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Changes in Resting Energy Expenditure in Orthotopic Liver Transplantation
TUESDAY, OCTOBER 9
Poster Session: Wellness and Public Health Changes in Resting Energy Expenditure in Orthotopic Liver Transplantation
Saving at the Supermarket: Do Low Prices ⴝ High Nutritional Quality?
Author(s): S. K. Rifkin; Food and Nutrition, Rush Univ. Med. Ctr., Chicago, IL
Author(s): S. H. Thompson,1 B. D. Exum,1 L. A. Thompson; 21Health Promotion Program, Coastal Carolina Univ., Conway, SC, 2Human Nutrition Program, Winthrop Univ., Rock Hill, SC.
Learning Outcome: To describe the pattern of change in measured resting energy in orthotopic liver transplantation patients post surgery and caloric intake. There is no consensus on the pattern of change in resting energy expenditure (REE) following orthotopic liver transplantation (OLT) in patients with end stage liver disease. The objectives of this investigation were to: 1) describe changes in REE as determined by indirect calorimetry in a consecutive series of OLT subjects followed for 15 (n⫽22) and 60 (n⫽12) days after OLT; 2) compare changes in measured REE between men and women, and between those with liver disease of viral and non-viral etiologies.; 3) compare measured REE with those predicted by the Harris Benedict and Schofield equations, and; 4) compare recorded caloric intake to measured REE aftert OLT. Subjects were aged (mean ⫹ SD) 56.1⫹8.9 years, 51.4% male, 34.3% black, overweight (BMI 29.2⫹6.5), and 60% had disease of viral etiology. Measured REE ranged from 1574⫹381 to 1668⫹346 kilocalories over the 60 days following OLT, increasing by 77 kilocalories during the study period (n⫽12).; with the larger sample (n⫽22) with subjects followed to day 15, these estimates decreased from 1764⫹896 to 1577⫹423.. Measured REE were 92.5⫹16.8% to 111.8⫹68.8% of predicted REE during the 15 days. Caloric intake increased in parallel over time from 67⫹195 to 1121⫹572 kilocalories (p⬍0.0001). The findings suggest that although it may not be necessary to measure REE as frequently as performed in the present study, this population may have difficulty meeting their caloric needs. Funding Disclosure: None
Learning Outcome: The participant will be able to analyze pricing and nutritional quality of advertised meal deals and buy-one-get-one-free offers at major grocery store chains. Low fruit and vegetable intake is associated with heart disease, some cancers, and other major causes of death. Product pricing influences food purchases and economic declines have affected food budgets; therefore, this study examined pricing and nutritional quality of advertised meal deals (MD) and buy-one-get-one free (BOGO) offers at three major Grocery Store Chains (GSC) over 10 weeks in Fall 2011. USDA’s Super Tracker and Diet Analysis Plus (2011) were used for analyses. MD Analysis - 10 week averages per person: Prices ranged from $1.25 to $5.00. When analyzing nutritional composition, these high (H) / low (L) ranges were found: Total calories (L: 1052, H: 1738), Total fat (L: 31 g., H: 74 g.), Saturated fat (L: 15 g., H: 24 g.), and sodium (L: 1745 mg., H: 3114 mg.). Evaluation of MyPlate categories revealed empty calories ranged from 38% (GSC#3) to 303% (GSC#1) of allowance. BOGO Analysis - 10 week averages: When examining MyPlate categories, two GSC had the highest percentage of products offered in the Empty Calories category (GSC#1: 42%, GS#3: 31%) while GSC #2 products were highest in Grains (31%). Few products were in the fruit (F) and Vegetable (V) categories: GSC #1 (F: 2%, V: 11%); GSC #2 (F: 5%, V: 9%); and, GSC #3 (F: 4%, V: 16%). Health professionals, policymakers, grocery store chains and other stakeholders should join together to identify innovative solutions to improve access to low-priced, healthy food. Funding Disclosure: None
Knowledge, Risk Factors and Behaviors Associated with Lower-Limb Complications in Patients with Diabetes on Hemodialysis Author(s): M. Therrien,1 R. A. Brody,2 L. Byham-Gray,2 J. S. Parrott2; 1Dialysis Care of Maine, Eastern Maine Med. Ctr., Bangor, ME, 2Department of Nutritional Sciences, Univ. of Med. and Dentistry of New Jersey, Newark, NJ Learning Outcome: Identify risk factors for lower-limb complications, knowledge of diabetes self-management and foot care behaviors performed in patients with diabetes on hemodialysis. Objective: Identify the risk factors for lower-limb complications, knowledge of diabetes selfmanagement and foot care behaviors in a sample of hemodialysis patients with diabetes. Design/Subjects: A prospective, cross-sectional pilot study using a convenience sample of patients with diabetes on hemodialysis was conducted. Participants completed a survey on diabetes knowledge and foot care behaviors. Demographic and clinical data were gathered from the electronic medical record. Statistical Analysis: Pearson’s correlation and Kendall’s Tau were used to test the relationships among knowledge, risk factors and foot care behaviors with p⫽ⱕ 0.05 considered significant. Results: The mean age of the 79 participants was 65.6 years, 55.7% were female and 96.2% were Caucasian. Participants had diabetes for 22.4 years. Neuropathy was diagnosed in 60.3% of participants; 34.2% had a previous foot ulcer, 33.3% had peripheral vascular disease, 24.4% had an amputation, and 25.6% had foot deformities. Participants scored 78.2% on the Diabetes Knowledge Test, and the mean number of foot care behaviors performed was 1.61 out of 4. Knowledge deficits included carbohydrate content of foods and A1c testing. Foot care behaviors, including foot moisturizing and toenail trimming, were not performed according to recommended guidelines. There were positive correlations found between dialysis vintage and the following risk factors: PVD (r⫽0.283, p⫽0.012), neuropathy (r⫽0.244, p⫽0.031), foot ulcer (r⫽0.233, p⫽0.040), and amputation (r⫽0.324, p⫽0.004). Conclusions: Risk factors and knowledge gaps regarding diabetes and foot care behaviors were identified. Interventions are warranted to bridge knowledge gaps in diabetes selfmanagement and improve the performance of foot care behaviors. Funding Disclosure: None
September 2012 Suppl 3—Abstracts Volume 112 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-97
Poster Session: Wellness and Public Health Changes in Resting Energy Expenditure in Orthotopic Liver Transplantation
Saving at the Supermarket: Do Low Prices ⴝ High Nutritional Quality?
Author(s): S. K. Rifkin; Food and Nutrition, Rush Univ. Med. Ctr., Chicago, IL
Author(s): S. H. Thompson,1 B. D. Exum,1 L. A. Thompson; 21Health Promotion Program, Coastal Carolina Univ., Conway, SC, 2Human Nutrition Program, Winthrop Univ., Rock Hill, SC.
Learning Outcome: To describe the pattern of change in measured resting energy in orthotopic liver transplantation patients post surgery and caloric intake. There is no consensus on the pattern of change in resting energy expenditure (REE) following orthotopic liver transplantation (OLT) in patients with end stage liver disease. The objectives of this investigation were to: 1) describe changes in REE as determined by indirect calorimetry in a consecutive series of OLT subjects followed for 15 (n⫽22) and 60 (n⫽12) days after OLT; 2) compare changes in measured REE between men and women, and between those with liver disease of viral and non-viral etiologies.; 3) compare measured REE with those predicted by the Harris Benedict and Schofield equations, and; 4) compare recorded caloric intake to measured REE aftert OLT. Subjects were aged (mean ⫹ SD) 56.1⫹8.9 years, 51.4% male, 34.3% black, overweight (BMI 29.2⫹6.5), and 60% had disease of viral etiology. Measured REE ranged from 1574⫹381 to 1668⫹346 kilocalories over the 60 days following OLT, increasing by 77 kilocalories during the study period (n⫽12).; with the larger sample (n⫽22) with subjects followed to day 15, these estimates decreased from 1764⫹896 to 1577⫹423.. Measured REE were 92.5⫹16.8% to 111.8⫹68.8% of predicted REE during the 15 days. Caloric intake increased in parallel over time from 67⫹195 to 1121⫹572 kilocalories (p⬍0.0001). The findings suggest that although it may not be necessary to measure REE as frequently as performed in the present study, this population may have difficulty meeting their caloric needs. Funding Disclosure: None
Learning Outcome: The participant will be able to analyze pricing and nutritional quality of advertised meal deals and buy-one-get-one-free offers at major grocery store chains. Low fruit and vegetable intake is associated with heart disease, some cancers, and other major causes of death. Product pricing influences food purchases and economic declines have affected food budgets; therefore, this study examined pricing and nutritional quality of advertised meal deals (MD) and buy-one-get-one free (BOGO) offers at three major Grocery Store Chains (GSC) over 10 weeks in Fall 2011. USDA’s Super Tracker and Diet Analysis Plus (2011) were used for analyses. MD Analysis - 10 week averages per person: Prices ranged from $1.25 to $5.00. When analyzing nutritional composition, these high (H) / low (L) ranges were found: Total calories (L: 1052, H: 1738), Total fat (L: 31 g., H: 74 g.), Saturated fat (L: 15 g., H: 24 g.), and sodium (L: 1745 mg., H: 3114 mg.). Evaluation of MyPlate categories revealed empty calories ranged from 38% (GSC#3) to 303% (GSC#1) of allowance. BOGO Analysis - 10 week averages: When examining MyPlate categories, two GSC had the highest percentage of products offered in the Empty Calories category (GSC#1: 42%, GS#3: 31%) while GSC #2 products were highest in Grains (31%). Few products were in the fruit (F) and Vegetable (V) categories: GSC #1 (F: 2%, V: 11%); GSC #2 (F: 5%, V: 9%); and, GSC #3 (F: 4%, V: 16%). Health professionals, policymakers, grocery store chains and other stakeholders should join together to identify innovative solutions to improve access to low-priced, healthy food. Funding Disclosure: None
Knowledge, Risk Factors and Behaviors Associated with Lower-Limb Complications in Patients with Diabetes on Hemodialysis Author(s): M. Therrien,1 R. A. Brody,2 L. Byham-Gray,2 J. S. Parrott2; 1Dialysis Care of Maine, Eastern Maine Med. Ctr., Bangor, ME, 2Department of Nutritional Sciences, Univ. of Med. and Dentistry of New Jersey, Newark, NJ Learning Outcome: Identify risk factors for lower-limb complications, knowledge of diabetes self-management and foot care behaviors performed in patients with diabetes on hemodialysis. Objective: Identify the risk factors for lower-limb complications, knowledge of diabetes selfmanagement and foot care behaviors in a sample of hemodialysis patients with diabetes. Design/Subjects: A prospective, cross-sectional pilot study using a convenience sample of patients with diabetes on hemodialysis was conducted. Participants completed a survey on diabetes knowledge and foot care behaviors. Demographic and clinical data were gathered from the electronic medical record. Statistical Analysis: Pearson’s correlation and Kendall’s Tau were used to test the relationships among knowledge, risk factors and foot care behaviors with p⫽ⱕ 0.05 considered significant. Results: The mean age of the 79 participants was 65.6 years, 55.7% were female and 96.2% were Caucasian. Participants had diabetes for 22.4 years. Neuropathy was diagnosed in 60.3% of participants; 34.2% had a previous foot ulcer, 33.3% had peripheral vascular disease, 24.4% had an amputation, and 25.6% had foot deformities. Participants scored 78.2% on the Diabetes Knowledge Test, and the mean number of foot care behaviors performed was 1.61 out of 4. Knowledge deficits included carbohydrate content of foods and A1c testing. Foot care behaviors, including foot moisturizing and toenail trimming, were not performed according to recommended guidelines. There were positive correlations found between dialysis vintage and the following risk factors: PVD (r⫽0.283, p⫽0.012), neuropathy (r⫽0.244, p⫽0.031), foot ulcer (r⫽0.233, p⫽0.040), and amputation (r⫽0.324, p⫽0.004). Conclusions: Risk factors and knowledge gaps regarding diabetes and foot care behaviors were identified. Interventions are warranted to bridge knowledge gaps in diabetes selfmanagement and improve the performance of foot care behaviors. Funding Disclosure: None
September 2012 Suppl 3—Abstracts Volume 112 Number 9
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
A-97