- Email: [email protected]
Malnutrition's Role as a Fall Risk Factor: Eat Well, Fall Less
SUNDAY, OCTOBER 4
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Pre-Surgery Micronutrient Screening by The Registered Dietitian Nutritionist and Post-Surgery Readmission in Bariatric Surgery Patients Author(s): N.M. Crowley1, A. Shokri2, D. Petitpain3, D.M. DellaValle2; 1Bariatric Surgery Program, MUSC, Charleston, SC, 2Department of Medicine, MUSC, Charleston, SC, 3Office of Health Promotion, MUSC, Charleston, SC Learning Outcome: The participants will be able to explain how RDN-led micronutrient screening decreases post-bariatric surgery readmission rates. Introduction: Micronutrient (MN) screening is essential to the nutrition assessment prior to bariatric surgery (BS). It is unknown whether pre-BS repletion of non-routine MN deficiencies (B1, B6, Cu, Zn) impacts post-surgical outcomes. The objective of this study was to examine relationships between pre-BS MN screening by the RDN and post-BS readmissions. Methods: A retrospective study of primary BS patients was conducted from 2013-2014 (N¼267, 44% Black, 43.711.8y). RDNs identified non-routine MN deficiencies and developed repletion plans pre-BS (MN cohort: N¼97, 59% Black). A separate non-MN cohort (N¼ 170, 35% Black) proceeded with usual pre-BS MN regimen. Compared to the non-MN group, 7% more patients in the MN group completed BS (p¼0.048).
Malnutrition’s Role as a Fall Risk Factor: Eat Well, Fall Less Author(s): M. Julius1, D. Kresevic2, C. Burant2, M. Turcoliveri1, M. Pearson1, S.M. Corlett1, E. Gable1; 1Nutrition, Louis Stokes Cleveland VA Med. Ctr., Cleveland, OH, 2Louis Stokes Cleveland VA Med. Ctr., Cleveland, OH Learning Outcome: The participant will understand the relationship between weight loss, hemoglobin decline, vitamin D deficiency, and frequency of falls. To assess unique risk factors for falling in individuals with dementia. Introduction: Several assessment tools to mitigate falls risk have been developed, but these instruments have neglected nutritional risk factors. Design/Participants: This retrospective descriptive study assessed the relationship between weight loss, hemoglobin decline, and vitamin D deficiency in single and repeat fallers. The secondary aim of the study is to assess nutrition risk factors for fallers who have a diagnosis of dementia. Data was obtained from Veterans with recorded falls at the Louis Stokes Cleveland VA Medical Center at twelve, six, three, and one month antecedent to the first fall event.
Results: While post-BS readmission rates were similar between cohorts (w51%), more time elapsed between screening and BS in the MN cohort (5.73.1 vs. 3.62.4 months in non-MN, p<0.001). We observed a significant interaction between MN group and time to BS, such that those in the MN cohort who had BS delayed to replete deficiencies were 1.4x less-likely to be readmitted, compared to those without a MN repletion plan and those who had BS sooner (p¼0.06 for the MN Cohort Group-by-Time interaction).
Results: In the total population, weight loss one month prior to the first fall was correlated with the incidence of recurrent falls (p¼ 0.004). There was a significant decline in Hgb levels in both single event fallers and frequent fallers at 12 and 6 months prior to the first fall (95% CI, p < 0.0001). In individuals without dementia, greater weight loss was associated with increased falls (n¼55, p¼0.0147) at 12 months. Diagnosis of dementia and malnutrition was greater in frequent fallers than in single event fallers (n¼55, p¼0.0028). Weight loss, hemoglobin and Vitamin D status were similar between the single and multiple fall groups (p>0.05).
Conclusions: While patients with MN repletion plans took about 60 d to replete MN status prior to BS, this intervention led to fewer post-BS readmissions. It is worthwhile to delay BS in order to allow for complete repletion of both routine and non-routine MN deficiencies. This repletion can improve nutrition status, as well as decrease post-BS readmission rates.
Conclusions: Weight loss alone increased the risk of multiple falls in individuals without dementia. In those with dementia, weight loss plus decline in Hemoglobin values increased multiple fall risk. Further research is needed to develop fall risk screening tools that include nutritional assessment along with constellation specific interventions to address these risk factors.
Funding Disclosure: None
Funding Disclosure: None
Fruit and Vegetable Consumption in College Freshmen at Mississippi State University
Characterization of Artificial Sweetener Consumption Patterns in a Sample of Rural Southwest Virginian Adults
Author(s): L. Coats, S.H. Byrd, D. Buys, B. Fountain; Food Science, Nutrition, and Health Promotion, Mississippi State Univ., Mississippi State, MS
Author(s): E.M. Passaro, J.M. Zoellner, B.M. Davy, V.E. Hedrick; Virginia Tech, Blacksburg, VA
Learning Outcome: The participant will understand and identify fruit and vegetable intake of college freshmen at Mississippi State University. Background: Dietary Guidelines for Americans recommend five or more servings of fruit and vegetable daily to improve health and prevent chronic disease and obesity. According to the Behavioral Risk Factor Surveillance System, 83% of individual’s ages 18-24 years old do not consume recommended daily servings of fruit and vegetable. College freshmen fall within this cohort, increasing risks for developing chronic disease and obesity. Influences of dietary habits within this population are not well understood. Methods: College freshmen (n¼2,197) at Mississippi State University were recruited via mass email communication. Freshmen (n¼132) who met inclusion criteria received a demographic survey and Eating at America’s Table Study- “All-Day Fruit and Vegetable Intake Screener.” Following survey completion, fruit and vegetable intake scores were obtained using a standardized scoring sheet. Fruit and vegetable intake was compared to sociodemographic to determine possible associations. Study was approved by the Institutional Review Board. Results: Preliminary results showed survey respondents (n¼78) as primarily white (75%) and female (72%). Average body mass index of male participants was 23.62 and female was 25.59. Seventy one percent reported consuming fruit and 66% reported consuming vegetables 4 times or less per week. Discussion: Preliminary data indicated respondents’ daily fruit and vegetable consumption below recommended daily intake by the Dietary Guidelines for Americans, placing students at risk for developing chronic diseases and obesity and indicating needed intervention. Funding Disclosure: Mississippi Agricultural and Forestry Experiment Station (MAFES)
A-20
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
Learning Outcome: Participants will be able to describe the characterization of artificial sweetener intake of adults living in a rural Southwest Virginia and the comparison of artificial sweetener intake to national dietary consumption patterns (NHANES). Introduction: Controversy surrounds the use of artificial sweeteners (non-nutritive sweeteners [NNS]) as effective weight-loss/maintenance strategies. Minimal data assessing NNS consumption is available, and no literature exists for rural, health-disparate areas, where obesity and related co-morbidities are prevalent. The objective of this investigation is to characterize NNS consumption patterns of a rural adult population. Methods: A cross-sectional sample of Southwest Virginian adults completed three 24-hour dietary recalls. NNS intake was characterized by type of NNS and dietary source. NNS consumption was extracted from the component/ingredient level of dietary intake using nutrition analysis software (NDS-R). Results: Among participants (n¼301) (41.813.4 years), 33% (n¼100) reported consuming NNS. Mean BMI was higher for NNS consumers versus non-consumers (34.710.6, 32.18.2; p<0.05). Mean daily NNS intake for NNS consumers¼8693,553mg, with sucralose being the largest contributor, followed by aspartame, acesulfame potassium, and saccharin. Table NNS, diet tea, and diet soda were the top contributors to absolute NNS intake (38%, 34%, 27%). Diet soda, juice drinks, and table NNS were the most frequently consumed NNS dietary sources (56%, 25%, 23%). NNS consumption for this sample (33%) was higher than national levels (24%) (NHANES 2001-2002). Conclusions: Replacing sugar-sweetened items with NNS could be an effective weight loss/ control strategy within this population. However, longitudinal data is needed to determine causality, and specifically if weight status prompted the use of NNS or if NNS use increased BMI. These findings will inform the development of a NNS food-frequency questionnaire, which will facilitate the inferential testing of NNS consumption and weight status associations. Funding Disclosure: PI Zoellner: NIH NIH/NCI (R01 CA 154364) PI Hedrick: AHA (13POST16560008)
September 2015 Suppl 2—Abstracts Volume 115 Number 9
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy Pre-Surgery Micronutrient Screening by The Registered Dietitian Nutritionist and Post-Surgery Readmission in Bariatric Surgery Patients Author(s): N.M. Crowley1, A. Shokri2, D. Petitpain3, D.M. DellaValle2; 1Bariatric Surgery Program, MUSC, Charleston, SC, 2Department of Medicine, MUSC, Charleston, SC, 3Office of Health Promotion, MUSC, Charleston, SC Learning Outcome: The participants will be able to explain how RDN-led micronutrient screening decreases post-bariatric surgery readmission rates. Introduction: Micronutrient (MN) screening is essential to the nutrition assessment prior to bariatric surgery (BS). It is unknown whether pre-BS repletion of non-routine MN deficiencies (B1, B6, Cu, Zn) impacts post-surgical outcomes. The objective of this study was to examine relationships between pre-BS MN screening by the RDN and post-BS readmissions. Methods: A retrospective study of primary BS patients was conducted from 2013-2014 (N¼267, 44% Black, 43.711.8y). RDNs identified non-routine MN deficiencies and developed repletion plans pre-BS (MN cohort: N¼97, 59% Black). A separate non-MN cohort (N¼ 170, 35% Black) proceeded with usual pre-BS MN regimen. Compared to the non-MN group, 7% more patients in the MN group completed BS (p¼0.048).
Malnutrition’s Role as a Fall Risk Factor: Eat Well, Fall Less Author(s): M. Julius1, D. Kresevic2, C. Burant2, M. Turcoliveri1, M. Pearson1, S.M. Corlett1, E. Gable1; 1Nutrition, Louis Stokes Cleveland VA Med. Ctr., Cleveland, OH, 2Louis Stokes Cleveland VA Med. Ctr., Cleveland, OH Learning Outcome: The participant will understand the relationship between weight loss, hemoglobin decline, vitamin D deficiency, and frequency of falls. To assess unique risk factors for falling in individuals with dementia. Introduction: Several assessment tools to mitigate falls risk have been developed, but these instruments have neglected nutritional risk factors. Design/Participants: This retrospective descriptive study assessed the relationship between weight loss, hemoglobin decline, and vitamin D deficiency in single and repeat fallers. The secondary aim of the study is to assess nutrition risk factors for fallers who have a diagnosis of dementia. Data was obtained from Veterans with recorded falls at the Louis Stokes Cleveland VA Medical Center at twelve, six, three, and one month antecedent to the first fall event.
Results: While post-BS readmission rates were similar between cohorts (w51%), more time elapsed between screening and BS in the MN cohort (5.73.1 vs. 3.62.4 months in non-MN, p<0.001). We observed a significant interaction between MN group and time to BS, such that those in the MN cohort who had BS delayed to replete deficiencies were 1.4x less-likely to be readmitted, compared to those without a MN repletion plan and those who had BS sooner (p¼0.06 for the MN Cohort Group-by-Time interaction).
Results: In the total population, weight loss one month prior to the first fall was correlated with the incidence of recurrent falls (p¼ 0.004). There was a significant decline in Hgb levels in both single event fallers and frequent fallers at 12 and 6 months prior to the first fall (95% CI, p < 0.0001). In individuals without dementia, greater weight loss was associated with increased falls (n¼55, p¼0.0147) at 12 months. Diagnosis of dementia and malnutrition was greater in frequent fallers than in single event fallers (n¼55, p¼0.0028). Weight loss, hemoglobin and Vitamin D status were similar between the single and multiple fall groups (p>0.05).
Conclusions: While patients with MN repletion plans took about 60 d to replete MN status prior to BS, this intervention led to fewer post-BS readmissions. It is worthwhile to delay BS in order to allow for complete repletion of both routine and non-routine MN deficiencies. This repletion can improve nutrition status, as well as decrease post-BS readmission rates.
Conclusions: Weight loss alone increased the risk of multiple falls in individuals without dementia. In those with dementia, weight loss plus decline in Hemoglobin values increased multiple fall risk. Further research is needed to develop fall risk screening tools that include nutritional assessment along with constellation specific interventions to address these risk factors.
Funding Disclosure: None
Funding Disclosure: None
Fruit and Vegetable Consumption in College Freshmen at Mississippi State University
Characterization of Artificial Sweetener Consumption Patterns in a Sample of Rural Southwest Virginian Adults
Author(s): L. Coats, S.H. Byrd, D. Buys, B. Fountain; Food Science, Nutrition, and Health Promotion, Mississippi State Univ., Mississippi State, MS
Author(s): E.M. Passaro, J.M. Zoellner, B.M. Davy, V.E. Hedrick; Virginia Tech, Blacksburg, VA
Learning Outcome: The participant will understand and identify fruit and vegetable intake of college freshmen at Mississippi State University. Background: Dietary Guidelines for Americans recommend five or more servings of fruit and vegetable daily to improve health and prevent chronic disease and obesity. According to the Behavioral Risk Factor Surveillance System, 83% of individual’s ages 18-24 years old do not consume recommended daily servings of fruit and vegetable. College freshmen fall within this cohort, increasing risks for developing chronic disease and obesity. Influences of dietary habits within this population are not well understood. Methods: College freshmen (n¼2,197) at Mississippi State University were recruited via mass email communication. Freshmen (n¼132) who met inclusion criteria received a demographic survey and Eating at America’s Table Study- “All-Day Fruit and Vegetable Intake Screener.” Following survey completion, fruit and vegetable intake scores were obtained using a standardized scoring sheet. Fruit and vegetable intake was compared to sociodemographic to determine possible associations. Study was approved by the Institutional Review Board. Results: Preliminary results showed survey respondents (n¼78) as primarily white (75%) and female (72%). Average body mass index of male participants was 23.62 and female was 25.59. Seventy one percent reported consuming fruit and 66% reported consuming vegetables 4 times or less per week. Discussion: Preliminary data indicated respondents’ daily fruit and vegetable consumption below recommended daily intake by the Dietary Guidelines for Americans, placing students at risk for developing chronic diseases and obesity and indicating needed intervention. Funding Disclosure: Mississippi Agricultural and Forestry Experiment Station (MAFES)
A-20
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
Learning Outcome: Participants will be able to describe the characterization of artificial sweetener intake of adults living in a rural Southwest Virginia and the comparison of artificial sweetener intake to national dietary consumption patterns (NHANES). Introduction: Controversy surrounds the use of artificial sweeteners (non-nutritive sweeteners [NNS]) as effective weight-loss/maintenance strategies. Minimal data assessing NNS consumption is available, and no literature exists for rural, health-disparate areas, where obesity and related co-morbidities are prevalent. The objective of this investigation is to characterize NNS consumption patterns of a rural adult population. Methods: A cross-sectional sample of Southwest Virginian adults completed three 24-hour dietary recalls. NNS intake was characterized by type of NNS and dietary source. NNS consumption was extracted from the component/ingredient level of dietary intake using nutrition analysis software (NDS-R). Results: Among participants (n¼301) (41.813.4 years), 33% (n¼100) reported consuming NNS. Mean BMI was higher for NNS consumers versus non-consumers (34.710.6, 32.18.2; p<0.05). Mean daily NNS intake for NNS consumers¼8693,553mg, with sucralose being the largest contributor, followed by aspartame, acesulfame potassium, and saccharin. Table NNS, diet tea, and diet soda were the top contributors to absolute NNS intake (38%, 34%, 27%). Diet soda, juice drinks, and table NNS were the most frequently consumed NNS dietary sources (56%, 25%, 23%). NNS consumption for this sample (33%) was higher than national levels (24%) (NHANES 2001-2002). Conclusions: Replacing sugar-sweetened items with NNS could be an effective weight loss/ control strategy within this population. However, longitudinal data is needed to determine causality, and specifically if weight status prompted the use of NNS or if NNS use increased BMI. These findings will inform the development of a NNS food-frequency questionnaire, which will facilitate the inferential testing of NNS consumption and weight status associations. Funding Disclosure: PI Zoellner: NIH NIH/NCI (R01 CA 154364) PI Hedrick: AHA (13POST16560008)
September 2015 Suppl 2—Abstracts Volume 115 Number 9