietary supplementation, sport, vitamins, performance, prevalence

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THE IMPORTANCE OF ADEQUATE VITAMIN D INTAKE AND STATUS IN ELDERLY – THE RESULTS OF THE STUDY WITH OLDER WOMEN Irena Keser Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10 000 Zagreb

Vitamin D is a major determinant of intestinal calcium absorption and is needed for normal bone metabolism. Low vitamin D status is also associated with chronic diseases such as some types of cancers, type 1 diabetes and heart disease. Vitamin D deficiency is a concern in the elderly for a number of reasons. Intakes of this vitamin are often low in the elderly population. The amount of provitamin D formed in the skin is also reduced in the elderly. This occurs both because the capacity to synthesize provitamin D when the skin is exposed to sunlight is reduced and because the elderly spend less time outdoors. The only rich dietary sources of vitamin D are fatty fish such as salmon, mackerel, sardines and tuna, but these are rarely major contributors to the diet. Other useful sources are eggs and, depending on the country, fortified foods such as milk, yoghurts, margarines and breakfast cereals. Participants were Croatian older women with mean age 76.0 years (n=105). Vitamin D status was assessed by determining the concentration of circulating 25-hydroxyvitamin D [25(OH) D] by enzyme immunoassay. Vitamin D intake was estimated by 24-hour dietary recalls for 3 days. The average level of 25 (OH) D was 44.9 nmol/L, which is lower than referent values. Low vitamin D status had 58.1% of the participants (47.7 nmol/L; Immunodiagnostic Systems Ltd, Boldon, UK). The group of older women ≥75 years of age had significantly lower levels of vitamin D, according to the group of women aged 65-74 years. The average vitamin D intake was only 1.42 µg/day. Suitable measures for prevention of low vitamin D status in older women are moderate exposure to sunlight and increased intake of vitamin D in the form of supplements and/or fortified foods. Keywords: older women, 25-hydroxyvitamin D, vitamin D intake

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ROLE OF NUTRITION IN THE EARLY PROGRAMMING OF LONG-TERM HEALTH Sanja Kolaček University Children’s Hospital Zagreb, Croatia

In 2001 a total of about 30,000 active genes have been identified; this was considered as one of the most important scientific developments ever made, anticipating that by sequencing our genome answers to many crucial health problems, particularly in respect to the current epidemics of malignant, autoimmune and other incurable chronic diseases will be provided. However, answers were not found. The global pandemic of non-communicable diseases such as cardiovascular (CVD), diabetes mellitus type 2, obesity, autoimmune disorders and malignancies cannot be causally linked only to the genetic background or to marked changes in the current/adult diet and lifestyle. The potential link between these disorders and the early environmental experience has been first proposed by D. Barker and was originally named as “foetal programming”. Subsequently, this link was named as “Developmental Origins of Health and Disease - DOHaD”, which refers to long-term changes in metabolic responses, immune system, fertility, cellular senescence, etc. initiated as a response to environmental influences such as lack or excess of nutrients that occurred early in life or even before conception. Every step in the transfer of genetic information, from gene expression to protein synthesis and degradation, can be affected by our diet, lifestyle and other environmental factors. Potential mechanism that can confer early environmental influences into the long lasting phenotypic changes and metabolic programming potentially are: a. effect of oxidative stress on telomeres shortening; b. organ structure remodelling; c. clonal selection; and d. epigenetic variations. It is important to recognize that epigenetic processes moderate the activity of the genes but not the nucleotide sequence. Studies have clearly shown that epigenetic changes in the gene activity can be transmitted through several generations. Therefore, the epigenetic mechanisms are currently considered as the most probable mediator of the long-term programming effect of early environment. Among the most important initiators of epigenetic processes are nutrients, particularly those from the perinatal period of human development. The aims of this presentation are: a. to clarify the DOHaD hypothesis; b. to define the terms of developmental plasticity, predictive adaptive responses and developmental mismatch; c. to explain the potential mechanisms that can mediate the long-term programming effects of the early environment; and to discuss the role of nutrients in the long-term programming. Keywords: long term programming, nutrition, children

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ASSESSMENT OF NUTRITIONAL INTAKE AND ENERGY CONSUMPTION FOR PHYSICAL ACTIVITY IN FIFTEEN-YEAR-OLDS WITH DIFFERENT BODY COMPOSITION Jerneja Kožar1, Katja Zdešar Kotnik2, Gregor Starc3, Matej Gregorič4, Petra Golja2 University of Ljubljana, Biotechnical Faculty, Department of Food Science and Technology, Jamnikarjeva 101, SI-1000 Ljubljana, Slovenia 2 University of Ljubljana, Biotechnical Faculty, Department of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia; petra.golja@bf.uni-lj.si 3 University of Ljubljana, Faculty of Sports, Laboratory for physical and motor development diagnosis, Gortanova 22, SI-1000 Ljubljana, Slovenia 4 National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia 1

The trend of inappropriate diet and lack of physical activity among adolescents has been reported to increase for several years. What makes this fact alarming is not only the current health condition of the adolescents, but also the health risks these individuals will face at a later age. In previous studies, the authors focused primarily on either individual effects of dietary habits or on the consequences of (in) sufficient physical activity. In order to identify, which of these two factors has a greater effect on body composition in adolescents, we focused on the two factors in a single study. Data were collected within a larger study entitled “Analysis of Children’s Development in Slovenia” (ACDSi). Data on weekly sports activity, anthropometric, and nutritional data were collected. The adolescents were divided into three groups (underweight, optimal, and overweight) depending on their body composition, which was estimated from anthropometric data. Then, weekly energy consumption for their physical activity and Husky index were calculated. Parametric data were analyzed with analysis of variance and non-parametric data with Chi square test. The percentage of adolescents, who (do not) have healthy eating habits, as well as those, who are (not) sufficiently physically active, will be presented. Factors influencing body composition, thus the weekly amounts of physical activity and nutritional factors, will be discussed in detail. Our data shed some light on the crucial factors that need to be addressed, when dealing with (in)appropriate body composition in adolescents. As such, data are valuable for the preparation of prevention activities. Keywords: diet, physical activity, adolescents, body composition

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EPIDERMOLYSIS BULLOSA AND IMPORTANCE OF DIETARY INTAKE Petra Kučan Department of Dietetics and Nutrition, Children´s Hospital Zagreb, Klaićeva 16, Zagreb

Epidermolysis bullosa is a group of inherited diseases characterized by the appearance of blisters on the skin and mucous membranes as a consequence of genetic disorders in structural skin proteins. However, depending on the clinical picture, various systems, and often ectodermal structures, such as nails, hair and teeth, may be affected. Energy needs are increased due to the metabolism of the disease, the burden of the immune system and the constant healing process of scars. Symptoms caused by the disease interfere with the intake and adequate absorption of nutrients. A nutritional plan that includes adequate nutrition is a key element of a treatment strategy for children and young people with EB, which is unfortunately often missing. We distinguish four main types of EB, depending on the localization of the affected protein and the site of skin separation: EB simplex, junctional EB, dystrophic EB and Kindler syndrome. Each type differentiates more sub types of the disease.Clinical picture almost always involve gastrointestinal (GI) problems, and complications can be observed in different parts of the GI tract. Area of mouth and oesophagus are often affected, teeth are structurally defective and they usually decay with gingivitis, which causes chewing problems. Among complications the oesophageal stenosis should be highlighted, which limits the intake of foods that can be swallowed. Constipation is one of the most common clinical features in all forms of EB. Anemia, reduced albumin values, and absorption disorder are common complications in more severe forms. Nutritional needs of children and adolescents with minimal wounds and little or no gastrointestinal problems will probably be greater than the healthy peers, while in more severe forms it is difficult to quantify the needs because of the multisystemic nature of the disease. It is important to pay attention on the intake of energy, protein, iron, zinc, and vitamin D and fibres. Although EB is primarily defined as a skin disease, depending on the type, EB shows clinical features that often have a negative impact on the growth and nutritional status of patients. Also, children and adolescents with EB have an increased energy and nutrient needs due to growth, constant wound healing and inflammatory processes. Therefore, at the same time inadequate food intake and increased nutritional requirements lead to poor nutritional status and failure to thrive. That is why it is extremely important that the treatment of each patient with EB includes a nutritional plan with regular monitoring of the patient’s condition. Keywords: epidermolysis bullosa, gastrointestinal problems, nutrition, nutritional status

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THE PRESENCE OF N-NITROSAMINES IN MEAT PRODUCTS Iva Pavlinić Prokurica1, Sandra Pavičić Žeželj2,Danijel Brkić3, Dario Lasić3 Crotian Centre for agriculture, food and rural affairs, Rim 98, Zagreb, Croatia, e-mail: iva.pavlinic.prokurica@hcphs.hr 2 Teaching Institute of public health Mountain-littoral, Country, Krešimirova 52a, Rijeka, Croatia 3 Teaching Institute of Public Health "dr. Andrija, Štampar", Mirogojska 16, Zagreb, Croatia

Nitrosamines are carcinogenic and toxic compounds that can form in meat and meat products as a result of the reaction of nitrite with meat proteins after adding nitrite or nitrates to meat or meat products. Nitrites or nitrite salt is used as food preservatives in different types of food products. They are added to both meat and meat products in order to preserve the characteristic red colour of the meat and the specific flavour of processed as well as cured meat. Harmful effects of nitrosamines have been proven in many scientific papers published over the past 40 years. Therefore, there has been even more pressure on food producers, and the meat industry to reduce the amount of added nitrites and nitrates in order to reduce human exposure to nitroso compounds. Nevertheless, the constant systematic control of the presence of N-nitrosamines in meat and meat products is essential since they are still the main source of proteins and make up a large proportion of the diet of the adult population as well as children. As a part of this study the presence of 6 different compounds of volatile N-nitrosamines in the samples of manufactured liver pâtè of two different manufacturers on the Croatian market has been examined. Prior to the analysis the samples were stored at 3 different temperatures, and the presence of N-nitrosamines was determined at specific time intervals. After sample preparation using steam distillation and the extraction of redistillates with dichloromethane, the processed and purified sample extracts were analyzed by monitoring the characteristic ions using gas chromatography and mass spectrometry (GC-MS-SIM). The results obtained were in the range from 0.0002 mg / kg to 0,996 mg / kg, depending on the temperature and the length of storage. This research has established that the storage temperature is actually associated with the development of N-nitrosamines in meat products. This is particularly true for the products stored at higher temperatures, or at room temperature as well as the temperature of 37°C for 5-10 days. It has also been confirmed that the formation of N-nitrosamines is closely linked to the amount of added nitrites in meat products and the method of storage of products. Keywords: N-nitrosamines, meat, liver pâtè, storage

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DETERMINATION OF THE DIETARY HABITS OF ADULTS POPULATION FROM ISTRIA USING THE 14-POINT QUESTIONNAIRE NAMED MEDAS Tamara Poklar Vatovec, Zala Jenko PraĹžnikar, Mojca Stubelj, Ana Petelin University of Primorska, Faculty of Health Sciences, Polje 42, SI-6310 Izola

Mediterranean diet is considered as a model for good health. People who follow the Mediterranean diet have a longer life expectancy and lower rates of chronic diseases compared with other adults. Mediterranean food and is extremely rich in monounsaturated fatty acids, dietary fiber, antioxidants, vitamins and elements. The foundation of health is established by adequate and balanced nutrition. Therefore, the purpose of our study was to study the effects of the Mediterranean food on selected determinants of health, with emphasis on the prevention of cardiovascular diseases. 159 adults from the Istria region were recruited to the study (33% male and 67% female, all employed). The eating habits were investigated using a 14-point questionnaire Medas and assessed with the Slovenian recommendations for healthy eating.14-point questionnaire Medas allows the verification of compliance with the Mediterranean diet and the effects of a diet on human health. Statistical analysis was performed using SPSS. We found that more than half of the Istrian adults consumed the recommended content of vegetables, fruits, olive oil, lean white meats. On the other hand, less than half of the adults consume adequate content of legumes (42.1%), fish (39.6%) and nuts (46.5%). None of the adults reached the maximum points of Medas questionnaire, whereas most of the adults (18.2%) gathered 8 points. A key finding of our study is the link between higher visceral fat rating and higher intake of fish and wine, which not confirm the beneficial effect of the fish as part of the Mediterranean diet on human health. The Mediterranean diet has a positive impact on the health of the individual. Therefore, the integration of the Mediterranean diet in Slovenian space is a big challenge, in order to achieve the objectives of the nutritional policy in Slovenia. In addition, effective promotion, education of consumers and encouragement consumption of healthy, locally grown food, which the Mediterranean diet certainly is, is also very important. Keywords: dietary habits, Mediterranean diet, anthropometry, health promotion

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NUTRITIONAL INTERVENTIONS IN PEOPLE WITH DOWN SYNDROME Milka Popović1,2, Jelena Bjelanović1,2, Radmila Velicki1,2, Violeta Popović2,3 Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia Institute of Public Health of Vojvodina, Novi Sad, Serbia 3 Association for support people with Down syndrome, Novi Sad, Serbia 1

Down syndrome (DS) is a genetic disorder resulting from trisomy 21. It’s the most common genetic birth defect, affecting approximately 1:700 babies. Besides the characteristic physical appearance, there are difficulties in intellectual development. The most common are: lower body height, dental and lower jaw malformations, large tongue, hypotonia, numerous structural malformations and metabolic disorders which have a powerful impact on nutritional status, including gastrointestinal malformations (constipation, GERD, Hirschsprung disease), heart defects, disorders of the musculoskeletal system, various immune system alterations, frequent occurrence of diabetes mellitus, Hashimoto’s thyroiditis, hypothyroidism and celiac disease. There is a great prevalence of obesity amongst people with DS. The aim was to consider the available methods for early detection of nutritional disorders (ND) and to recommend a protocol for nutritional status assessment (NS) and early nutritional interventions (NI) for DS individuals. Review of the available literature, development of the protocols for ND and early NI, as well as education of teams for implementation of the protocols. In cooperation with the Down Syndrome Supporting Association the protocols were developed, adapted to the specific surroundings, available personnel and resources. Protocols were presented to Developmental counseling teams. NI include early education of parents and breastfeeding support, evaluation of the likelihood of breastfeeding/supplemental food/ nutrition, medical nutrition therapy for diagnosing ND with constant monitoring of progress, surgical or pharmacological treatment, behavioral interventions and feeding, nutrition education and a number of socioeconomic interventions. Education on proper nutrition and habits starts with the crucial role of families and significant technical assistance of doctors/ pediatricians and nutritionists. Early detection of ND in DS requires continuous interdisciplinary work involving: monitoring of the growth and NS, as well as a screening of the hypothyroidism, celiac disease, diabetes mellitus or malformations requiring surgical treatment. NI should be personalized for each one in particular. Implementation of the protocols for early detection of ND and early NI is part of a complex system of support for people with DS and their families. That allows reaching the full capacity of a child, also the adoption of desirable behaviors and prevention of secondary disabilities. Keywords: Down syndrome; nutritional status; nutrition; intervention

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PROTEIN ENERGY WASTING IN PATIENTS WITH CHRONIC KIDNEY DISEASE Josipa Radić Department of Nephrology and Dialysis, University Hospital Split

Protein energy wasting (PEW) is common in patients with chronic kidney disease (CKD) and is associated with adverse clinical outcomes and results in increased rates of hospitalization and death. A frequent and important cause of PEW in CKD patients is inadequate dietary protein and energy intake. A major contributing factor to inadequate dietary intake is anorexia. Anorexia may develop as a result of retention of uremic toxins, the dialysis procedure itself, intercurrent illness, inflammation, acidemia, and/or cardiovascular disease. Inadequate nutrient intake may also occur secondary to comorbid illness that affects gastrointestinal function, depression, cognitive deficits, poor oral status, poor socioeconomic situation, or early satiety feeling with peritoneal fluid infusion, and peritoneal glucose absorption in peritoneal dialysis. Amino acid and protein losses during the dialysis session, additional nutrient loss during dialysis such as vitamins, trace elements, blood and glucose, together with low nutrient intake promotes low nutrient availability for muscle synthesis. In clinically stable patients with stage 3–5 CKD who are not on dialysis, dietary protein and energy intakes of 0.6–0.8 g/kg of ideal body weight per day and 30–35 kcal/ kg of ideal body weight per day, respectively, are able to preserve their protein stores throughout the progression of kidney disease. However, these levels should be adjusted when hypermetabolic conditions such as acute illness and hospitalizations occur. The minimum protein and energy requirements for patients on maintenance dialysis are 1.2 g/kg of ideal body weight per day and 30–35 kcal/ kg of ideal body weight per day based on physical activity level, respectively. As mentioned variety of factors can affect the nutritional and metabolic status of CKD patients so in treating PEW a combination of therapeutic manoeuvres are required to prevent or reverse protein and energy depletion. Key words: protein energy wasting, chronic kidney disease, haemodialysis, peritoneal dialysis

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SALT REDUCTION: CHALLENGE AND OPPORTUNITY FOR INNOVATION IN THE FOOD INDUSTRY Jasmina Ranilović, Sašenka Vugrinec, Tanja Cvetković, Davorka Gajari Podravka, Research & Development, Ante Starčevića 32, Koprivnica

The majority of salt intake comes from processed foods.The role of salt in food products is multiple: for taste and texture, as preservative by inhibiting or reducing of undesirable microorganisms, preventing spoilage, influence on water activity and fermentation processes. Having in mind the role that salt plays in food products and the importance of salt reduction in public health, the objectives of this work are to provide an overview of the possible approaches for salt reduction and to show the results of a new salt reduced product, through innovative ingredient. In the first phase a new and innovative reduced sodium ingredient was theoretically designed, practically developed and taste evaluated. In the second phase, an innovative ingredient was used as a solution for development of new, salt/sodium reduced soups. Acceptance tests and preferences of new products with reduced sodium content, were carried out on a significant number of consumers over a period of two years. Classical and innovative methods of taste preferences were applied. A patent pending ingredient was developed as a solution for salt/sodium reduced food products that are consumer’s accepted and ready for commercialization. Before choosing a better approach in a development of salt reduced food products, it is important to think the role salt plays, preferably not compromising the taste and shelf life. Regarding that, numerous chances exist for innovation in product formulation. Reduced salt/ sodium food products would help consumer in healthy dietary practice. However, in order to achieve long term aims in reducing salt intake at national level, promoting consumer awareness about salt intake, and creating a demand for low-salt products through positive media campaigns, would significantly contribute to health behaviour change. Jointly participation of all stakeholders (governmental authorities, food industry, media, universities, consumers) seems the most promising in creating an environment for a sustainable diet throughout lifecycle. Keywords: salt reduction, innovation, new product development, health, consumer behaviour

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MILK AND DAIRY PROTEINS FOR EXERCISE RECOVERY Emma Stevenson Human Nutrition Research Centre, Newcastle University, United Kingdom

Several athletes train or compete more than once a day or on consecutive days and therefore, maximizing and accelerating the recovery processes is crucial to potentiate their performance (Betts & Williams, 2010). Nutritional supplements consumed during the recovery period following intense exercise can significantly influence the recovery process. There has been a significant focus on the use of milk and dairy proteins (particularly whey) in recovery from both endurance and strength-based exercise. This talk will consider the role of milk and milk proteins as a recovery aid and discuss the available scientific evidence to support the use of milk in an applied setting. Studies that have investigated the role of milk in muscle protein synthesis, rehydration and recovery from muscle damaging exercise will be discussed. Keywords: milk protein, regeneration, sport activity

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MILK AND DAIRY PRODUCTS IN ADOLESCENT DIET Irzada Taljić University of Sarajevo, Faculty of Educational Sciences, Skenderija 72, 71000 Sarajevo, Bosnia and Herzegovina

Accelerated growth happens in adolescence: increase of muscle mass, the maturation and increased physical activity. During adolescence, 50.0% of total weight gain and more than 20.0% of the height (Spear, 2002). Milk is a complete food which contains many nutrients and meets needs for calcium, magnesium, selenium, riboflavin, vitamins B12 and B5. The protein in cow milk is of high-quality (defined as a protein that supports maximal growth), containing a good balance of all the essential amino acids, including lysine. Many diets are deficient in certain essential amino acids: wheat and maize-based diets contain only 57% and 58% of required levels of lysine (WHO, FAO and UNU, 2007). The main objective is presence of milk and dairy products in adolescent’s diet identified through the place of residence (rural/ urban). The study included 630 participants, 60 boys and 73 girls from rural and 264 boys and 233 girls from the urban part of Canton Sarajevo. Participants were 13-15 years old and were interviewed in the schools, the consent of the Ministry of Education and Science of Canton Sarajevo was obtained. Used questionnaire is classified as a semi-quantitative and represents a modified questionnaire used in similar research among adolescents in the Canton Sarajevo (Taljić, 2015; Hodžić and Smajić, 2012). Data were statistically analyzed using SPSS 13.0. Statistical significance according to the place of residence for boys was proven for daily consumption of milk (p=0.014, χ2=5.819), and for girls was proven for daily consumption of milk (?=-0.211, p<0.005) and the daily consumption of milk / yoghurt expressed quantitatively (?=0.135, p=0.04). Milk is the most common choice of beverage for breakfast (boys: urban vs. rural: 44.80%: 36.70%; girls: rural vs. urban: 32.90%: 43.35%). Milk is consumed more by boys from urban and girls from rural areas; also confirmed for daily intake expressed in quantity; weekly consumption of milk is more present in the boy’s diet in urban and girls’ diet in rural areas (<4 cups); Cheese is consumed 1-2 times a week (boys: rural vs. urban: 5.30% 47.00%; girls: rural vs. urban: 48.65: 57.10%). Keywords: adolescents, consumption, growth and development, dairy products

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AN EXAMPLE OF SUCESSFUL HEALTH PROMOTION – HEALTHY DIET IN THE WORKPLACE Leon Vedenik1, Ilonka Feher1, Branislava Belović2 Police directorate Murska Sobota, Ulica arhitekta Novaka 5, 9000 Murska Sobota, Slovenia Pomurje Cancer Society , Ulica arhitekta Novaka 2b, 9000 Murska Sobota, Slovenia

1 2

A healthy lifestyle, including healthy diet, is an important element of workplace health promotion. A key to success is a comprehensive approach (permanent information and education, encouraging environment, active participation of employees, positive policy of the work organisation, connection to the community, innovative approaches.) The programme concerned connects health protection at work and health promotion at the Police directorate Murska Sobota – Slovenia with 537 employees. In 2016, the programme was recognised as one the most successful programmes in the Republic of Slovenia and it received an award of the European Agency for Safety and Health at Work. Health promotion in the framework of this programme focuses particularly on healthy diet, physical activity, stress management and participation in preventive programmes. Encouraging employees to develop healthy eating habits, we provide information and education through workshops/ lectures, exhibitions and informational material. There is a very rich supply of informational and educational materials that contain recipes for healthy dishes. Printed materials are available at info points and intranet. At the same time we improved the menu of the canteen by including dishes with a national certificate “Health beneficial food”. Competitions of amateur cooks (employees) are used as an innovative and attractive approach to motivate the employees. Recipes from these competitions are published in e-publications and available to all employees via intranet. Competitions of the amateur cooks have grown into a tradition. Better informed employees that have more knowledge and are more conscious about healthy eating. Improved menu at the canteen of the Police directorate Murska Sobota (dishes with certificate “Health beneficial food”) and at the same time 40 % growth in consummation of vegetables. Sharing of information, experience and recipes have become a part of employees’ everyday life. Continuous information and awareness-raising about healthy eating, giving employees the opportunity to eat healthy food at the workplace canteen and attractive ways of motivating employees can have a large impact on healthier lifestyle, quality of life and employees’ productivity. Keywords: workplace health promotion, promotion of healthy eating, certificate “Health beneficial food”, amateur cooking competition in preparation of healthy dishes, Police directorate Murska Sobota

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MANAGEMENT OF A DIABETES PATIENT IN THE REFERENCE CLINICS Zvezdana Vražič Health center “dr. Adolfa Drolca Maribor”, Ulica talcev 9, 2000 Maribor

According to the data from the collection of prescription pharmaceuticals in Slovenia, the number of recipients of diabetes is increased by 3% each year (approximately 2,500 people). According to the European Health Interview Survey data, the prevalence of diabetes is estimated at 6.9% of the population (confidence interval: 6.3-7.6%) among people aged 15 years and above in 2014. In 2014, there were 104,550 patients with diabetes in Slovenia receiving medicines for decreasing blood sugar. Also, data from the Health and Behavioral Research Study conducted by the National Institute for Public Health between 2001 and 2012 on the inhabitants of Slovenia aged 25 to 64 show an increase in diabetesoccurancy. The high or very high risk for type 2 diabetes in the next 10 years was found in the FINDRISC model at 28% of respondents aged 55-64 years. In this age group, diabetes mellitus is increasing and is almost twice as commonamong women. Among patients with diabetes, 69% have high blood pressure, 67% dyslipidemia, 41% obesity, and 19% aresmokers. A third of patients do not eat according to recommendations, and only half are physically active. The share of obesity among adults in 2012 was 17.4%. Unhealthy lifestyle choices that contribute to the onset of diabetes, especially unhealthy eating, excessive food intake, obesity and insufficient physical activity, have had an upward trend in this period. Early diagnosis of diabetes and timely treatment can prevent the complications of diabetes, which pose a great burden both for the individual and his relatives, for the health system and for the society. By establishing a systematic screening we identify people with a high risk of type 2 diabetes. Among them, we are actively looking for sick people, while in others, with additional measures, we reduce the incidence of the disease. (1). The significance of the Reference Clinic (RA) is reflected in the systematic and protocolbased approach of active search for the diabetes patients. The multidisciplinary approach to managing chronic patients, including diabetes, is shifting to the primary level with the new health care system. It is therefore important that we all speak the same language and work together to avoid duplicating the work.

Keywords: reference clinic (RA), selected personal physician, diabetic patient

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Physical activity and usage of dietary supplements among adolescents Katja Zdešar Kotnik1, Gregor Jurak2, Gregor Starc2, Martina Puc3, Petra Golja1 University of Ljubljana, Biotechnical Faculty, Department of Biology, Vecna pot 111, SI-1000 Ljubljana 2 University of Ljubljana, Faculty of Sport, Gortanova 22, SI-1000 Ljubljana 1

Institute for Quality Research and Development, Parmova 14, SI-1000 Ljubljana

Although dietary supplements (DS) use was extensively investigated in both athlete and nonathlete adolescents, there is almost a complete lack of studies that examined the prevalence of DS use among the general populationof adolescents in relation to the extent of their physical activity (PA). Therefore, the aim of our study was to determine the prevalence and frequency of DS use among adolescents, in relation to the extent of their PA. Data were obtained from the Slovenian ACDSi-2014 cross-sectional study. Adolescents (14–19 years old) that were enrolled in 15 public highschools in Slovenia were included in nationally representative study sample (N=1463). Average daily energy expenditure of physical activity (DEEPA) was determined by standard SHAPES (School Health Action, Planning and Evaluation System) questionnaire, as was membership in sports clubs (sports club members were classified as athletes (N=365), sports clubs non-members as non-athletes (N=640)). DS data were collected by purposely prepared questionnaire.The statistical analysis was performed with Chi-square (χ2) test and with either independent t-test or analysis of variance. Our results indicate that more than two-thirds (69%) of adolescents used DS, when DS users were defined as anyone using DS at least several times per year. However, if DS users were defined differently, i.e. according to the frequency of DS use, the prevalence changed considerably, namely to 52%, 40%, and 14% for those using DS at least once per month, week, or day, respectively. Multivitamins/multiminerals DS are the most popular DS in males (49%), vitamins in females (45%). Highly significant increase in DS use was observed with higher average DEEPA and with sports club membership; significantly higher prevalence of DS use was observed in athletes (76%) compared to non-athletes (66%). Dietary supplementation is widespread in adolescents, both among athletes and nonathletes, and is positively associated with higher extent of PA and sports club membership. Comparisons of different prevalence of DS use, according to different frequencies of DS use demonstrate a big discrepancy in the estimation of prevalence, thus there is an urgent need for methodological standardization of data acquisition regarding DS. Keywords: dietary supplementation, physical activity, sports club membership, standardization

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UNDERSTANDING EATING DISORDERS THE ROLE OF REGISTERED DIETICIANS IN MULTIDISCIPLINARY TREATMENT OF ED PATIENTS Maja Žanko Day Hospital for Eating Disorders, Psychiatric Hospital “Sveti Ivan”, Jankomir 11, 10090 Zagreb; Centre for Eating disorders BEA, Ribnjak 38, 10000 Zagreb

According to APA (American Psychiatric Association), eating disorders (ED) are “illnesses in which people experience severe disturbances in their eating behaviors and related thoughts and emotions”. The number of individuals currently suffering from ED in Croatia is estimated around thirty-five to forty-five thousand. According to the most widely used diagnostic manuals (ICD 10; DSM 5), there are three main categories of ED: anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorders (BED). Of these, AN has the highest mortality rate of any psychiatric disorder. Psychotherapy is the recommended treatment for ED patients. Can ED be successfully treated only through psychotherapy? A growing body of evidence suggests that multidisciplinary team approaches are the most effective in the treatment of ED. In this context, nutrition intervention plays a fundamental role. This paper will emphasize the importance of registered dieticians (RD) in early recognition and group treatment of patients with all types of ED and will stress the need for mutual collaboration between specialists in the field. As part of a multidisciplinary treatment, nutritional counseling combined with CBT (cognitive behavioral therapy) and intuitive eating principles shows significant results in decreasing symptoms of ED. In conclusion, test-based methods for the identification of persons with ED – together with the steps required after such identification – will be discussed. Keywords: eating disorders, multidisciplinary treatment, registered dietitians, nutritional counseling, cognitive behavioral therapy

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5. Poster section abstracts

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EDUCATION ON NUTRITION AS NECESSARY PART OF CHRONIC PAIN TREATMENT – PRESENTATION OF THE FIRST MULTIDISCIPLINARY TEAM FOR CHRONIC PAIN TREATMENT IN CROATIA Jelena Balkić1, Maja Gradinjan1, Ivan Radoš2, Ivana Lubina3, Ines Banjari4 Department for Dietetics and Nutrition, University Hospital Osijek, J. Huttlera 4, 31000 Osijek, Croatia University J.J. Strossmayer Osijek, Faculty of Medicine, Sub-Department of Anesthesiology, Reanimatology and Intensive Care, Cara Hadrijana 10E, 31000 Osijek, Croatia 3 Clinic for Anesthesiology, Rheumatology and Intensive Care, Department for Pain Treatment, University Hospital Osijek, J. Huttlera Osijek, Croatia 4 University J.J. Strossmayer Osijek, Faculty of Food Technology, Sub-Department of Nutrition, F. Kuhača 20, 31000 Osijek, Croatia 1

Chronic pain is defined as a long-term pain of 3-6 months duration from the healing period, and is described as continuous or recurrent. European Pain Federation (EFIC) in its Declaration on Pain (2001) identifies chronic pain, unlike acute pain, as a distinct health issue. Every fifth person in Europe suffers from chronic pain syndrome. It often alters all aspects of the patient’s life inducing severe physical, psychological, and social impairments while significantly affecting individual’s quality of life. Modern medicine still has no efficient treatment to deal with chronic pain. The aim is to present the multidisciplinary four-week programme for treating chronic pain, which has been carried out at the University Hospital Osijek, within the Department for Pain Treatment under the leadership of assist. Prof. Ivan Radoš, PhD, MD. This is the first programme of this kind in Croatia, and so far 300 patients have been treated and educated. The programme aims to reduce the chronic pain and improve quality of life through a strict individual approach. Multidisciplinary team consists of anaesthesiologist, nurse, physiotherapist, endocrinologist, nutritionist, occupational therapist, psychologist, and psychiatrist, who educate patients about pharmacological as well as non-pharmacological treatments of the pain. Education aims to diminish patient’s dependence of the health care system and to improve their daily physical and emotional functioning. The link between nutrition and chronic pain is observed through inflammatory (e.g. fast food, sweetened beverages, etc.), i.e. anti-inflammatory cytokines (e.g. olive oil, fish, green leafy vegetables, etc.) after the consumption of certain foods, which can increase or decrease the pain. Preferred diet for individuals suffering from chronic pain is the Mediterranean diet. Nutritionist has been involved in the multidisciplinary team since September 2016, with 70 patients educated so far. The aim is to show dietary habits and knowledge about diet adjusted to the health condition of patients prior and after the programme. Key words: chronic pain, multidisciplinary team of experts, education, nutrition

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EATING HABITS OF THE ROMA POPULATION IN POMURJE Branislava Belović1, Lijana Zaletel Kragelj2, Jerneja Farkaš Lainščak3, Staša Tkalec4 Pomurje Cancer Society , Ulica arhitekta Novaka 2b, 9000 Murska Sobota, Slovenia Faculty of Medicine Ljubljana, Vrazov trg 5, 1104 Ljubljana, Slovenia 3 Murska Sobota General Hospital, Ulica dr. Vrbnjaka 6, 9000 Murska Sobota, Slovenia 4 National Assembly of the Republic of Slovenia, Party of Modern Centre Deputy Group Šubičeva ulica 4, 1000 Ljubljana – Slovenia 1

Introduction: Unhealthy lifestyle or unhealthy diet and early forms of chronic noncommunicable diseases are more common among poorer and less educated groups of people. That is why it is essential to dedicate special attention to these groups; not only at the level of research, but also in health promotion and in preventive programmes. One of such vulnerable groups is also the Roma population. Methods and respondents: The research was based on WHO - CINDI Health Monitor Survey, which is used in Slovenia for research in health-related lifestyle among the population. This method enables comparison between the lifestyle of the Roma and the rest of the population. The research is based on a suitable sample of 258 members of the Roma population who live in Pomurje. The results of the survey are compared with the results of the similar research among the population of Pomurje. Results: The results relate to the part of research that examines eating habits: frequency of breakfast consumption, consumption of vegetables, fruits, fats-plant oils, aromatized sparkling and non-carbonated drinks and additional salting. Breakfast, as the most important meal of the day, is consumed by 50.6 % of the Roma respondents. These results do not significantly vary from the results obtained among the general population of Pomurje. Fresh vegetables are consumed every day by 36.2 % of the Roma and 65.2 % of the population of Pomurje. The Roma are also less likely to daily consume fresh fruit (31% of the Roma eat fruit every day) than the rest of the population (54.8 %). Plant oils are used in preparation of food by 80.9 % of the Roma population and 70.8 % of the population of Pomurje. Aromatized sparkling and non-carbonated drinks are daily consumed by 45.6 % of the Roma and 28.7 % of the general population. 68.6 % of the Roma and 41.2 % of the population of Pomurje does not add salt to their dishes at the table. Conclusion: The results of the research provide a basis for policies and programmes that aim at the protection and promotion of health among the Roma population and whose implementation contributes to reducing health inequalities. Keywords eating habits, Roma, population of Pomurje, CINDI Health Monitor Survey

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A MODEL OF INNOVATIVE APPROACH TO LOCAL SUSTAINABLE DEVELOPMENT – AN EXAMPLE OF GOOD PRACTICE FROM POMURJE Branislava Belović1, Staša Tkalec2, Andreja Počič1 Agricultural tourist cooperative Žitek, Petanjci 19a, 9251 Tišina, Slovenia National Assembly of the Republic of Slovenia, Party of Modern Centre Deputy Group, Šubičeva ulica 4, 1000 Ljubljana - Slovenia

1 2

Introduction: Pomurje is one of the least developed regions in Slovenia that has the worst socioeconomic status and, consequentially, lower health status and health of the population. Local food supply is one of the measures that can contribute to the local economy, environment protection, health of the population, and to the development of the rural area and demographic renewal of the society. Methods: The agricultural tourist cooperative Žitek was formed on the initiative of the local community. The specialities of cooperative in the Pomurje region are pooling the knowledge of acclaimed specialists (members of the cooperative), utilisation of traditional skills and the local knowledge (members of the cooperative – farmers and the local population, developing connections between the various institutions in Pomurje, and fair agricultural tourist cooperative. It includes the following activities: promotion and easier sales of surpluses of agricultural produce/products that are grown/produced in traditional ways at the economically weak farms through complementary activity; encouragement of selfsufficiency through locally produced food; information, awareness-raising and education of farmers at the economically weak farms about production, development of new products and environment protection, and motivation of people to consume locally produced food. Results: The results include: the network of 25 agricultural producers from the economically weak farms that sell their surplus in the framework of the cooperative; established sales to the network of consumers; production and sells of the first larger quantities of the autochthonous Slovenian garlic with large media coverage at the national and at the local level that has led to massive production of the autochthonous Slovenian garlic; increased information, awareness-raising and knowledge of farmers and other potential members of the cooperative, and contribution to popularization and demand for local agricultural produce/products. Conclusion: Encouraging self-sufficiency and supply with locally produced food, mostly vegetables, fruit and cereals, the Agricultural tourist cooperative Žitek contributes to healthier diet and better quality of life of the population, especially of individuals from the economically weak farms. What is more, by selling the surpluses it contributes to the economy of the farms concerned and to the local economy and development. Keywords, local food supply/self-sufficiency, economically weak farms, local economy

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INFLUENCE OF DENTAL STATUS ON THE QUALITY OF FOOD INTAKE AND THE NUTRITIONAL STATUS IN ELDERY Inga Beganović1, Irena Keser2, Ivana Rumbak2, Ivana Rumora Samarin2, Darko Kantoci3, Lorena Honović4, Vedrana Fontana5, Adnan Ćatović6, Irena Colić Barić2 Dental Clinic H-dent, Andree Amoroso 6, 52210 Rovinj, Croatia Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottieva 6, 10000 Zagreb, Croatia 3 KanDar Enterprises, Inc., 250 Commercial Street, Suite 3005F, Manchester, NH 03101, USA 4 Departament of laboratory medicine, General hospital Pula, Negrijeva 6, 52102 Pula, Croatia 5 Nutrition consultation, Croatian institute of public health, Nazarova 23, 52102 Pula, Croatia 6 Department of Fixed Prosthodontics and Geriatric Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia 1

Introducton: Dental status decreases in elderly people consequently disrupting eating habits and reflecting on the quality of food intake and nutritional status. Decreased oral function is associated with a reduced body mass index (BMI). Edentulous subjects had a significantly lower intake of vegetables, fiber and carotenoids and a higher intake of cholesterol, saturated fat, and calories. Metodology: We recruited 118 female Croatian participants, aged 55 or older. Participants answered food frequency questionnaire (FFQ) and Mini Nutritional Assessment (MNA) questionnaire to evaluate their quality of food intake, anthropometric measurements were taken, blood samples were collected for measurement of serum folate, serum vitamin B12 and lipid concentrations and were given an oral examination to record dental status. The standard questionnaire contains various scales from 2 to 11 which is based on a question/sub question structure. To be able to statistically analyze question structure variability, all data was normalized to a range between 0 and 1. Most answers were normalized by calculating the average answer value and dividing by the number of answers. Results: The biggest challenge was to normalize tooth status with plaque and prosthetics status. A special algorithm was developed to link these three properties together to uniquely describe overall dental status. For dental status associate weighting factors from 0 to 1 each for intact tooth, missing teeth, caries, filling, residual dental root, crown, pontic tooth, tooth in prosthetics were given. After analysis of all collected data we found a strong correlation between BMI and dental status (0.412). It also showed a significant correlation between dental status and quality of food intake (0.317). Conclusion: Statistical analysis which was performed on normalized dental status and nutritional quality factors found a strong correlation between dental status, food quality intake and nutritional status in the elderly population. The results obtained in this study are the first of this kind in Croatian scientific bibliography. Key words: dental status, food intake, body mass index, elderly 148

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THE QUALITY OF NUTRITION FOR STUDENTS OF COACH EDUCATION IN KINESIOLOGICAL RECREATION Leda Borovac Štefanović,1,2, Iva Karla Crnogorac, student1, Čučević Đivo, student1, Petra Jagarinec, student1, IvančicaDelaš1* School of Medicine, University of Zagreb, Zagreb, Croatia

Prolife, Marulićev trg 12, Zagreb

Introduction: Daily energy requirements represent the amount of energy that is required to support basal metabolism, physical activity, and repair of damaged tissues. Training or sport competition generally increases daily energy requirements depending on duration, type and intensity of the activity.The right diet will optimize energy levels and help the athlete to recover more effectively. The aim of this study was to investigate the quality of nutrition among coaches of kinesiological recreation. Participants and methods: The study included 16 students (3 women, 13 men) of coach education in kinesiological recreation. Anthropometric measurements were performed and lifestyle data were collected. Resting energy expenditure (REE) was calculated according to Harris-Benedict formula, and compared to total nutritional intake that was recorded for three days. Results: The mean age of the participants was 36.5 years (range 27 to 48), with the average body mass index (BMI) of 26.3 kg/m2 (range 21.0 to 29.9). Fifty percent of the participants declared at least 30 min of physical activity per day, while the others perform regular trainings for 1-2 hours a day. The average daily energy intake was sufficient to cover REE and sedentary activity. However, the more intensive activity was not always covered with the appropriate nutritional intake. In a few cases, very low protein intake was identified. Also, the consumption of fruits and green vegetables was rather low. Conclusion: Students of coach education in kinesiological recreation are aware of the nutritional requirements and the importance of regular physical activity for health preservation. However, additional education is necessary to improve their skills for more appropriate nutrition planning. Key words: nutrition, kinesiological recreation, energy intake, proteins

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SELECTED CHARACTERISTICS OF FOOD FOR SPECIAL MEDICAL PURPOSES Marijana Ceilinger1, Valerija Bukvić2, Nina Puhač Bogadi2, Jelena Miličević2, Lenkica Penava1, Vesna Popijač2, Davorka Gajari2 , Helena Tomić-Obrdalj2 Belupo lijekovi i kozmetika d.d., Ulica Danica 5, 48 000 Koprivnica Podravka d.d., A. Starčevića 32, 48 000 Koprivnica

1 2

Introduction: Development of food for special medical purposes is multidisciplinary and it includes networking expertises in the fields of technology, nutrition and medicine. Different aspects are considered to assure suitability of food product for nutritional therapy. Food for special medical purposesis specially formulated for the dietary management of patients and it is used under medical supervision. Methods: Selected product characteristics and requirements in this review are: nutritional composition, product labelling, sensory assessment, nutritional characteristics confirmation and food safety management systems. Results: To assure that the product composition meets nutritional requirements of patients and that product labelling guarantees adequate information for patients and health professionals, general and specific food regulations are respected. Professional society guidelines, main nutritional and medical principles and clinical nutrition findings are also used in meeting this purpose. Sensory analysis and consumer testing of these products comply with the standard methodology as all other foods. Sensory panel training includes familiarization with specific attributes for nutritionaly highly enriched products to prevent discrimination between products. By the participation of The Quality Control laboratory in the Proficiency Testing Schemes, an external evaluation of the test results quality has been demonstrated. From the aspect of food safety, this food is produced according to the Food Law and its related regulations so that production can be certified according to accepted standards by the Global Food Safety Initiative. The IFS standard is applied as one of the most stringent food safety management standard regarding the high level of risk of this type of production. Conclusion: Although the composition of this food is defined by the valid legislation, the influence of nutritional guidelines and clinical nutrition research findings is significant. Sensory analysis with the target group is potentially limited, however well trained sensory and consumer panel gives excellent insight and helps in the development process and quality control. Proficiency Testing Schemes are an essential part of the laboratory control process and, by participating in them, laboratories gain confidence in the used laboratory equipment, methods and staff, as well as evidence that they deliver trustworthy results. Certification of production by GFSI accepted standards guarantees everyone in the food chain additional confidence in the health safety of products. Keywords: food for special medical purposes, nutritional characteristics, product labelling, sensory assessment, food safety management systems 150

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WATER CONSUMPTION AMONG MOSTAR STUDENTS Daniela Čačić Kenjerić1,2, Marija Leko2, Ivana Flanjak1, Marizela Šabanović3 1 Josip Juraj Strossmayer University of Osijek, Faculty of Food Technology Osijek, Franje Kuhača 20, 31 000 Osijek, Hrvatska 2 Faculty of Agronomy and Food Technology, University of Mostar, Biskupa Čule bb, 88 000 Mostar, Bosnia and Herzegovina

Faculty of Technology, University of Tuzla, Univerzitetska 8, 75000 Tuzla, Bosnia and Herzegovina

Introduction: Water is a crucial compound of foods and beverages and main constituent of the human body which contributes around 60 % of the total body mass. Highest representation is in body fluids, saliva and urine. Water requirements are mostly met by intake of various foods and beverages and small amount of water is ensured through metabolic processes. Yet, water intake assessment is primarily focused on water itself. According to the World Health Organization (WHO), water adequate intake (AI) recommendation is 30 mL/kg of body weight, or on average 2.0 L/day for females and 2.5 L/day for males. The aim of this study was to get an insight into water consumption habits among students in Mostar. Subjects and methods: Cross-sectional study encompassed 97 students (35 males and 62 females) from 19 to 26 years of age. Data were collected by single anonymous questionnaire by an interview. Questionnaire encompassed general participant’s information, lifestyle data and food frequency part regarding selected food and beverages which contribute significantly to water intake. Data collection was conducted in June 2016. For the purpose of this paper, data regarding water consumption were analysed. Results: Results are presented for the whole studied population and subgroups based on gender, nutritional status by body mass index (BMI) criteria, physical activity and smoking habits. Results revealed that most of the studied population consumes water in amount of 1 L/day (43 %) or 1-2 L/day (30 %). Adequate intake was noted in just 6 % of females and possibly in 20 % of males. Analysis also confirmed trends of higher water consumption among subjects with adequate nutritional status in comparison to overweight and obese subjects, among those involved in physical activity in comparison to sedentary subjects and among non-smokers in comparison to smokers. Conclusion: Considering the fact that most of the students do not comply with adequate intake of water, education regarding its importance and benefits in comparison to other beverages is recommended. Keywords: water, students, Mostar

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NUTRITION COUNSELING IN INSTITUTE OF PUBLIC HEALTH COUNTY OF ISTRIA Olga Dabović Rac, Klaudija Blarežina, Helena Mitrović,Kristina Jelenić, Lara Meden, Vedrana Fontana, Aleksandar Stojanović Institute of Public Health County of Istria - Istituto di sanità pubblica della Regione Istriana (ZZJZIŽ), Nazorova 23, 52100 Pula

Introduction: In Plan for Health and Social Well Being for Istria County (IC) from 2017 to 2020 one of the public health priorities is Health promotion, prevention and early detection of chronic non-communicable diseases (CND). Through a given period, it will be organized work of the Center for the prevention of chronic non-communicable diseases in Institute within the existing activities of the Institute. Since the beginning of 2017, as a part of this priority, in Institute started working Nutrition Counseling which services are free for all people living in IC. Materials and Methods: Nutrition Counseling is integrated activity in Institute in whose work participates nutritionists, doctors with special in epidemiology, doctors with special of school medicine and psychologists. Activities of the Nutrition Counseling are particularly intended for children and their parents, adolescents, students and young people, but also could be participated by other IC population. Nutrition Counseling is working in morning and afternoon shifts. Approach in Nutrition counseling is individual and in groups, but it also can be used E-counseling. The individual counseling is used to estimate nutrition habits (dietetic and anthropometric methods) and, if necessary, evaluation by a specialist in school medicine and psychologist. In group working the accent is on the implementation of healthy lifestyles through various workshops within the community (cooperation with educational institutions, pensioners clubs, sports clubs, associations and the media). Users do not need a doctor referral for of the Counseling services, and it is preferred preordering by phone, e-mail or Facebook page. Results: In the individual counseling, we will monitor the improvement of lifestyle and reduction of the risk for CND. It is expected that the long term results of this project will have a positive impact on improving lifestyle with a focus on improving the nutritional quality of people living in IC. Conclusion: Through the continuous and longtime work of the Department of public health in the prevention programs, there was a need for the establishment of the Nutrition Counseling. Also, through regular reviews of school doctors in Istrian County it has been shown that the incidence of overweight and obesity in school-age children is in continuous growth, which further confirms the need for this type of Counseling. All mentioned was recognized by the Istrian County who is financing project of Nutrition Counseling in the period from 2017 to 2020. Through the outcomes of the project it will be shown the need for continuous work of Nutrition Counseling in Institute. Keywords: Institute of Public Health County of Istria, prevention of chronic no communicable diseases, nutrition counseling, multidisciplinary approach, support of local government 152

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IMPLEMENTATION OF THE SCHOOL FRUIT AND VEGETABLES SCHEME IN SLOVENIAN SCHOOLS Vida Fajdiga Turk1, Matej Gregorič1, KatjaZdešar Kotnik2, Marcel Kralj1, Mitja Vrdelja1 National Institute of Public Health, Trubarjeva 2, SI-1000 Ljubljana, Slovenia; University of Ljubljana, Biotechical Faculty, Department of Biology, Večna pot 111, SI-1000 Ljubljana, Slovenia

Introduction: The increasing obesity trend and the negative trend of fruit and vegetable (FV) consumption among children and adolescents is a big public health problem in the EU. The purpose of our study is to establish successfulness and efficiency of the School fruit and vegetables scheme (SFVS) in Slovenia. Materials and methods: The information was extracted through the SFVS evaluation study which is performed annually and every five years carried out in depth. Into the research were between 2011-2016 annually included teachers and 4th, 6th and 8th grade pupils from all participating schools. They used the survey questionnaire method at the beginning and at the end of the school year. The in-depth evaluation was carried out on a representative pattern of 10 schools. They later included an in-depth survey questionnaire method, 2x24h recall method for the dietary intake evaluation and anthropometric measurements for the dietary status evaluation. The data was statistically analysed with different statistical tests using SPSS. Results: The measure was demonstrated as effective on the level of schools which continuously hand out diverse FV throughout the year (most commonly once per week) and include local and seasonal products. The majority of schools performed planned accompanying activities which brought important knowledge about the benefits of FV. The measure effects on the pupil level are most visible within one school year. They show progress in the frequency and quantity of FV consumption. The trend during the scheme realization has also shown increased frequency of vegetable consumption. It can be observed especially by the boys, older pupils and pupils with higher SES. Conclusion: The SFVS has diverse effects on school level, but also on different pupil groups. In the future it is reasonable to devote the most encouragement to the most vulnerable groups and to adjust the way of action to them. The results have also shown the scheme’s long-term effect on the increased FV consumption. The accompanying measures of the SFVS have significantly contributed to the knowledge, therefore they should be upgraded and to large extent added to the curriculum. Keywords: fruit, vegetables, school, School fruit and vegetables scheme

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IMPROVEMENT OF DIETARY HABITS OF EMPLOYEES Davorka Gajari, Helena Tomić-Obrdalj, Jasmina Ranilović, Maja Vidaković Podravka, Research and Development, Ante Starčevića 32, Koprivnica

Introduction: Healthy diet is important for good health. On the contrary, poor diet and lack of physical activities are risk factors for non-communicable diseases that threaten health and are putting a burden on economic growth. Corporate social responsibility also includes company employees as they are the most important for its development. Assessment of employees’ eating habits would help in detection of critical elements in their diet and would help in developing programs for diet improvements. Materials and methods: 784 employees participated in an online survey titled „Assessment of eating habits of employees” with 27 questions. Questionnaire was developed by SurveyMonkey (SurveyMonkey Inc, San Mateo, California, USA) and sent to respondents via e-mail. Research was anonymous and lasted during July 2016. Data analysis was performed using SurveyMonkey and SPSS (IBM SPSS Statistics for Windows, v 19.0. Armonk, NY, USA). Based on the results, specific measures and educational principles were developed and examined by 2 focus groups discussion with 10 employees. Results: Eight critical employees´ habits are revealed. The participants mostly don´t have special diet regimens. Only half of them take care about energy intake, sugar intake and eating fruits daily. One third of participants eat vegetables every day and take care about salt and fat intake. One third consume fish every week. The most important information’s on food labels are expiration date, ingredients list and suggestion for preparation. One fifth of participants read nutrition facts regularly. One fifth of participants has regular physical activities according to recommendations and one fifth of them never do any physical activities. Qualitative assessment resulted by 2 focus groups confirmed efficiency of appointed measures in improving employees´ habits in term of health and pointed out needs for pilot programme according to education plan. Conclusion: Dietary habits among most of employees are not satisfying. It is working age population that understands very well the meaning of a healthy diet, but don´t care about it in their everyday lives. Adherence to the basic education principles in work organisation along with innovative measures and tools could be effective in changing employees´ dietary attitudes. Indirectly it could affect dietary habits of theirs families. Key words: employees, dietary habits research, education, health

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NUTRITIONAL STATUS EVALUATION AMONG RESIDENTS IN RETIREMENT HOMES Matej Gregorič1, KatjaZdešar Kotnik2, Igor Pigac3 National Institute of Public Health, Trubarjeva 2, Ljubljana, Slovenia; University of Ljubljana, Biotechnical Faculty, Department of Biology, Večna pot 111, Ljubljana, Slovenia 3 University of Ljubljana,Biotechnical faculty, Department of food science, Jamnikarjeva 101, Ljubljana, Slovenia 1

Introduction: Retirement home residents are among the most vulnerable groups due to the poor physical health and the associated chronic diseases. Their dietary patterns and food choices mostly differ from nutritional requirements and from their past food patterns. Thus, the aim of our study was to determine the nutritional status among retirement home residents. Materials and Methods: The study data were obtained within PANGeA (The Physical Activity and Nutrition for Great Ageing) cross-sectional study. Healthy adult’s volunteers older than 65 years, but with good cognitive functions, were recruited from three representative retirement homes. Nutritional status of the participants was assessed by body mass index (BMI) and with two non-consecutive 24-h recalls, as well as with 3 days weighed food record. Food intake data were estimated with Open platform for clinical nutrition (OPEN) application. The results were compared to the dietary guidelines for elderly and D-A-CH reference values for nutrient intake. Results:The results of our study demonstrated that daily energy intake of participants was 19–34% lower than the recommended values. Served meals contained only 70%, 76%, 77%, and 53% of recommended values for proteins, total fat, carbohydrates, and dietary fibres, respectively. The intake of fluid, certain elements (I, Se,Mg, Ca) and most vitamins (vitamin D, C, E and B vitamins) was not adequate. The lowest intake was observed for vitamin D. It was found that female retirement home residents have a more sufficient diet than the male residents. Both methods for assessment of nutritional status provide comparable results. Additionally, according to the BMI, 50 % of females and 40 % of males were obese. Conclusion:The results of our study revealed that the diet of retirement home residents was unsuitable due to low energy intake, as well as low intake of micronutrients, which calls for appropriate prevention and public health intervention strategies that can target this vulnerable group of the population. Two non-consecutive 24-h recalls is a suitable method for assessment of nutritional status in elderly with good cognitive function and provide enough accurate results comparable to reference method. Keywords: Nutrition, elderly, retirement homes, reference values, energy and nutrient intake

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EFFICIENCY OF THE MULTIDISCIPLINARY PROGRAM ON SLJEME IN REDUCED BODY WEIGHT AND CORRECTING COMPOSITION BODY OF OBESE PEOPLE Jasmina Hasanović1,2, Andrea Bilandžija1,2, Zvonimir Šatalić2 1

Association for overweight prevetion, Marulićev trg 15, HR-10000 Zagreb, Hrvatska Faculty of Food Technology and Biotechnology, Pierottijeva 6, HR-10000 Zagreb, Hrvatska

Introduction: In the treatment of obesity, there is a high failure rate and invested considerable effort in developing effective programs. While it is equally important to pay attention and to reduce energy intake and increasing energy expenditure is. His is an important multidisciplinary approach that will possibly affect other lifestyle habits. Objective: The objective of this particular thought multidisciplinary program on the ridge, was to educate obese adult individuals on the risks that arise as a result of overweight, the basic principles of proper nutrition and the importance of physical activity. Subjects and methods: In this program includes a total of 127 respondents is too small, out of which 104 respondents were female and 23 male patients, aged over 45 years. The program took place in small groups of 10 to 15 slide block. Results: Subjects who completed a ten-day program had lost 3.39 ± 1,15kg, ie. 27.3 ± 12.1% loss of body weight. Body mass index (BMI) at the end of the program, on the tenth day, it was 34.71 ± 7,66kg / m2, compared to body mass index on the first day which was 35.91 ± 8.00. Respondents BMI on average decreased by 1.20 units. The average value of body fat percentage and pounds at the beginning of the program is reaches 42.47 ± 7.59% (± 42.08 14,69kg), and the end of the program the value of the average body fat percentage amounted to 40.91 ± 8.31% (41.36 ± 15.34kg). Conclusion: A significant difference of the first and tenth days was determined for all test parameters: body weight, body mass index (BMI) and percent body fat. Group work creates a positive atmosphere and provides mutual support, which facilitates easier introduction of new food and lifestyle habits. Keywords: obesity, body weight, body composition, body mass index, the multidisciplinary program

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ASSESSMENT OF FOOD QUALITY IN MENUS OF SCOUT CAMPS Ana Ilić, Sara Sila, Anamarija Švagelj Croatian Academic Centre for Applied Nutritional Science, Supilova 7, 10000 Zagreb

Introduction: The quality of menus in scout camps is influenced by a number of factors, such as the possibilities of the foods store, food shop, food prices, tradition of cooking at the camp, eating habits of children and the education of people responsible for meal planning. The purpose of this study was to assess the quality of nutrition in the camps and the presence of certain food groups in the menus. Materials and Methods: This study used food menus and their norms, made for the purpose of scout association summer camps. The assessment of the nutritional value itself was made with Danish and American food composition databases. After evaluating the nutritional value, HEI-2010 was used for dietary quality assessment and HEI-1995 for estimating the food diversity. Data analysis was performed using Microsoft Office Excel 2010 computer software. Results: With the help of HEI-2010, it has been established that the menus of the two associations (association 1, association 2) were classified as an inadequate diet (39 and 42 points), while one of the association fell into the category of diet that needs to be improved (56 points). A parameter from HEI-1995, relating to food diversity, was used to establish that association 1 and association 2 had less varied diets (5 and 6 points), while association 3 had a high food diversity (10 points). In all associations’ diets it is necessary to increase the intake of whole grains, milk and dairy products, seafood and vegetable protein sources such as legumes, seeds and nuts, and reduce intake of refined grains and sodium. However, the results obtained indicate that association 3, in spite of the aforementioned problems, had a higher intake of green leafy vegetables and legumes, whole grains, animal protein sources, seafood and vegetable protein sources, and a lower intake of sodium, refined grains and empty calories. It is also apparent that association 3 has a balanced intake of unsaturated and saturated fatty acids. This result was achieved by the fact that the menu of association 3 was made by a person educated about the dietary requirements of children and young people. Conclusion: Despite problems associated with planning and preparation of food in scout summer camps, with the help of norms and menus created by trained professionals, such as nutricionists and chefs, the quality of food can be greatly increased. Key words: nutrition quality, HEI, nutrition diversity, scout camps, menus

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ASSESSMENT OF FOOD QUALITY IN MENUS OF SCOUT CAMPS Ana Ilić, Sara Sila, Anamarija Švagelj Croatian Academic Centre for Applied Nutritional Science, Supilova 7, 10000 Zagreb

Introduction: The quality of menus in scout camps is influenced by a number of factors, such as the possibilities of the foods store, food shop, food prices, tradition of cooking at the camp, eating habits of children and the education of people responsible for meal planning. The purpose of this study was to assess the quality of nutrition in the camps and the presence of certain food groups in the menus. Materials and Methods: This study used food menus and their norms, made for the purpose of scout association summer camps. The assessment of the nutritional value itself was made with Danish and American food composition databases. After evaluating the nutritional value, HEI-2010 was used for dietary quality assessment and HEI-1995 for estimating the food diversity. Data analysis was performed using Microsoft Office Excel 2010 computer software. Results: With the help of HEI-2010, it has been established that the menus of the two associations (association 1, association 2) were classified as an inadequate diet (39 and 42 points), while one of the association fell into the category of diet that needs to be improved (56 points). A parameter from HEI-1995, relating to food diversity, was used to establish that association 1 and association 2 had less varied diets (5 and 6 points), while association 3 had a high food diversity (10 points). In all associations’ diets it is necessary to increase the intake of whole grains, milk and dairy products, seafood and vegetable protein sources such as legumes, seeds and nuts, and reduce intake of refined grains and sodium. However, the results obtained indicate that association 3, in spite of the aforementioned problems, had a higher intake of green leafy vegetables and legumes, whole grains, animal protein sources, seafood and vegetable protein sources, and a lower intake of sodium, refined grains and empty calories. It is also apparent that association 3 has a balanced intake of unsaturated and saturated fatty acids. This result was achieved by the fact that the menu of association 3 was made by a person educated about the dietary requirements of children and young people. Conclusion: Despite problems associated with planning and preparation of food in scout summer camps, with the help of norms and menus created by trained professionals, such as nutritionists and chefs, the quality of food can be greatly increased. Key words: nutrition quality, HEI, nutrition diversity, scout camps, menus

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RECREATIONAL ATHLETES AWARENESS OF DIETARY SUPPLEMENTS USAGE Martina Jakovljević2, Josipa Mađarić1, Martina Pavlić2, Lidija Šoher1* 1

Nutricionizam Balans, Šetalište P. Preradovića 7, 31000 Osijek, Croatia Faculty of Food Tehnology Osijek, Franje Kuhača 20, 31000 Osijek, Croatia

Introduction: Dietary supplements include a wide range of different products from vitamin and minerals to the products for reimbursement of macronutrients. Supplements are used in general population for various purposes and are available without a prescription (OTC’s). It is known that recreational athletes often use various supplements depending on the goal they want to achieve by exercise, personal needs and knowledge about supplements. The aim of this study was to determine the incidence and reasons for dietary supplement usage within recreational athletes. The specific objective of this study was to exemine the level of awareness of supplement usage. Subjects and Methods: Observational study was conducted by an on – line questionnaire on a group of recreational athletes. The study included 746 subjects, 15 to 55 years old. The questionnaire was designed exclusively for the purposes of this research. Results were analyzed by Microsoft Excel 2016. Results: A total of 746 people filled out the survey, 12 subjects were excluded due to incomplete questionnaire responses. 52 % respondents were male. 69 % of respondents said they are using supplements, while 23 % using them sometimes. Most of the respondents (52 %) exercise 3 – 4 times a week. 89.3 % of recreational athletes consume protein supplements, individually or in combination with other supplements. The most common reasons for supplement usage are improvement of athletic performance, increase of muscle mass or a combination of those two (83%). 33.7 % of respondents the information about supplements obtained exclusively from trainers, 37.1 % through the media, while only 6.4 % of respondents information obtained from a nutritionist. On the other hand, when asked from who would they want to get verified information 31.4 % answered exclusively from sports trainers, 10.5 % through the media and 29.6 % from a nutritionist. Conclusion: Most recreational athletes take supplements. When it comes to awareness about supplement usage, most of them information obtained through the media or from sports trainer, while a small number from a nutritionist. The results show that some of them still want to get verified information from experts suggesting the need to include nutritionists in recreational athletes education on the dietary supplement usage. Keywords: dietary supplements, supplementation, sports nutrition, recreational athletes www.kongresnutricionista.com |

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NUTRITIONAL HABBITS OF HEALTH WORKERS IN EASTERN CROATIA Darija Kajtar, Betilija Fadi SekoĹĄan ZU Ljekarne Tripolski, Osijek, J.J. Strossmayera 14

Introduction: Health care professionals have an important role in raising awareness of healthy eating and other habits of the population. The assumption is that they are more aware of the importance of a healthy diet than the rest of the population and they serve as role models. The aim of this study was to determine what the nutritional and other health related habits of health care professionals are, as well as their awareness of the composition and calorific value of foods. Materials and Methods: The survey was conducted in eastern Croatia and included 304 persons employed in the health care sector aged from 19 to 70. Of the 304 respondents, 223 live in a city and 81 in villages. There was a total of 248 female and 56 male subjects. 96 respondents have a university degree (doctors, pharmacists, masters of medical biochemistry, dentists), 60 respondents have a college degree (bachelors in various areas of health care), and 148 respondents have secondary education (nurses and technicians, pharmaceutical technicians, laboratory technicians, physiotherapists). The anonymous questionnaire contained questions regarding eating habits of respondents, smoking, frequency of alcohol use and awareness of the caloric and nutritional composition of food products. Results: 58.88% of respondents eat breakfast every day. However, 31.91% of respondents eat only one meal a day. 77.63% of respondents have at least 1-2 servings of fish per week. 33.88% of respondents never consume fast food. Although respondents often read declarations on food products (23.36% always and 54.93% occasionally), 52.30% of them still do not pay attention to the caloric value of food. 39.47% of respondents eat even after they feel full. 35.20% of respondents declared themselves as smokers. They did not show significant differences in habits in relation to education, occupation, age, gender or place of residence. Conclusion: Health workers have good breakfast eating habits and consume a high percentage of fish and seafood, eating these at least 1-2 times per week. A large percentage of respondents read the declaration on products and donâ&#x20AC;&#x2122;t eat fast food. Nevertheless, a significant percentage of respondents do not pay attention to the caloric value of food and they tend to continue eating even after they feel full. The share of smokers is also significant. The conclusion is that health care professionals are mostly good at selecting the right types of food, but they often do not have well-spaced meals. This is probably not caused by a lack of awareness of healthy habits, but a shortage of time for their implementation. Keywords: health care workers, calorific value, dietary habits, smoking

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NUTRITION KNOWLEDGE ABOUT MILK AND MILK PRODUCTS AFFECTS BETTER DAIRY PRODUCTS CONSUMPTION ACCORDING TO RECOMMENDATIONS Gordana Kenđel Jovanović1, Sandra Pavičić Žeželj1, Greta Krešić2 1 Teaching Institute of Public Health of Primorsko-goranska County, Department of Health Ecology, Krešimirova 52a, Rijeka, Croatia; School of Medicine University of Rijeka, Department of Health Ecology, Braće Branchetta 20/1, Rijeka, Croatia 2 Faculty of Tourism and Hospitality Management, University of Rijeka, Department of Food and Nutrition, Primorska 42, p.p. 97, Opatija, Croatia

Introduction:Milk and milk products have many health benefits and their consumer represents good dietary habits important for every age. Students, because of its characteristic life habits, can have health benefits of dairy consummation, but as consumers, their dairy products, nutrition knowledge and attitudes may affect dairy product consummation choice. The aim of this study was to determine how dairy products, nutrition knowledge affects the choice to consume dairy products. Subjects and Methods:Among 1005 students from the University of Rijeka, we determined physical activity and smoking habits and the average monthly dairy products intake from FFQ questionnaire, while dairy products nutrition knowledge and attitudes was established with 5 questions. Students were divided according to total knowledge score on those with a good knowledge - SDZ (total score 4 and 5), and to those with poor knowledge - SLZ (total score of 1, 2 and 3). Results:One third (30.1%) of students had good dairy products, nutrition knowledge where 58.7% of students met the recommendations of daily milk and dairy product consumption, statistically significantly more than the SLZ students where 41.6% of students satisfied the recommendations of daily milk and dairy product consumption (p 0.0001). SDZ students were significantly more physically active (61.4% SDZ, 50.9% SLZ; p = 0.0027), and there were almost evenly non-smokers in both groups (67.9% SDZ, 64.5% SLZ). Significantly more SDZ students chose dairy products with less than 1% fat (38.6% SDZ, 6.5% SLZ; p 0.0001). When choosing dairy products significantly more SDZ students considered dairy fat content, not relevant (13.5% SDZ, 7.3% SLZ; p 0.0001). Students more often and in greater quantities consumed fermented dairy products, SDZ students (48,59g ± 29,50SD) significantly more than SLZ students did (39,85g ± 37,89SD; p = 0.004). Conclusion:Study results showed that better nutrition knowledge of dairy products quality and health role influenced on better dairy product consumption, according to recommendations, but better knowledge was not a predictor for choosing dairy product type among surveyed students. Provided results can help shape the public health message and promotion of dairy product consumption among younger population groups. Key words: students, milk and dairy products,knowledge, public health, health benefits www.kongresnutricionista.com |

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NON-GOVERNMENTAL ORGANIZATIONS AS A SIGNIFICANT FACTOR IN PROMOTION OF HEALTHY EATING Albina Knapp, Branislava Belović, Anica Benkovič Local branch of the Red Cross association Murska Sobota, Staneta Rozmana 3, 9000 Murska Sobota, Slovenia

Introduction: Non-governmental organizations are a significant factor in promotion of healthy eating. Many non-governmental organizations namely include the topic of health and healthy lifestyle in their field of work. What is more, non-governmental organizations have human resources at their disposal – experts (working and retired experts) and welldeveloped network in the field. Humanitarian organization of the Red Cross is an example of such organization. Methods:The local branch of the Red Cross association Murska Sobota covers 12 municipalities in Pomurje. In addition to other programmes, projects and activities, the branch has, for several years now, been offering the courses in lay care for the elderly and ill persons. The course participants are adults that care for older people in their families or offer voluntary help to their relatives, friends, neighbours, acquaintances or members of the local community. The course entails the following contents: special needs of the elderly, care for elderly and ill persons, lay care for patients, physical activity, healthy eating, communication and stress management. The course participants gain the necessary knowledge and practical skills to provide care for the elderly and general care for ill persons at home. Concerning the healthy eating, the course participants introduce themselves with dietary guidelines, groups of foodstuffs, combining foodstuffs, healthy preparation of food and basic features of the diet for the elderly. In addition to the handbook Lay care for the elderly and ill persons with a chapter dedicated to healthy eating, the course participants get booklets and brochures with advice on healthy eating and recipes. Results More than 500 adults have participated in the courses of the lay care. The examination of results at the end of the course, focusing on obtained information, knowledge and skills, have amongst else pointed to increased knowledge and information about healthy eating and the use of recipes for preparation of healthy dishes in participants’ families. Talking to course participants, we have learnt that they are keen on spreading the information and knowledge they gained onto their environment. Conclusion Non-governmental organizations working in the field of health and healthy life style can be a significant factor in promotion of healthy eating. Keywords healthy food promotion, non-governmental organizations, courses in lay care for the elderly and ill persons

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THE IMPORTANCE OF NUTRITION FOR SYMPTOM MANAGEMENT OF PARKINSON DISEASE PATIENTS Barbara Kolarić1, Svetlana Tomić2, Danijela Skelac2, Anja Bašnec1, Ines Banjari1 Josip Juraj Strossmayer University of Osijek, Faculty of Food Tehnology Osijek, Franje Kuhača 20, HR-31000 Osijek, Croatia 1

Department of Neurology, University Hospital Center Osijek,Josipa Hutlera 4, HR-31000 Osijek, Croatia

Parkinson’s diseases are a chronic degenerative disease of the brain resulting from a defect of numerous brain cells. Risk increases with age and currently 1 % of people older than 60 years live with the diagnosis. Causes still haven’t been clarified, but aetiology includes heavy metals, toxins, insecticides and herbicides, and inherited genetic mutations. As one of the first symptoms, loss of smell and taste occur. The disease is followed by a number of motorized and non-motoric symptoms, which significantly affect patients’ quality of life. Except for the need of increased intake of unsaturated fatty acids, no clear dietary guidelines have been set. However, considering the symptoms of the disease, especially those that related with the gastrointestinal system (e.g. constipation), clearly consumption of specific food groups could significantly improve patients’ quality of life. Additionally, newest findings imply a high risk of undernourishment and malnutrition among Parkinson’s disease patients. An observational study was conducted on Parkinson’s disease patients at the Department of Neurology, University Hospital Centre Osijek (N=30). The main aim was to determine patients’ level of knowledge on the importance of nutrition adapted to the disease, and to determine whether the patients need education about nutrition. The average age of patients was 66 years (46 to 83 years), 48 % males 52 % females, with average disease diagnosis of 6 years (from just diagnosed to 16 years). Out of symptoms that follow Parkinson’s disease, patients said that in everyday life the biggest issue represents constipation (31.7 %), mood change (24.4 %), problems with swallowing (22.0 %), and sleeping and blood pressure problems (21.9 %). 36 % of patients think their diet is not adequately adapted for their disease, while 68 % of them think that their knowledge is very low regarding diet for their disease. Even 96 % of patients said they want to learn more about diet customized to their disease. The results clearly show the need for education of patients with primary aim to alter symptoms of the disease that significantly affect patients’ everyday life.

Keywords: Parkinson’s disease, symptoms, education, patient’s knowledge, diet therapy

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IMPLEMENTATION OF NATIONAL DIETARY GUIDELINES FOR HEALTHY NUTRITION IN KINDERGARTENS AND SCHOOLS: AN EXAMPLE OF REDUCING SUGAR IN THE NUTRITION OF CHILDREN ENROLLED IN KINDERGARTEN MURSKA SOBOTA Nataša Kučan1, Zdenka Sočič Tkalec1, Staša Tkalec2 Kidergarten Murska Sobota, Talanyijeva ulica 6, 9000 Murska Sobota, Slovenia National Assembly of the Republic of Slovenia, Party of Modern Centre Deputy Group Šubičeva ulica 4, 1000 Ljubljana - Slovenia 1

Introduction: Kindergartensand schools are the perfect place for application of systemic measures with an impact on dietary habits and health of children. That is why Slovenia pays special attention and addresses this issue with organizational and legal measures. Special care is being paid to the national strategic documents, such as “National dietary guidelines for healthy nutrition in kindergartens and schools” that has been implemented in 2006. Kindergartens are faced with various everyday challenges, such as finding a compromise between the guidelines on one hand and the wishes of parents and children on the other. Methods: We introduce a good practice in everyday nutrition of children enrolled in Kindergarten Murska Sobota with emphasis on reduction of sugar. This example includes public procurement of locally-produced food, adjustment of recipes, education of children about healthy food (regular and hidden curriculum) and raising parents’ awareness. Kindergarten Murska Sobota takes advantage of the possibility enshrined in provisions of law on public procurement and gives priority to the locally produced food/foodstuffs from the quality scheme (seasonal/organic food...). Local producers can thus adapt to our needs and produce fruit products with less/no sugar. We also choose food products with no or with less added sugar (hidden sugars). Nutrition in the kindergarten excludes aromatized drinks and beverages prepared on the basis of fruit syrups. We invent recipes that are adapted to dietary guidelines, so that sweet dishes are prepared on the basis of fruits and vegetables. In preparation of dishes we use the minimum quantity of honey. Birthdays are celebrated only with fruit. Kindergarten teachers follow the reactions of children to new dishes (how they accept/reject the food, if they eat less/the regular amount of food, etc.) while kitchen staff pays attention to the amount of leftover food. Results: The changed menu, which includes dishes prepared on the basis of adapted and modern recipes and avoids procurement of processed food, has improved nutrition in Kindergarten Murska Sobota (around 750 children) between the years 2013 and 2016. The amount of sugar used in preparation of dishes has dropped by 11% and the use of honey by 28%. We have also reduced consumption of products that contain great(er) quantity of sugar (bakery products by 39%, dairy products with fruit and similar products by 77%). Gradual introduction of new (adapted) recipes was accepted very well by the children. Nutrition in Kindergarten Murska Sobota received a positive assesment in the reports on nutrition in kindergartens/schools published by the National Institute of Public Health. Conclusion: Successful implementation of guidelines in kindergarten does not only depend on the organization and legal provisions; it also demands expert knowledge, motivated food organiser and kitchen staff, support of the administration, of each team and parents, and recognition of the link between education and food offered in kindergarten. Keywords National dietary guidelines for healthy nutrition in kindergartens and schools, kindergartens, reduced consumption of sugar, education and information about healthy nutrition 164

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INFLUENCE OF MEDIA AVAILABLE DIETS ON EATING BEHAVIOURS AND THE SPREAD OF THE OBESITY EPIDEMIC Snjezana Longin– Merle du Bourg1, Silvestra Kolega2 1

Privatna nutricionisticka ordinacija, 291, rue de l’Abbé Bonpain, 59700 Marcq, Francuska Privatna specijalisticka ordinacija obiteljske medicine, Trg Bratski Dvor 1, 23272 Kali, Hrvatska

Diets available in the media seem justified and obvious because we are faced with a galloping obesity epidemic and a widespread desire for weight-loss (a consequence of social pressure). But, the long-term failure of the majority of such diets is also obvious (skinny does not mean happy). Numerous studies of strict-protocol diets in the last 20 years show at least 95% failure rate. How do we explain that phenomenon? The hypothalamus, the central area of the brain, is mostly responsible for our energy balance. It triggers a number of neurotransmitters in the complex communication within the body. All those hormones and neuro-signals influence normal relationship towards food: eating when hungry, eating because of appetite (guiding us to certain foods for pleasure) and ending food intake when satiety is reached. Increase in bodyweight is caused by a disturbed and inefficient natural bodyweight regulation. A diet found in a media or a shop, designed for everyone cannot fully satisfy neither the personal history nor the living conditions of individual persons. A strict and rigid food intake control is opposite of the spontaneous and unconscious adaption to nutrition. Diets make us eat according to a specific protocol or programme, disregarding our personal preferences and situation. Slowly, we stop paying attention to our food-related reflexes and feelings. The cognitive part of the brain takes over the function of the hypothalamus and switches off the spontaneous regulation. Inappropriate diets cause significant physical and psychological damage in a population. And yet, new diets with promises of fast and easy weight-loss constantly attract new fans, although their effect is often short-term (3 - 9 moths). What is the real solution for pathological obesity? Gradual change in eating habits and harmful behaviours. Uncovering the real often manifold and complex causes of weight-gain. It is essential to recognize the reasons leading to psychological strain and understand how they push a person towards emotional food consumption. Obese or overweight persons are often stuck in the “cognitive restriction” scheme even when they stop the diet. Which is why a long-term therapy with health professionals (nutritionists, doctors, psychiatrists, psychologists) trained in treating the multiple factors of pathological obesity is recommended. The final goal is to recover a normal relationship with food, body perception and to increase self-confidence. Visible results will take weeks and months - patience is fundamental. But there is always the possibility of success. Keywords: media available diets, eating behavior, obesity epidemic www.kongresnutricionista.com |

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ENERGY INTAKE OF HOSPITALIZED PEDIATRIC PATIENTS Marinela Mamić, Petra Kučan, Diana Vukman Department of Dietetics and Nutrition, Children´s Hospital Zagreb, Klaićeva 16, Zagreb

Introduction: Adequate nutrition in early stages of life is crucial to ensure healthy growth. Children have limited energy reserves and higher energy demands which puts them at a particularly high risk of malnutrition. Dietary intake has an important role in both the prevention and treatment of childhood malnutrition. The accurate assessment of food intake in children and adolescents is important because dietary habits formed early in life may have considerable impact on long-term health status. Patients and Methods: Energy intake of hospitalized pediatric patients was monitored 4 years in a row (2013-2016) as a part of a one day cross-sectional study to assess the difference between recommendations and actual intake of pediatric inpatients. 370 patients admitted to Children´s Hospital Zagreb aged 0 months to 18 years were included in the study. Information on demographic data and energy intake were documented during a structured interview and compared with daily requirements recommended by Croatian nutritional standard for hospital diets. Results: In 4 years of our study 37% of all studied patients had an average daily energy intake between 60-90% of recommended values. Average daily energy intake was below 60% of recommendations in 30% of patients and above 90% of recommended values in 33% of patients. Average daily energy intake of children under 1 year of age was within the recommendations except in 2014 (energy intake of children aged 0-4 months was above recommendations) and 2015 (energy intake of children aged 4-12 months was below recommendations). Average daily energy intake of children aged 10 -13 years was also within the recommendations with the exception of 2014 where the intake was below recommended values. In all other age groups average daily energy intake was below recommendations. Conclusion: Key elements in improving dietary intake are the combination of screening, appropriate nutritional assessment, further monitoring of patients and improving the hospital menu. Adapting hospital menus and mealtime atmosphere to meet patients’ expectations may improve food intake and coverage of their needs. The provision of meals should be flexible and individualized, and all patients should have the option of ordering extra food at any time and be informed of that possibility. Keywords: energy intake, recommendations, hospitalized children, hospital menus

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PREGNANCY AND BREASTFEEDING DIET Monika Novak1, Ivana Tkalec2, Monika Vidović3 Županijska bolnica Čakovec, I. G. Kovačića 1E, Čakovec Hrvatski Zbor Nutricionista, Ilica 134, Zagreb 3 Županijska bolnica Čakovec, I. G. Kovačića 1E, Čakovec 1

Introduction: Pregnancy is a physiological process in which many changes in the woman’s organism are occurred. As the wish of every pregnant woman is to deliver alive and healthy baby, they inform themselves about proper diet and behaviour during the pregnancy. Balanced and proper diet in pregnancy influences on the growth and development of the baby because all important nutrients are provided from mother. Recent researches indicate that the vitamin supplements do not have any effects on the health improvement during pregnancy except the vitamin D and folic acid. British scientists state that the balanced and diverse diet during pregnancy is the most important for a pregnant woman and a baby whereaswrong diet and lack of vitamins from food can cause pregnancy problems such as high blood pressure, complications that include labour induction, fetal growth restriction, low birth weight, bones deformations, different brain and spine damages. Materials and Methods: There were 35 participants, the average age was 28. Among them, there were 24 pregnant women and 11 breastfeeding mums in Međimurje County while attending the course on healthy diet during pregnancy and breastfeeding and visiting the County hospital Čakovec. The questionnaire includes eating habits and physical activities. The questions on supplements are also added. Results: Over 50% of pregnant women and breastfeeding mums sit at work, while 46% do medium tiring jobs, 3% do physically demanding jobs. All thepregnant women and breastfeeding mums do physical activities on daily basis , 86% of them walk at least 30min every day. 20% have 5 meals a day. 21% skip snacks, whereas 54% skip late meal. 29% drink 1 litre of water a day, 23% drink 1,5 l, 31% drink 2 l. 31% consume milk and dairy products twice or more times a day, while 34% once a day. 23% consume whole grain cereals 4-6 times a week. Fruit and vegetable is mostly consumed once a day, 48% of them fruit, while 46% vegetable. Meat is mostly consumed once a day (43% of them). Fish is mostly consumed once a week (48% of them). Eggs are mostly consumedonce a week (40% of them). 56% take supplements. Conclusion: The research indicated that most of the pregnant women and breastfeeding mums eat unproperly. All of them have at least three meals a day. Our survey revealed that most of them consume fruit, vegetables, whole grain cereals and fish is eaten insufficiently. Most of the participants take supplements. Key terms: pregnant women, breastfeeding mums, questionnaire, meals

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THE FREQUENCY OF CONSUMPTION OF MILK AND DAIRY PRODUCTS IN CHILDREN OF 11- 14 YEARS IN THE AREA OF CENTRAL BOSNIA CANTON Mateja Paklarčić, Ermina Kukić, Sead Karakaš Public Health Institute of Central Bosnia Canton,Bolnička 1, 72270 Travnik, Bosna i Hercegovina

Introduction: Milk and dairy products play an important role in the diet of children and are the most important dietary sources of calcium that children need for growth and development. An adequate calcium intake from milk and dairy products, especially in childhood and adolescence is a crucial factor for the formation of the maximum bone mass and preventing osteoporosis. The aim of this study was to determine the frequency of consumption of dairy products in relation to sex, age, place of residence, on eating habits / lifestyle and nutritional status in children aged 11-14 years in the field of Central Bosnia Canton. Materials and Methods: The examination includes school children from Central Bosnia Canton. The study covered a total of 51 schools, which is a total of 1804 students. Data collection was done using custom single anonymous questionnaire, which included general information about the subject, as well as issues related to eating habits / lifestyle. Results: When it comes to the consumption of milk and dairy products, from the total number of respondents, the proportion of 953 boys (52.82%) who consume the above products compared to 769 girls (42.62%) is higher. Regarding the milk and dairy product consumption in relation to the place of residence, the proportion of those who consume milk and dairy products in the rural environment is 905 (50.16%) compared to the urban environment 817 (45.29%). To the question of the frequency of milk and dairy product consumption in relation to the number of main meals, of the total number of respondents, the largest proportion of those who consume milk and dairy products is among those who have three main meals a day 1383 (76.66%), while the largest proportion of those who do not consume milk and dairy products is among those who have only one main meal per day, ie 65 (3.6%). Of the total number of respondents who consume milk and dairy products, 1466 (81.26%) of them are engaged in sports, while 255 (14.13%) do not engage in sports but they consume these products. Conclusion: Considering that early adolescence is a delicate period when a rapid decline in daily intake of milk occurs, this period should become the focus of public health. There is a widespread opinion among young people that milk increases body weight, and social pressure from youth seeking slenderness often tends to decrease milk consumption, which is particularly pronounced among girls. We believe that our results can be used as a starting point to initiate prevention programs which would seek to increase milk consumption among young people. Keywords: dairy, children, gender, age, nutritional status 168

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AN INNOVATIVE WAY IN INTEGRATION ENCOURAGING OF THE PROPER NUTRITION IN AN INSTITUTIONAL TREATMENT OF THE ALCOHOLICS Zoltan Pap1, Branislava Belović2 University Clinical Center Maribor, Department of Psychiatry,Ob železnici 30, 2000 Maribor, Slovenija. Pomurje Cancer Society, Ulica arhitekta Novaka 2b, 9000 Murska Sobota, Slovenija.

1 2

Introduction: The modern approach of treating alcohol addiction is based on encouraging the rapid integration of patients in their domestic environment. The treatment program requires various therapeutic facilities which enable the development of patient’s abilities in all major life areas and allow him to reintegrate into daily life. The Department of Psychiatry of University Clinical Center Maribor carries out a treatment program of alcohol addiction which contains various sociotherapeutic activities, but one of them includes an innovative way of proper nutrition. Methods: The program of institutional treatment of alcohol addicts includes an innovative approach that is also sociotherapeutic method and that raises the awareness of proper nutrition and healthy lifestyle. The approach includes practical work at the demonstration kitchen by principles of self-helping groups, growing the vegetables, herbs and spices at the demonstration garden and lectures/workshops of proper nutrition. With this approach, the alcohol addicts acquire the information, knowledge and skills of proper nutrition, and are encouraged to integrate the healthy life choices daily. It also provides patients the possibility of developing the working habits, discipline, functional ability, organization of free time and healthy ways of relaxations. Working in the demonstration kitchen includes choosing and preparation of healthy meals, degustation and care for the hygiene in the kitchen. The food selection takes into account the traditional meals adapted to proper nutrition, seasons and current holidays, by which appropriate recipes of well-known professionals from primary health care are used. The activities since 2016 have involved 40 patients. Success contributes involving professionals from primary health care and non-governmental organizations. Results: Review of the results of acquired information and knowledge about proper nutrition by interviews and acquired skills with demonstration of preparing food, growing vegetables and herbs indicates the improvement of required skills. Patients consume the food prepared in demonstration kitchen and thus consume more healthy foods (vegetables, fruits, whole grains, lower fat dairy product etc.). Results indicate increasing of the awareness and knowledge of proper nutrition, acquired skills in preparing meals and growing of vegetables, spices and herbs. Some patients are transferring knowledge and skills in domestic environment (during weekend release). Through the observation method, occupational therapist examine that patients accountability and functional abilities have been improved. Patients also report about positive feelings (feeling of ability, usefulness and contribution to common good). Conclusion: An innovative way of encouraging a proper nutrition in institutional treatment of alcohol addicts presents an optimal example of good practice which could be successfully transferred to other institutions. Keywords: Institutional treatment of alcohol addicts, encouraging of proper nutrition, demonstrational kitchen, demonstrational garden. www.kongresnutricionista.com |

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GLYCEMIC CONTROL AND NUTRITION AMONG DMT1 PATIENTS IN CROATIA Martina Pavlić1, Nevena Valić Marjanac2, Igor Marjanac3, Zvonimir Barišić1, Ines Banjari1 Josip Juraj Strossmayer University of Osijek, Faculty of Food Tehnology Osijek, Franje Kuhača 20, HR-31000 Osijek, Croatia, 2 Community Health Centre Osijek, Park kralja Petra Krešimira IV. 6, HR-31000 Osijek, Croatia, 3 Department of Pediatrics, University Hospital Center Osijek,Josipa Hutlera 4, HR-31000 Osijek, Croatia 1

Introduction: Glycemic control in diabetic patients is the key to prevent acute complications, delay chronic conditions, as well as to affect the overall quality of life. Nutrition based on counting diabetic units helps in achieving good glycemic control. This is especially important in cases of patients with type 1 diabetes (DMT1).The goal of this research was to determine the level of (self)control of DMT1 patients and the compliance with general dietary recommendations for people with diabetes. Method: Observational study conducted on DMT1 patients in the Republic of Croatia with an on-line questionnaire. The questionnaire was created specifically for the purpose of the present research. The study group included 101 diabetic patients aged 6 to 50. Results: 2/3 of the participants report poor glycemic control, that is, a glycosylated hemoglobin level (HbA1c) over 6.5 %. A positive family history is reported by 6.9 % of the participants. Overall, 44.5 % of the participants suffered from diabetic ketoacidosis, 40.0 % of them had it more than once. Chronic conditions were reported by 20.8 % of the participants. Additionally, the results indicate that while 67.3 % percent of the participants rely only on the carbohydrate counting method, 17.8 % do not follow neither the general dietary guidelines for patients with diabetes nor count carbohydrates. Half of the participants consume fast food at least once a month while 71.3 % consume monosaccharides more than 2 times a week. One third of the participants think that they are not educated enough about the diabetic diet. Interestingly, 44.5 % of the participant think that the diabetic diet is considerably more expensive than a normal diet. Conclusion: The results indicate poor glycemic (self)control as well as inadequate knowledge about diabetic recommendations and principles among DMT1 patients. There is an urgent need to educate and reeducate DMT1 patients regarding balanced nutrition to ensure better glycemic control through health institutions and diabetes associations. Keywords: diabetes mellitus type 1, eating habit, nutrition, glycemic control

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SALT AND SUGAR SOURCES IN DIET AMONG STUDENT’S POPULATION ATUNIVERSITY OF MOSTAR Marija Pehar1, Marijana Palac1, Katarina Marušić1, Daniela Čačić Kenjerić1,2 Faculty of Agronomy and Food Technology, University of Mostar, Biskupa Čule bb, 88 000 Mostar, Bosnia and Herzegovina 2 Josip Juraj Strossmayer University of Osijek, Faculty of Food Technology Osijek, Franje Kuhača 20, 31 000 Osijek, Croatia 1

Introduction: The elevated intake of energy and nutrients is one of the major contributors in the development of the chronic non-communicable diseases. Modern diet and lifestyle have resulted with intakes of salt and sugar above recommendations. Highest contribution to salt intake is from processed and ready to eat food („hidden salt“) whose consumption is often combined by sweetened beverages which contain high concentrations of added sugar („hidden sugar“). The aim of this study was to assess the frequency of consumption for selected food and drinks among students in Mostar and determine which among them are the main sources of salt and sugar. Subjects and Methods: The study was designed as a cross-sectional. It encompassed 146 participants among which both genders were equally represented. Data were collected from volunteers by single anonymous questionnaire. Questionnaire encompassed three parts, of which first was aimed to collect subjects general data, second one encompassed a group of question designed to determine dietary habits and preferences and the third one was in the form of the food frequency questionnaire. Results: Collected data were analysed in Microsoft Excel and presented for the whole study population and subgroups based on gender and nutritional status. Since most of the study participants (49 %) for breakfast consume bakery products and sandwiches (52 %) or breakfast cereals (26 %), it was not surprising that they were the main contributors to the salt and sugar intake. Besides them, fast food was determined as the important contributor to salt intake while pudding was determined as an important contributor to sugar intake. Conclusion: Considering the fact that most of the study participants declared themselves to consume food of mild saltiness and results indicated elevated salt intake, it is obvious that saltiness perception is subjective and education is needed to prevent consequences of elevated intake. Keywords: salt, sugar, students, dietary intake, sources

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EATING HABITS AND ATTITUDES OF VETERINARY MEDICINE STUDENTS WHO LIVE AT HOME OR AWAY FROM HOME Loredana Pincan, Marina Prišlin, Ozren Šiftar, Lana Vranković, Jasna Aladrović Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10000 Zagreb

Introduction: By enrolling at the faculty, students are faced with an increasing number of obligations and a significantly greater burden. That is why food and life habits often change. The quality of the diet therefore depends on the habits gained in the family and on the foods available to them when preparing meals or on the meals that they consume in student campus restaurants. The aim of the research was to determine the influence of moving out of the family home on nutrition and living habits of veterinary medicine students. Materials and Methods: The research was conducted from 2014 to 2017 on 265 students. Students were divided into two groups, a group of students residing in Zagreb (N = 127) and students staying in Zagreb during the academic year (N = 138). The research was conducted through a questionnaire that contained 20 questions. The statistical analysis was carried out by the computer program Statistica v. 12. Results: The highest number of students was eating both at home and in student campus restaurants (81%). A significantly higher number of students who have a place of residence in Zagreb eat at the student restaurant (p≤0.05). Most students (58%), regardless of their place of residence, evaluate the quality of a student’s restaurant with a good and very good rating. A significantly higher number of students living in Zagreb eat daily fresh meals (p≤0.05) and eat 5 or more than 5 meals per day (p≤0.05). Students living in Zagreb have a significantly higher percentage of daily breakfast eating (p≤0.05) and consume milk and dairy products daily (p≤0.05). Of the total number of students, 47% play sports recreationally and 7% are active sportsmen. Most of the students, regardless of their place of residence, were not on the restrictive diet for the last year (81%) and does not feel obese (84%). Half of the participants feel that they are healthy (50%). Conclusion: The results point to the importance of life with parents because breakfast and consumption of milk and dairy products are more frequent in students living with parents. Milk and dairy products are a good source of calcium needed for growth and development of adolescents as well as affecting cognitive abilities and memory. Keywords: students, eating habits, attitudes, living at home, living away from home

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THE EFFECT OF THE EDUCATION ON PRIMARY SCHOOL CHILDREN’S KNOWLEDGE ABOUT SUGAR SWEETENED BEVERAGES 1

Juliana Lana Prah, 2Ivana Rumbak, 2Irena Colić Barić

Graduate student of Molecular biotechnology, Faculty of food technology and biotechnology, Pierottijeva 6, 10000 Zagreb, Croatia 2 University of Zagreb, Faculty of food technology and biotechnology, Pierottijeva 6, 10000 Zagreb, Croatia 1

Introduction: Limiting the intake of sugar sweetened beverages (SSB) is one of the main preventive strategies to combat the obesity epidemic. High intake of SSB in children is connected with lower intake of nutritious beverage such as milk. It is also related to inadequate intake of vitamins and minerals in children. In the long term, this kind of diet could be connected with obesity and other chronic noncommunicable diseases. The main aim of this study was to evaluate the effect of brief education on knowledge about sugar content in different types of sugar sweetened beverages and their possible health effect. Materials and Methods: Primary school children from Karlovac attending 5th grade participated in this study (n=42). Education lasted for 45 minutes and it included activities adjusted to the children’s age. Before education, children filled questionnaire about their knowledge regarding added sugar intake and recommended beverage choices. The same knowledge questionnaire was filled immediately after education and 9 months after education. Descriptive statistics were used to describe the basic features of the data and the chi-squared test was used to compare the frequency of the correct answers. Results: The best knowledge children have shown on the recommendation of daily water intake, while the lowest number of correct answers was regisetred on the question regarding recommendations of added sugar daily intake. There was statistically significant improvement in the number of correct answers right after education compared to the number of correct answers before education (p<0.05). After 9 months, there was no statistically significant difference in the number of correct answers, but there was 5.75% increase in the number of correct answers compared to the number of correct answers before education. In other words, before education 14 students had more than 50% correct answers and after 9 months 22 students (n=42) had more than 50% correct answers. Conclusion: Considering the aim of the study, we can conclude that there is a significant difference in the number of correct answers before and right after the education. Although there is no visible statistically significant positive long term effect of education, improvement in the number of correct answers was evident. Future research should include a larger number of subjects. Also, it should include interventions that would encourage students to apply their knowledge in order to change their eating habits, reduction of SSB and added sugar intake. Keywords: sugar sweetened beverages children, education, added sugar www.kongresnutricionista.com |

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SUGAR AND SALT IN CONSUMER PRODUCT Marija Prčić, Milica Bećir Marija Prčić, Dr Babović Anti Aging Centar, Krunska 80, 11000 Belgrade, Republic of Serbia

Introduction: Chronic non-communicable diseases for decades have dominated our national pathology. The leading causes of death in Serbia are almost identical to those in more developed parts of the world. In Serbia, nearly 100,000 people die of chronic noncommunicable diseases every year. Almost every other citizen of Serbia dies of cardiovascular diseases and every fifth of malignant tumours, diabetes. Around 710,000 people or 12.4% of the Serbian population has diabetes, 465,000 or 8.1% of the adult population is aware of their diabetes and 245,000 more have not yet been diagnosed and are not treated. One of the risk factors for developing non-communicable chronic diseases is imbalanced and inadequate nutrition. The frequent selection of food products which are the source of hidden sugar (“empty calories”), sugar and salt, may trigger the diseases from the mentioned group. Materials and methods: The relevant data has been collected through market analysis of confectionery products, study of product declarations and specifications. Results: Over 100 food products have been analyzed and divided into three statistical groups – cookies, cereal and nuts and seeds. The acquired data indicate an elevated sugar and salt content in these products. Conclusion: Based on the results, there is an obvious need to educate the population on proper nutrition to alter their eating habits and to assist them to properly read and understand food product declarations and nutritional facts. It is possible to increase the intake of consistently deficient complex carbohydrates and decrease the share of “empty calories” and salt by re-education. Such changes would have an indirect impact on the reduction of the rate of diseases which are the result of imbalanced nutrition. Key words: salt, sugar, CND, education

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PROFILE OF PATIENTS IN THE CLINIC FOR OBESE CHILDREN AND ADOLESCENTS IN A CHILDREN’S HOSPITAL ZAGREB Sara Sila, Tena Niseteo Children’s hospital Zagreb, Klaićeva ulica 16, 10000 Zagreb

Introduction: Obesity in children and adolescents is one of the greatest public health concerns in the 21st century. Over 80% of obese children become obese adolescent and 20% of obese adolescents become obese adults. Obesity in children can cause many health problems, such as hypertension, type 2 diabetes, insulin resistance, dyslipidemia, and psychosocial consequences. The aim of this study was to evaluate the profile of children in clinic for obese children at Children’s Hospital Zagreb. Materials and Methods: This study used anthropometric data of patients who visited the clinic for obese children since 2013 in which, apart from the body mass and body height, were determined the percentage of fat tissue, muscle mass and other anthropometric measures. Data analysis was performed using Microsoft Office Excel 2010 computer software. Results: Data analysis revealed that there was a total of 53 patients, of which 60.4% were males and 58.5% living in urban area. Average age (median) of patients is 14 years. 24 (45.2%) attended elementary school, and 29 attended high school (54.8%). 37.7% of respondents were overweight and 58,4 % were obese (50.9% obese class I (BMI from 25,0 to 29,9) and 7.5% obese class II (BMI from 30,0 to 34,9). There is no statistically significant difference in the degree of obesity between children living in the urban and rural area. Out of 53, only 16 children responded to the first check-up. Of those who came to the first checkup 8 had a lower body mass index (BMI) compared to the first dietary consultation, while 8 increased their body mass from the first consultation. The second check-up included 6 subjects, all of whom increased their body weight from the last control. Conclusion: Treatment of obesity in children and adolescents is a very demanding and longlasting process that depends significantly on the motivation of patients and their parents. Very few patients succeed in losing weight, and even fewer manage to keep that body mass. It is therefore essential to work on preventing obesity among children and adolescents as well as educating them about the importance of healthy nutrition and exercise. Keywords: overweight, obesity, children, adolescents, body mass index

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FISH INTAKE, MERCURY, AND METABOLIC SYNDROME: A REVIEW OF THE LITERATURE Tamara Sorić1,Ivona Dragičević2 1

Psychiatric Hospital Ugljan, Otočkih dragovoljaca 42, 23 275 Ugljan, Croatia Omnipharma d.o.o., Radnička cesta 54, 10 000 Zagreb, Croatia

Introduction: It is already well established that mercury, as a toxic metal, may induce oxidative stress, inactivate several antioxidant mechanisms, and induce a chronic low-grade inflammation, eventually leading to increased risk for metabolic syndrome development. Even though fish intake is commonly associated with the beneficial effects on health, all fish species contain methylmercury, which may have a toxic effect on the human body. Taking into account the impact of fish intake on mercury concentration, together with that of mercury exposure on metabolic syndrome, the aim of this research was to review the existing scientific data regarding the association of all three factors. Results of included studies and discussion: Numerous works examinated the role of mercury in the development of single metabolic syndrome component, but a smaller number of research dealt with the influence of mercury on the metabolic syndrome itself. To our knowledge, only four studies examined the association between mercury concentration and metabolic syndrome, taking fish intake into account. Three out of four studies indicated that exposure, even to low-dose of mercury is associated with metabolic syndrome or at least some of its components. Two of them determined that total fish intake or the intake of some species containing relatively high levels of methylmercury is a contributing factor for mercury concentration in human body. Conclusion: For better understanding of the association between fish intake, mercury, and metabolic syndome it is necessary to obtain larger prospective cohort studies or randomized controlled trails. Further studies should be carried out over a wider geographic area and elucidate all significant contributing exposure sources for mercury levels. Keywords: fish intake, mercury, metabolic syndrome

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EFFECT OF MATERNAL AND OFFSPRING DIET ON SURFACE AREA AND NUMBER OF WHITE ADIPOSE TISSUE ADIPOCYTES IN MALE RAT OFFSPRING Darija Šnajder1, 2, Željka Perić Kačarević1, Matija Fenrich3, Nikola Bijelić4, Marina Bakula5, Radivoje Radić1 1 Department of Anatomy and Neuroscience, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia 2 Clinical Institute of Nuclear Medicine and Radiation Protection, University Hospital Osijek, Osijek, Croatia 3 Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia 4 Department of Histology and Embryology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia 5 Clinical Institute of Pathology and Forensic Medicine, University Hospital Osijek, Osijek, Croatia

Introduction: In mammals, adipose tissue can be divided into two main types, white and brown, the white adipose tissue being predominant in the body and specialized to store energy. To be able to adapt to an excessive supply of energy, adipose tissue expansion can occur through several ways: 1) an enlargement in adipocyte size (hypertrophy) and/or an increase in adipocyte numbers (hyperplasia), 2) infiltration of inflammatory cells and 3) remodeling of the vasculature and extracellular matrix. But when the state of inflammation and obesity is continuous, homeostatic mechanisms fail causing tissue dysfunction. Materials and Methods: Ten female Sprague Dawley rats, 9 weeks old, were randomly divided into two groups and fed either standard laboratory chow or food rich in saturated fatty acids during 5 weeks and then mated with genetically similar male rats. After birth and lactation male rat offspring from both groups were divided into four subgroups depending on the diet they were fed until 22 weeks of age. After sacrifice, samples of white adipose tissue were taken from the subcutaneous compartment of two compartments of visceral fat: epididymal and perirenal. Tissue sections were formalin fixed, paraffin embedded, cut, stained with hematoxylin and eosin, digital images were obtained and histomorphometric analysis was conducted using the CellProfiler program v. 2.1.1. Results: Greater mean surface area of subcutaneous and epididymal adipocytes was found in groups of male rat offspring with altered pre- and postnatal diet compared with groups whose diet was not changed, those groups had accordingly smaller adipocyte number. In visceral adipose tissue the smallest mean adipocyte surface area and the highest number of adipocytes was measured in the group where both mother and offspring were fed a diet rich in saturated fatty acids. Conclusion: Changed postnatal diet leads to adipocyte hyperplasia in subcutaneous and epididymal adipose tissue, and high-fat diet leads to adipocyte hyperplasia in perirenal white adipose tissue. Keywords: High-Fat Diet, Adipose Tissue, Histomorphometry, Rats www.kongresnutricionista.com |

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FACTORS WHICH AFFECT THE AMOUNT OF HOUSEHOLD FOOD WASTE Anamarija Švagelj1, Irena Colić Barić2 Croatian Academic Centre for Applied Nutritional Science, Supilova 7, 10000 Zagreb Faculty of food technology and biotechnology, University of Zagreb, Food science laboratory, Pierottijeva 6, 10 000 Zagreb 1

Introduction: Household food waste greatly contributes to the amount of total food waste, so it is necessary to concentrate on this type of food waste while designing means of prevention and reduction of the amount of total food waste and to determine the factors which affect its creation. Researches conducted on this topic link food waste with a number of socioeconomic factors and behavioral factors which refer to food supply, preparation, storaging and diet and lifestyle. Methods and subjects: The research was conducted using an on-line questionnaire. 252 subjects older than 16 were gathered from 24.06. to 31.08.2015., and the data was processed in the SPSS v. 20.0 statistical package. An analysis was conducted using certain questions connected to sociodemographic factors and food handling procedures and the amount of food waste. A criteria of a statistical significance under 5% (p<0.05) was used. The test used to determine the statistically significant connection of all relevant parameters is Chi-squared test. Results: There is a link (p=0,006) between the size of the household and the amount of food waste, as well as the type of the household and the amount of food waste (p=0,002). Households with more members and households with children waste more food. There is a link (p=0,006) between the amount of food waste and the frequency of spontaneous shopping or shopping for supplies. Subjects who more rarely do this type of shopping waste less food. Subjects who buy food in supermarkets and local stores waste more food than those who buy their food at markets or grow food themselves (p<0,001). There is a link (p=0,039) between the amount of food waste and establishing the need for buying food before going to the store. Subjects who have wasted large amounts of food state food expiration date as their main reason for doing so, the next reason being bought, preparing or serving a greater amount of food than needed (p<0,001). Not planning meals is linked to large amounts of household food waste (p=0,028). Improper food storage is also linked to large amounts of food waste (p=0,013), while consuming leftovers kept in a fridge or freezer (p<0,001) and checking the taste, smell and/or the look of the food which is past its expiry date (p=0,005) is linked to smaller amounts of food waste. Conclusion: The results show that certain procedures during food supply, preparation and storage are linked to the creation of food waste in households, therefore it is necessary to introduce them into a population education plan. It is also necessary, while designing methods of prevention and reduction of food waste in households, to pay closer attention to households with more members and households with children, seeing as those households waste more food. Key words: household food waste, behavioral factors 178

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