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PP115-MON UNFAVOURABLE BODY COMPOSITION IS ASSOCIATED WITH INFLAMMATION IN PATIENTS WITH RHEUMATOID ARTHRITIS
Nutritional assessment II Azcona C, Fruhbeck G. Gasto Energ´ etico en reposo en ni˜ nos y adolescentes sanos y afectados de obesidad. Rev Espa˜ nola de Obesidad. 2009; 7: 52 58. Mars´ e P, Diez M, Raurich J. Calorimetría: aplicaciones y manejo. Nutr Clin Med. 2008; 2: 155 166. Disclosure of Interest: None Declared.
PP113-MON COMPARISON OF BODY FAT ESTIMATION BY LEG-TOLEG AND HAND-TO-LEG BIOELECTRICAL IMPEDANCE ANALYSIS WITH ANTHROPOMETRY K. Zdesar Kotnik1 , T. Robic1 , P. Golja1 . 1 Department of Biology, Biotechnical Faculty, Ljubljana, Slovenia Rationale: Position of the body and consequent distribution of body water between body compartments affect the accuraccy of bioelectrical impedance analysis (BIA) and may lead to incorrect information about an individual’s body composition. This study aimed to compare the accuracy of body fat estimates obtained with standing leg-to-leg (LL) and supine hand-to-leg (HL) BIA techniques relative to anthropometry, and to evaluate the effects of body position on BIA-determined body fat percentage (BFP). Methods: The BFP of young males and females (n = 40) was determined with LL (adjusted for standing position) and HL (adjusted for supine position) BIA analysers, as well as from gender-specific Durnin and Womersly anthropometric equations used as the reference method for BIA body fat estimation. Each subject was measured with LL analyser in a standing position, before and after 20 minutes of supine rest, and with HL analyser in a standing and a supine position, before and after 20 minutes of supine rest. All measurements were taken under constant and controlled conditions. Significance of differences was assessed by means of one-way ANOVA for repeated measures. Results: The results demonstrate that the BFP as determined with different BIA analysers in different body positions differ significantly according to the procedure used (P < 0.01). In general, BIA values of BFP obtained after 20 minutes of supine rest tend to overestimate, and values obtained in upright position underestimate the actual BFP. Conclusion: The results of this study demonstrate that BIA estimations of BFP depend on the position of the body during the measurement, likely due to the posturerelated distribution of water in the body. Consequently, the use of different metods can classify one subject into different body fat content categories, which calls for further standardisation. Disclosure of Interest: None Declared.
PP114-MON Outstanding abstract HIGH PROPORTION OF DIETARY FAT INTAKE INCREASES RISK OF BEING MALNOURISHED 10 YEARS LATER H. Frid1 , L. S¨ oderstr¨ om1 , A. Wolk2 , L. Bergkvist1 , 1 1 aster˚ as, A. Rosenblad . Center for Clinical Research V¨ Uppsala University, V¨ aster˚ as, 2 Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden Rationale: Malnutrition in elderly is likely to be affected by illness, but the association with eating habits is unclear. The aim of the study was to examine the
183 association between previous eating habits and current nutritional status in elderly individuals. Methods: In 1997 (baseline), men born 1918 1952 and women born 1917 1948 and living in Mid-Sweden were asked to report eating habits using a food frequency questionnaire. At follow-up in 2008 2009, the nutritional status of n = 732 (378 women; 51.6%) of these participants was assessed using the Mini Nutritional Assessment (MNA) instrument at the age of 65 years. Potential predictors for nutritional status at baseline (sex, age, BMI, tobacco use and percentage energy, E%, from dietary fat, carbohydrates, protein and alcohol intake) were analysed using multinomial logistic regression model with nutritional status at follow-up [well-nourished (MNA > 23.5) n = 294, (ref.); at risk of malnutrition (MNA 17 23.5) n = 385; malnourished (MNA < 17) n = 53] as outcome. P-values <0.05 were considered statistically significant. Results: At baseline, mean±sd age, BMI and energy intake were 66.7±7.1 years, 25.7±4.2 kg/m2 and 2090±839 kcal/day, respectively, while n = 170 (23.4%) were current smokers. Mean±sd time to follow-up was 10.9±0.5 years. Univariately, age, BMI, smoking, and E% from fat were significantly associated with nutritional status, while sex and E% from carbohydrate, protein and alcohol were not. After adjusting for age, BMI and tobacco use, the OR (95% CI) for being malnourished was 1.09 (1.02 1.16) for each additional percentage point of E% intake from fat (p = 0.005); Nagelkerke R2 = 0.105. Conclusion: Malnutrition in elderly is associated with previous percentage energy intake of dietary fat. These results imply that effects of traditional preventive interventions such as increasing energy intake from fat need to be further evaluated. Disclosure of Interest: None Declared.
PP115-MON UNFAVOURABLE BODY COMPOSITION IS ASSOCIATED WITH INFLAMMATION IN PATIENTS WITH RHEUMATOID ARTHRITIS N. Konijn1 , L. van Tuyl2 , I. Bultink2 , W. Lems2 , M. van Bokhorst-de van der Schueren1 . 1 Department of Nutrition and Dietetics, 2 Department of Rheumatology, VU University Medical Center, Amsterdam, Netherlands Rationale: Disease activity may play a pivotal role in body composition changes reported in patients with chronic, inflammatory disease, like rheumatoid arthritis (RA). However, few data are currently available. Methods: Body Mass Index (BMI) and Fat Free Mass Index (FFMI), using single-frequency Bio-electrical Impedance Analysis, were measured in a cohort of RA patients visiting the outpatient department. Inflammatory parameters measured were erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Disease activity was assessed by Disease Activity Score 28 (DAS28) and Rheumatoid Arthritis Disease Activity Index (RADAI); physical functioning by the Health Assessment Questionnaire Disability Index (HAQ-DI). Results: 103 consecutive patients (76% women, median age 62 years, median disease duration 8 years) with moderate active disease (mean DAS28: 3.3; mean RADAI: 3.3) and moderate disability (median HAQ-DI: 0.88) were
184 included. Elevated ESR and CRP levels were found in 59% and 24% of the patients, respectively. BMI categorized patients predominantly in the normal (45%) and high (37%) categories, whereas FFMI was low (19%) and normal (55%) in most patients. BMI and FFMI were both significantly positively correlated with ESR (r = 0.429, p = 0.001; and r = 0.387, p = 0.003; respectively) and CRP (r = 0.442, p = 0.005; and r = 0.553, p < 0.001; respectively). Linear regression analyses showed that ESR (b = 0.183, p = 0.001) explained 18% of the variance of BMI, whereas the combined impact of elevated ESR (b = 0.071, p < 0.001) and male gender (b = 3.247, p < 0.001) in the multivariate model of FFMI was 46%. Conclusion: Unfavourable body composition, characterized by low FFMI and high fat mass, is highly frequent in RA patients, but remains unrecognized by measurement of BMI. BMI and FFMI were positively correlated with elevated inflammatory parameters, possibly reflecting the increased risk of RA patients for cardiovascular morbidity. Disclosure of Interest: None Declared.
PP116-MON SHORT BOWEL SYNDROME: DO WE HAVE AN ACCEPTABLE PREDICTIVE EQUATION FOR CALCULATING BASAL METABOLIC RATE? M. Køhler1 , T. Beermann1 , L. Vinter-Jensen1 , H.H. Rasmussen1 . 1 Center for Nutrition and Bowel Diseases, Faculty of Health, Aalborg University Hospital, Aalborg, Denmark Rationale: Indirect calorimetry is an accurate method to measure basal metabolic rate (BMR), however it is expensive and time consuming. The aim of this study was to find the best equation model to predict BMR in patients with short bowel syndrome (SBS) by testing BMR measured by indirect calorimetry (BMRm) to Harris Benedict (BMRhb), Schofield (BMRs), and an equation based on fat free mass (BMRffm) [1]. Further, to investigate the correlation between BMRm, handgrip strength (HGS) and fat free mass (FFM). Methods: A cross-sectional investigation of patients with SBS stratified according to the use of home parenteral nutrition (HPN) or oral nutrition therapy (ONT). The following data were recorded: Demographics, anthropometrics (HGS, body mass index [BMI]), bioimpedance analysis (FFM) and indirect calorimetry (BMRm). Statistics: Differences were tested using t-tests and Pearson correlation. Significance level: p < 0.05. Results: 100 patients were included (age 60.9±14.0, BMI 21.2±3.8, female 65%, HPN users 51%). The two groups were comparable according to age, gender, BMI and FFM. BMRm was 1244±219 kcal/d vs. BMRhb (1278±208 kcal/d, p = 0.028), BMRs (1295±110 kcal/d, p = 0.003) and BMRffm (1434±223 kcal/d, p < 0.001). However, the difference was non significant in patients on HPN for BMRhb and BMRs. BMRm correlated to FFM (r = 0.72, p < 0.05) and HGS (r = 0.35, p < 0.05). Conclusion: This study showed that BMR predicted by Harris Benedict, Schofield or the fat free mass equation generally overestimates in patients with short bowel syndrome. However, Harris Benedict and Schofield might provide an acceptable estimate, where indirect calorimetry measurement is not an option.
Poster presentations References [1] O Korth, Clin Nutr 2007; 61: 582 589. Disclosure of Interest: None Declared.
PP117-MON ANTHROPOMETRIC ASSESSMENT OF NUTRITIONAL STATUS AMONG SOUTH SINAI CHILDREN N.E. Hassan1 , S.A. El-masry1 , G.A. Yamamah2 . 1 Biological Anthropology, 2 Peadiatrics, National Research Centre, Egypt, Cairo, Egypt Rationale: No information exists on nutritional status of South Sinai residing children, Egypt. Aim: Assessing prevalence of malnutrition among South Sinai children. Methods: This piece of work was mediated through the project “Improvement of health and nutrition status of children living at South Sinai”, funded by the SSRDP which belong to the EU (project 238). Cross sectional study included 3987 healthy children (0 to 11 years); randomly selected; represent about 12% of all children from the 6 areas of South Sinai. Height and weight were measured. Anthropometric indices of weightfor-age Z score (WAZ), height-for-age Z score (HAZ) and weight-for-height Z score (HAZ) were used to estimate the children’s nutritional status. Venous blood sample was obtained to measure plasma hemoglobin level for school students only. Results: Wasting (WHZ < 1.96 SD), underweight (WAZ < 1.96 SD) and stunting (HAZ < 1.96 SD) were prevalent among 4.2%, 8.9% and 11%, respectively. Prevalence of underweight, at risk of wasting and be anemic were more prevalent among boys than girls (p < 0.01). On the other side, 8% were overweight and 4% were obese. Although small percentage of anemic school children was suffering from growth deviation (wasting, 2.8%; underweight, 5.6%; stunting, 9.9%; overweight, 2.8% and obese, 1.4%), >55% of them were at risk of growth deviations (wasting, underweight and stunting). Under nutrition were more prevalent among South Sinai children than their peers in Greater Cairo, while over nutrition was less prevalent. Conclusion: The highest prevalence of malnutrition was detected in infant’s age. Anemia among primary school childrenwas more prevalent in those at risk of under nutrition than among undernourished children. Community education on environmental sanitation and personal hygienic practices, proper child rearing, breastfeeding and weaning practices would possibly reverse the trends. Disclosure of Interest: None Declared.
PP118-MON SCREENING THE NUTRITIONAL STATUS IN GERMAN ONCOLOGY PATIENTS ACCORDING TO THE GUIDELINES: WHAT IS THE PRACTICE? O. Cwieluch1 , M. Drissi1 , K. Hengst1 , M. Masin1 . 1 Medical Clinic B/Clinical Nutrition & Diabetology, Universit¨ atsklinikum M¨ unster, M¨ unster, Germany Rationale: Weight loss and malnutrition are common in cancer patients leading to a reduced expectancy and
PP113-MON COMPARISON OF BODY FAT ESTIMATION BY LEG-TOLEG AND HAND-TO-LEG BIOELECTRICAL IMPEDANCE ANALYSIS WITH ANTHROPOMETRY K. Zdesar Kotnik1 , T. Robic1 , P. Golja1 . 1 Department of Biology, Biotechnical Faculty, Ljubljana, Slovenia Rationale: Position of the body and consequent distribution of body water between body compartments affect the accuraccy of bioelectrical impedance analysis (BIA) and may lead to incorrect information about an individual’s body composition. This study aimed to compare the accuracy of body fat estimates obtained with standing leg-to-leg (LL) and supine hand-to-leg (HL) BIA techniques relative to anthropometry, and to evaluate the effects of body position on BIA-determined body fat percentage (BFP). Methods: The BFP of young males and females (n = 40) was determined with LL (adjusted for standing position) and HL (adjusted for supine position) BIA analysers, as well as from gender-specific Durnin and Womersly anthropometric equations used as the reference method for BIA body fat estimation. Each subject was measured with LL analyser in a standing position, before and after 20 minutes of supine rest, and with HL analyser in a standing and a supine position, before and after 20 minutes of supine rest. All measurements were taken under constant and controlled conditions. Significance of differences was assessed by means of one-way ANOVA for repeated measures. Results: The results demonstrate that the BFP as determined with different BIA analysers in different body positions differ significantly according to the procedure used (P < 0.01). In general, BIA values of BFP obtained after 20 minutes of supine rest tend to overestimate, and values obtained in upright position underestimate the actual BFP. Conclusion: The results of this study demonstrate that BIA estimations of BFP depend on the position of the body during the measurement, likely due to the posturerelated distribution of water in the body. Consequently, the use of different metods can classify one subject into different body fat content categories, which calls for further standardisation. Disclosure of Interest: None Declared.
PP114-MON Outstanding abstract HIGH PROPORTION OF DIETARY FAT INTAKE INCREASES RISK OF BEING MALNOURISHED 10 YEARS LATER H. Frid1 , L. S¨ oderstr¨ om1 , A. Wolk2 , L. Bergkvist1 , 1 1 aster˚ as, A. Rosenblad . Center for Clinical Research V¨ Uppsala University, V¨ aster˚ as, 2 Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden Rationale: Malnutrition in elderly is likely to be affected by illness, but the association with eating habits is unclear. The aim of the study was to examine the
183 association between previous eating habits and current nutritional status in elderly individuals. Methods: In 1997 (baseline), men born 1918 1952 and women born 1917 1948 and living in Mid-Sweden were asked to report eating habits using a food frequency questionnaire. At follow-up in 2008 2009, the nutritional status of n = 732 (378 women; 51.6%) of these participants was assessed using the Mini Nutritional Assessment (MNA) instrument at the age of 65 years. Potential predictors for nutritional status at baseline (sex, age, BMI, tobacco use and percentage energy, E%, from dietary fat, carbohydrates, protein and alcohol intake) were analysed using multinomial logistic regression model with nutritional status at follow-up [well-nourished (MNA > 23.5) n = 294, (ref.); at risk of malnutrition (MNA 17 23.5) n = 385; malnourished (MNA < 17) n = 53] as outcome. P-values <0.05 were considered statistically significant. Results: At baseline, mean±sd age, BMI and energy intake were 66.7±7.1 years, 25.7±4.2 kg/m2 and 2090±839 kcal/day, respectively, while n = 170 (23.4%) were current smokers. Mean±sd time to follow-up was 10.9±0.5 years. Univariately, age, BMI, smoking, and E% from fat were significantly associated with nutritional status, while sex and E% from carbohydrate, protein and alcohol were not. After adjusting for age, BMI and tobacco use, the OR (95% CI) for being malnourished was 1.09 (1.02 1.16) for each additional percentage point of E% intake from fat (p = 0.005); Nagelkerke R2 = 0.105. Conclusion: Malnutrition in elderly is associated with previous percentage energy intake of dietary fat. These results imply that effects of traditional preventive interventions such as increasing energy intake from fat need to be further evaluated. Disclosure of Interest: None Declared.
PP115-MON UNFAVOURABLE BODY COMPOSITION IS ASSOCIATED WITH INFLAMMATION IN PATIENTS WITH RHEUMATOID ARTHRITIS N. Konijn1 , L. van Tuyl2 , I. Bultink2 , W. Lems2 , M. van Bokhorst-de van der Schueren1 . 1 Department of Nutrition and Dietetics, 2 Department of Rheumatology, VU University Medical Center, Amsterdam, Netherlands Rationale: Disease activity may play a pivotal role in body composition changes reported in patients with chronic, inflammatory disease, like rheumatoid arthritis (RA). However, few data are currently available. Methods: Body Mass Index (BMI) and Fat Free Mass Index (FFMI), using single-frequency Bio-electrical Impedance Analysis, were measured in a cohort of RA patients visiting the outpatient department. Inflammatory parameters measured were erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Disease activity was assessed by Disease Activity Score 28 (DAS28) and Rheumatoid Arthritis Disease Activity Index (RADAI); physical functioning by the Health Assessment Questionnaire Disability Index (HAQ-DI). Results: 103 consecutive patients (76% women, median age 62 years, median disease duration 8 years) with moderate active disease (mean DAS28: 3.3; mean RADAI: 3.3) and moderate disability (median HAQ-DI: 0.88) were
184 included. Elevated ESR and CRP levels were found in 59% and 24% of the patients, respectively. BMI categorized patients predominantly in the normal (45%) and high (37%) categories, whereas FFMI was low (19%) and normal (55%) in most patients. BMI and FFMI were both significantly positively correlated with ESR (r = 0.429, p = 0.001; and r = 0.387, p = 0.003; respectively) and CRP (r = 0.442, p = 0.005; and r = 0.553, p < 0.001; respectively). Linear regression analyses showed that ESR (b = 0.183, p = 0.001) explained 18% of the variance of BMI, whereas the combined impact of elevated ESR (b = 0.071, p < 0.001) and male gender (b = 3.247, p < 0.001) in the multivariate model of FFMI was 46%. Conclusion: Unfavourable body composition, characterized by low FFMI and high fat mass, is highly frequent in RA patients, but remains unrecognized by measurement of BMI. BMI and FFMI were positively correlated with elevated inflammatory parameters, possibly reflecting the increased risk of RA patients for cardiovascular morbidity. Disclosure of Interest: None Declared.
PP116-MON SHORT BOWEL SYNDROME: DO WE HAVE AN ACCEPTABLE PREDICTIVE EQUATION FOR CALCULATING BASAL METABOLIC RATE? M. Køhler1 , T. Beermann1 , L. Vinter-Jensen1 , H.H. Rasmussen1 . 1 Center for Nutrition and Bowel Diseases, Faculty of Health, Aalborg University Hospital, Aalborg, Denmark Rationale: Indirect calorimetry is an accurate method to measure basal metabolic rate (BMR), however it is expensive and time consuming. The aim of this study was to find the best equation model to predict BMR in patients with short bowel syndrome (SBS) by testing BMR measured by indirect calorimetry (BMRm) to Harris Benedict (BMRhb), Schofield (BMRs), and an equation based on fat free mass (BMRffm) [1]. Further, to investigate the correlation between BMRm, handgrip strength (HGS) and fat free mass (FFM). Methods: A cross-sectional investigation of patients with SBS stratified according to the use of home parenteral nutrition (HPN) or oral nutrition therapy (ONT). The following data were recorded: Demographics, anthropometrics (HGS, body mass index [BMI]), bioimpedance analysis (FFM) and indirect calorimetry (BMRm). Statistics: Differences were tested using t-tests and Pearson correlation. Significance level: p < 0.05. Results: 100 patients were included (age 60.9±14.0, BMI 21.2±3.8, female 65%, HPN users 51%). The two groups were comparable according to age, gender, BMI and FFM. BMRm was 1244±219 kcal/d vs. BMRhb (1278±208 kcal/d, p = 0.028), BMRs (1295±110 kcal/d, p = 0.003) and BMRffm (1434±223 kcal/d, p < 0.001). However, the difference was non significant in patients on HPN for BMRhb and BMRs. BMRm correlated to FFM (r = 0.72, p < 0.05) and HGS (r = 0.35, p < 0.05). Conclusion: This study showed that BMR predicted by Harris Benedict, Schofield or the fat free mass equation generally overestimates in patients with short bowel syndrome. However, Harris Benedict and Schofield might provide an acceptable estimate, where indirect calorimetry measurement is not an option.
Poster presentations References [1] O Korth, Clin Nutr 2007; 61: 582 589. Disclosure of Interest: None Declared.
PP117-MON ANTHROPOMETRIC ASSESSMENT OF NUTRITIONAL STATUS AMONG SOUTH SINAI CHILDREN N.E. Hassan1 , S.A. El-masry1 , G.A. Yamamah2 . 1 Biological Anthropology, 2 Peadiatrics, National Research Centre, Egypt, Cairo, Egypt Rationale: No information exists on nutritional status of South Sinai residing children, Egypt. Aim: Assessing prevalence of malnutrition among South Sinai children. Methods: This piece of work was mediated through the project “Improvement of health and nutrition status of children living at South Sinai”, funded by the SSRDP which belong to the EU (project 238). Cross sectional study included 3987 healthy children (0 to 11 years); randomly selected; represent about 12% of all children from the 6 areas of South Sinai. Height and weight were measured. Anthropometric indices of weightfor-age Z score (WAZ), height-for-age Z score (HAZ) and weight-for-height Z score (HAZ) were used to estimate the children’s nutritional status. Venous blood sample was obtained to measure plasma hemoglobin level for school students only. Results: Wasting (WHZ < 1.96 SD), underweight (WAZ < 1.96 SD) and stunting (HAZ < 1.96 SD) were prevalent among 4.2%, 8.9% and 11%, respectively. Prevalence of underweight, at risk of wasting and be anemic were more prevalent among boys than girls (p < 0.01). On the other side, 8% were overweight and 4% were obese. Although small percentage of anemic school children was suffering from growth deviation (wasting, 2.8%; underweight, 5.6%; stunting, 9.9%; overweight, 2.8% and obese, 1.4%), >55% of them were at risk of growth deviations (wasting, underweight and stunting). Under nutrition were more prevalent among South Sinai children than their peers in Greater Cairo, while over nutrition was less prevalent. Conclusion: The highest prevalence of malnutrition was detected in infant’s age. Anemia among primary school childrenwas more prevalent in those at risk of under nutrition than among undernourished children. Community education on environmental sanitation and personal hygienic practices, proper child rearing, breastfeeding and weaning practices would possibly reverse the trends. Disclosure of Interest: None Declared.
PP118-MON SCREENING THE NUTRITIONAL STATUS IN GERMAN ONCOLOGY PATIENTS ACCORDING TO THE GUIDELINES: WHAT IS THE PRACTICE? O. Cwieluch1 , M. Drissi1 , K. Hengst1 , M. Masin1 . 1 Medical Clinic B/Clinical Nutrition & Diabetology, Universit¨ atsklinikum M¨ unster, M¨ unster, Germany Rationale: Weight loss and malnutrition are common in cancer patients leading to a reduced expectancy and