TITLE: A MULTI-DISCIPLINARY TRANSPLANT DIABETESEDUCATION AND SELF-CARE PROGRAM IMPROVES GLYCEMICCONTROL AND DECREASES DIABETES-RELATED HOSPITALREADMISSIONS

AUTHOR(S): P.A. Obayashi, MS, RD, CDE; A.M. Simos, MPH, CDE;Stanford University Medical Center, Stanford, California

LEARNING OUTCOME: To recognize the impact of a patient-centeredmulti-disciplinary education program designed to improve glycemiccontrol, optimize organ function and reduce diabetes-related hospitalreadmissions in a high risk multi-organ transplant population withdiabetes.

TEXT: Multi-organ transplant and diabetes (DM) challenges providing cleareducation to patients with organ failure, post-transplant surgical stress, andpoly-pharmaceutical side-effects. A specialized multi-disciplinary TransplantDiabetes Program was organized by the Registered Dietitian, Diabetes NurseSpecialist, and Program Research Coordinator due to a 30–45% incidence ofDM or Post Transplant DM (PTDM) in adult transplant patients. We see pre-and post-transplant, 40% kidney, 37% liver, 30% heart, and 32% lung andheart/lung with either preexisting DM or PTDM. Overall, 57% male, 43%female, with 47% Caucasian, 24% Hispanic, 11% Asian, 6% Pacific Islander,4% Indian sub-continent, 4% other; ages 18–75. Family history, ethnicbackground plus diabetogenic immunosuppressive medications and insulinresistance increase risks. Hospital readmissions and wound infections frompoor glycemic control, and the need for coordinated individualized,transplant-specific DM education addressing changes in medication andorgan function spawned the Program. Consistent DM educators see in- andout-patients, building continuity and trust. Out-patient group sessionsreinforce learning. Teaching materials use jargon-free language and 12 pointfont size for optimal visual acuity. On-going coordination and communicationamong the multi-disciplinary team facilitates excellent long-term DM/PTDMmanagement for reduced wound infections, fewer DM-related hospitalreadmissions, and optimal graft function. Results show improved lipid levelsand 1.6% decrease in average HbA1c to 7.2% following � three monthsmanagement, with stable creatinine and body mass index. 40% reduction ofDM-related re-admissions one year post-transplant, a rating of 95% patientsatisfaction and 94% provider satisfaction, and a 26% decrease in rejectiondemonstrate the Program’s efficacy.

FUNDING DISCLOSURE: None

TITLE: THE HARRIS BENEDICT EQUATION IS VALID FORESTIMATING RESTING METABOLIC RATE IN OVERWEIGHT/OBESEMEXICAN INDIVIDUALS IN A UNIVERSITY SETTING

AUTHOR(S): O. Perichart-Perera, MS, RD; A. Suverza-Fernandez, BSc,NC; A. Salinas-Deffis, BSc, NC; S.K. Loza-Hirishaka, BSc; C. Villegas-Sepulveda, BSc; Health Department, Universidad Iberoamericana MexicoCity; Research Direction, Instituto Nacional de Perinatologia Mexico City

LEARNING OUTCOME: To understand the validity of RMR estimationformulas to use in overweight/obese Mexican subjects.

TEXT: The measurement of resting metabolic rate (RMR) by indirectcalorimetry (IC) is considered the gold standard for estimating energyexpenditure in individuals. In clinical practice, this measurement is notoften possible, however, their estimation is essential for establishing anadequate nutrition intervention in patients with obesity due thealterations in his RMR. Validated formulas have been used for a longtime, but differences in methods and populations make generalizationdifficult. No validated formulas exist for the Mexican population. Weconducted an observational study to compare RMR estimation withdifferent formulas against IC measured with a Metabolic Monitor(Deltatrac), in 50 overweight/obese Mexican adults (25 women, 25 men,body mass index �25) from the Nutrition Clinic at UniversidadIberoamericana Mexico City. Comparisons between IC and four RMRestimation formulas were done (Harris & Benedict-HB, Food andAgriculture Organization/World Health Organization/United NationsUniversity-FAO/WHO/UNU, Owen-O and Mifflin-M) using t-student test.RMR (Mean � SD, kcal) by IC for the total population was of 1599.00�266.72. We found a significant mean underestimation with O and Mformulas (4.6% and 4.8%, respectively)(t� �3.8 and t� �4.6, p�0.000),with 95% confidence intervals (IC95) below cero (�2.22 to �7.00 and�2.73 to �6.97, respectively) and a consistent overestimation with FAO/WHO/UNU of 4.9% (IC95�2.44–7.35) (t� 4.014, p�0.000). HB did notoverestimate significantly (1.4%; IC95� �0.68 to 3.52) (t�1.36, p�0.18)when compared to IC. Given these results, we concluded that the use ofthe HB equation is valid and accurate for overweight/obese Mexicansubjects in our clinical setting.

FUNDING DISCLOSURE: Self-funded

TITLE: THE EFFECTS OF RECORD KEEPING ON WEIGHT LOSS INOVERWEIGHT ADOLESCENTS

AUTHOR(S): K. Patterson, MS, Graduate Student, Department ofNutrition and Food Science, University of Kentucky, Lexington, KY; M.Roseman, PhD, RD, LD, Department of Nutrition and Food Science,University of Kentucky, Lexington, KY; A.W. Major, MS, RD, GraduateCenter for Nutritional Sciences, University of Kentucky, Lexington, KY

LEARNING OUTCOME: To identify the effects of parental involvement,school behaviors and demographics on quality of record keeping inoverweight adolescents and the effects of the quality of record keeping onweight loss.

TEXT: Major and Anderson recently reported that overweight adolescentswith parental support lost significantly more weight than adolescentswithout parental support. This research includes subjects from Major andAnderson’s study. Analyses on the effects of parental involvement, schoolbehaviors and demographics on record keeping quality were conducted todetermine if these variables indirectly optimize weight loss by increasingquality of records. Thirty-seven overweight adolescents completed a 16-week Health Management Resources (HMR) Healthy Solutions weight lossprogram. Daily records of food intake, activity and progress were keptduring the program. The average change in BMI was �10.6 � 0.058%.School behaviors were assessed by the PedsQL questionnaire (PediatricQuality of Life Inventory). PedsQL scores ranged from 0 to 13 (mean7.18 � 4.16). Higher values indicate more difficulty keeping up withschoolwork. Quality of record keeping was grouped into three categories:poor (PQR), average (AQR) and good quality records (GQR). GQR wasinsignificantly associated with a greater weight loss (�12.1% BMI forGQR vs. �9.1% and �10.3% for AQR and PQR). A direct correlation of0.138 was found between %BMI change and record quality. Parentalinvolvement approached significance (p�0.0731) with a trend seentowards GQR. PedsQL score (p�0.0154) and place of residence (p�0.006)were significantly associated with record quality. This study encouragesthe use of record keeping to aid weight loss in overweight adolescents. Italso identifies demographic variables and school behaviors that affectGQR. Further study is needed on the role parental support plays inimproving record keeping by adolescents.

FUNDING DISCLOSURE: NIH GCRC Grant M01-RR02602, HealthManagement Resources, and HCF Nutrition Foundation

TITLE: THE ACCURACY OF PERSONAL WEIGHT PERCEPTIONSIN AFRICAN AMERICAN WOMEN

AUTHOR(S): K.L. Lofton, MS, RD; W. Bounds, PhD, RD; C.L.Connell, PhD, RD; M.F. Nettles, PhD, RD; The University ofSouthern Mississippi, Department of Nutrition and Food Systems

LEARNING OUTCOME: To identify the process used to understandpersonal weight perceptions of African American women.

TEXT: Previous research indicates that African American womenmay be more accepting of larger body sizes compared with women ofother races. The present study assessed whether African Americanwomen perceived their own weight status accurately, when comparedwith their actual weight classification based on self-reported heightand weight. African American women (n � 274) enrolling theirchildren in south Mississippi Head Start centers were asked todescribe their own weight status as underweight, normal weight,overweight or obese. Self-reported height and weight were used tocalculate a body mass index (BMI, kg/m2) for each woman. Women’sweight status was then classified using the National Institutes ofHealth (NIH) criteria for defining underweight, normal weight,overweight, and obesity based on BMI. A chi-square test ofindependence comparing women’s perceptions of their own weightstatus to their actual weight classification was significant (�2(N�274,df � 9) � 166.12, p�.0001). The standardized residuals wereanalyzed, and results indicated that 55% of women underestimatedtheir weight status by at least one weight category. Of the 123women classifying themselves as of normal weight, 26.8% wereactually overweight and 16.3% were actually obese according to NIHcriteria. Other results revealed that 68.4% of women who perceivedtheir weight status as overweight were actually obese according toNIH criteria. Although limited by self-reported measures, the currentfindings suggest a need for weight management interventions forAfrican American women that increase awareness of true weightstatus and the health consequences that may accompany increases inBMI.

FUNDING DISCLOSURE: Funded by the Southern RuralDevelopment Center at Mississippi State University

SUNDAY, OCTOBER 23

POSTER SESSION: NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY

A-30 / August 2005 Suppl 2—Abstracts Volume 105 Number 8