Abstracts of Pharma Nutrition 2013 / PharmaNutrition 2 (2014) 75–119 89 brain maturation and neurodevelopmental impairment have been described in preterm infants with neonatal infection (Stoll et al., 2004, JAMA; De Kieviet et al., 2012, Peadiatrics). Altogether, the management of these multi-factorial disorders needs a new and integrated therapeutic approach. Medical nutrition targeting the gut-immune-brain axis is such a multi-component and multitar- get approach. In rodent models for ASD and neuroinflammation, a strong association was found between behavioural and cogni- tive deficits and site-specific intestinal inflammatory reactions and changed microbiome. Vice versa, studies using different murine models for food allergy demonstrated that the intestinal hypersen- sitivity reaction is associated with abnormal (social) behaviour and impaired cognition. In food allergy, altered neuronal activity and monoamine levels were observed in brain areas that are involved in attention, perception and social behaviour. In addition, dietary interventions with specific microbes, non-digestible oligosaccha- rides and polyunsaturated fatty acids restored both food allergy intestinal symptoms as well behavioural and cognitive deficits. These preclinical data demonstrated that a multi-component and multi-target approach using specific medical nutrition could be beneficial for the treatment of neurodevelopmental disorders. Keywords: Gut-immune-brain; Neurodevelopmental disor- ders; Allergy; Dietary interventions http://dx.doi.org/10.1016/j.phanu.2013.11.039 [O26] Effects of glutamine supplementation on brain development of very preterm children: A followup study at school-age J.F. de Kieviet 1 , J. Oosterlaan 1 , P.J.W. Pouwels 3 , P.J. Vuijk 1 , G. Boehm 2 , A. van Zwol 3 , A. van den Berg 4 , H.N. Lafeber 3 , R.J. Vermeulen 3 , R.M. van Elburg 2,3,* 1 VU University Amsterdam, The Netherlands 2 Danone Research Centre for Specialised NutritionWageningen, The Netherlands 3 VU University Medical Center Amsterdam, The Netherlands 4 University Medical Center Utrecht, The Netherlands Background and aims: The amino acid glutamine has been shown to reduce the number of serious neonatal infections in very preterm children (<32 weeks of gestation), which may benefit long term brain development. The aim of this study was to elucidate potential effects of glutamine supplementation on brain develop- ment, reflected by head circumference growth and brain volumes at school age, in very preterm children at school-age. Methods: First, we investigated growth trajectories of head cir- cumference, weight, and length in the first year for 65 very preterm children who originally participated in a randomized controlled trial on enteral glutamine supplementation between day 3 and 30 of life. Second, we measured brain structure volumes and white matter integrity for 52 very preterm children at school-age, using magnetic resonance imaging (MRI) and Diffusion Tensor Imaging (DTI), respectively. Group differences were tested using ANOVA statistics. Results: Glutamine supplementation was associated with improved growth trajectories of head circumference in the first year of life (d = 0.66, p = .03), whereas no differences were present in the growth trajectories of weight and length. Glu- tamine supplementation was associated with increases in white matter (d = 0.54, p = .03), hippocampus (d = 0.47, p = .02), brain stem (d = 0.54, p = .04) volumes at school-age. All differences were strongly related with the number of serious neonatal infections (all p < .02). Conclusions: We found evidence that reduction of serious infections by neonatal glutamine supplementation improves head growth in the first year of life, as well as brain structure volumes at school-age. Furthermore, our results indicate that glutamine has a specific effect on brain growth, as opposed to growth in weight and length. Together, outcomes suggest an early programming effect of nutritional intervention with enteral glutamine in very preterm children, specifically on brain development. Keywords: Glutamine; RCT; Brain development; Growth http://dx.doi.org/10.1016/j.phanu.2013.11.040 [O27] Neurodegeneration-induced cognitive deficits are associated with severe gastrointestinal disturbances, which were atten- uated by dietary, but not pharmacological intervention: Implications for novel therapies Y.E. Borre 1,2,* , M.E. Morgan 1 , P.J. Koelink 1 , G.F.G. Bezemer 1 , K.G.C. Westphal 1 , B. Olivier 1,2 , R. Oosting 1,2 , J. Garssen 1,3 , A.D. Kraneveld 1 1 Utrecht University, The Netherlands 2 Rudolf Magnus Institute of Neuroscience, The Netherlands 3 Danone Research, The Netherlands Neurodegenerative diseases are debilitating and largely untreatable conditions. However, current pharmacological approaches offer incomplete and transient benefit to patients with a plethora of the aversive side effects, creating an urgent need for novel and more integrative approaches. Dietary components have emerged as a safer alternative for the prevention and/or treatment for neurodegenerative disorders. Yet, their effects on neurodegeneration-induced deficits need to be elucidated. The aim of the present study was to examine whether a diet containing multi-targeted ingredients with various pleiotropic properties alleviates the neurodegeneration-induced patholo- gies compared to existing pharmacological therapeutics. To investigate this, we used the olfactory bulbectomized (OBX) rat model, an animal model of neurodegeneration and cog- nitive decline. OBX rats were fed a control or experimental diet for 14 days prior to and 28 days after the bulbectomy. A separate group of animals were treated with memantine (20 mg/kg, p.o.), a drug used for management of Alzheimer’s disease, for 28 days starting 2 days before the bulbectomy. OBX resulted in previously reported robust behavioral and cogni- tive deficits, and neuronal loss. Surprisingly, we observed that bulbectomy also leads to severe gastrointestinal disturbances such as constipation, gas, and altered microbiome. Importantly, these OBX-induced brain-gut axis associated aberrant changes were independent of anosmia. Although both the experimental diet and memantine normalized OBX-mediated behavioral and cognitive deficits, only the nutritional treatment rescued the neuronal cell count in the hippocampus, attenuated the gastroin- testinal disturbances and modulated microbiome. In contrast, memantine exacerbated the OBX-induced intestinal disorder and disturbed microbiome. In the control animals, memantine led to intestinal irritation, gas, constipation, altered microbiome, and increased anxiety. The present data provide evidence that (1) neurodegeneration leads to gastrointestinal disorders; (2) dietary intervention provides a greater symptomatic efficacy both in the brain and the gut, in comparison to existing neurodegenerative pharmacotherapies. Keywords: Neurodegeneration; Nutrition; Pharmacology; Gas- trointestinal disorder http://dx.doi.org/10.1016/j.phanu.2013.11.041