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Soft drink consumption and bone mineral density
SUNDAY, OCTOBER 3
POSTER SESSION: NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY TITLE: EVALUATING SELF-REPORTED DATA OF NUTRITION SCREENING AND ASSESSMENT FORMS IN HOSPITALIZED PATIENTS AUTHOR(S): E.K. Hogan, 1LT, RD; S.E. Gormley, 1LT, RD; R.M. Seifried, 1LT, RD; A. Wozney, 1LT, RD; S.L. Mobley, 1LT, PhD, RD; The United States Army, Walter Reed Army Medical Center, Washington, D.C. LEARNING OUTCOME: To identify potential inaccuracies of selfreported data in nutrition screening and assessment forms.
TITLE: SOFT DRINK CONSUMPTION AND BONE MINERAL DENSITY AUTHOR(S): R.C. Bessinger, PhD, RD; J. Silagyi-Rebovich, EdD, RD; Department of Human Nutrition, Winthrop University, Rock Hill, SC LEARNING OUTCOME: To describe the association between soft drink consumption and bone density.
TEXT: The purpose of this study was to evaluate self-reported data used most often in nutrition screening and assessment forms for hospitalized patients. As part of a larger study evaluating nutritional status of hospitalized patients, subjects (n⫽63) were asked to selfreport their weight. Subjects were then weighed to the nearest kilogram using digital scales. Another set of subjects (n ⫽ 10) participated in the verification of self-reported dietary intake. Duplicate portions of each patient’s tray food as well as leftovers were weighed to the nearest gram to calculate “true” percent of tray food consumption. Six hours postprandial, patients were then asked to report their percent of tray food consumed for that meal. Regression analysis was performed to compare actual and selfreported parameters. All values were considered significant at P⬍0.05. The results from this study showed the strongest correlation between self-reported weight and actual weight (R2⫽98.1%; P⬍0.0001) compared to chart weight and actual weight (R2⫽85.8%; P⬍0.0001). Self-reported food intake was not associated with actual food intake (R2⫽3.4%; P⫽0.6361). The findings from this study suggest that self-reported weights may be accurate in most hospitalized patients; however, inaccuracies may exist with documented chart weights. Additional findings suggest that selfreported dietary intake may not be accurate in hospitalized patients. Clinicians should verify all weights before providing dietary recommendations and self-reported dietary intake should be used with caution in developing medical nutrition therapy plans.
TEXT: Soft drink consumption has been associated with the occurrence of bone fractures. Proposed mechanisms include phosphoric acid promoting bone resorption and/or some beverage ingredients increasing urinary calcium. Either mechanism might be expected to lead to reduced bone density. However, studies that have investigated soft drink consumption and fractures have not examined the relation between soft drinks and bone density. Thus, one of the aims of this study was to investigate the relationship between soft drink consumption and bone density. Bone density was assessed in 291 college students using ultrasound technology (Sahara Clinical Bone Sonometer™). Soft drink consumption was assessed using a questionnaire asking about the quantity, type, and brand name of beverages commonly consumed. The questionnaire was selfadministered. Participants in the study were instructed to answer accurately and thoroughly. On the whole, the responses were complete. Pearson correlation analysis indicated a significant, but weak inverse relationship (r⫽⫺.148) between soft drink consumption and bone density. The low coefficient of determination (r2⫽.022) indicates that soft drink consumption only explains a small percent of the variability in bone density. Over the past 2 decades there has been an approximate 50% decrease in milk consumption among adolescents and a similar increase in soft drink consumption. Any association between soft drinks and bone effects (bone density and fractures) is likely due to soft drinks replacing milk and decreasing calcium intake. However, further research is needed to clarify the association between soft drink consumption, milk displacement (calcium intake), and bone effects.
FUNDING DISCLOSURE: Funding was not received for this research
FUNDING DISCLOSURE: Supported by Winthrop University Research funds
TITLE: PG-SGA IS THE BEST NUTRITION-RELATED PREDICTOR FOR LENGTH OF HOSPITAL STAY IN HOSPITALIZED PATIENTS
TITLE: NORMAL WEIGHT ADULTS CONSUME MORE FIBER AND FRUIT THAN THEIR AGE AND HEIGHT MATCHED OVERWEIGHT/OBESE COUNTERPARTS
AUTHOR(S): S.L. Mobley, 1LT, PhD, RD; E.K. Hogan, 1LT, RD; S.E. Gormley, 1LT, RD; R.M Seifried, 1LT, RD; A. Wozney, 1LT, RD; The United States Army, Walter Reed Army Medical Center, Washington, D.C. LEARNING OUTCOME: To identify the best nutrition-related predictor of clinical outcomes in hospitalized patients. TEXT: Recognizing at risk and malnourished patients requires a multifactorial approach involving several nutritional parameters. Obtaining many of those parameters are clinically impractical and/or unavailable; therefore, identifying the single best predictor of clinical outcomes may overcome many of those barriers. This purpose of this study was to identify the single best nutrition-related predictor for length of hospital stay in hospitalized patients. Patients (n⫽63) were recruited from the General Medicine, General Surgery, and Oncology wards within 48 hours of hospital admission and followed until discharged. Trained dietetic professionals performed a Patient-Generated Subjective Global Assessment (PG-SGA) as well as anthropometric measurements such as height, weight, triceps skin fold, and mid-arm circumference. Body mass index, percent usual body weight, percent desirable weight, and midarm muscle circumference were calculated. Handgrip strength was also measured using a hand dynamometer. Standard laboratory values such as albumin, hematocrit, hemoglobin, blood urea nitrogen, and creatinine were also obtained. Data was analyzed using step-wise multiple linear regression models. All values were considered significant at P⬍0.05. The results from this study indicate that PG-SGA is the single best predictor for length of hospital stay (Length of hospital stay⫽2.414⫹0.217 *PG-SGA score; P⬍0.05). The findings from this study suggest that the PG-SGA may be a valuable screening tool to identify those patients who may require intensive medical nutrition therapy, especially in hospital settings where laboratory data is limited and/or unavailable. Early nutritional intervention in those patients with increased PG-SGA scores may lead to better clinical outcomes. FUNDING DISCLOSURE: Funding was not received for this research
AUTHOR(S): J.N. Davis, RD, LD; V.A. Hodges, MS, RD, LD; M.B. Gillham, PhD, RD, LD; Graduate Program in Nutritional Sciences, Department of Human Ecology The University of Texas at Austin, Austin, TX LEARNING OUTCOME: To assess differences in dietary intakes of overweight/obese subjects and their normal weight counterparts matched for sex, age and height and to describe dietary components associated with increased deposition of body fat. TEXT: A convenience sample of 52 overweight/obese adults and their normal weight controls matched for sex, height (⫾1 inch), and age (⫾1 year) were recruited from the local area to assess differences in dietary components. Dietary intake was assessed by the Block 60-item food frequency questionnaire; physical activity was measured by the Yale Physical Activity Survey; and percent body fat was measured via dual energy X-ray absorptiometry (DEXA). Independent t tests compared consumption of various dietary components between groups. Multiple regression analyses determined the extent to which dietary components predicted percent body fat before and after controlling for age, gender, physical activity-related energy expenditure and other macronutrients. Spearman correlation coefficients were used to assess relationships between nutrients and food guide pyramid servings and percent body fat. Overweight/obese subjects consumed more total fat, saturated fat and cholesterol and less carbohydrate, complex carbohydrate, and dietary fiber when compared to their normal weight controls. Reported intakes of dietary fiber were inversely related to percent body fat without (R2⫽0.052, P⫽.02) and with (R2⫽0.045, P⫽.02) control for potential confounding factors: age, gender, physical activity-related energy expenditure and other macronutrients. Fruit servings per day were negatively related to percent body fat (r⫽⫺0.40, P⬍.01). These findings suggest that the composition of the diet, especially low dietary fiber intake, plays a role in the etiology of obesity. FUNDING DISCLOSURE: No external funding
Journal of THE AMERICAN DIETETIC ASSOCIATION / A-15
POSTER SESSION: NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY TITLE: EVALUATING SELF-REPORTED DATA OF NUTRITION SCREENING AND ASSESSMENT FORMS IN HOSPITALIZED PATIENTS AUTHOR(S): E.K. Hogan, 1LT, RD; S.E. Gormley, 1LT, RD; R.M. Seifried, 1LT, RD; A. Wozney, 1LT, RD; S.L. Mobley, 1LT, PhD, RD; The United States Army, Walter Reed Army Medical Center, Washington, D.C. LEARNING OUTCOME: To identify potential inaccuracies of selfreported data in nutrition screening and assessment forms.
TITLE: SOFT DRINK CONSUMPTION AND BONE MINERAL DENSITY AUTHOR(S): R.C. Bessinger, PhD, RD; J. Silagyi-Rebovich, EdD, RD; Department of Human Nutrition, Winthrop University, Rock Hill, SC LEARNING OUTCOME: To describe the association between soft drink consumption and bone density.
TEXT: The purpose of this study was to evaluate self-reported data used most often in nutrition screening and assessment forms for hospitalized patients. As part of a larger study evaluating nutritional status of hospitalized patients, subjects (n⫽63) were asked to selfreport their weight. Subjects were then weighed to the nearest kilogram using digital scales. Another set of subjects (n ⫽ 10) participated in the verification of self-reported dietary intake. Duplicate portions of each patient’s tray food as well as leftovers were weighed to the nearest gram to calculate “true” percent of tray food consumption. Six hours postprandial, patients were then asked to report their percent of tray food consumed for that meal. Regression analysis was performed to compare actual and selfreported parameters. All values were considered significant at P⬍0.05. The results from this study showed the strongest correlation between self-reported weight and actual weight (R2⫽98.1%; P⬍0.0001) compared to chart weight and actual weight (R2⫽85.8%; P⬍0.0001). Self-reported food intake was not associated with actual food intake (R2⫽3.4%; P⫽0.6361). The findings from this study suggest that self-reported weights may be accurate in most hospitalized patients; however, inaccuracies may exist with documented chart weights. Additional findings suggest that selfreported dietary intake may not be accurate in hospitalized patients. Clinicians should verify all weights before providing dietary recommendations and self-reported dietary intake should be used with caution in developing medical nutrition therapy plans.
TEXT: Soft drink consumption has been associated with the occurrence of bone fractures. Proposed mechanisms include phosphoric acid promoting bone resorption and/or some beverage ingredients increasing urinary calcium. Either mechanism might be expected to lead to reduced bone density. However, studies that have investigated soft drink consumption and fractures have not examined the relation between soft drinks and bone density. Thus, one of the aims of this study was to investigate the relationship between soft drink consumption and bone density. Bone density was assessed in 291 college students using ultrasound technology (Sahara Clinical Bone Sonometer™). Soft drink consumption was assessed using a questionnaire asking about the quantity, type, and brand name of beverages commonly consumed. The questionnaire was selfadministered. Participants in the study were instructed to answer accurately and thoroughly. On the whole, the responses were complete. Pearson correlation analysis indicated a significant, but weak inverse relationship (r⫽⫺.148) between soft drink consumption and bone density. The low coefficient of determination (r2⫽.022) indicates that soft drink consumption only explains a small percent of the variability in bone density. Over the past 2 decades there has been an approximate 50% decrease in milk consumption among adolescents and a similar increase in soft drink consumption. Any association between soft drinks and bone effects (bone density and fractures) is likely due to soft drinks replacing milk and decreasing calcium intake. However, further research is needed to clarify the association between soft drink consumption, milk displacement (calcium intake), and bone effects.
FUNDING DISCLOSURE: Funding was not received for this research
FUNDING DISCLOSURE: Supported by Winthrop University Research funds
TITLE: PG-SGA IS THE BEST NUTRITION-RELATED PREDICTOR FOR LENGTH OF HOSPITAL STAY IN HOSPITALIZED PATIENTS
TITLE: NORMAL WEIGHT ADULTS CONSUME MORE FIBER AND FRUIT THAN THEIR AGE AND HEIGHT MATCHED OVERWEIGHT/OBESE COUNTERPARTS
AUTHOR(S): S.L. Mobley, 1LT, PhD, RD; E.K. Hogan, 1LT, RD; S.E. Gormley, 1LT, RD; R.M Seifried, 1LT, RD; A. Wozney, 1LT, RD; The United States Army, Walter Reed Army Medical Center, Washington, D.C. LEARNING OUTCOME: To identify the best nutrition-related predictor of clinical outcomes in hospitalized patients. TEXT: Recognizing at risk and malnourished patients requires a multifactorial approach involving several nutritional parameters. Obtaining many of those parameters are clinically impractical and/or unavailable; therefore, identifying the single best predictor of clinical outcomes may overcome many of those barriers. This purpose of this study was to identify the single best nutrition-related predictor for length of hospital stay in hospitalized patients. Patients (n⫽63) were recruited from the General Medicine, General Surgery, and Oncology wards within 48 hours of hospital admission and followed until discharged. Trained dietetic professionals performed a Patient-Generated Subjective Global Assessment (PG-SGA) as well as anthropometric measurements such as height, weight, triceps skin fold, and mid-arm circumference. Body mass index, percent usual body weight, percent desirable weight, and midarm muscle circumference were calculated. Handgrip strength was also measured using a hand dynamometer. Standard laboratory values such as albumin, hematocrit, hemoglobin, blood urea nitrogen, and creatinine were also obtained. Data was analyzed using step-wise multiple linear regression models. All values were considered significant at P⬍0.05. The results from this study indicate that PG-SGA is the single best predictor for length of hospital stay (Length of hospital stay⫽2.414⫹0.217 *PG-SGA score; P⬍0.05). The findings from this study suggest that the PG-SGA may be a valuable screening tool to identify those patients who may require intensive medical nutrition therapy, especially in hospital settings where laboratory data is limited and/or unavailable. Early nutritional intervention in those patients with increased PG-SGA scores may lead to better clinical outcomes. FUNDING DISCLOSURE: Funding was not received for this research
AUTHOR(S): J.N. Davis, RD, LD; V.A. Hodges, MS, RD, LD; M.B. Gillham, PhD, RD, LD; Graduate Program in Nutritional Sciences, Department of Human Ecology The University of Texas at Austin, Austin, TX LEARNING OUTCOME: To assess differences in dietary intakes of overweight/obese subjects and their normal weight counterparts matched for sex, age and height and to describe dietary components associated with increased deposition of body fat. TEXT: A convenience sample of 52 overweight/obese adults and their normal weight controls matched for sex, height (⫾1 inch), and age (⫾1 year) were recruited from the local area to assess differences in dietary components. Dietary intake was assessed by the Block 60-item food frequency questionnaire; physical activity was measured by the Yale Physical Activity Survey; and percent body fat was measured via dual energy X-ray absorptiometry (DEXA). Independent t tests compared consumption of various dietary components between groups. Multiple regression analyses determined the extent to which dietary components predicted percent body fat before and after controlling for age, gender, physical activity-related energy expenditure and other macronutrients. Spearman correlation coefficients were used to assess relationships between nutrients and food guide pyramid servings and percent body fat. Overweight/obese subjects consumed more total fat, saturated fat and cholesterol and less carbohydrate, complex carbohydrate, and dietary fiber when compared to their normal weight controls. Reported intakes of dietary fiber were inversely related to percent body fat without (R2⫽0.052, P⫽.02) and with (R2⫽0.045, P⫽.02) control for potential confounding factors: age, gender, physical activity-related energy expenditure and other macronutrients. Fruit servings per day were negatively related to percent body fat (r⫽⫺0.40, P⬍.01). These findings suggest that the composition of the diet, especially low dietary fiber intake, plays a role in the etiology of obesity. FUNDING DISCLOSURE: No external funding
Journal of THE AMERICAN DIETETIC ASSOCIATION / A-15