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OBESITY / WEIGHT MANAGEMENT
R - 453: Non-surgical weight loss outcome of a multidisciplinary weight management center in the Philippines Llido LO, Umali MN, Quizon O, Sinamban R, Carlos CS, Felicilda FS. Center of weight management and clinical nutrition, St. Luke’s Medical Center, Quezon City, Metro-Manila, Philippines
PEDIATRIC CLINICAL NUTRITION (top)
1) R-397 : Comparison of standard values of nutrition screening and assessment using BMI percentiles from FNRI-PPS, IRS, CDC 2000, and WHO child growth standards in the pediatric population of a tertiary care hospital in the Philippines admitted between years 2000 and 2003. Llido LO, Reyes MCS, Gundao ND, Llido EP, Macalintal MM, Navarrete DI, Santos MAB. Pediatric Clinical Nutrition Section, Center for Weight Management and Clinical Nutrition, St. Luke’s Medical Center, Metro Manila, Philippines
2) R-475: Clinical outcome of pediatric patients based on nutrition status. Eun Mee Kim, Meeyong Rha, YoungYun Cho. Dietetics, Samsung Medical Center, Seoul, South Korea
3) R-420: Nutrient intake in PICU patients: report from a tertiary care private hospital in the Philippines (year 2004). Reyes MCS, Makalintal M, Llido EP,Gundao ND, Santos M, Llido LO. Weight Management and Clinical Nutrition Center, St. Luke’s Medical Center, Philippines
ABSTRACTS OF POSTER PRESENTATION
R - 453 (top)
Non-surgical weight loss outcome of a multidisciplinary weight management center in the Philippines
Llido LO, Umali MN, Quizon O, Sinamban R, Carlos CS, Felicilda FS.
Center of weight management and clinical nutrition, St. Luke’s Medical Center, Quezon City, Metro-Manila, Philippines
Background/Objective(s): Obesity and weight problems are increasing in the Philippines. A multidisiciplinary weight management center was organized to deal with this emerging problem and this study reports on the outcome of the center after two years of operation (2004 to 2006).
Methods: All patients enrolled in the non-surgical management program were included in the study. Weight loss regimen was a series of packages which were combinations of diet management, exercise, and other ancillary approaches as designed by the team. Weight was regularly monitored and weight changes were verifi ed by BIA. Weight loss goal was 3% to 5% per package. Statistical analysis used was paired samples ttest for normal data.
Results: 84 patients completed the packages. Male/female ratio was 1:1.3, mean age was 27.7 years, 40.5% were pediatric, 57.1% were adults, and 2% were geriatric. 5% weight loss was achieved within 45 to 150 days (2 to 5 months) and if patients persisted in the program reaching 400 days (more than one year) they achieved a 13% weight loss amounting to 13.5 kg (Std.Dev.: 16.38). BMI dropped to 5.04 points (Std Dev.: 6.26; P < 0.05 paired samples t-test). Signifi cant weight loss started at 4.33 kg loss (P < 0.05; paired samples t-test). BIA showed that the signifi cant weight loss was in the fat compartment (5 kg mean weight loss) while the body cell mass and total body water compartments had no signifi cant changes. 76% of enrollees achieved their goals of weight loss.
Conclusion: Non-surgical multidisciplinary approach to weight loss can achieve signifi cant results after the program reaching 13% excess weight loss in one year.
R - 397 (top)
Comparison of standard values of nutrition screening and assessment using BMI percentiles from CDC 2000, WHO child growth standards, International Reference Standard, and local Philippine standards in the pediatric population of a tertiary care hospital in the Philippines admitted between years 2000 and 2003.
Llido LO, Reyes MCS, Gundao ND, Llido EP, Macalintal MM, Navarrete DI, Santos MAB Pediatric Clinical Nutrition Section, Center for Weight Management and Clinical Nutrition, St. Luke’s Medical Center, Metro Manila, Philippines
Background: Nutrition screening in pediatrics patients uses standards to evaluate the patient’s body composition. The nutrition support group in SLMC planned to develop a BMI based nutrition screening form based on existing standards: FNRI-PPS, IRS, CDC 2000, and WHO child growth standards.
Objective: To identify the standard that best refl ected the Filipino pediatric population admitted in a private tertiary care hospital.
Methods: Data from 24,957 pediatric patients aged 1 month to 18 years (1.25:1 male to female ratio) were collected from years 2000-2003. BMI percentiles (p5, p50, and p95) were developed from all the reference standards and the number of patients who fell into the following categories: below p5, between p5 and p95, and above p95, were counted and resulting data were compared as to which comes closest to normal distribution pattern.
Results: Analysis per age group showed that the CDC 2000 and WHO child growth standards values closely followed normal pattern with the 5th to 95th values higher compared to below 5th percentile and above 95th percentile, where as FNRI-PPS and IRS showed lower values in the 5th to 95th percentile, but higher in the below p5th and above 95th percentile. In the one to twelve month age group the distribution of the WHO child growth standards comes closer to normal compared to the CDC 2000.
Conclusion: We conclude that the WHO child growth standard is the preferred tool for use in BMI-based nutrition screening of pediatric patients in the one to twelve month group, whereas WHO and CDC 2000 are equally effective in the two to eighteen year old group.
R - 475 (top)
Clinical outcome of pediatric patients based on nutrition status
Eun Mee Kim, Meeyong Rha, YoungYun Cho
Dietetics, Samsung Medical Center, Seoul, South Korea
Objectives: Pediatric patients are more susceptible to malnutrition after admission for their smaller body size and nutritional storage than adult . It is important to assess patient’s nutrition status and malnutrition risk at initial period. The objects of this study were to assess nutritional factors and to correlate nutritional status with clinical outcomes.
Methods: Patients who were admitted and stayed more than 2 days at one university hospital pediatric department from May to July 2005, height, weight, laboratory data were recorded. Nutrition status was classified as normal (include mild malnutrition), moderate or severe malnutrition using height percentile and % Wt-for-Ht. The clinical outcome factors included length of hospital stay, incidence of hospital infection, and cost. Data were analyzed using ANOVA, infection rate data were analyzed non-numeric chi-square test (SPSS 10 Inc. Chicago, IL, USA).
Results: 334 patients, 209 male, were 5.6±6.8 years old. 180(53.9%) were normal state, 137(41.0%) were moderate, 17(5.1%) were considered as severe malnutrition. Nutritional indices; % Wt-for-Ht was 96.41±17.61% [99.90±12.78% was normal, 93.35±21.86% was moderate, 84.47±12.76% was severe malnutrition (p<0.001)], body mass index was 16.8±3.5 kg/m2 [17.3±2.9, 16.3±4.1, 14.5±2.1, respectively; (p=0.001)]. Hemoglobin level was 11.44±1.90 g/dl [11.88±1.64, 11.01±2.04, 10.34±2.25, respectively; (p<0.001)], total lymphocyte counts was 2,735±2,589 cell/mm3 [3,356±2,539, 2,026±2,449, 1,889±2,650, respectively; (p<0.001)], serum albumin level was 3.90±0.50 g/dl [3.96±0.41, 3.87±0.55, 3.59±0.84, respectively; (p=0.01)]. The clinical outcome factors that were found to be signifi cantly different according to the severity of malnutrition were length of hospital stay 9.7±10.8 days [8.3±8.7, 10.2±11.0, 20.5±20.4, respectively; (p <0.001)], incidence of infection 3.0%(10/344 patients) [1.7, 4.4, 5.9, respectively; (p<0.001)], and cost 3.52E±5.66E [2.45E±2.96E, 4.15E±6.34E, 9.84E±13.04E, respectively; (p<0.001)].
Conclusion: The means of all Nutritional indices were within normal range, but signifi cantly decreased as malnutrition and the clinical outcomes of pediatrics patients were decreased by malnutrition.
R - 420 (top)
Nutrient intake in PICU patients: report from a tertiary care private hospital in the Philippines (year 2004)
Reyes MCS, Makalintal M, Llido EP,Gundao ND, Santos MB, Llido LO.
Pediatric Clinical Nutrition Section, Center for Weight Management and Clinical Nutrition, St. Luke’s Medical Center, Metro Manila, Philippines
Background/Objective(s): Adequate nutrient intake is a key factor in pediatric patient recovery in the intensive care unit. This study determines whether pediatric patients received adequate calorie and protein intake while in the PICU.
Methods: All PICU patients staying more than 2 days had their calorie and protein intake measured and compared with the computed requirements. Type of nutrition delivered was also recorded whether oral, enteral, parenteral, or combination. Adequate intake was pegged at 75% of computed. Kruskal-Wallis ANOVA was used with post hoc comparison using Tukey-Kramer test. Signifi cance was set at P < 0.05.
Results: 30 patients (M:18/F:12) were included with 33.3% underweight and 10% obese. Mean calorie intake was inadequate from D1 to D5 (44.6% to 68.1%) and became adequate on D6 and D7 (77%, 109%). Signifi cant defi ciency was noted from D1 to D3. A similar pattern was also observed in the protein intake. 45% of patients had inadequate intake especially on D2 to D4.
Conclusion: Half of PICU patients are underfed with signifi cant defi ciencies in calorie and protein intake occurring during the first three days after admission. Half of the nutritionally high risk patients were not able to achieve adequacy of intake. Measures to correct this defi ciency should be done.