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SUN-PP205: High Prevalence of Nutritional Risk in in Elderly People Without Cognitive Impairment Living in Nursing Homes
Nutritional assessment 1 Conclusion: CONUT system in HIV-infected patients, overestimates nutritional risk and can lead to additional evaluations. Nevertheless, the natural history of HIV-infection, in developed countries, has changed (including nutritional status) in the last decades. Other nutritional screening tools or analytical parameters may be also taken into account in HIV population. Disclosure of Interest: None declared
SUN-PP203 THE PORTUGUESE SELF-ADMINISTERED PAC24 COMPUTERISED 24-HOUR DIETARY RECALL M.A. Carvalho1 , A. Rito2 , J. Pereira Miguel1 . 1 Institute of Preventive Medicine & Public Health, Faculty of Medicine of Lisbon, 2 National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal Rationale: Measuring the diets of school-aged children is a challenging process. Technology offers the opportunity to automate more accurate methods of dietary assessment, making them less expensive, easier to use and an alternative to nutritionist interviews. Methods: PAC24 is a web-based 24-hour Dietary Recall designed for use with second-, third-, and fourth-grade Portuguese children. PAC24 guides children through six daily eating occasions and queried about food and drink consumption on the previous day. For the majority of foods, amounts consumed are estimated by selecting the closest portion size served and leftover, if any, among seven different digital images. Data about time, place and television watch and computer use are assigned to each eating occasion. A literature review and focus groups informed the development of PAC24. A prototype system was tested and its content was validated through an expert meeting. Accuracy was determined by comparison of PAC24 with lunch observations. A pilot study was conducted on two non-consecutive days to test reliability, and also check the feasibility in respect of procedures, methods and data processing. Results: PAC24 was well received by children taking part in the usability and validity studies; was relatively quick to complete; and, worked in the school environment. The accuracy and reliability was close to that of similar computerbased systems currently used in dietary studies. Comparison of PAC24 against lunch observations at the food level indicated 67.0% for matches, 11.5% for intrusions and 21.5% for omissions. Significant differences were not observed in reliability of energy and nutrient intakes (p > 0.05). Conclusion: PAC24 is an intuitive, cost-effective and engaging method to collect detailed dietary data from school-age children. Further development to improve the usability and accuracy of PAC24 is necessary. Disclosure of Interest: None declared
S99 SUN-PP204 ESTABLISHING A SCREENING SYSTEM FOR MALNUTRITION IN AN INTERNAL MEDICINE DEPARTMENT: A PILOT STUDY M.D. Ballesteros-Pomar1 , A. Calleja-Fern´ andez1 , M. Gonz´ alez-Vald´ es2 , B. Pintor de la Maza1 , R. Villar Taibo1 , R.M. Arias Garcia1 , A. Vidal Casariego1 , A. Urioste Fondo1 , J.L. Mostaza Fern´ andez2 , I. Cano Rodriguez1 . 1 Endocrinology and Nutrition, 2 Internal Medicine, Complejo Asistencial Universitario de Le´ on, Leon, Spain Rationale: Recent studies have reported a high prevalence of hospital malnutrition, 23%, related to higher hospital costs and longer length of stay. Our aim was to assess Malnutrition Universal Screening Tool (MUST) and nutritional support in an Internal Medicine Department, as part of a national program to reduce hospital malnutrition (http://www.alianzamasnutridos.es). Methods: We report data for the first month of a prospective pilot study. MUST was included in the nurses’ electronic charting and nurses were instructed to perform MUST in the first 24 48 hours of admission. Patients with MUST score 2 were assessed, including Charlson comorbidity score (CCS) and nutritional assessment, and treated as needed. Results: 111 patients were admitted during February 2015, 51.4% men. Median age was 76 (IQR21) and CCS 5.60 (IQR 2.35). Respiratory diseases were the cause of admission in 25%, cardiovascular in 19% and gastrointestinal in 15%. MUST score was 2 in 27.6% of the patients at admission, and in 15.4% of those patients admitted >1 week. Patients with MUST 2 were not different either in age (p 0.444), sex (p0.175) or CCS [5.30 (SD2.71) vs 5.73 (SD2.35), p 0.479], but they had a lower weight [58.0 (SD12.6) vs 71.6 (SD15.7) kg, p < 0.001] and higher weight loss [3.7 (SD5.6) vs 0.5 (SD1.2)%, p 0.009]. Patients with MUST2 were coded as protein malnutrition in 22%, severe caloric or mixed malnutrition in 13% and moderate in 65%. 57% of the patients were treated with dietary modifications, 39% oral nutritional supplements and 4% enteral nutrition. Length of stay was similar in MUST 2: 7.96 (DE 4.41) vs 8.72 (DE 4.34), p 0.454. Conclusion: Disease-related malnutrition is highly prevalent in an Internal Medicine Department and needs assessment and treatment to reduce the differences in length of stay previously reported. Disclosure of Interest: None declared
SUN-PP205 HIGH PREVALENCE OF NUTRITIONAL RISK IN IN ELDERLY PEOPLE WITHOUT COGNITIVE IMPAIRMENT LIVING IN NURSING HOMES M.D.M.M. Ruperto1 , M.M. Trullen1 , C.C. Iglesias1 , M.M. G´ omez1 . 1 Human Nutrition and Dietetics, Universidad Alfonso X el Sabio, Madrid, Spain Rationale: Protein-energy malnutrition (PEM) is a frequent condition in institutionalized elderly population. The aim of the study was to analyse the prevalence of PEM in elderly people without cognitive impairment in nursing homes. Methods: Cross-sectional study in 116 elders (25.9% men, mean age 84.5±6.3 years, and time of institutionalization 29.5±27.9 months). Clinical, demographic and nutritional indicators were recorded. Nutritional screening by Mini-
S100 Nutritional Assessment (MNA) and, anthropometric, biochemical parameters. Body composition by bioelectrical impedance was used. Subjects were classified into three groups (G): Group I: Well-nourished (MNA 24 points), Group II: at nutritional risk (MNA 23.5 17 points) and PEM (<17 points). Statistical analysis by SPSS v. 19. Results: Prevalence of nutritional risk and PEM were 58.6% and 16.3%, respectively. MNA showed significantly positive correlation with fat and muscle mass, intracellular water and serum albumin (at least, P < 0.05). Only 8.2% of institutionalized elderly subjects had oral nutritional supplement prescription. Linear regression analysis showed that the percentage of standard body weight, Mediterranean diet questionnaire, adipose-muscle index, hemoglobin and serum albumin were predictors of nutritional status (at least, p < 0.05; R = 0.62; R2 = 0.38). Conclusion: Nutritional assessment measured by MNA identifies nutritional at risk or PEM in elders. The conjoint use of clinical, anthropometric and laboratory markers confirm the nutritional diagnose and help to plan personalized nutritional intervention. Further studies in elderly institutionalized people are required. Disclosure of Interest: None declared
SUN-PP206 THE RELATIONSHIP BETWEEN THE BODY MASS INDEX/AGE AND ARM CIRCUMFERENCE IN THE NUTRITIONAL ASSESSMENT OF CHILDREN AGED 2 TO 5 YEARS M.P.G. Souza1 , F.C.L. Jataí2 , S.P.M. Arruda2 . 1 Athlone Institute of Technology, Athlone, Ireland; 2 Universidade Estadual do Cear´ a, Fortaleza, Brazil Rationale: The objective of this study is to evaluate the correlation between body mass index/age and the measure of arm circumference in the nutritional assessment of children. Methods: This is a cross-sectional study conducted with 40 children 2 5 years of age enrolled in a daycare in Fortaleza, CE-Brazil. To collect anthropometric data the team used an anthropometric balance Filizola, a stadiometer attached to the balance and a Sanny nondistensible tape. The Spearman correlation test was used for the analysis of the correlation between body mass index/age and arm circumference, and for its relationship with weight and height. The values of body mass index were classified according to the cutoff points established by the World Health Organization, while, for the results obtained by the measures of arm circumference, the cutoff points suggested by Coutinho (1988) were adopted. Results: The correlation strength between weight and arm circumference, height and arm circumference, body mass index and arm circumference was 0.65, 0.57 and 0.71, respectively. Added, all variables showed highly significant correlation with arm circumference (p < 0.001). Conclusion: This study revealed a strong and significant correlation between body mass index and the measure of arm circumference. It means that arm circumference can replace the calculation of body mass index in situations where there is impossibility of checking weight and height, or even just to facilitate the nutritional assessment in the clinical practice. The measurement of arm circumference requires fewer steps and the equipment used is simpler. It is very valid, especially in the nutritional assessment of children who show greater resistance to cooperate with the process.
Poster presentations References Coutinho SB. Influˆ encia do tipo de aleitamento sobre o ganho pondoestatural de crian¸ cas no primeiro ano de vida. J Pediatr (Rio J). 1988; 64:75 82. Disclosure of Interest: None declared
SUN-PP207 BALANCE STUDIES IN COMBINATION WITH NUTRITIONAL ASSESSMENTS IN PATIENTS WITH INTESTINAL FAILURE M. Køhler1 , L. Vinter-Jensen1 , H.H. Rasmussen1,2 . 1 Center for Nutrition and Bowel disease, Aalborg University Hospital, 2 Faculty of Health, Aalborg University, Aalborg, Denmark Rationale: Due to reduced absorption capacity, patients with intestinal insufficiency are prone to adapt to lower metabolic rate and to develop sarcopenia. The aim of this study was to investigate the influence of absorption capacity on basal metabolic rate, body composition and muscle strength, in patient with or without supplementary home parenteral nutrition. Methods: A 4-days balance study, indirect calorimetry for basal metabolic rate (BMRm), bioimpedance analysis (BIA) and hand grip strength (HGS) were performed in a cross-sectional investigation of patients with intestinal failure, stratified according to the use of home parenteral nutrition (HPN) or oral nutrition therapy (ONT). The following data were recorded: Energy absorption (E-abs), demographics (age, sex), body mass index (BMI), HGS, BMRm, predicted BMRhb (Harris & Benedict), fat free mass index (FFMI), fat mass index (FMI), muscle mass index (MMI) and body cell mass index (BCMI). Statistics: T-test and Pearson correlation. Significance level: p < 0.05. Results: Overall 39 patients were included (age 57±14, BMI 20.2±3.9, female 72%, HPN users 46%). The two groups were comparable according to age and E-abs. BMRm for ONT 20.5±3.2 kcal/d/kg was significantly lower than BMRm for HPN 23.5±3.6 kcal/d/kg, p 0.05). Patients on ONT had significantly lower BMRm than BMRhb ( 117±142 kcal/d, p < 0.01) compared to patients on HPN ( 21±131 kcal/d, p = 0.517). E-abs correlated positively to BMRm for ONT (r = 0.39, p = 0.08) and HPN (r = 0.44, p = 0.08) and HGS for HPN (r = 0.21, p = 0.41) but not to muscle mass. Conclusion: The study indicates that patients on HPN are able to achieve adequate energy intake and thereby maintain muscle strength and muscle mass independent of energy absorption. Patients on ONT are more influenced by their absorption capacity, however not significantly. Disclosure of Interest: None declared
SUN-PP208 NUTRITIONAL STATUS AND NUTRITION QUALITY IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE M. Nutrizio1 , D. Vranesic Bender2 , D. Ljubas Kelecic2 , M. Sremac3 , Z. Krznaric2 . 1 Faculty of Food Technology and Biotechnology, 2 Center of Clinical Nutrition, 3 University Hospital Zagreb, Zagreb, Croatia Rationale: Non-alcoholic fatty liver disease (NAFLD) is becoming a major health burden with increasing worldwide prevalence due to its close association with the epidemic of
SUN-PP203 THE PORTUGUESE SELF-ADMINISTERED PAC24 COMPUTERISED 24-HOUR DIETARY RECALL M.A. Carvalho1 , A. Rito2 , J. Pereira Miguel1 . 1 Institute of Preventive Medicine & Public Health, Faculty of Medicine of Lisbon, 2 National Institute of Health Doutor Ricardo Jorge, Lisboa, Portugal Rationale: Measuring the diets of school-aged children is a challenging process. Technology offers the opportunity to automate more accurate methods of dietary assessment, making them less expensive, easier to use and an alternative to nutritionist interviews. Methods: PAC24 is a web-based 24-hour Dietary Recall designed for use with second-, third-, and fourth-grade Portuguese children. PAC24 guides children through six daily eating occasions and queried about food and drink consumption on the previous day. For the majority of foods, amounts consumed are estimated by selecting the closest portion size served and leftover, if any, among seven different digital images. Data about time, place and television watch and computer use are assigned to each eating occasion. A literature review and focus groups informed the development of PAC24. A prototype system was tested and its content was validated through an expert meeting. Accuracy was determined by comparison of PAC24 with lunch observations. A pilot study was conducted on two non-consecutive days to test reliability, and also check the feasibility in respect of procedures, methods and data processing. Results: PAC24 was well received by children taking part in the usability and validity studies; was relatively quick to complete; and, worked in the school environment. The accuracy and reliability was close to that of similar computerbased systems currently used in dietary studies. Comparison of PAC24 against lunch observations at the food level indicated 67.0% for matches, 11.5% for intrusions and 21.5% for omissions. Significant differences were not observed in reliability of energy and nutrient intakes (p > 0.05). Conclusion: PAC24 is an intuitive, cost-effective and engaging method to collect detailed dietary data from school-age children. Further development to improve the usability and accuracy of PAC24 is necessary. Disclosure of Interest: None declared
S99 SUN-PP204 ESTABLISHING A SCREENING SYSTEM FOR MALNUTRITION IN AN INTERNAL MEDICINE DEPARTMENT: A PILOT STUDY M.D. Ballesteros-Pomar1 , A. Calleja-Fern´ andez1 , M. Gonz´ alez-Vald´ es2 , B. Pintor de la Maza1 , R. Villar Taibo1 , R.M. Arias Garcia1 , A. Vidal Casariego1 , A. Urioste Fondo1 , J.L. Mostaza Fern´ andez2 , I. Cano Rodriguez1 . 1 Endocrinology and Nutrition, 2 Internal Medicine, Complejo Asistencial Universitario de Le´ on, Leon, Spain Rationale: Recent studies have reported a high prevalence of hospital malnutrition, 23%, related to higher hospital costs and longer length of stay. Our aim was to assess Malnutrition Universal Screening Tool (MUST) and nutritional support in an Internal Medicine Department, as part of a national program to reduce hospital malnutrition (http://www.alianzamasnutridos.es). Methods: We report data for the first month of a prospective pilot study. MUST was included in the nurses’ electronic charting and nurses were instructed to perform MUST in the first 24 48 hours of admission. Patients with MUST score 2 were assessed, including Charlson comorbidity score (CCS) and nutritional assessment, and treated as needed. Results: 111 patients were admitted during February 2015, 51.4% men. Median age was 76 (IQR21) and CCS 5.60 (IQR 2.35). Respiratory diseases were the cause of admission in 25%, cardiovascular in 19% and gastrointestinal in 15%. MUST score was 2 in 27.6% of the patients at admission, and in 15.4% of those patients admitted >1 week. Patients with MUST 2 were not different either in age (p 0.444), sex (p0.175) or CCS [5.30 (SD2.71) vs 5.73 (SD2.35), p 0.479], but they had a lower weight [58.0 (SD12.6) vs 71.6 (SD15.7) kg, p < 0.001] and higher weight loss [3.7 (SD5.6) vs 0.5 (SD1.2)%, p 0.009]. Patients with MUST2 were coded as protein malnutrition in 22%, severe caloric or mixed malnutrition in 13% and moderate in 65%. 57% of the patients were treated with dietary modifications, 39% oral nutritional supplements and 4% enteral nutrition. Length of stay was similar in MUST 2: 7.96 (DE 4.41) vs 8.72 (DE 4.34), p 0.454. Conclusion: Disease-related malnutrition is highly prevalent in an Internal Medicine Department and needs assessment and treatment to reduce the differences in length of stay previously reported. Disclosure of Interest: None declared
SUN-PP205 HIGH PREVALENCE OF NUTRITIONAL RISK IN IN ELDERLY PEOPLE WITHOUT COGNITIVE IMPAIRMENT LIVING IN NURSING HOMES M.D.M.M. Ruperto1 , M.M. Trullen1 , C.C. Iglesias1 , M.M. G´ omez1 . 1 Human Nutrition and Dietetics, Universidad Alfonso X el Sabio, Madrid, Spain Rationale: Protein-energy malnutrition (PEM) is a frequent condition in institutionalized elderly population. The aim of the study was to analyse the prevalence of PEM in elderly people without cognitive impairment in nursing homes. Methods: Cross-sectional study in 116 elders (25.9% men, mean age 84.5±6.3 years, and time of institutionalization 29.5±27.9 months). Clinical, demographic and nutritional indicators were recorded. Nutritional screening by Mini-
S100 Nutritional Assessment (MNA) and, anthropometric, biochemical parameters. Body composition by bioelectrical impedance was used. Subjects were classified into three groups (G): Group I: Well-nourished (MNA 24 points), Group II: at nutritional risk (MNA 23.5 17 points) and PEM (<17 points). Statistical analysis by SPSS v. 19. Results: Prevalence of nutritional risk and PEM were 58.6% and 16.3%, respectively. MNA showed significantly positive correlation with fat and muscle mass, intracellular water and serum albumin (at least, P < 0.05). Only 8.2% of institutionalized elderly subjects had oral nutritional supplement prescription. Linear regression analysis showed that the percentage of standard body weight, Mediterranean diet questionnaire, adipose-muscle index, hemoglobin and serum albumin were predictors of nutritional status (at least, p < 0.05; R = 0.62; R2 = 0.38). Conclusion: Nutritional assessment measured by MNA identifies nutritional at risk or PEM in elders. The conjoint use of clinical, anthropometric and laboratory markers confirm the nutritional diagnose and help to plan personalized nutritional intervention. Further studies in elderly institutionalized people are required. Disclosure of Interest: None declared
SUN-PP206 THE RELATIONSHIP BETWEEN THE BODY MASS INDEX/AGE AND ARM CIRCUMFERENCE IN THE NUTRITIONAL ASSESSMENT OF CHILDREN AGED 2 TO 5 YEARS M.P.G. Souza1 , F.C.L. Jataí2 , S.P.M. Arruda2 . 1 Athlone Institute of Technology, Athlone, Ireland; 2 Universidade Estadual do Cear´ a, Fortaleza, Brazil Rationale: The objective of this study is to evaluate the correlation between body mass index/age and the measure of arm circumference in the nutritional assessment of children. Methods: This is a cross-sectional study conducted with 40 children 2 5 years of age enrolled in a daycare in Fortaleza, CE-Brazil. To collect anthropometric data the team used an anthropometric balance Filizola, a stadiometer attached to the balance and a Sanny nondistensible tape. The Spearman correlation test was used for the analysis of the correlation between body mass index/age and arm circumference, and for its relationship with weight and height. The values of body mass index were classified according to the cutoff points established by the World Health Organization, while, for the results obtained by the measures of arm circumference, the cutoff points suggested by Coutinho (1988) were adopted. Results: The correlation strength between weight and arm circumference, height and arm circumference, body mass index and arm circumference was 0.65, 0.57 and 0.71, respectively. Added, all variables showed highly significant correlation with arm circumference (p < 0.001). Conclusion: This study revealed a strong and significant correlation between body mass index and the measure of arm circumference. It means that arm circumference can replace the calculation of body mass index in situations where there is impossibility of checking weight and height, or even just to facilitate the nutritional assessment in the clinical practice. The measurement of arm circumference requires fewer steps and the equipment used is simpler. It is very valid, especially in the nutritional assessment of children who show greater resistance to cooperate with the process.
Poster presentations References Coutinho SB. Influˆ encia do tipo de aleitamento sobre o ganho pondoestatural de crian¸ cas no primeiro ano de vida. J Pediatr (Rio J). 1988; 64:75 82. Disclosure of Interest: None declared
SUN-PP207 BALANCE STUDIES IN COMBINATION WITH NUTRITIONAL ASSESSMENTS IN PATIENTS WITH INTESTINAL FAILURE M. Køhler1 , L. Vinter-Jensen1 , H.H. Rasmussen1,2 . 1 Center for Nutrition and Bowel disease, Aalborg University Hospital, 2 Faculty of Health, Aalborg University, Aalborg, Denmark Rationale: Due to reduced absorption capacity, patients with intestinal insufficiency are prone to adapt to lower metabolic rate and to develop sarcopenia. The aim of this study was to investigate the influence of absorption capacity on basal metabolic rate, body composition and muscle strength, in patient with or without supplementary home parenteral nutrition. Methods: A 4-days balance study, indirect calorimetry for basal metabolic rate (BMRm), bioimpedance analysis (BIA) and hand grip strength (HGS) were performed in a cross-sectional investigation of patients with intestinal failure, stratified according to the use of home parenteral nutrition (HPN) or oral nutrition therapy (ONT). The following data were recorded: Energy absorption (E-abs), demographics (age, sex), body mass index (BMI), HGS, BMRm, predicted BMRhb (Harris & Benedict), fat free mass index (FFMI), fat mass index (FMI), muscle mass index (MMI) and body cell mass index (BCMI). Statistics: T-test and Pearson correlation. Significance level: p < 0.05. Results: Overall 39 patients were included (age 57±14, BMI 20.2±3.9, female 72%, HPN users 46%). The two groups were comparable according to age and E-abs. BMRm for ONT 20.5±3.2 kcal/d/kg was significantly lower than BMRm for HPN 23.5±3.6 kcal/d/kg, p 0.05). Patients on ONT had significantly lower BMRm than BMRhb ( 117±142 kcal/d, p < 0.01) compared to patients on HPN ( 21±131 kcal/d, p = 0.517). E-abs correlated positively to BMRm for ONT (r = 0.39, p = 0.08) and HPN (r = 0.44, p = 0.08) and HGS for HPN (r = 0.21, p = 0.41) but not to muscle mass. Conclusion: The study indicates that patients on HPN are able to achieve adequate energy intake and thereby maintain muscle strength and muscle mass independent of energy absorption. Patients on ONT are more influenced by their absorption capacity, however not significantly. Disclosure of Interest: None declared
SUN-PP208 NUTRITIONAL STATUS AND NUTRITION QUALITY IN PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE M. Nutrizio1 , D. Vranesic Bender2 , D. Ljubas Kelecic2 , M. Sremac3 , Z. Krznaric2 . 1 Faculty of Food Technology and Biotechnology, 2 Center of Clinical Nutrition, 3 University Hospital Zagreb, Zagreb, Croatia Rationale: Non-alcoholic fatty liver disease (NAFLD) is becoming a major health burden with increasing worldwide prevalence due to its close association with the epidemic of