- Email: [email protected]
Associations Between Iron Intake and Hemoglobin Levels in Older Adults
MONDAY, OCTOBER 23
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Antioxidant Vitamin Consumption during Meals in Elderly Patients with Dementia and its Correlation with the Recommended Dietary Allowance
Assessing the Effectiveness of an Interprofessional Simulation Experience on ADIME Note Scores of Nutrition Students
Author(s): A. Guedez Mijares, A. Landry, N. Roofe; University of Central Arkansas
Author(s): P.Y. Hsiao, E. Skarbowski, N. Clark, J. Boothby; Indiana University of Pennsylvania
Learning Outcome: This study will identify if diet intake in elderly patients with dementia (1) meet the minimum recommendation for antioxidant vitamin intake for patient’s age and condition (2) have added supplements or medication that impact food consumption (3) differ depending on cognitive dysfunction. Prevalence of dementia has increased, thus innovative prevention/treatment strategies are important. Use of antioxidant vitamins and cognitive improvement in older adults has been examined to a limited extent. Quantifying current consumption of these vitamins (i.e., Vitamin C [VC], Vitamin E [VE] and b-carotene [BC]) in dementia patients is needed. This study evaluated current consumption in patients with dementia to determine if individuals were meeting recommendations. Data were collected utilizing chart audits of patients at a memory facility. Daily intake was gathered using a computer system and portion sizes were calculated by multiplying the percentage eaten by the portion on production records. The Food ProcessorÒ Nutrition Analysis software (ESHA) was used to estimate vitamin consumption and a one-sample t-test was conducted to compare intake to minimum recommendations (VC 75 mg; VE 15 mg; BC 750 mcg). This descriptive study included 14 subjects (13 females) aged 48-91 years. Eight had moderate-severe dementia diagnosis. Average three-day intake of BC was significantly higher (p<.001), VE was significantly lower (p<.001) and VC was not significantly different than recommendations (p¼.146). Megadoses of these vitamins have been prescribed to improve cognitive function thus dietary intake would need supplementation in order to achieve therapeutic effects. The comparison using BC is questionable. The USDA dietary recommended intake for Vitamin A is 5,000 IU where 2,500 IU retinol and 2,500 IU is BC (BC was transformed using 1 IU retinol equals 0.3 mcg). Further investigation into dietary adequacy of these nutrients is needed to establish criteria for supplementation.
Learning Outcome: To educate learners on the use of a video-recorded interprofessional simulation experience used with undergraduate dietetic students. Background: Clinical simulation experiences, which allow for a safe, controlled learning experience, are increasingly being used in the undergraduate setting, however nutrition students are not often exposed to these learning tools. To further understanding of the impact of clinical simulations on nutrition students, an interprofessional study was conducted that included nutrition, nursing, and speech pathology students. The objective of this analysis is taken from that larger study.
Methods: To understand the effectiveness of using clinical simulations in a learning environment, two groups of nutrition students were analyzed. One group of nutrition students (control group; CON; n¼37) was assigned a non-dynamic, paper-based case study. The other group of students (experimental group; EXP; n¼30) viewed a video recording of the same case study scenario played out by their peers from nursing, nutrition, and speech-language pathology disciplines (i.e., interprofessional simulation). Both groups of students were instructed to write an ADIME note. ADIME notes are used in nutrition to assess patient information, diagnose nutrition-related problems, recommend nutrition interventions, and monitor/evaluate short- and long-term nutrition goals. These ADIME notes were scored independently, using a common rubric by three registered dietitians. An independent t-test was used to compare ADIME note scores. Results: While total ADIME note scores between the CON and EXP groups were not significantly different (p¼.414), student feedback from viewing the simulation was overwhelmingly positive.
Conclusion: Lack of statistical significance could be related to rubric reliability and graders. Future research should focus on testing the reliability and use of the ADIME note rubric. Funding Disclosure: Indiana University of Pennsylvania College of Health and Human Services Research Incentive Award
Funding Disclosure: None
Associations Between Iron Intake and Hemoglobin Levels in Older Adults
Are Dietary Supplements for Toddlers in Line with Recommendations? 1
1
1
2
2
Author(s): L. Saldanha , J. Dwyer , L. Brown , K. Andrews , P. Gusev , P. Pehrsson3; 1Office of Dietary Supplements, NIH, 2Nutrient Data Laboratory, USDA, 3Agriculture Research Service, USDA Learning Outcome: Know why it is important to read dietary supplements labels to determine if the dose, source, and safety of nutrients are appropriate for the intended user. Become familiar with upcoming changes to dietary supplement labels. In the US, Dietary Supplements (DSs) are labeled for three age categories <12 months (infants), 1-3 years (toddlers), and 4years (adults). We determined how well DSs formulated for toddlers compared with Daily Values (DVs). We identified DSs labeled for toddlers in the Dietary Supplement Label Database (DSLD). We searched labels for %DV of vitamins A, E, C, and D, folate, and iodine; recognized as shortfall nutrients in toddler diets, and identified 406 toddler DSs. More than 60% of the vitamin, multivitamin or combination DSs contained one or more nutrients > 100%DV, and some, e.g., vitamin C, as high as 625%DV. The %DV on product labels are expected to comply with the “new” food labeling regulations in 2018. The “new” % DVs, issued by FDA in 2016, for iodine and vitamin D have increased by w30 and 50%. Thus, product labels will likely reflect “new” values of vitamin D and iodine by 2018. The “new” % DVs for vitamins A, E, C, and folate have decreased by 40-60%. If current formulations remain unchanged, product labels for these nutrients will show levels of 200-250%DV from DS alone. Chemical analyses of similar products were higher than labeled amounts by 14% for vitamin A, 11% for vitamin E, 39% for vitamin D, 19% for folate, and 18% for iodine. These values may represent overages to ensure label claims are met at the end of shelf-life. Dietitians should review labels to evaluate if product formulations meet the toddler’s nutrient needs and encourage parents to do so. Funding Disclosure: Office of Dietary Supplements, National Institutes of Health
Author(s): S. McClafferty1, J. Phelps2, T. Crook2, R. Hakkak2; 1Saline Memorial Hospital, 2University of Arkansas for Medical Science Learning Outcome: Participants will be able to describe the adequacy of dietary iron, associations between iron supplementation and hemoglobin levels, and the importance of monitoring iron supplementation among older adults who are not being treated for iron deficiency anemia. Background: Considering the prevalence of supplement use in the older adult population, there is reason to question if the potential benefits of oral iron supplementation outweigh risks of over-supplementation. The purpose of this study was to explore associations between iron intake and hemoglobin (Hgb) levels among older adults not being treated for iron deficiency anemia (IDA). Methods: Analyses of unadjusted National Health and Nutrition Examination Survey (NHANES) data (2011-2012) were performed on 1,205 participants >60 years of age not being treated for IDA. Wilcoxon signed-rank tests were used to determine if dietary iron intakes differed from appropriate Estimated Average Requirements (EAR). A Mann-Whitney U test was used to determine if Hgb levels differed between participants taking iron supplements versus participants not taking iron supplements. Results: Median dietary iron intake was significantly higher than the EAR for both males (z¼.095, p¼<.0005; median 15.81 mg/day v. EAR 6 mg/day) and females (z¼.081, p¼<.0005; median 12.34 mg/day v. EAR 5 mg/day). Fourteen percent of participants (n¼163) reported taking iron supplements. Median Hgb levels did not significantly differ between participants taking iron supplements versus participants not taking iron supplements (z¼.311, p¼.756). Conclusion: Despite not being treated for IDA and exceeding the EAR for dietary iron intake, 14% of older adults indicated taking iron supplements. When screening and assessing older adults it is important to inquire about all supplement use, including iron, to avoid potential negative health outcomes. Funding Disclosure: None
A-52
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2017 Suppl 1—Abstracts Volume 117 Number 9
Poster Session: Food/Nutrition Science; Education; Management; Food Services/Culinary; Research Antioxidant Vitamin Consumption during Meals in Elderly Patients with Dementia and its Correlation with the Recommended Dietary Allowance
Assessing the Effectiveness of an Interprofessional Simulation Experience on ADIME Note Scores of Nutrition Students
Author(s): A. Guedez Mijares, A. Landry, N. Roofe; University of Central Arkansas
Author(s): P.Y. Hsiao, E. Skarbowski, N. Clark, J. Boothby; Indiana University of Pennsylvania
Learning Outcome: This study will identify if diet intake in elderly patients with dementia (1) meet the minimum recommendation for antioxidant vitamin intake for patient’s age and condition (2) have added supplements or medication that impact food consumption (3) differ depending on cognitive dysfunction. Prevalence of dementia has increased, thus innovative prevention/treatment strategies are important. Use of antioxidant vitamins and cognitive improvement in older adults has been examined to a limited extent. Quantifying current consumption of these vitamins (i.e., Vitamin C [VC], Vitamin E [VE] and b-carotene [BC]) in dementia patients is needed. This study evaluated current consumption in patients with dementia to determine if individuals were meeting recommendations. Data were collected utilizing chart audits of patients at a memory facility. Daily intake was gathered using a computer system and portion sizes were calculated by multiplying the percentage eaten by the portion on production records. The Food ProcessorÒ Nutrition Analysis software (ESHA) was used to estimate vitamin consumption and a one-sample t-test was conducted to compare intake to minimum recommendations (VC 75 mg; VE 15 mg; BC 750 mcg). This descriptive study included 14 subjects (13 females) aged 48-91 years. Eight had moderate-severe dementia diagnosis. Average three-day intake of BC was significantly higher (p<.001), VE was significantly lower (p<.001) and VC was not significantly different than recommendations (p¼.146). Megadoses of these vitamins have been prescribed to improve cognitive function thus dietary intake would need supplementation in order to achieve therapeutic effects. The comparison using BC is questionable. The USDA dietary recommended intake for Vitamin A is 5,000 IU where 2,500 IU retinol and 2,500 IU is BC (BC was transformed using 1 IU retinol equals 0.3 mcg). Further investigation into dietary adequacy of these nutrients is needed to establish criteria for supplementation.
Learning Outcome: To educate learners on the use of a video-recorded interprofessional simulation experience used with undergraduate dietetic students. Background: Clinical simulation experiences, which allow for a safe, controlled learning experience, are increasingly being used in the undergraduate setting, however nutrition students are not often exposed to these learning tools. To further understanding of the impact of clinical simulations on nutrition students, an interprofessional study was conducted that included nutrition, nursing, and speech pathology students. The objective of this analysis is taken from that larger study.
Methods: To understand the effectiveness of using clinical simulations in a learning environment, two groups of nutrition students were analyzed. One group of nutrition students (control group; CON; n¼37) was assigned a non-dynamic, paper-based case study. The other group of students (experimental group; EXP; n¼30) viewed a video recording of the same case study scenario played out by their peers from nursing, nutrition, and speech-language pathology disciplines (i.e., interprofessional simulation). Both groups of students were instructed to write an ADIME note. ADIME notes are used in nutrition to assess patient information, diagnose nutrition-related problems, recommend nutrition interventions, and monitor/evaluate short- and long-term nutrition goals. These ADIME notes were scored independently, using a common rubric by three registered dietitians. An independent t-test was used to compare ADIME note scores. Results: While total ADIME note scores between the CON and EXP groups were not significantly different (p¼.414), student feedback from viewing the simulation was overwhelmingly positive.
Conclusion: Lack of statistical significance could be related to rubric reliability and graders. Future research should focus on testing the reliability and use of the ADIME note rubric. Funding Disclosure: Indiana University of Pennsylvania College of Health and Human Services Research Incentive Award
Funding Disclosure: None
Associations Between Iron Intake and Hemoglobin Levels in Older Adults
Are Dietary Supplements for Toddlers in Line with Recommendations? 1
1
1
2
2
Author(s): L. Saldanha , J. Dwyer , L. Brown , K. Andrews , P. Gusev , P. Pehrsson3; 1Office of Dietary Supplements, NIH, 2Nutrient Data Laboratory, USDA, 3Agriculture Research Service, USDA Learning Outcome: Know why it is important to read dietary supplements labels to determine if the dose, source, and safety of nutrients are appropriate for the intended user. Become familiar with upcoming changes to dietary supplement labels. In the US, Dietary Supplements (DSs) are labeled for three age categories <12 months (infants), 1-3 years (toddlers), and 4years (adults). We determined how well DSs formulated for toddlers compared with Daily Values (DVs). We identified DSs labeled for toddlers in the Dietary Supplement Label Database (DSLD). We searched labels for %DV of vitamins A, E, C, and D, folate, and iodine; recognized as shortfall nutrients in toddler diets, and identified 406 toddler DSs. More than 60% of the vitamin, multivitamin or combination DSs contained one or more nutrients > 100%DV, and some, e.g., vitamin C, as high as 625%DV. The %DV on product labels are expected to comply with the “new” food labeling regulations in 2018. The “new” % DVs, issued by FDA in 2016, for iodine and vitamin D have increased by w30 and 50%. Thus, product labels will likely reflect “new” values of vitamin D and iodine by 2018. The “new” % DVs for vitamins A, E, C, and folate have decreased by 40-60%. If current formulations remain unchanged, product labels for these nutrients will show levels of 200-250%DV from DS alone. Chemical analyses of similar products were higher than labeled amounts by 14% for vitamin A, 11% for vitamin E, 39% for vitamin D, 19% for folate, and 18% for iodine. These values may represent overages to ensure label claims are met at the end of shelf-life. Dietitians should review labels to evaluate if product formulations meet the toddler’s nutrient needs and encourage parents to do so. Funding Disclosure: Office of Dietary Supplements, National Institutes of Health
Author(s): S. McClafferty1, J. Phelps2, T. Crook2, R. Hakkak2; 1Saline Memorial Hospital, 2University of Arkansas for Medical Science Learning Outcome: Participants will be able to describe the adequacy of dietary iron, associations between iron supplementation and hemoglobin levels, and the importance of monitoring iron supplementation among older adults who are not being treated for iron deficiency anemia. Background: Considering the prevalence of supplement use in the older adult population, there is reason to question if the potential benefits of oral iron supplementation outweigh risks of over-supplementation. The purpose of this study was to explore associations between iron intake and hemoglobin (Hgb) levels among older adults not being treated for iron deficiency anemia (IDA). Methods: Analyses of unadjusted National Health and Nutrition Examination Survey (NHANES) data (2011-2012) were performed on 1,205 participants >60 years of age not being treated for IDA. Wilcoxon signed-rank tests were used to determine if dietary iron intakes differed from appropriate Estimated Average Requirements (EAR). A Mann-Whitney U test was used to determine if Hgb levels differed between participants taking iron supplements versus participants not taking iron supplements. Results: Median dietary iron intake was significantly higher than the EAR for both males (z¼.095, p¼<.0005; median 15.81 mg/day v. EAR 6 mg/day) and females (z¼.081, p¼<.0005; median 12.34 mg/day v. EAR 5 mg/day). Fourteen percent of participants (n¼163) reported taking iron supplements. Median Hgb levels did not significantly differ between participants taking iron supplements versus participants not taking iron supplements (z¼.311, p¼.756). Conclusion: Despite not being treated for IDA and exceeding the EAR for dietary iron intake, 14% of older adults indicated taking iron supplements. When screening and assessing older adults it is important to inquire about all supplement use, including iron, to avoid potential negative health outcomes. Funding Disclosure: None
A-52
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
September 2017 Suppl 1—Abstracts Volume 117 Number 9