- Email: [email protected]
The Relationship between the Structure of Family Meals and Overall Diet Quality among Children with Autism Spectrum Disorder (ASD) and Typically Developing (TD) Children Ages 3-11 Years
TUESDAY, OCTOBER 18
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy The National Dysphagia Diet Perceptions and Practice Patterns among Registered Dietitian-Nutritionists and Speech-Language Pathologists
The Recovery Experience of Celiac Patients Following a Gluten-Free Diet: An Exploratory Study
Author(s): E. Davis, C. Hartney, L. LaGorio, K. Gustashaw, K. Keim, D. Sowa; Rush University Medical Center
Author(s): C. Nealis, C. LaSalle, C. Hollenbeck; San Jose State University
Learning Outcome: The learning objectives are: to describe the perceptions of the National Dysphagia Diet (NDD) and practice patterns among Registered Dietitian-Nutritionists (RDNs) and Speech-Language Pathologists (SLP); to identify the prevalence of the use of the NDD, and reason for non-use; and to compare the NDD perceptions and practice pattern between RDNs and SLPs. Texture-modified diets are used in dysphagia management; but, comparing health outcomes across facilities is difficult due to terminology variations. In 2002, the National Dysphagia Diet (NDD) was created to standardize terminology. The NDD was expected to become the standard of practice in dysphagia management and improve health outcomes; but, neither has been studied. This study surveyed registered dietitian-nutritionists (RDN) and speech-language pathologists (SLP) working with adult dysphagia patients to identify the NDD perceptions and practice patterns. An online survey was created, validated by recognized RDN and SLP experts, and sent to about 18,300 clinicians via email. Clinicians were identified via dietetic practice groups and SLP special interest groups. Descriptive statistics quantified demographics and responses. Post-hoc analyses compared RDN and SLP responses. A total of 828 participants responded, with majority being RDNs (67%). Most respondents thought texture-modified diets improved health outcomes (85%), the NDD is evidence-based (73%), and supported the NDD use (84%); but, only 61% currently used the NDD. The main reason for the NDD non-use was due to already existing diets (44%). SLPs were more likely to disagree that the NDD is evidence-based compared to RDNs (22% vs 9%, p<0.01). Most respondents perceived that texture-modified diets improved health outcomes and utilized the NDD in their practice; but, the NDD has not been fully adopted across facilities, and negative perceptions regarding its use persist. Future studies investigating the NDD-related health outcomes may help change the negative perceptions to advance dietary management of dysphagia.
Learning Outcome: Participants will be able describe the relationship between dietary counseling and resolution of symptoms in celiac patients following a gluten-free diet. In theory, adherence to a strict gluten-free diet should result in the remission of symptoms for individuals with celiac disease, yet this is not always the case. The purpose of this study was to investigate symptom resolution in celiac patients following a gluten-free diet and associations with certain dietary factors. 83 adults ( 18 years) with celiac disease following a glutenfree diet completed an online survey pertaining to their symptoms and dietary habits. 11% (9/82) reported complete symptom resolution. A positive but weak correlation (r ¼ 0.371, p ¼ 0.001) was found between resolution of symptoms and length of time on a gluten-free diet, with only 13-14% of the resolution of symptoms explained for by the length of time on a gluten-free diet (r2 ¼ 0.138). For respondents who continued to have symptoms after eliminating gluten, those who received additional dietary guidance from their doctors or dietitians were significantly more likely to have fewer symptoms than those who did not (p ¼ 0.017). There was no significant difference in symptoms between those who ate oats vs. those who did not eat oats or those who ate away from home frequently vs. those who ate away from home infrequently. This study suggests that there may be a substantial number of adults with celiac disease who continue to have symptoms despite being on gluten-free diets and that healthcare providers may play an important role in their patients’ symptom resolution via dietary counseling. Funding Disclosure: None
Funding Disclosure: Departmental funding by Department of Clinical Nutrition, Rush University, Chicago IL The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) Score as a Predictor of Mortality in Critically Ill Patients Author(s): A. Nakayama1, T. Otero2, C. Canales3, D. Belcher1, S. Quraishi4; 1Department of Nutrition and Food Services, Massachusetts General Hospital, 2Tufts University School of Medicine, 3University of California, Irvine School of Medicine, 4Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital
Learning Outcome: To identify whether Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) scores are associated with 30-day mortality in critically ill patients.
Introduction: The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) score was recently developed and validated as a tool for predicting 30-day mortality in hospitalized patients; however, its utility in the intensive care unit (ICU) setting is not known. Therefore, our goal was to investigate whether PANDORA scores are associated with 30-day mortality in critically ill patients.
The Relationship between the Structure of Family Meals and Overall Diet Quality among Children with Autism Spectrum Disorder (ASD) and Typically Developing (TD) Children Ages 3-11 Years Author(s): L. Truex1, M. Weems1, K. Patton1, S. Phillips2, A. Must2, C. Curtin1, L. Bandini1; 1 University of Massachusetts Medical School, 2Tufts University School of Medicine
Learning Outcome: Attendees will be able to describe how the structure of the mealtime environment may have influenced diet quality of young children with and without Autism Spectrum Disorder participating in the Children’s Activity and Meal Patterns Study (CHAMPS). Background: Food selectivity and problematic mealtime behaviors among children with ASD may impact diet quality and also challenge families’ ability to establish mealtime structure and enjoy meals together. The association between mealtime environments and diet quality in children with ASD has received little attention. Methods: From 2007-2008, CHAMPS enrolled 58 TD children and 53 children with ASD
Methods: We performed a retrospective analysis of data from an ongoing, prospective study of nutritional status and outcomes in critically ill patients. Daily protein and caloric deficit was summed over the duration of ICU stay for each patient. To investigate the association of PANDORA scores with 30-day mortality, we performed a logistic regression analysis, while controlling for age, sex, race, body mass index (BMI), as well as protein deficit, caloric deficit, and length of stay (LOS) in the ICU.
Results: 967 patients comprised the analytic cohort with the following key characteristics (mean standard deviation): age e 64 14; BMI e 27 7; APACHE II score 18 7; and PANDORA score e 26 9. Median ICU LOS was 13 days (interquartile range 7-22). The overall 30-day mortality rate was 19%. Each unit increment in PANDORA score was associated with a 6% (OR 1.06: 95%CI 1.03-1.08; p<0.001) increased likelihood of 30-day mortality. Conclusion: In our cohort of critically ill patients, PANDORA scores were independently associated with 30-day mortality after the initiation of critical care. Future studies are needed to determine whether prospective assessments of PANDORA scores can help to predict outcomes and influence care in ICU patients.
aged 3-11 years. Parents completed a 3-day food record for their child and the Meals in Our Household questionnaire to assess degree of structure of family meals (range 0 to 5). Food records were entered into NDSR; the Healthy Eating Index (HEI-2005) was used to measure diet quality.
Results: The overall HEI score did not differ between TD children and children with ASD (50.3 vs. 53.5, p¼0.12), reflecting poor diet quality in both groups. TD children ate meals in a more structured family environment compared to children with ASD (30.1 vs. 27.3, p¼0.003). Compared to TD children, children with ASD were significantly more likely to eat alone (p¼0.001) and/or eat a different meal from the rest of the family (p¼0.001). The ASD group showed no significant correlation between HEI score and mealtime structure (r¼0.11, p¼0.41); the TD group showed a borderline correlation (r¼0.23, p¼0.09). Conclusions: Diet quality was poor among children 3-11 years, regardless of ASD status. Among children with ASD, lack of a significant correlation between HEI score and mealtime structure suggests other factors such as food selectivity and problematic mealtime behaviors may be associated with mealtime environments. Funding Disclosure: Grant funding: NIH R21 HD048989 HRSA/MCHB UA3MC25735-
Funding Disclosure: None
A-96
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
01-00
September 2016 Suppl 1—Abstracts Volume 116 Number 9
Poster Session: Professional Skills; Nutrition Assessment; Medical Nutrition Therapy The National Dysphagia Diet Perceptions and Practice Patterns among Registered Dietitian-Nutritionists and Speech-Language Pathologists
The Recovery Experience of Celiac Patients Following a Gluten-Free Diet: An Exploratory Study
Author(s): E. Davis, C. Hartney, L. LaGorio, K. Gustashaw, K. Keim, D. Sowa; Rush University Medical Center
Author(s): C. Nealis, C. LaSalle, C. Hollenbeck; San Jose State University
Learning Outcome: The learning objectives are: to describe the perceptions of the National Dysphagia Diet (NDD) and practice patterns among Registered Dietitian-Nutritionists (RDNs) and Speech-Language Pathologists (SLP); to identify the prevalence of the use of the NDD, and reason for non-use; and to compare the NDD perceptions and practice pattern between RDNs and SLPs. Texture-modified diets are used in dysphagia management; but, comparing health outcomes across facilities is difficult due to terminology variations. In 2002, the National Dysphagia Diet (NDD) was created to standardize terminology. The NDD was expected to become the standard of practice in dysphagia management and improve health outcomes; but, neither has been studied. This study surveyed registered dietitian-nutritionists (RDN) and speech-language pathologists (SLP) working with adult dysphagia patients to identify the NDD perceptions and practice patterns. An online survey was created, validated by recognized RDN and SLP experts, and sent to about 18,300 clinicians via email. Clinicians were identified via dietetic practice groups and SLP special interest groups. Descriptive statistics quantified demographics and responses. Post-hoc analyses compared RDN and SLP responses. A total of 828 participants responded, with majority being RDNs (67%). Most respondents thought texture-modified diets improved health outcomes (85%), the NDD is evidence-based (73%), and supported the NDD use (84%); but, only 61% currently used the NDD. The main reason for the NDD non-use was due to already existing diets (44%). SLPs were more likely to disagree that the NDD is evidence-based compared to RDNs (22% vs 9%, p<0.01). Most respondents perceived that texture-modified diets improved health outcomes and utilized the NDD in their practice; but, the NDD has not been fully adopted across facilities, and negative perceptions regarding its use persist. Future studies investigating the NDD-related health outcomes may help change the negative perceptions to advance dietary management of dysphagia.
Learning Outcome: Participants will be able describe the relationship between dietary counseling and resolution of symptoms in celiac patients following a gluten-free diet. In theory, adherence to a strict gluten-free diet should result in the remission of symptoms for individuals with celiac disease, yet this is not always the case. The purpose of this study was to investigate symptom resolution in celiac patients following a gluten-free diet and associations with certain dietary factors. 83 adults ( 18 years) with celiac disease following a glutenfree diet completed an online survey pertaining to their symptoms and dietary habits. 11% (9/82) reported complete symptom resolution. A positive but weak correlation (r ¼ 0.371, p ¼ 0.001) was found between resolution of symptoms and length of time on a gluten-free diet, with only 13-14% of the resolution of symptoms explained for by the length of time on a gluten-free diet (r2 ¼ 0.138). For respondents who continued to have symptoms after eliminating gluten, those who received additional dietary guidance from their doctors or dietitians were significantly more likely to have fewer symptoms than those who did not (p ¼ 0.017). There was no significant difference in symptoms between those who ate oats vs. those who did not eat oats or those who ate away from home frequently vs. those who ate away from home infrequently. This study suggests that there may be a substantial number of adults with celiac disease who continue to have symptoms despite being on gluten-free diets and that healthcare providers may play an important role in their patients’ symptom resolution via dietary counseling. Funding Disclosure: None
Funding Disclosure: Departmental funding by Department of Clinical Nutrition, Rush University, Chicago IL The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) Score as a Predictor of Mortality in Critically Ill Patients Author(s): A. Nakayama1, T. Otero2, C. Canales3, D. Belcher1, S. Quraishi4; 1Department of Nutrition and Food Services, Massachusetts General Hospital, 2Tufts University School of Medicine, 3University of California, Irvine School of Medicine, 4Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital
Learning Outcome: To identify whether Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) scores are associated with 30-day mortality in critically ill patients.
Introduction: The Patient- And Nutrition-Derived Outcome Risk Assessment (PANDORA) score was recently developed and validated as a tool for predicting 30-day mortality in hospitalized patients; however, its utility in the intensive care unit (ICU) setting is not known. Therefore, our goal was to investigate whether PANDORA scores are associated with 30-day mortality in critically ill patients.
The Relationship between the Structure of Family Meals and Overall Diet Quality among Children with Autism Spectrum Disorder (ASD) and Typically Developing (TD) Children Ages 3-11 Years Author(s): L. Truex1, M. Weems1, K. Patton1, S. Phillips2, A. Must2, C. Curtin1, L. Bandini1; 1 University of Massachusetts Medical School, 2Tufts University School of Medicine
Learning Outcome: Attendees will be able to describe how the structure of the mealtime environment may have influenced diet quality of young children with and without Autism Spectrum Disorder participating in the Children’s Activity and Meal Patterns Study (CHAMPS). Background: Food selectivity and problematic mealtime behaviors among children with ASD may impact diet quality and also challenge families’ ability to establish mealtime structure and enjoy meals together. The association between mealtime environments and diet quality in children with ASD has received little attention. Methods: From 2007-2008, CHAMPS enrolled 58 TD children and 53 children with ASD
Methods: We performed a retrospective analysis of data from an ongoing, prospective study of nutritional status and outcomes in critically ill patients. Daily protein and caloric deficit was summed over the duration of ICU stay for each patient. To investigate the association of PANDORA scores with 30-day mortality, we performed a logistic regression analysis, while controlling for age, sex, race, body mass index (BMI), as well as protein deficit, caloric deficit, and length of stay (LOS) in the ICU.
Results: 967 patients comprised the analytic cohort with the following key characteristics (mean standard deviation): age e 64 14; BMI e 27 7; APACHE II score 18 7; and PANDORA score e 26 9. Median ICU LOS was 13 days (interquartile range 7-22). The overall 30-day mortality rate was 19%. Each unit increment in PANDORA score was associated with a 6% (OR 1.06: 95%CI 1.03-1.08; p<0.001) increased likelihood of 30-day mortality. Conclusion: In our cohort of critically ill patients, PANDORA scores were independently associated with 30-day mortality after the initiation of critical care. Future studies are needed to determine whether prospective assessments of PANDORA scores can help to predict outcomes and influence care in ICU patients.
aged 3-11 years. Parents completed a 3-day food record for their child and the Meals in Our Household questionnaire to assess degree of structure of family meals (range 0 to 5). Food records were entered into NDSR; the Healthy Eating Index (HEI-2005) was used to measure diet quality.
Results: The overall HEI score did not differ between TD children and children with ASD (50.3 vs. 53.5, p¼0.12), reflecting poor diet quality in both groups. TD children ate meals in a more structured family environment compared to children with ASD (30.1 vs. 27.3, p¼0.003). Compared to TD children, children with ASD were significantly more likely to eat alone (p¼0.001) and/or eat a different meal from the rest of the family (p¼0.001). The ASD group showed no significant correlation between HEI score and mealtime structure (r¼0.11, p¼0.41); the TD group showed a borderline correlation (r¼0.23, p¼0.09). Conclusions: Diet quality was poor among children 3-11 years, regardless of ASD status. Among children with ASD, lack of a significant correlation between HEI score and mealtime structure suggests other factors such as food selectivity and problematic mealtime behaviors may be associated with mealtime environments. Funding Disclosure: Grant funding: NIH R21 HD048989 HRSA/MCHB UA3MC25735-
Funding Disclosure: None
A-96
JOURNAL OF THE ACADEMY OF NUTRITION AND DIETETICS
01-00
September 2016 Suppl 1—Abstracts Volume 116 Number 9