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Established 2003
Pakistan Nutrition & Dietetic Society
Nutrition Research Symposium: 2013
Abstract Book
Saturday 29th June, 2013
at Avari Towers
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Program at a glance
About PNDS Research symposium
About PNDS and Executive Committee
Scientific Committee
Organizing Committee
Welcome message from the President
Message from the Chair Scientific Committee
Message from the Chief Guest
Introduction to speakers
CONTENTS
Key note Lecture: Abstract
Scientific Program
Oral Abstracts
Poster Abstracts
Acknowledgment (Sponsors and Event Organizers)
About Sponsors
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'Compliance with
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The Importance of Research Putting Pakistan on the Nutritional Map'
'How to Translate Clinical Work into Publishable Research'
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: Faiza Shoaib Joint Sect. PNDS
Animal Model.
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Program at a glance
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4:40 pm - 4:45 pm
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PNDS Nutrition Research Symposium: 2013
Research plays a vital role in the practice and advancement of nutrition and dietetics.
Pakistan Nutrition & Dietetic Society (PNDS) is organizing a full day 'PNDS Nutrition
Research Symposium: 2013' to commemorate their 10th anniversary. This forum is
mainly organized for health care professionals focusing on recent food, nutrition and
dietetic research conducted in Pakistan. The aim is to promote a research culture
and sharing of results among colleagues. The forum will provide a learning opportunity
for many new researchers to present their work strengthen PNDS members' abilities
to conduct, understand, present and communicate their food and nutrition related
researches in an organized manner. We hope that this will help to create a research
environment and will also benefit the Society at large.
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PAKISTAN NUTRITION AND DIETETIC SOCIETY
PNDS is registered under the societies ACT XXXI of 1860. Reg Number 070 of 2003
Introduction:
Pakistan Nutrition and Dietetic Society (PNDS) was founded and registered in 2003
as a professional society with the aim to represent, promote and advance the science
and profession of nutrition. PNDS is a non-profit Society being run by a voluntary
group of Nutrition Professionals. The society strives to achieve better nutritional
status for the population in Pakistan.
Only those with necessary nutrition related qualification are entitled to regular
membership. Associate and student membership is open to all those with an interest
in nutrition and dietetics. Every two years nine members are elected to form the
Executive Committee. Currently PNDS has more than 300 members representing all
membership categories.
Professional Development Activities for PNDS members: Since its inception PNDS
has been involved in a wide range of professional activities.
Continuing Nutrition Education Sessions: These sessions are a regular bi-monthly
activity of the Society. Wide range of topics in the field of nutrition and dietetics are
covered with updated, research backed information.
Hands on Workshops: The Society conducts hands-on workshops to provide an indepth understanding of the chosen topic. Topics are decided in the on the basis of
member; needs.
PNDS Newsletter: PNDS publishes a quarterly Newsletter which provides state of
the art information on different nutrition related topics.
Accreditation of Nutrition and Dietetic Professionals: PNDS has developed an
accreditation exam to certify practicing dietitians and nutritionist.
Nutrition Education Seminars for Health Care Professionals: The Society organizes
nutrition seminars for nutritionist, dietitian and other health care professionals with
a major emphasis on nutritional concerns in various health conditions.
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Nutrition Activities related to Public Health: Celebration of World Days: PNDS
conducts nutrition awareness activities for the general public and health care
professionals on a regular basis to commemorate selected 'world days' such as;
World Heart Day, World Diabetes Day and World Food Day. They are organized in
collaboration with health and educational institutions
Public Awareness: Many of our members actively participate in different health
media programs. This is primarily encouraged to ensure that qualified nutritionists
and dietitians provide scientifically based advice regarding food, diet and nutrition
related topics.
Public Health Education: PNDS does not have the policy to provide individual or
personal advice to any person or company; however it can be contacted to check
the validity of nutrition claims made by a food manufacturer, advertiser, TV presenter,
cooking experts, and other professionals.
Health and Nutrition Resources: PNDS has a web site (www.pnds.org) and can also
be contacted at [email protected]. The web site is regularly updated and reflects the
current status of the society and its activities.
International Memberships: PNDS is an active member of Asian Federation of Dietetic
Associations (AFDA). Some of the PNDS members have also had the privilege of being
invited speaker at their conferences. PNDS in 2010 was elected Council Member of
AFDA. Two of the PNDS members serve as country representatives at American
Overseas Dietetic Association (AODA). In 2010, PNDS was also approved to represent
Pakistan as a professional body in the field of Nutrition and Dietetics by International
Confederation of Dietetic Associations (ICDA). In 2012, PNDS has become affiliated
with UK Society Nutrition.
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Executive Committee PNDS
(2011-2013)
Office Bearers:
President: Dr. Nilofer Fatmi Safdar
Vice President: Fayza Khan
General Secretary: Ayesha Zahid Khan
Joint Secretary: Faiza Shoaib
Treasurer: Sana Ovais
Members:
Badder Hina
Saima Rasheed
Samina Adam
Shabana Pervaiz
Rumella Masood
Honorary Life President:
Dr. Salma H. Badruddin
Past President:
Dr. Rubina Hakeem
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Scientific Committee
PNDS Research Symposium: 2013
Dr. Salma H Badruddin
Dr. Nilofer Safdar
Dr. Rubina Hakeem
Samina Adam
Erum Jhumra
Organizing Committee
PNDS Research Symposium: 2013
Ayesha Zahid Khan
Fayza Khan
Ayesha Khalid
Summaya Irshad
Maryam Arif
Sana Azfar
Rabea Khan
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Message from the President (2011-2013)
Dear Colleagues,
On behalf of Pakistan Nutrition and Dietetic Society (PNDS) and the Organizing
Committees of the "PNDS Nutrition Research Symposium: 2013", I am pleased and
honored to welcome you all to the Nutrition Research Symposium: 2013 to be held
on Saturday, June 29 atAvari Towers, Karachi, Pakistan. The objectives of the symposium
are to share research experiences, learn about conducting research and learn to
critically evaluate published research in the field of Nutritional Sciences. The
Symposium is planned to have a plenary talk, two main lectures and three free paper
sessions on various aspect of Clinical and Public Health Nutrition. We are expecting
a wide representation of professionals and students in nutrition & other health
sciences.
As my term as president of PNDS comes to completion in June, 2013, I would like
to take this opportunity to thank the PNDS executive committee members and all
my colleagues who have made this term a huge success for our Society. I am extremely
grateful and indebted for the continuous guidance, support and the leadership of
Dr Salma H. Badruddin, Honorary Lifetime President who has always and will continue
to provide a strong framework to PNDS members for the priorities that will establish
the Society as the authoritative leader in nutrition through science, education, and
research. I have been associated with the PNDS since its inception in 2003 and as
we celebrate our 10th anniversary this year, I am very proud and satisfied of the
Society's progress in promoting nutrition education, providing opportunities for
young nutrition scientists, and advocating nutrition in the domain of public health
in Pakistan. PNDS has made progressive strides over the past ten years and I am very
fortunate to have been a part of these activities during the ten years as part of the
PNDS Executive Committee. Our international partnerships with other Societies have
also continued to grow during this term and I look forward to more future
accomplishments.
We look forward to meeting you at the Nutrition Research Symposium on 29th June,
2013.
Sincerely,
Dr. Nilofer Fatimi Safdar, M.Sc, M.S, PhD
President, Pakistan Nutrition & Dietetic Society
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Message from the Chair, Scientific Committee
Dear Colleagues,I would like to extend my warmest welcome to you to the First
Pakistan Nutrition and Dietetic Society (PNDS) Nutrition Research Symposium: 2013.
As nutritionists we recognize the importance of nutrition research relevant to our
country. However in the past the training of nutritionist and dietitians in Pakistan
has focused primarily on clinical competencies rather than on developing research
capabilities. This Symposium is our attempt to encourage more active participation
in research by members of our profession.
I would like to thank the members of the Scientific Committee for dedicating their
minds, effort and time to the preparation of the scientific program.
We hope you will enjoy this nascent attempt at highlighting nutrition research done
by beginning researchers. We look forward to your active participation in this event.
Yours Sincerely
Professor, Dr. Salma Halai Badruddin,
Chair, Scientific Committee
PNDS Nutrition Research Symposium: 2013
Honorary, Life President PNDS
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Message from Chief Guest
Dear Colleagues and members of Pakistan Nutrition & Dietetic Society (PNDS),
It is a pleasure to have seen the PNDS grow and reach its tenth year in 2013. It was
founded in 2003 with an aim to promote the science of nutrition in all fields of
medicine, food industry and the general public. The founding members, Dr. Salma
Badruddin, Dr. Nilofer Safdar and Ms. Deneize Puri along with their numerous
colleagues have worked hard to bring PNDS to this very prestigious status which we
see today.
I have had the opportunity and honor to be affiliated with PNDS right from its
inception and participate in many of the symposia and workshops. I always found
all events well attended and dispersing the latest knowledge to all its members. From
this platform dedicated dietitians and nutritionists have grown and attained seniority.
With the low literacy level in Pakistan, especially in women along with the prevailing
myths and economic setbacks, good knowledge on how to make the most of available
nutrients especially for children, is essential. This knowledge has to be conveyed to
women who are the backbone of every home. The related education has been
provided regularly for the public through the electronic and print media by PNDS.
The Millenium Development Goal is still at a distance before the targets can be met.
The Annual Plan Report of Pakistan 2008 shows that in the sector of Nutrition a lot
more has to be achieved. Nutritional improvement, adequacy and security are
important factors on which awareness has to be created at all levels of the society.
Hopefully with the expertise available at PNDS, their services will be utilized for the
betterment of the population of Pakistan.
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The National Nutrition Survey of Pakistan published in 2011 also shows results raising
concern on the nation's health. The message has to be spread on the importance of
good nutrition especially for children and women. I am confident that PNDS will take
up this challenge.
Finally I congratulate all the members of PNDS on this event and wish them luck and
motivation in achieving more success.
Dr. Fatema Jawad,
Consultant Diabetologist, SIUT, Karachi
Editor-in-chief,
Journal of Pakistan Medical Association, Karachi
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INTRODUCTION TO SPEAKERS
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Dr. Nilofer Fatimi Safdar,
M.Sc., M.S, PhD.
Director Nutritional Science Program,
School of Public Health, Dow University of Health Sciences, Karachi
Dr Safdar has a PhD in Nutrition from School of Public health, University of
Massachusetts, USA. Her master's degree is in Clinical Nutrition from The City
University of New York , USA. Her undergraduate degree is in Home. Economics from
College of Home Economics, Karachi. She has done one year of professional training
in International Nutrition from Cornell University, USA. Dr Safdar is a two time
recipient of Fulbright Scholarship and was recently awarded the 'Delta Omega' public
health excellence award from USA to recognize her academic and professional
achievement in the field of public health. Her clinical work in nutrition span over 25
years. She has worked with Aga Khan University and The Kidney Center, Post graduate
Institute, as Head of the Nutrition Department. She is a member of the editorial
board of the Journal of Pakistan Medical Association. Dr Safdar is the Founder
member of Pakistan Nutrition and Dietetic Society (PNDS) and is currently the
President of the Society. She represents PNDS in Asian Federation of Dietetic
Association, British Dietetic Association & American Overseas Dietetic Association.
Her research interest are dietary patterns, diet in the prevention of non-communicable
diseases, community health and public health nutrition.
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Professor Salma H. Badruddin
MSc, PhD
Nutrition Consultant,
Mahar Medical Center, Karachi.
Professor Salma H. Badruddin is amongst the first PhD in Nutrition in Pakistan. She
has a long career in community nutrition as well as in academics. She worked for
many years as a USAID consultant to train and develop nutrition capacity grass root
workers in Primary Health Care centers across Sindh and Balauchistan. She has
been a faculty member at the Aga Khan Medical College from 1988 to 2006. Thanks
to the vision of the then Dean Dr Camer Vellani she single handedly managed to get
nutrition education into the curriculum for medical students.
She was the founder President of the Pakistan Nutrition and Dietetic Society at its
inception in 2003 and has been actively involved in the Society's work since then.
Currently she is the Honorary Life President of the Society.
Ayesha Zahid Khan
M.Sc.
Senior Research Officer,
Human Development Program,
Aga Khan University.
Ayesha Zahid Khan started her career as a clinical nutritionist with Aga Khan Unv
Hospital in 1987. Starting from grass root in 1990 she became the Chief Senior Clinical
Dietician supervising the nutrition department. In 1991 she was awarded the USAID
scholarship which provided for her fellowship in Nutrition from Massachusetts
General Hospital, Boston. She has been practicing as a Consultant Nutritionist at
different facilities. In 2004, Ayesha shifted towards community nutrition research.
In her first project she worked as a Nutrition Coordinator - Health Educator with the
Control of Blood Pressure and Risk Attenuation (COBRA) trial. Presently she is working
as Senior Research Officer- Nutrition with the Human Development Programme of
Aga Khan University where she is involved in developing and implementing community
based nutrition related interventions.
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Dr. Fatima Mir,
MBBS, FCPS, MSc (Clinical Research)
Assistant Professor, Department of Pediatrics & Child Health, Aga Khan
University, Karachi.
Dr Fatima Mir is a pediatrician and infectious disease specialist by training.
She has an MBBS from Khyber Medical College, Peshawar and an MSc in Clinical
Research from Emory University, USA. Her residency and fellowship training
has predominantly been at The Aga Khan University. She currently distributes
her time between clinical practice and community as well as clinical research
at AKU.
Dr Mir's has a special interest in neonatal sepsis, simplified antibiotic regimens
for infections in infants and HIV. She has received multiple travel burseries
and presented her research at international and national scientific meetings.
She has also been principal investigator on three clinical trials within the
community.
Dr. Mir is a member of the Pakistan Pediatrics Association and the AKU Alumni
Association.
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Dr. Syeda Kanwal Aslam,
Senior Lecturer, School of Public Health, Dow University of Health Sciences
(DUHS), Karachi
Dr Aslam, completed her M.B.B.S from Dow Medical College. After her internship
at Civil Hospital, Karachi, she joined Aga Khan University Hospital as Community
Medicine Resident. She also completed her Clinical Research Certified
Professional program from Clinical Trial Unit, Dow University of Health Sciences
(DUHS). Currently she is working as. Apart from being the In charge Office of
Students' Affairs, SPH; she has also been elected as the Secretary to Vice
Chancellor for Institutional Review Board (IRB), Institute of Pharmaceutical
and Environmental Research, DUHS.
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Scientific Sessions
The Importance of Research Putting Pakistan on the Nutritional Map'
'How to Translate Clinical Work into Publishable Research'
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Plenary Lecture
The Importance of Research; Putting Pakistan on the Nutritional Map'
Dr Nilofer F. Safdar,
M.Sc., M.S., PhD
Research plays a vital role in the practice and advancement of any science. Its
importance is reflected in the standards of its professional practice. To many food
and nutrition professionals the term research brings thoughts of data, numbers,
measurements. It may relate to identifying an issue, answering a question, or
advancement of knowledge across a wide range of scientific and practical issues in
nutrition and dietetics. My talk will highlight some of the gaps and challenges in
nutritional surveys, research and interventions in Pakistan. Regrettably many of
them have failed at addressing the root causes and effects of malnutrition. The focus
is often mainly on assessing indicators and less on identifying causal factors. Lack of
qualitative data for addressing the cause of malnutrition and absence of a qualified
nutritionist among teams that conduct nutrition research results in a dismal situation
where malnutrition remains high.
Paramount with documenting the effectiveness of nutrition professionals is
their ability to conduct well-designed studies and use research in practice to improve
the nutritional status of Pakistani people. Research skills are so vital in today's world
of cutting edge science that education, formal training and experience in this area
has become an integral part of health sciences. I will try to examine few examples
of nutrition research and interventions through a scientist lens. By discussing the
various nutrition surveys, intervention programs and research in Pakistan, I will
illuminate some of the ways in which nutrition professionals can change the health
science landscape in Pakistan. I will shed some light on the rich and multifaceted
education that a nutrition graduate is equipped with that can enhance and improve
the quality and application of nutrition research in improving the health of the nation.
In today's time, hardly a week goes by when a breaking food and diet related study
is not reported. Public interest in food, diet and nutrition has increased dramatically.
Regardless of the magnitude of research work in the area of nutritional sciences, the
few research studies which included the expertise of a nutrition scientist have
benefitted in a considerable manner the population at large. Putting the results of
such research into practice might make a difference in the public's understanding
of diet and health. I will conclude my talk by shedding some light on ways and means
by which the Pakistan Nutrition and Dietetic Society can help in developing research
ability and sensitizing our members to the research culture.
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Lecture 1
'How to Translate Clinical Work into Publishable Research'
Dr.Fatima Mir,
M.B.B.S. M.Sc.
In this presentation, Dr. Fatima Mir shares her talk on why translating clinical
experience into publications is important, what skill sets and input it demands and
why it remains an uncomfortable challenge for the best of us. This presentation is
intended for those who want to hear some practical pearls of wisdom as opposed
to bookish information they could attain from anywhere else. Dr Mir shares her
struggles with the process and how successful networking with other writers helped
her overcome her fear of writing. It includes simple tips to start and eventually finish
a manuscript.
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Lecture 2
How to critically appraise the scientific literature?
Dr. Syeda Kanwal Aslam,
M.B.B.S.
Scientific research is considered as an integral source of information for a health
practitioner. It forms the very basis of today's highly preferred evidence based
practice. It is now assumed that professionals must be well-informed and up-to-date
with the newest knowledge in order to best serve their clients and remain professionally
relevant. It is thus, imperative for any health practitioner to have a sound knowledge
of how to do critical appraisal.
Critical appraisal is defined as "the process of carefully and systematically examining
research to judge its trustworthiness, and its value and relevance in a particular
context". In today's era of information overload , it is very difficult to filter out any
"pseudo science", which in no way should serve as a source of information for
evidence based practice. Issues like information overload, incorrect methodologies,
conflict of interests, overstatement of benefits, continuously haunt an evidence
based practitioner. Thus, it is mandatory for a reader to sort out the precise, valid
information used to inform practice. My talk at the PNDS Symposium will guide a
reader to effectively appraise a primary research paper by using a 10 step guideline.
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Oral Abstracts
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Efficacy of Dietary Counseling in Management of Moderate Malnutrition: A One
Year Experience at the Indus Hospital.Deneize Asim Puri, Saba Shahid, Bushra Sadiq,
and Ayesha Khalid. The Indus Hospital, Korangi, Karachi.
Introduction: Malnutrition in children is a major problem in Pakistan where
approximately 38% children are suffering from severe to moderate
malnutrition.Moderate malnutrition does not receive the attention it deserves and
is not treated as a public heath priority.The present study aimed to assess the efficacy
of dietary counseling in managing moderate malnutrition.
Method: This study is a retrospective review of 159 moderately malnourished children
treated in our "Pediatric Nutrition Clinics" started on 14th November 2011 to 12th
November 2012.All consecutive children with moderate acute malnutrition from 660 months of age were included. Moderate malnutrition was classified according to
World Health Organization guidelines: mid upper arm circumference (MUAC) between
11.5cms and 12.5cms and weight for height(WH) between -3 and -2 Z-scores.Primary
outcome was reduction in severity of malnutrition and increase in caloric and protein
intake.
Results: Results showed that the nutritional status of 74(47%) children out of
159moderately malnourished children improved. WHZand MUAC Z scores improved
for the whole population (p=<0.0001). Mean caloric and protein intake of children
whose nutritional status improved increased significantly after dietary counseling
promoting intake of nutrient dense diets (p=<0.0001).
Conclusion: Dietary counseling based on locally available nutrient dense diets
improved nutritional status and dietary intake of moderate malnourished children.
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Therapeutic Effect of Flavonoids Rich Extract of Apricots on High-Fat Diet Induced
Hyperlipidemic Animal Model. Tooba Lateef 1&2, Samia Asif 1, Shamim A. Qureshi 2.1
Department of Biochemistry, Jinnah University for Women, Karachi. 2 Department
of Biochemistry, University of Karachi.
Introduction: Flavonoid rich extract (FREt) of Prunusarmenia(Apricots) was studied
for its therapeutic effect on hyperlipidemia on high-fat diet (HFD) induced
hyperlipidemic animal model. Hyperlipidemia is a group of metabolic disorders
characterized by the elevated levels of triglycerides (TG), cholesterol (TC) and low
density lipoprotein (LDL-c) and low level of high density lipoprotein (HDL-c) in the
blood. The prevalence of hyperlipidemia has dramatically increased worldwide due
to a modern lifestyle and an increase of consumption of a high-fat diet.
Methods: The experimental rabbits were divided into three control groups including
control (distilled water 1 ml), HFD control (HFD + distilled water 1 ml) and HFD
positive control (HFD + simvastatin 20 mg/kg), and a test group (FREt 200 mg/kg)
consecutively for 14 days. On completion of trial, rabbits were sacrificed to collect
blood and serum was separated to estimate lipid profile including TC, TG, HDL-c by
using Randox kits whereas LDL-c and antiatherogenic index (AAI) were calculated by
formulae.
Results: FREt showed significant decrease in TC, TG and LDL-c levels whereas increase
in HDL-c when compared with HFD induced control groups (p<0.05). In addition AAI
was improved.
Conclusion: The results demonstrate that flavonoid rich extract ofapricotshas great
potential in the treatment of hyperlipidemia by observing its antihyperlipidemic
effect on HFD induced hyperlipidemia in rabbits.
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Assessment of Dietary Compliance among Patients with Type 2 Diabetes Mellitus
Receiving Text Message (SMS) Reminders. Gulshan Bano, Romaina Iqbal, Syed Iqbal
Azam, Shariq Khoja, Jaweed Akhtar. Departments of Community Health Sciences and
Medicine, Aga Khan University, Pakistan
Introduction: Compliance to a healthy diet is very important for effective management
of type 2 DM. Use of electronic devices in the field of health care has been successful
in motivating patients to improve their health behaviors. This study aimed to assess
the difference in dietary compliance in patients with type-II diabetes, who were
reminded through text message (SMS) vs. those provided standard care.
Method: Sixty diabetic patients age 30 to 70 years having a cell phone were invited
to participate in the randomized control trial.. In the intervention arm three weekly
diet related text messages were sent for 3 months. Compliance to diet was assessed
by assigning score to the dietary intake assessed by Food Frequency Questionnaire
(FFQ) and fortnightly intake of fruits and vegetables. Interim analysis after followup of 1.5 months is reported.
Results: There was no difference in dietary habits in the two arms of the study (F
(group) = 0.065; p-value= 0.79) as well as within the arms (F (time) = 0; p-value>0.99).
There was no significant effect of the intervention status as well as response to
fortnightly two-item questionnaire on the mean dietary compliance score assessed
with FFQ ( p-value( Intervention status )= 0.65; p-value( Response status )= 0.29).
Conclusion: We are unable to make conclusion about the relationship of dietary text
message reminders and dietary compliance in type 2 diabetic patients with the
available data.
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Compliance with Use of Micronutrient Sprinkle for Children aged 6-24 months;
The Qualitative Aspect. Shelina Aamir. Aman Tele-health, Aman Foundation.
Introduction: Micronutrient deficiencies account for large number of morbidity and
mortality in infants and young children around the world, especially in developing
countries. The present study aimed to assess the compliance of Micronutrient
Sprinkles in 6- 24 months old children.
Method: A qualitative study was conducted in Karachi. A purposive sample of fourteen
caregivers participated in the in-depth interview based on a semi structured
questionnaire. Interviews of caregivers were tape recorded and then fully transcribed.
Thematic analysis was done manually.
Results: The result showed that the compliance to Sprinkle was 50% as cited by the
caregivers of the children. The reason for non compliance was the unacceptability
by the children because of the change in taste and color of food to which Sprinkles
was added, side effects such as frequent and dark stools, teething, inadequate
counseling by the health care provider, and forgetting to add Sprinkles. Some
caregivers also mentioned that they did not feel it was important enough to be given
to their child. Those who did comply stated that Sprinkles had beneficial effects on
their child's overall health such as, increase in appetite, weight and height, as well
as prevent/ cures anemia.
Conclusion: To improve acceptability of Sprinkles by children, a flexible routine for
3-4 months should be promoted instead of its daily administration for 2 months. The
role of LHV and volunteers should also be strengthened.
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Perceptions on Infant Feeding Practices of Women Living in Balochistan.
Ayesha Zahid Khan, Syeda Amber Syed. Human Development Programme- Aga Khan
University.
Introduction: Optimal infant feeding practices are effective in reducing child mortality
and morbidity. The National Nutritional Survey-2011 infers that thelargest province
of Pakistan, Balochistan is facing a nutritional emergency. This qualitative study was
under taken to explore infant feeding practices prevalent in Balochistan.
Methods: A purposive sampling design was used. Data was collected through 14
Focus Group Discussions (FGDs) conducted with mothers (10) and grand mothers
(4) from Gwadar, Qilla Saifullah and Quetta, districts of Balochistan. Each session
comprised of 10-15 participants and an average duration of 70 minutes. The data
was transcribed in roman Urdu and then analyzed using N-VIVO version 2.0. Three
major themes emerged and are reported on.
Results: The rate of breastfeeding in Pakistan is high but "exclusive" breastfeeding
is rare and practices are suboptimal. There is delayed breastfeeding initiation and
rampant use of pre-lacteal feeds. It is claimed that pre-lacteal feeds cleanse the
infant's stomach. Some participants said they give colostrum while majoritysaid they
discard it as they consider colostrum to be impure and unhealthy. There is a general
consensus that breastfeeding should be continued till two years of age. Some mothers
discontinued feeding before two years due to the onset of next pregnancy. Another
milk source was added besides breastmilk because some mothers perceived that
their milk supply had diminished.
Conclusion: Cultural practices that have a detrimental effect on breastfeeding such
as discarding of colostrum, delayed initiation of breast feeding and use of pre-lacteal
feeds need to be addressed through nutrition education.
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Impact of Nutritional Assessment and Intervention onthe Nutritional Status of
Bone Marrow Transplant Patients. Maryam Saeed and Mozamila Mughal. Nutrition
and Food Service Department-Aga Khan University and Hospital, Karachi, Pakistan.
Introduction: Bone marrow transplantation (BMT) includes grafting with allogeneic
or autologous stem cells derived from bone marrow, peripheral blood and cord
blood. An autologous transplant involves receiving patient's own cells where as an
allogeneic bone marrow transplant involves receiving very high-doses of chemotherapy
and/or radiation therapy, followed by the infusion donor's bone marrow or peripheral
stem cells. The objective of this study was to assess nutritional status pre-transplant
and the impact of aggressive post transplant nutritional intervention on BMT subjects.
Methods: This 5 year study was conducted from 2008 to 2013 and included 73
patients whose nutritional status was assessed. This included anthropometric
measurements, biochemical data and diet history evaluation.
Results: Total number of BMT patient seen were 73 with 58 % allogeneic 42 %
autologous (BMT), BMI was found to be low in both groups (<19). The incidence of
mucositis was significantly higher (81 %) in the autologous group than in the allogenic
group (67 %, P<0.005). Serum albumin was found low in allogenic transplant patients
(56% <2.5). Early nutritional interventions included nutritional screening and
assessment with aggressive post-transplant feeding regimes before onset of BMT
side effects. The requirement for TPN was reduced in 38% patient with early nutritional
interventions.
Conclusion: Nutritional assessment and intervention is an important consideration
in both groups. Further studies are needed to focus on specific dietary management.
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Risk Factors for Gestational Diabetes Mellitus in Women with Polycystic Ovary
Syndrome. Maleeha Mohsin, Indus Hospital, Karachi.
Introduction: Polycystic ovary syndrome (PCOS) is a condition that affects 4-7%
women of reproductive age.Rise in sedentary lifestyles and obesogenic environment
make them more susceptible to negative health outcomes. PCOS also causes a
predisposition to glucose intolerance, placing such women at a greater risk of
developing GDM. This study aims to determine whether the BMI and glycaemic load
of meals places women with PCOS at a greater risk for developing GDM.
Methods: This case control study wasconducted on 18 women with PCOS and 20
controls residing in the United Kingdom.The women were aged 20-40 years and from
various ethnic groups. Diet was recorded as a 24 hour Recall for a period of three
days. The average glycemic load of breakfast, lunch, dinner, and snacks was calculated
using the online Glycemic Index Database. Participant height and weight were also
recorded for BMI. Data was later analyzed via the SPSS software.
Results: Almost 83% of the PCOS population had a BMI>25 versus 15% of the control
population. Daily average glycaemic load was significantly higher in the PCOS
population versus the Control population (PCOS 40.3±21 versus Control population
25.5±8.2, P<0.05).
Conclusion: Based on a high BMI and Glycaemic load of meals coupled together with
the predisposition of insulin resistance in PCOS, PCOS women are at a higher risk of
developing GDM.
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Dietary Patterns Associated with Hypertension among Low Income Urban Adults in
Pakistan. Nilofer F. Safdar 1 , Elizabeth Bertone-Johnson 2 , Lorraine Cordeiro 3 ,
Tazeen H. Jafar 4, and Nancy L. Cohen 5.
1. School of Public Health, Dow University of Health Sciences, Karachi, Pakistan
2. Department of Public Health,
3. Department of Nutrition, School of Public Health and Health Sciences, University of
Massachusetts, Amherst MA, USA
4. Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Introduction: Hypertension affects 33% of the adult population in Pakistan. Various studies
have shown the critical role of specific dietary patterns in the prevention and management
of hypertension. However, the dietary determinants of hypertension in Pakistan remain
unknown. In this study we aimed to identify dietary patterns from baseline food frequency
data and assess their associations with hypertension in 5491 subjects from the Control
of Hypertension and Risk Attenuation (COBRA) study, 2004.
Method: Factor analysis was used to identify the "fat and sweet", "fruit and vegetable"
and "seafood and yogurt" patterns with 20% variance in food intake. Associations between
dietary patterns and subject characteristics were assessed using ANOVA and chi square
tests.
Results: Odds of hypertension were higher in women and increased with age and BMI in
both genders (<0.001). When adjusted for covariates, the seafood and yogurt (OR= 0.72:
95% CI: 0.61, 0.84; p-value <0.001) and fruit and vegetable (OR =0.89: 95% CI: 0.80, 0.99;
p-value= 0.039) patterns were inversely related with hypertension, whereas no significant
association was seen for the fat and sweet pattern.
Conclusion: Our findings suggests that specific dietary patterns may have a role in regulating
blood pressure in this population, however, more prospective studies are needed.
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Poster Abstracts
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Early Childhood Milk and Milk Products Intake-Maternal Perceptions and Practices.
Dr. Asma Makhani, Ayesha Zahid Khan, Ghazala Rafique. The Human Development
Programme- Aga Khan University and Hospital Karachi, Pakistan
Introduction: Micronutrients deficiencies in young children have profound effects
on their immune system, growth and mental development. However, many
micronutrients deficiencies in children such as calcium can be prevented. This research
has explored the perceptions and practices of mothers, residing in Karachi, regarding
milk and milk products (MAMPs) intake in children of age 2-5 years.
Methods: This is a qualitative exploratory study. Semi structured, in-depth interviews
were conducted. Eighteen mothers whose children's age were 2-5 years old were
purposively recruited from three daycare centers of three different socioeconomic
status areas of Karachi.
Results: MAMPs intake of all children was in accordance with 2006's, American
Academy of Pediatrics recommendations for requirements, i.e. 2 cups per day of
Milk/Dairy for 2-4 years old children. However, the type of MAMPs and children's
preferences differs considerably. The most preferred MAMPs among children of 25 years of age were yogurt and plain milk. The preferences for MAMPs in children
were mainly determined by their peers, mother's ethnicity and media advertisements.
Most of the mothers did not give MAMPs in several common childhood illnesses.
Maternal ethnicity plays considerable role in selecting and combining various food
items especially fish with MAMPs.
Conclusion: The majority of children in this study had an adequate intake of milk
and milk products. However ethnicity and media advertisements also had an impact
on intake.
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A Comparison of Pre and Post-Surgical Nutritional Status in Head and Neck Surgery
Patients.
Mozamila Mughal. Nutrition and Food Service Department - Aga Khan University
and Hospital Karachi, Pakistan.
Introduction: Otolaryngology - is a surgical subspecialty dealing with surgical resections
of head and neck region post trauma or in squamous cell carcinoma patients. The
post-surgical patient is at nutritional risk for depletion due to altered ability to swallow
and many post-operative patients require special long term nutrition support.
Objective: To determine the impact of nutritional intervention on the post-surgical
nutritional status of head and neck surgery patients
Methods: This study was conducted from 2011 -2012 in a tertiary care private hospital
of Karachi, Pakistan. The pre -surgical serum albumin level of 10 subjects was
compared with the serum albumin level after nutritional intervention. These patients
were on long term nasogastric or gastrostomy feeding. Interventions included written
tube feeding plans based on caloric requirement and vitamin and mineral
supplementation. The patients with pre- surgery serum albumin levels of < 2.8 mg
dl were followed up in outpatient clinics after discharge for 2 consecutive follow-up
visits, 15 days and 1 month after discharge. During this period the patients were in
communication with the dietitian on email.
Results: The serum albumin levels reached the optimum target level of > 3.5 mg/dl
in all post-surgical patients with intervention.
Conclusion: Early nutritional intervention in long term enteral support patients
improved nutritional status. Further studies are needed to study the impact of
nutritional intervention on wound healing, infection rate and readmissions.
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Diabetes Self Management Practices of People With Diabetes Living in Karachi.
Nida Jawed. Food and Nutrition Department, RLAK Government College of Home
Economics Karachi, Pakistan.
Introduction: Understanding existing self management practices of various groups
of people with diabetes can help in providing appropriate guidance and promoting
good management of diabetes. The present study aimed to assess diabetes self
management practices and gender differences in diet of people with diabetes on
Metformin plus insulin.
Methods: There were 40 type II diabetes subjects selected through purposeful
convenient sampling (30 females and 10 males). The inclusion criterion was that
subjects were on metformin HCL and rapid acting insulin for at least three months.
The data was collected by interview using a questionnaire, 3-day 24 hr recall and
food frequency questionnaire.
Results: Only 40% mentioned doing any exercise on daily basis and only 15% did it
for more than 15 min/day. Majority reported good compliance with medication and
had Glucometers, however only 55% used glucometers at least once a week. Most
of subjects had irregular eating habits (90%). Pattern of intake of calories from
different sources was similar among both males and females. The 24hr recall results
showed significant intake of calories from fat by both groups. 75% of the patient's
had a BMI > 23. The mean caloric intake by males was 1505±302 kcal/day as compared
to females whose mean intake was 1378±299 kcal/day (P<0.05).
Conclusion: This study has identified potential areas of concern that health care
professionals can focus on for better counselling of patients for a healthy lifestyle.
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A Comparative Study of Eating Habits of Preschool Children of Home Economist
Versus/Non-Home Economist Mothers. Sidra Sirajuddin. Tabba Heart Institute,
Karachi, Pakistan.
Introduction: The preschool years are a crucial time to develop good eating habits.
The objective of the study was to study the differences between the food habits
and food behavior of preschool children whose mothers were Home Economists
(HE) versus non-Home Economist (NHE).
Methods: A random sample of 25 (HE) and 25 (NHE) mothers reported on eating
habits and eating behaviors of their children using a self-administered Food Frequency
Questionnaire. Food habits include food choice, method of eating, on, numbers of
meals per day, time of eating and portion size of foods consumed. Food consumption
was compared with food guide pyramid for young children (USDA). SPSS© version
14 was used to analyze the data.
Results: Almost 40% preschool children of HE mothers consumed 5 meals/day as
compared to 24% of preschool children of NHE mothers. The consumption of bread
and cereals (p<0.05), meat and poultry (p<0.05) was significantly higher among NHE
mothers while fruit (p< 0.01), vegetables (p<0.01) was significantly higher among
HE mothers. Mothers of both groups considered nutritional value while preparing
food for their preschool children. More than 80% of mothers encouraged their
children to taste new foods. Several concerns about children's eating habits were
identified such as consumption of low calorie density food, skipping meals and fussy
eating.
Conclusion: Food habits of preschool children of HE mothers were better than
preschool children of NHE whereas the food behavior of both groups were same.
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Assessment of Vitamin B Complex Intake Before and During Ramadan.
Summayya Irshad Khan. Food and Nutrition Department, RLAK Government College
of Home Economics Karachi, Pakistan.
Introduction: During ramadan, approximately one billion muslims abstain from food
and fluid during the day light hours. Therefore there is a possibility that there is a
decrease in the intake of some vitamins during ramadan. The present study aimed
to investigate the difference in the intake of thiamine, riboflavin, niacin, pantothenic
acid, pyridoxine, folate and cobalamin of 770 subjects between 12 to 90 years before
and during ramadan.
Methods: The data was collected by using 24 hour dietary recall by the help of
generic food photograph atlas. The vitamin b content of the food was calculated
using USDA and Allama Iqbal open university food composition tables. The data
collected was analyzed by paired t-test and multivariate analysis of variance to assess
the difference in the intake among the genders and age groups.
Results: There was a significant decrease in vitamin b complex intake p<0.039 during
ramadan accept for folate which increased from 266.5µg to 328µg/day in ramadan.
The vitamin b intake among 465 females was significantly lower than the intake
by305 males (p< 0.005); but, there was no significant difference observed among
age groups i.e. 12-19,20-64 and 65-90 years during ramadan.
Conclusion: There was a significant decline in the intake of vitamin b complex during
the month of ramadan accept for folate intake possibly due to an increased intake
of fruits during ramadan.
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A Comparative Study of Bone Mineral Density and Associated Factors Among High
and Low Income School Children.
Samia Samar, Rubina Hakeem. Food and Nutrition Department, RLAK Government
College of Home Economics Karachi, Pakistan.
Introduction: Bone mineral density (BMD) increases during childhood and adolescence
until peak bone mass is reached at maturity - usually by 25-30 years of age. Peak
bone mass and subsequent bone losses are important determinants of osteoporosis
later in life. Objective of the study was to compare BMD in children belonging to low
and high socio-economic levels and study factors associated with BMD.
Methodology: One hundred children aged 10-12 years were selected from two
schools of Karachi, one from a low income area (LIA) and the second from a high
income area (HIA). Weight and height of each child was measured. BMD was measured
by Ultrasonic Densitometry in the region of heel. Information regarding dietary habits
and physical activities were obtained through questionnaire.
Results: Measurement of BMD revealed that the mean T-score was significantly
lower at (-2.82) in children from HIA as compared to (-2.36) in children from LIA, (p
<0.05). Whereas overall mineral consumption was better in HIA children as compared
to those from the LIA. The children from HIA were consuming higher amounts of
carbonated drinks and chocolates. Average activity level and exposure to sunlight
of children from LIA was greater than that of children from HIA.
Conclusion: Poor eating habits, inadequate physical activity and less exposure to
sunlight led to lower BMD in children from HIA in spite of higher minerals intake.
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Socioeconomic Determinants of Maternal and Child Food-Security in a Rural District
of Pakistan.
Atiya Hussain Khowaja, Nadia Shah, Sidra Zaheer. School of Public Health, Dow
University of Health Sciences Karachi, Pakistan.
Introduction: Globally, in 2012 the state of food insecurity remained about 870
millions chronically under-nourished individuals, vast majority of this belong to the
developing countries, with women and children being more affected. The present
study aimed to compare the determinants of maternal and child food-security through
the number of meals consumed per day in households enrolled in the Benazir Income
Support Program (BISP) and those households that were not part of the BISP.
Methods: An Analytical Cross-sectional study design was carried out from JulySeptember 2012, using a multistage cluster sampling technique, in Matiari, Sindh,
Pakistan. Local and trained data collectors administered structured questionnaire in
731households through a door to door survey. Households with at least one woman
and one child were included. The Data was double entered; analysis was using
Logistic Regression Analysis.
Results: 300 hundred households including 150 BISP recipients were selected. After
Multivariate Logistic regression, mothers (BISP recipient) were 1.3 times more likely
to receive 2 or more meals per day. Statistically insignificant after controlling for
variables: socio-economic index, average monthly household income, total members
in the family, and total number of earning member in the family.
Conclusion: BISP had no effect on food security of mothers and children. However,
socio-economic index, average monthly household income, and number of earning
members in the household had positive relation with food security.
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Acknowledgment
Established 2003
The Executive Committee of Paksitan Nutrition & Dietetic Society (PNDS)
and the Organizing Committee of
PNDS Nutrition Research Symposium: 2013
would like to express its gratitude
to the following Sponsors
whose support has been of tremendous assistance
in the ongoing organization of
PNDS Nutrition Research Symposium: 2103
Saturday, June 29, 2013, Avari Towers, Karachi.
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Established 2003
B-Braun Pakistan (Pvt.) Limited
"B. Braun is one of the world´s leading healthcare suppliers. Our four divisions
orient their products and services toward different medical fields: hospital,
surgery, private practice (medical care and doctors´ offices) and extracorporeal
blood treatment Our Global Promise, Our goal is to Acquire , preserve, and
expand knowledge for the health market. We pledge to use, share, and
broaden knowledge in dialogue with all our partners.
We will transform our knowledge into products and services that embody
the three fundamental values of our corporate culture:
Innovation, Efficiency, Sustainability.
To ensure that children get adequate micronutrient supplementation to
excel in their daily, educational and extra-curricular life, GlaxoSmithKline
Consumer Healthcare has launched Horlicks, in Pakistan. This delicious and
nutritional health food drink, available in two different flavors (Chocolate
& Regular), is packed with multiple bioavailable micronutrients proven to
be essential for the optimum development of the child's muscular, skeletal
and mental systems. Hence, Horlicks is Now Proven to make kids: Taller,
Stronger & Sharper!
PharmEvo (Pvt.) Limited
Nestle Health Sciences
PharmEvo is backed by a reputable corporate group with a history of successful
business ventures spreaded over 30 years. The group made its debut in 1971,
with the sales and marketing of prestigious brands of consumer products.
The first dream that became a reality was the group's involvement in
pharmaceutical and healthcare business in 1974. This was a modest beginning,
but it led to the emergence of the diversified group. PharmEvo has come a
long way since its launch back in September 1999. During this short span,
PharmEvo has successfully carved a niche amongst the giants of the
pharmaceutical industry purely based on quality, professionalism and
marketing ethics. Today, we are being recognized as a responsible and
respectable provider of quality healthcare through marketing excellence. It
is our utmost desire that PharmEvo should be perceived as a company
providing a 'Service means to make a difference', and are striving hard to
foster a healthier environment.
Nestle Health Science is a separate entity of Nestle Switzerland that holds
a unique place in the nutrition industry. Pioneering science based nutritional
solutions to deliver improved personalized healthcare for people with medical
conditions. Nestle Health Science is a quality conscious, research based
Nutrition Company which focuses on the development of products that
meet the nutritional needs of individuals all over the world. Nestle Health
Science Products are considered as the premium brands internationally
among the customers because of their quality. In Pakistan also Nestle Health
Science is offering the power of nutrition through each and every one of its
products. IBL HealthCare Ltd. in Pakistan holds the rights of marketing, sales
and distribution of Nestle Health Science products in Pakistan. IBL HealthCare
is Subsidiary of The Searle Company and operates under its umbrella.
Tapal Tea (Pvt.) Limited
Himont Pharmaceuticals (Pvt.) Limited
In 1947, Tapal started out as a family concern under the personal supervision
of its founder, Mr. Adam Ali Tapal. From this auspicious beginning, Tapal
moved from success to success introducing tea brands to suit every taste
and pocket, sold from its retail outlet in Jodia Bazar, Karachi. For convenience
of customers, tea distribution was initiated to retail outlets around the city
(Karachi) and spread over the country. Tapal Danedar is the flagship brand
of the company and the name has become synonymous with Tapal's
reputation as a market leader and innovator. First introduced in Pakistan in
1987, this unique blend retains its leadership position because of an extremely
loyal following of tea connoisseurs across Pakistan and the globe.
Himont has established itself among the medical community as a responsible
and professional partner with quality products and services. Within short
span of Seventeen Years Himont has established itself as market leader in
certain formulations, causing other companies to test their quality against
Himont products. Himont, after satisfactory growth in the last seventeen
years, entered in nutritional business in collaboration with world's best
nutrition manufacturers from France and Switzerland with the vision to
provide cost effective and quality products while working to improve
awareness about nutrition in community.
> At the moment Himont is operating in the field of adult, pediatric, maternal
and infant nutrition along with its PHARMA and natural product port folio.
Pfizer Pakistan Limited
Pfizer Pakistan has been working for the health and well-being of people in
Pakistan since 1961.We are committed to delivering novel medicines to fulfill
unmet medical needs of patients. The very purpose of our existence is to
work with the nation for a healthier Pakistan and build invigorating,
empowered communities. Pfizer Pakistan has always remained instrumental
in addressing the healthcare challenges faced by the country, meeting them
by providing the expertise the company holds in this sector. Our vision,
mission and values are more than mere words. They illustrate the purpose
of our existence and define how we do our business. Our mission and vision
are deeply rooted in all our business strategies!
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Established 2003
Notes
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