Accuracy of Energy Prediction Equations in Korean Children
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Title: CHOCOLATE, STRAWBERRY, VANILLA, AND WHITE: FOURTH- GRADE CHILDREN ARE ABLE TO ACCURATELY RECALL THE FLAVOR OF MILK CONSUMED AT SCHOOL MEALS Author(s): S. D. Baxter, 1 J. A. Royer, 1 J. W. Hardin, 2 C. H. Guinn, 1 A. J. Mackelprang 1 ; 1 Institute for Families in Society, University of South Carolina, Columbia, SC, 2 Center for Health Services and Policy Research, and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC Learning Outcome: To describe fourth-grade children’s ability to accurately recall the flavor of milk they were observed to have consumed at school meals. Text: We investigated children’s ability to accurately recall milk flavors consumed at school meals. Each of 376 randomly-selected fourth-grade children (96% Black) was observed eating school breakfast and school lunch and then interviewed to obtain a 24-hour recall using one of six protocols created by crossing two target periods (previous-day; prior-24-hours) with three interview times (morning; afternoon; evening). Each protocol had 62-64 children (half boys). Logistic regression was used to model the likelihood of accurately reporting milk flavors. Chocolate, strawberry, vanilla, and white milk were observed to have been consumed at 139, 46, 56, and 121 meals, respectively, and were reported to have been consumed at 139, 33, 54, and 103 meals, respectively. When a milk was reported, children were 67 times more likely to report chocolate correctly than incorrectly (95% Confidence Interval [CI]25-181), 96 times more likely to report strawberry correctly than incorrectly (95% CI34-268), 55 times more likely to report vanilla correctly than incorrectly (95% CI22-136), and 31 times more likely to report white correctly than incorrectly (95% CI15-66). Accuracy of reported milk flavors did not depend on sex or race, but was better for the prior-24- hour than previous-day target period (p0.0001); reported milk flavors matched observed milk flavors 77% and 59% of the time for the prior-24-hour and previous-day target period, respectively. Because children accurately recalled milk flavors consumed at school meals, we recommend classifying correctly-reported milk flavors as matches and incorrectly-reported milk flavors as intrusions for validation studies that use school-meal observations to assess recall accuracy. Funding Disclosure: Grant R01 HL74358 from the National Heart, Lung, and Blood Institute of the National Institutes of Health. SD Baxter was Principal Investigator. Title: ACCURACY OF ENERGY PREDICTION EQUATIONS IN KOREAN CHILDREN Author(s): J. C. Lawrence, 1 H. M. Lee, 2 J. H. Kim, 2 E. K. Kim 2 ; 1 University of Alabama, Tuscaloosa, AL, 2 Department of Food Science, Kangnung National University, Gangwon-do, Republic of Korea Learning Outcome: Participants will be able to evaluate accuracy of prediction equations used for persons of Korean heritage and identify body composition variable which could improve accuracy of predictive equations. Text: Relevance: Energy needs are affected by ethnic heritage. Identification of the most accurate energy prediction equation for use in a given ethnicity is important to avoid under- or over-nutrition. Priority: Study aims are to identify prediction equations that correlated with measured resting metabolic rate (MRMR) in Korean children and to identify anthropometric and/or body composition variables that could be incorporated into the prediction equation to increase accuracy for this population. Results: Subjects were 92 healthy, South Korean children (38 boys, 54 girls; mean age 7.72.7 years). Measurements included: MRMR (TrueOne 2400 metabolic cart), weight/height (digital scale/stadiometer); body fat (BIA, Inbody720), blood pressure (sphingomanometer), triceps skinfold thickness (MD-500 skinfold calipers), muscle mass (Heymsfield’s formula) and body surface area (Dubois formula) calculations. Predicted resting metabolic rates (PRMR) were calculated using the Harris-Benedict, WHO/NAO/FAO, Altman and Dittmer, Maffeis, and Schofield-HW equations, and the Dietary Reference Intake recommendations. PRMR were significantly correlated with MRMR (p0.01 for all) and accurately predicted MRMR (R 2 0.54-0.56). However, RMSPE analyses demonstrated prediction errors of 91-217 kcals/day. A newly developed energy prediction equation (RMR 5.38*obesity index (%) 824.39*body surface area (m 2) - 22.47*body fat(kg) - 201.91) produced an improved RMSPE; 84.38 74.90 (R 2 0.611). Synthesis: PRMR were significantly correlated with MRMR in Korean children, however predicted needs deviated up to 217 kcals/day, which could result in under- or over- nutrition over time. Data from this study suggests incorporation of anthropometric variables into an energy prediction equation can improve accuracy in persons of Korean heritage. Funding Disclosure: None Title: EARLY INFANT DIET IS NOT A PREDICTOR OF BODY MASS INDEX AND MACRONUTRIENT INTAKE AT 2 YEARS Author(s): S. A. Smith, 1 A. Andres, 2 T. M. Badger, 2 J. M. Gilchrist 2 ; 1 Arkansas Children’s Nutrition Center, Little Rock, AR, 2 University of Arkansas for Medical Science, Little Rock, AR Learning Outcome: To describe the significant BMI and dietary findings of 2 year old children as they relate to infant diet. Text: Many retrospective studies have suggested that breast feeding during the first year of life may provide protection against overweight and obesity during childhood and later in life. We compared body mass index (BMI) and macronutrient composition in 2 year old children who were fed breast milk (BF, N55), milk-based formula (MF, N63) or soy-based formula (SF, N64) during the first year of life and exclusively for the first four months. Participants were part of the on-going longitudinal prospective Beginnings study. Anthropometric measurements were taken and BMI was calculated as kg/m 2 . We obtained 3-day food records using Nutrition Data System for Research. BMI did not differ by feeding group (BF: 16.6 1.4, MF: 16.71.3, SF: 16.71.4) or sex (M: 16.81.3 F: 16.51.5). Caloric intake (kcal/day and kcal/kg) differed by sex (M: 1321344, F: 1184320, P0.004; and M: 7923, F: 7221, P0.027) but not by feeding group. Energy-adjusted macronutrient intake showed no significant group or sex differences. In our cohort, children fed BF, MF or SF as infants do not differ in their BMI or in the macronutrient composition of their diets at 2 years. We also see that BF children do not appear to be leaner than children fed formula. Although more research is needed, BMI seems to be influenced by more factors than diet alone at 2 years. Funding Disclosure: Funded by USDA-ARS CRIS # 6251- 51000-005-03S Title: PREADOLESCENT BOYS’ BODY SIZE PERCEPTIONS MATCH THOSE OF THEIR PARENTS Author(s): L. S. Brann; Nutrition Science and Dietetics, Syracuse University, Syracuse, NY Learning Outcome: To identify body size perceptions of preadolescent boys and their parents when boys are grouped by their body mass index. Text: A cross-sectional study of forty-nine preadolescent boys and their parents was performed to determine if differences existed in body esteem and body perceptions of the boys grouped by their body mass index (BMI; wt/ht 2 ) and to determine how accurately parents perceive their sons’ body size. Boys were grouped by their BMI into an average BMI group (BMI percentile between the 33 rd and the 68 th ) and a high BMI group (BMI percentile greater than the 85 th ). Boys completed the Body Esteem Scale and body size perceptions were assessed using figure drawings (included seven drawings of boys’ silhouettes, which ranged from very thin to very heavy). Parents completed questionnaires related to their perceptions of their sons’ current and ideal body size using the same figure drawings. No differences were found in body esteem of boys by their BMI groups. Boys in the high BMI group perceived themselves as bigger than the boys in the average BMI group (p0.001), and parents of boys with a high BMI perceived their sons as bigger than parents of boys with an average BMI (p0.001). Boys in the high BMI group rated their current figure as heavier than their ideal boy figure (p0.001). Results from this study support that boys and parents were aware of the boys’ current body size. However, parents of boys with a high BMI were more accepting of a larger ideal body figure. Practitioners should discuss with parents and boys their perceptions of body size in order to develop healthy weight management goals. Funding Disclosure: American Dietetic Association/Gerber Endowment in Pediatric Nutrition Scholarship TUESDAY, OCTOBER 28 POSTER SESSION: WELLNESS AND PUBLIC HEALTH A-114 / September 2008 Suppl 3—Abstracts Volume 108 Number 9
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Transcript of Accuracy of Energy Prediction Equations in Korean Children
Title: CHOCOLATE, STRAWBERRY, VANILLA, AND WHITE: FOURTH-GRADE CHILDREN ARE ABLE TO ACCURATELY RECALL THEFLAVOR OF MILK CONSUMED AT SCHOOL MEALS
Author(s): S. D. Baxter,1 J. A. Royer,1 J. W. Hardin,2 C. H. Guinn,1
A. J. Mackelprang1; 1Institute for Families in Society, University of SouthCarolina, Columbia, SC, 2Center for Health Services and Policy Research,and Department of Epidemiology and Biostatistics, University of SouthCarolina, Columbia, SC
Learning Outcome: To describe fourth-grade children’s ability toaccurately recall the flavor of milk they were observed to have consumedat school meals.
Text: We investigated children’s ability to accurately recall milk flavorsconsumed at school meals. Each of 376 randomly-selected fourth-gradechildren (96% Black) was observed eating school breakfast and school lunchand then interviewed to obtain a 24-hour recall using one of six protocolscreated by crossing two target periods (previous-day; prior-24-hours) with threeinterview times (morning; afternoon; evening). Each protocol had 62-64children (half boys). Logistic regression was used to model the likelihood ofaccurately reporting milk flavors. Chocolate, strawberry, vanilla, and whitemilk were observed to have been consumed at 139, 46, 56, and 121 meals,respectively, and were reported to have been consumed at 139, 33, 54, and103 meals, respectively. When a milk was reported, children were 67 timesmore likely to report chocolate correctly than incorrectly (95% ConfidenceInterval [CI]�25-181), 96 times more likely to report strawberry correctlythan incorrectly (95% CI�34-268), 55 times more likely to report vanillacorrectly than incorrectly (95% CI�22-136), and 31 times more likely toreport white correctly than incorrectly (95% CI�15-66). Accuracy of reportedmilk flavors did not depend on sex or race, but was better for the prior-24-hour than previous-day target period (p�0.0001); reported milk flavorsmatched observed milk flavors 77% and 59% of the time for the prior-24-hourand previous-day target period, respectively. Because children accuratelyrecalled milk flavors consumed at school meals, we recommend classifyingcorrectly-reported milk flavors as matches and incorrectly-reported milkflavors as intrusions for validation studies that use school-meal observationsto assess recall accuracy.
Funding Disclosure: Grant R01 HL74358 from the National Heart,Lung, and Blood Institute of the National Institutes of Health. SD Baxterwas Principal Investigator.
Title: ACCURACY OF ENERGY PREDICTION EQUATIONS INKOREAN CHILDREN
Author(s): J. C. Lawrence,1 H. M. Lee,2 J. H. Kim,2 E. K. Kim2;1University of Alabama, Tuscaloosa, AL, 2Department of Food Science,Kangnung National University, Gangwon-do, Republic of Korea
Learning Outcome: Participants will be able to evaluate accuracy ofprediction equations used for persons of Korean heritage and identifybody composition variable which could improve accuracy of predictiveequations.
Text: Relevance: Energy needs are affected by ethnic heritage.Identification of the most accurate energy prediction equation for use in agiven ethnicity is important to avoid under- or over-nutrition. Priority:Study aims are to identify prediction equations that correlated withmeasured resting metabolic rate (MRMR) in Korean children and toidentify anthropometric and/or body composition variables that could beincorporated into the prediction equation to increase accuracy for thispopulation. Results: Subjects were 92 healthy, South Korean children (38boys, 54 girls; mean age 7.7�2.7 years). Measurements included: MRMR(TrueOne 2400 metabolic cart), weight/height (digital scale/stadiometer);body fat (BIA, Inbody720), blood pressure (sphingomanometer), tricepsskinfold thickness (MD-500 skinfold calipers), muscle mass (Heymsfield’sformula) and body surface area (Dubois formula) calculations. Predictedresting metabolic rates (PRMR) were calculated using the Harris-Benedict,WHO/NAO/FAO, Altman and Dittmer, Maffeis, and Schofield-HWequations, and the Dietary Reference Intake recommendations. PRMRwere significantly correlated with MRMR (p�0.01 for all) and accuratelypredicted MRMR (R2 � 0.54-0.56). However, RMSPE analysesdemonstrated prediction errors of 91-217 kcals/day. A newly developedenergy prediction equation (RMR � 5.38*obesity index (%) � 824.39*bodysurface area (m2) - 22.47*body fat(kg) - 201.91) produced an improvedRMSPE; 84.38 � 74.90 (R2�0.611). Synthesis: PRMR were significantlycorrelated with MRMR in Korean children, however predicted needsdeviated up to �217 kcals/day, which could result in under- or over-nutrition over time. Data from this study suggests incorporation ofanthropometric variables into an energy prediction equation can improveaccuracy in persons of Korean heritage.
Funding Disclosure: None
Title: EARLY INFANT DIET IS NOT A PREDICTOR OF BODYMASS INDEX AND MACRONUTRIENT INTAKE AT 2 YEARS
Author(s): S. A. Smith,1 A. Andres,2 T. M. Badger,2
J. M. Gilchrist2; 1Arkansas Children’s Nutrition Center, LittleRock, AR, 2University of Arkansas for Medical Science, LittleRock, AR
Learning Outcome: To describe the significant BMI anddietary findings of 2 year old children as they relate to infantdiet.
Text: Many retrospective studies have suggested that breastfeeding during the first year of life may provide protectionagainst overweight and obesity during childhood and later in life.We compared body mass index (BMI) and macronutrientcomposition in 2 year old children who were fed breast milk (BF,N�55), milk-based formula (MF, N�63) or soy-based formula(SF, N�64) during the first year of life and exclusively for thefirst four months. Participants were part of the on-goinglongitudinal prospective Beginnings study. Anthropometricmeasurements were taken and BMI was calculated as kg/m2. Weobtained 3-day food records using Nutrition Data System forResearch. BMI did not differ by feeding group (BF: 16.6 �1.4,MF: 16.7�1.3, SF: 16.7�1.4) or sex (M: 16.8�1.3 F: 16.5�1.5).Caloric intake (kcal/day and kcal/kg) differed by sex (M:1321�344, F: 1184�320, P�0.004; and M: 79�23, F: 72�21,P�0.027) but not by feeding group. Energy-adjustedmacronutrient intake showed no significant group or sexdifferences. In our cohort, children fed BF, MF or SF as infantsdo not differ in their BMI or in the macronutrient composition oftheir diets at 2 years. We also see that BF children do notappear to be leaner than children fed formula. Although moreresearch is needed, BMI seems to be influenced by more factorsthan diet alone at 2 years.
Funding Disclosure: Funded by USDA-ARS CRIS # 6251-51000-005-03S
Title: PREADOLESCENT BOYS’ BODY SIZE PERCEPTIONSMATCH THOSE OF THEIR PARENTS
Author(s): L. S. Brann; Nutrition Science and Dietetics,Syracuse University, Syracuse, NY
Learning Outcome: To identify body size perceptions ofpreadolescent boys and their parents when boys are grouped bytheir body mass index.
Text: A cross-sectional study of forty-nine preadolescent boysand their parents was performed to determine if differencesexisted in body esteem and body perceptions of the boys groupedby their body mass index (BMI; wt/ht2) and to determine howaccurately parents perceive their sons’ body size. Boys weregrouped by their BMI into an average BMI group (BMIpercentile between the 33rd and the 68th) and a high BMI group(BMI percentile greater than the 85th). Boys completed the BodyEsteem Scale and body size perceptions were assessed usingfigure drawings (included seven drawings of boys’ silhouettes,which ranged from very thin to very heavy). Parents completedquestionnaires related to their perceptions of their sons’ currentand ideal body size using the same figure drawings. Nodifferences were found in body esteem of boys by their BMIgroups. Boys in the high BMI group perceived themselves asbigger than the boys in the average BMI group (p�0.001), andparents of boys with a high BMI perceived their sons as biggerthan parents of boys with an average BMI (p�0.001). Boys in thehigh BMI group rated their current figure as heavier than theirideal boy figure (p�0.001). Results from this study support thatboys and parents were aware of the boys’ current body size.However, parents of boys with a high BMI were more acceptingof a larger ideal body figure. Practitioners should discuss withparents and boys their perceptions of body size in order todevelop healthy weight management goals.
Funding Disclosure: American Dietetic Association/GerberEndowment in Pediatric Nutrition Scholarship
TUESDAY, OCTOBER 28
POSTER SESSION: WELLNESS AND PUBLIC HEALTH
A-114 / September 2008 Suppl 3—Abstracts Volume 108 Number 9
