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PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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Winning Poster Presentations

PhilSPEN 2014 Convention

Submitted: October 8, 2014 | Posted: October 10, 2014

  1. First Prize: Pediatric nutritional screening tool to identify malnutrition and at risk for malnutrition among admitted patients aged one to five years old (click)
  2. Second Prize: The cholesterol and glucose lowering effect of brown rice on hypercholesterolemic Filipino adults (click)
  3. Third Prize: Validation of diabetes risk assessment form (DRAF, adapted from FINDRISC) among undiagnosed Diabetes Mellitus Type 2 adults in Barangay 212, Zone 19, District 11. Manila – a cross sectional analytical study (click)

 

Title: Pediatric nutritional screening tool to identify malnutrition and at risk for malnutrition among admitted patients aged one to five years old

Authors: Jennifer A. Olay MD, Rebecca Abiog-Castro MD
Institution where study was conducted: Philippine Children’s Medical Center, Quezon City, Philippines

Background: Malnutrition among hospitalized children is a very important health issue that is associated with increased morbidity and mortality, length of hospital stay, health care cost and delayed functional recovery. However, routine screening of nutritional status has been hindered by lack of an accurate, simple and valid nutritional screening tool.

Objective(s): To develop a pediatric nutritional screening tool that will identify hospitalized patients who are malnourished and at risk of malnutrition and to establish cut off point and accuracy of risk scores using the Pediatric Nutritional Screening Tool.

Methodology: The Pediatric Nutritional Screening Tool was assessed prospectively among 246 patients aged 1-5 years old admitted at Philippine Children’s Medical Center. Anthropometric measurements, Body weight change, Clinical conditions and Dietary intake were evaluated within 24-48hours of admission. Statistical analyses done to measure accuracy were sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, prevalence and post test probability of each score. Cut-off point score was determined by using receiver operating characteristic curve.

Results: Multivariate analysis indicated that all the parameters used in the Pediatric Nutritional Screening Tool: Anthropometric, Body weight loss, Clinical condition and Dietary intake (p = 0.000001 for all factors) were all associated in identifying malnutrition and at risk for malnutrition. Cut-off point score of 6 was found out to indicate high risk of malnutrition.

Conclusion: The Pediatric Nutritional Screening Tool accurately identifies pediatric patients who are malnourished and at risk for malnutrition. This screening tool can be used as part of routine admission procedure to help in early identification and initiate appropriate nutritional intervention and help decrease and prevent morbidity associated with nutritional depletion.

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Title: The cholesterol and glucose lowering effects of brown rice among hypercholesterolemic Filipino adults

Author(s): Maureen Sarmago, RND, MSCN
Institution where study was conducted: Philippine Women's University, Manila, Philippines

Background: Several human trials have shown the brown rice intake can help lower blood cholesterol and fasting blood glucose.

Objective: To examine the effect of brown rice on cholesterol and fasting blood glucose compared to white rice.

Methodology: In this randomized parallel study thirty eight (38) hypercholesterolemic adults were randomized to the brown rice (BR) group (n=18) and to the white rice (WR) group (n=20). The participants consumed brown or white rice for 12 weeks. Total cholesterol, high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) and fasting blood glucose levels were measured before and after the intervention. Changes in the cholesterol and fasting blood glucose level were compared within and between groups.

Results: In the BR group, total cholesterol decreased significantly (p< 0.01) by 7.09% with an increase of 5.4% in HDL-C, which was not statistically significant. The fasting blood glucose was significantly reduced (4.2%, p<0.01). In the WR group, reduction in cholesterol and blood glucose were not significant, but their HDL-C improved significantly (8.85%, p<0.01). An unexpected significant increased in LDL cholesterol was observed in the BR group (8.1%, p=0.01) and WR group (9.96%, p=0.01) respectively.

Conclusion: This study suggests that brown rice consumption may help lower cholesterol and fasting blood glucose, and may be beneficial in the prevention and management of cardiovascular disease and other lifestyle related disorders.

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Title: Validation of diabetes risk assessment form (DRAF, adapted from FINDRISC) among undiagnosed Diabetes Mellitus Type 2 adults in Barangay 212, Zone 19, District 11. Manila – a cross sectional analytical study

Author(s): Cindy Chua, RND, MSCN and Jose Ma. Angbengco, MD, DPBCN
Institution where study was conducted: Philippine Women's University, Manila, Philippines

Background: Diabetes Mellitus (DM) is considered an emerging disease worldwide. The Western Pacific region has the largest number of DM-2 cases with 132 million where 76 million (57.9%) are undiagnosed. Being the 2nd  largest undiagnosed population following Africa, there are 1 in 3 adults with DM in this region. Since there is an increasing incidence of DM in the Philippines, the importance of early detection will prevent and delay onset of DM-2. Finding other assessment tools that is non-invasive could be helpful to increase awareness of undiagnosed population at risk for DM-2.

Objectives: This study was conducted to validate the usefulness of Diabetes Risk Assessment Form or DRAF (adapted from FINDRISC), using the following measures of accuracy: sensitivity, specificity, positive predictive value, and negative predictive value, for the identification of those with DM-2 among residents at Barangay 212 Zone 19, District II, in the City of Manila, from April 2014 – May 2014. The following were the major secondary objectives: to determine the demographic data of the undiagnosed residents; to determine the Total DM-2 Risk Score; and to determine the association between DM risk factors (age, BMI, waist circumference, daily physical activity, diet, presence of high blood pressure, history of DM, family history of DM) and the Total DM-2 Risk Score, with a cut-off point >9, versus OGTT.

Methods: The cross sectional analytical design was used, wherein 105, (70.48% female and 29.52% male), out of 121, finished the study. Purposive sampling was utilized with a sample size of 101 and 80% statistical power. Mean and standard deviation were used for numerical data, whereas, ratio and proportion were used for categorical data. Logistic Regression and Odds Ratio were computed to determine the risk total score versus OGTT, whereas, sensitivity, specificity, positive predictive value, and negative predictive value, and accuracy were used for measures of accuracy.

Results: The demographic profile were as follows: 16.19% young adult (19-39 years old), 51.43% middle age (40-59 years old), and 32.38% elderly group (>60 years old), with a mean age of 52.98. There was a waist-hip ratio of 31.43% normal cut off; while 68.57% above the cut off with a mean of 0.91. BMI reported were 60.95% (< 25kg/m2), 30.48% (25-30kg/m2), and 8.57% (>30kg/m2) with a mean of 24.02. Using OGTT, there were 74.29% without DM and with pre-diabetes, whereas, 25.71% had Type2DM. Based on the DRAF, the study showed that 86.67% participants had low to moderate DM risk; while 13.33% with DM high risk cut off (>15). Daily physical activity and diet showed no significant association with Total DM-2 risk score. There is a 3.2 times to 8 times chance that participants have DM-2 when classified, using a cut off score of >9. The following were the measures of accuracy: 74.07% Sensitivity; 52.56% Specificity; 85.42% Negative Predictive Value; 35.09% Positive Predictive Value; and 58.10% Accuracy (AUC: 0.63, 95% CI 0.53–0.73), that shows a moderate diagnostic accuracy. There was also a significant relationship between those with high risk scores and DM-2 status (OR 3.16, p=0.020 <0.05, 95% CI 1.20–8.34).

Conclusion: This study validates that Diabetes Risk Assessment Form (DRAF), adapted from FINDRISC, is a non-invasive screening tool that may be used as an adjunct to laboratory screening for DM-2.

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