Nutritional assessment S85

107 of the 815 cases (13.1%) the diagnosis of malnutritiontriggered additional revenues of 1,387€ per case, in totalamounting to 148,465€. The cost of nutritional therapy waspreliminarily estimated to be about 80€ per case.

Number of cases with malnutrition diagnosed and coded

Severe Moderate Mild Total

2012 (baseline) 21 168 10 1992013 201 548 66 815

Conclusion: The 1-year evaluation of this project showsthat targeted screening for malnutrition boosts the rate ofdetection and the patients may then be offered suitablenutritional support. Our data also suggest that nutritiontherapy is a cost-effective measure to fight disease-relatedmalnutrition.

Disclosure of Interest: None Declared.

PP174-SUNVALIDATION OF MULTIPLE 24-HOUR RECALLS IN DUTCHELITE ATHLETES BY MULTIPLE 24-HOUR URINARY NITROGENEXCRETIONSF. Wardenaar1, J. Steenis2, M. Mensink3, J. de Vries3. 1Sportsand Exercise Studies, HAN University of Applied Sciences,Nijmegen, 2InnoSportLab Papendal, Arnhem, 3HumanNutrition, Wagening University, Wageningen, Netherlands

Rationale: Multiple dietary recalls are considered a good toolto estimate dietary intake. In the present study we aimedto validate the protein intake by multiple 24 hour recalls(24HR) with multiple 24 hour nitrogen in urine (24HN) in eliteathletes.Methods: Forty-eight healthy disabled and non-disabled Dutchmale and female elite athletes (aged 18 50 y) participated inthe study. Subjects reported dietary intake on 3 independentdays by a web-based 24HR, and collected 3 time 24HNduring 3 week period, at least 3 days apart. Completeness ofurine collection was checked with using PABA supplements.To examine whether nitrogen-balance was stable, bodyweight was measured on recall days and creatinine levelswere analysed in the 24HN. Urine samples were analyzedon nitrogen content with the Kjeldahl-method. RepeatedMeasured ANOVA (using Mixed Models) was performed toexamine changes in creatinine and body weight over theresearch period. Correlation analysis was performed to assessthe association between reported protein intake from 24hRand protein calculated from 24HN levels.Results: Mean±SD protein intake estimated by the 24 h recallwas 107±36 g/d and by the 24 h urine was 142±39 g/d. Thus,the 24 h recall method underestimated the mean actualprotein intake with 35.5±32 g/d or 30%. Urinary creatininelevels and body weight did not differ between the recalldays (p = 0.08 and p = 0.78, respectively). Crude correlationbetween the intake estimates was r = 0.61 (95% CI: 0.42 0.74),and after correction for energy intake and body weight it wasr = 0.54 (95% CI: 0.33 0.70).Conclusion: Based on the stable bodyweight and urinarycreatinine levels the assumption of nitrogen-balance appearsto be correct. Therefore, the amount of urinary nitrogenmost likely best reflects protein intake. We conclude that

multiple 24HR underestimate protein intake in elite athleteswith approximately one-third.

Disclosure of Interest: None Declared.

PP175-SUNEFFECT OF NUTRITIONAL STATUS ON FUNCTIONALITY:SCOUTING BODY COMPOSITION CONFOUNDING VARIABLESIN ELDERLYS. Perna1, S. Sacco1, G. Peroni1, M.A. Faliva1, D. Guido1,M. Rondanelli1. 1University of Pavia, Pavia, Italy

Rationale: The aim of the present study was to assess thepotential confounding role of body fat distribution markers,measured by DEXA device, on the causal relationship betweenMNA levels and Barthel Index.Methods: A study was conducted on 164 elderly (65+ y)patients (120 females, 44 males, age = 82±6.62 y). BarthelIndex (58.52±26.90 u), MNA levels (17.89±4.04 u) and bodyfat distribution markers, i.e. fat mass (19.898±8.889 kg), fatmass% (31.80±11.10), android% (34.63±12.20) and ginoid%(38.58±10.25), were measured. We used a multiple linearregression models adjusted for gender, age and BMI. Weverified the crude relationship between MNA levels and BarthelIndex and verified which body fat distribution markers wereassociated to the MNA levels and which of them could beclassified as potential confounders. Finally, they assessed theconfounding effect (D%) for each body fat distribution markerand also fitted the overall regression model.Results: The crude effect of MNA levels on Barthel Indexresulted equal to +1.8843 (P< 0.001). According to gender,age and BMI, for a unit increase of MNA level, functionalityincreased of 1.8843 Barthel units: this effect was verystrong. All fat distribution markers showed a positive andhighly significant association (P< 0.001) with nutritional index.Finally, according to the last regression models adjusted forpotential confounders, the percentage variations of MNA-Barthel causal effect resulted +3.2% for fat mass, +6.9% forfat mass%, +1.2% for android% and +4.5% for ginoid%.Conclusion: Results shows that the magnitude of MNA-Barthelcausal relationship could be reduced by the presence of anexcess of fat mass also in normal weight elderly subjects. Fatmass could mask the presence of a condition of hypercaloricmalnutrition not revealed by MNA.

Disclosure of Interest: None Declared.

PP176-SUNRESTING ENERGY EXPENDITURE IN PATIENTS WITHMYOTONIC DYSTROPHY IN RELATION TO BODY COMPOSITIONP.L.M. Reijven1. 1Dietetics, University hospital Maastricht,Maastricht, Netherlands

Rationale: Myotonic dystrophy (MD) is an inheritable multisys-tem disorder characterized by muscle weakness and multipleorgan impairment. Patients are prone to develop malnutrition.True caloric needs are often not known.Aim: To compare measured resting energy expenditure (REE)in patients with MD with predicted values.Methods: In 61 patients (28 female, 33 male) REE was mea-sured by indirect calorimetry (ventilated hood system) andcompared with Harris Benedict predictions. Body compositionwas measured with the skinfold technique.