Title: CALORIC DEFICIT DIETS OF 55%, 40%, AND 25% RESULTIN A SIGNIFICANT METABOLIC ADAPTATION TO RESTINGENERGY EXPENDITURE AND DECLINE IN LEAN BODY MASSIN HEALTHY POST MENOPAUSAL WOMEN

Author(s): B. Reed,1 S. Fullmer,2 R. Davidson,3 N. Nyland,3

D. L. Eggett4; 1Brigham Young University, Provo, UT, 2Nutrition,Dietetics and Food Science, Brigham Young University, Provo, UT,3Nutrition, Dietetics, and Food Science, Brigham Young University,Provo, UT, 4Statistics, Brigham Young University, Provo, UT

Learning Outcome: To understand the negative effects of threecaloric restrictions on resting energy expenditure.

Text: The purpose of this study was to identify a range of caloricrestriction where metabolic adaptation occurs. A convenience sample ofhealthy postmenopausal overweight or obese females were randomlyassigned to one of three dietary intervention groups: 55%, 40% or 25%calorie deficits. The dietary intervention lasted three weeks, subjectsremained sedentary. Body composition was measured at the beginningand end of the treatment via dual energy x-ray absorptiometry. REEwas measured weekly via indirect calorimetry, and serum leptin, totalT3 and free T3 levels were assessed at the onset and end of theintervention. Subjects received all their food twice weekly during theintervention. Weight loss was significant in all three groups (4.5 kg, 3.8kg, and 3.2 kg, respectively) as was lean body mass; however theamount lost was not significantly different between groups (p�0.05).Loss in lean tissue increased with increased caloric restriction. Restingenergy expenditure declined significantly on all three diets beyond whatwas predicted due to the loss of lean tissue (72.64 � 26.57, 118.08 �27.00, and 105.17 � 25.09 kcals/day, respectively); however thedifference was not significant between groups. Changes in leptin orthyroid hormones did not explain the decline in REE/lean. This is thefirst study to report a metabolic adaptation based on a percent caloricdeficit. All three caloric deficit diets appear to elicit a similar metabolicadaptation to dieting and loss in lean tissue. Further research todetermine at what caloric deficit a metabolic decline does not occur iswarranted.

Funding Disclosure: Supported in part by an unrestricted gift fromthe Adelle Davis Foundation.

Title: HEALTHY KIDS, HEALTHY WEIGHT

Author(s): S. Lawhun, J. Laheta, L. Varkula, N. Uli,S. Sundararajan, L. Cuttler, E. Kutchman, L. Heinberg; Pediatrics,University Hospitals Rainbow Babies & Children’s Hospital,Cleveland, OH

Learning Outcome: Participants will be able to identify differentaspects of a successful pediatric weight management program.

Text: Childhood obesity rates have risen dramatically. The prevalenceof obesity in children and teens has tripled since 1980. NHANES 2003-2004 data shows that 17.1 % of children 2-19 years old are overweight.Childhood obesity has become a public health epidemic. Healthy Kids,Healthy Weight is an evidence-based weight management program forchildren 4-18 years old. The program includes comprehensive evaluation(medical, psychological, nutrition, and exercise testing) and treatmentfrom a multi-disciplinary team (endocrinologist, psychologist, dietitian,and exercise physiologist). The intervention program is an intense 12week multi-family, behaviorally-based program focusing on activity,decreased sedentary activity, improving nutritional intake andincreasing behavior-change skills. Curriculum was developed usingfavorable practices from literature and includes new elements toproduce positive outcomes. Unique strategies are used to achieveimproved outcomes: combined individual and group treatment,motivational interviewing, personal fitness recommendations, non-traditional fitness, strategies for addressing psychosocial predictors ofpoor outcome (e.g., body image distress), and family involvement withsiblings attending program. The program has a strong relapseprevention component. Monthly follow-up meetings are conducted for 1year post-intervention. Results show a 67.5% retention rate. Weightoutcomes show 68.5 % of patients had a reduction in BMI SD score. Inaddition to weight loss, weight saved also needs to be reported. 74.6 % ofpatients gained weight between evaluation and start of intervention.The predicted trajectory of their weight gain shows that weight gain wasalso prevented by the intervention. Improved lipid levels, blood glucoselevels, and insulin levels were also observed post- intervention.

Funding Disclosure: None

Title: LOW-FAT DAIRY INTAKE AND BODY WEIGHT ANDCOMPOSITION CHANGES IN COLLEGE STUDENTS

Author(s): K. H. Poddar,1 K. W. Hosig,1 S. M. Nickols-Richardson,2

E. S. Anderson3; 1Human Nutrition, Foods and Exercise, VirginiaPolytechnic Institute and State University, Blacksburg, VA, 2NutritionalSciences, The Pennsylvania State University, University Park, PA,3Psychology, Virginia Polytechnic Institute and State University,Blacksburg, VA

Learning Outcome: Describe potential associations between low fatdairy intake and changes in body composition in college students

Text: Research Outcome: Dairy calcium may prevent weightgain/obesity when consumed in adequate amounts (�3 servings/day).Studies in obese individuals have shown decreases in visceral adiposityand body weight with low-fat dairy calcium intake along with energyrestriction. Risk of rapid weight gain is increased during late adolescenceand/or early adulthood. This study examined the association between low-fat dairy intake and weight/fat loss in college students. Methods:Students (N�202) were recruited from a freshman-level nutrition course.Data collected included 7-day food records, height (in), weight (lbs), waistcircumference (WC; cm), and the truncal fat percentage (TF%) region ofinterest from dual-energy X-ray absorptiometry measurements. Data werecollected in September 2004, and April 2005, from 68 women and 11 men.Results: Mean (�SD) low-fat dairy intake was 0.48�0.49 servings/daywith total dairy intake of 1.41�0.82 servings/day. Independent samplest-tests (p � 0.05) were conducted to compare low-fat dairy intake betweensubjects who maintained vs. gained weight, WC, and TF%. Subjects whomaintained weight (34%; 0.63�0.62 servings/day) and WC (55%;0.58�0.52 servings/day) reported significantly higher low-fat dairy intakevs. subjects who gained weight (66%; 0.40�0.39 servings/day) or WC (45%;0.36�0.44 servings/day). No significant differences were seen in low-fatdairy intake of subjects who maintained (45%; 0.53�0.39 servings/day) orgained (55%; 0.42�0.54 servings/day) TF%. Mean energy intake wassignificantly lower in subjects who maintained (44%;1936�451 kcal/dayand 30�9kcal/kg) vs. gained (56%; 2187�551 kcal/day and 36�9 kcal/kg)TF%. Conclusions: Low-fat dairy intake may be associated withprevention of weight gain in college students.

Funding Disclosure: None

Title: IMPROVING THE NUTRITIONAL CARE OF PATIENTS VIA THEPATIENT MEDICAL RECORD: RESULTS OF A PHYSICIAN SURVEY

Author(s): K. Lewis, C. Parrish, A. Abad-Jorge, L. Fanning; NutritionServices, University of Virginia Health System, Charlottesville, VA

Learning Outcome: The participant will be able to state whatcharacteristics physicians prefer in Registered Dietitian’s chart notes.

Text: Introduction: Hospital patient medical records serve the importantpurpose of keeping all team members aware of the patient’s currentmedical treatment and plan including nutrition assessment andrecommendations made by registered dietitians (RD).Purpose: To determine which aspects of the RD’s chart note were mostbeneficial to physicians.Methods: A 2-page survey was distributed to general medicine andsurgical residents at UVAHS during weekly meetings in March 2006.Surveys must have been 75% complete to be included in the results.Results: Fifty surveys met completion criteria. Key results included: 78%preferred the nutrition assessment be included, 84% requested estimatednutritional needs, 100% desired nutrition recommendations listed withinthe note, 88% desired goals be clearly listed. When asked what hindersthe physicians from reading RD’s notes: 30% stated not concise enough,18% said irrelevant information, 10% said redundant information, 10%claimed not to understand the recommendations, 38% listed “other”“Other” included: Poor handwriting, Preferred verbal communication andorder entry (96% stated that the RD’s verbal order capacity was veryhelpful) or text paging. Information deemed unnecessary: Restating themedical and surgical history, Listing medication and lab values unlessdirectly related to the patient’s nutrition care plan.Conclusion: The preferences for the content of the RD notes asdetermined from the physician survey support the use of a more problemand goal-oriented chart note as proposed by ADA’s Nutrition Care ProcessModel method. A follow up study would be important to determine if thisnew charting method translates into improved patient outcomes.

Funding Disclosure: None

SUNDAY, SEPTEMBER 30

POSTER SESSION: PROFESSIONAL SKILLS/NUTRITION ASSESSMENT/MEDICAL NUTRITION THERAPY

Journal of the AMERICAN DIETETIC ASSOCIATION / A-45