1. NO EVIDENCE FOR A PROVOKING ROLE OF NUTRITIONAL FACTORS IN DISTAL INTESTINAL OBSTRUCTION SYNDROME (DIOS). D. Declercq, S. Van Biervliet, E. Robberecht Cystic Fibrosis Centre, Department of Paediatrics, Ghent University Hospital, B9000 Belgium Introduction The etiology of distal intestinal obstruction syndrome (DIOS) in cystic fibrosis (CF) patients remains unclear. Food intake and pancreatic enzyme replacement therapy (PERT) are often blamed for its occurrence. Aim The aim of this study was to evaluate the intake of calories, fat, protein, dietary fiber, liquid and pancreatic enzymes at a first DIOS attack. Methods All CF patients perform annually a 3-day-intake diary to evaluate their caloric, protein, fat, dietary fiber, liquid and PERT intake. Patients diagnosed with a first DIOS attack retrospectively completed an intake diary of the 3 days preceding the DIOS episode supervised by an expert dietitian. The results were compared to those of one year before and also to 36 CF controls matched for age, sex, genotype and disease severity. All patients were pancreatic insufficient. Results Over a six year period, a first DIOS attack was diagnosed in 12 CF patients (DIOS) out of 160 CF patients followed at the CF centre. The median age was 18 years (4.4 - 33.4 years) and 8 were male. The median age of the patients in the Control-group (n=36) was 18,4 years (2.6 – 39.1 years) and 24 were male. Table 1 shows the results of the intake of nutrients and pancreatic enzymes in the different groups. Values are presented as median with the range between brackets. Conclusion CF patients experiencing a first DIOS attack, showed no significant difference in intake when compared to one year earlier or versus controls. This study does not sustain a potential role of nutritional factors or PERT in the first DIOS episode. Conclusion CF patients experiencing a first DIOS attack, showed no significant difference in intake when compared to one year earlier or versus controls. This study does not sustain a potential role of nutritional factors or PERT in the first DIOS episode. MEDIAN INTAKE OF DIFFERENT MACRONUTRIENTS AND ENZYME INTAKE IN THE SUBGROUPS DIOS (n = 12) CONTROLS (n = 36) DIOS Before (n = 12) CONTROLS Before (n = 36) Caloric Intake (kcal) 2753 [1736; 3370] 2759 [1364; 3786] 2638 [1683; 3264] 2590 [1156; 3859] Protein (g) 99 [57; 140] 106 [34; 186] 93 [66; 140] 93 [31; 141] Fat (g) 114 [75; 154] 123 [55; 201] 96 (*1) [68; 139] 109 (*3) [41; 176] Dietary fiber (g) 16 [6; 25] 16 [5; 27] 17 [10; 24] 13,9 [4.1; 39.7] Water (l) 1.8 [0.8; 3] 1.6 [0.5; 3.3] 1.8 [1; 3.5] 1.6 [0.2; 4] Lipase (IU) 63.75x10 4 [3x10 5 ; 8,75x10 5 ] 52x10 4 [7.5x10 4 ; 125x10 4 ] 48.75x10 4 (*2) [22.5x10 4 ; 9x10 5 ] 46.25x10 4 [7.5x10 4 ; 150x10 4 ] Enzymes (IU/g fat) 5636 [2080; 7868] 4379 [825; 15162] 5112 [1730; 11204] 4191 [1838; 12711] Table 1: Median intake of different macronutrients and PERT in the subgroups. The range is presented between square brackets. DIOS is a group CF patients experiencing a first episode of DIOS. Controls is a age, sex, genotype and disease severity matched group without DIOS. DIOS Before and Controls Before respresent the nutritional data from one year prior to the study year (n = number of patients). Significant differences: group DIOS compared to DIOS Before : (*1): P = 0.015; (*2): P=0.035; Controls vs Controls Before : (*3): P=0.046 Only the absolute median fat intake (p < 0.05) and pancreatic enzyme intake (p < 0.05) was higher at the time of the DIOS attack in comparison to the preceding year. This could result from the difference in data collection or from the recommendations to increase fat intake and concomitant enzyme intake as this trend was also found in the control group. The significant difference disappears when enzyme intake is expressed as units lipase/gram fat. No other significant dietary differences were found.