Abstract 156: Nutrition therapy: Evaluating relevant interactions for therapeutic success

Abstract

Background: Clinical nutrition services focus on calories and when a patient looses weight, it may result in both fat and protein loss. There is a lacunae in incorporating anthropometric data as part of nutritional services.Aim: To evaluate nutritional therapy in Diabetes with anthropometric data beyond weight.Materials and Methods: A total number of 847 diabetes patients in age group 35-71 years referred to Division of Nutrition, St. John's Medical College Hospital, Bangalore were recruited from 2015 to 2017. Anthropometric measurements including Body-Mass-Index (BMI), Waist-circumference (WC), Waist–Hip Ratio (WHR), Mid-ArmCircumference (MAC) were carried out on the patients on the first visit and subsequently on every other visit. A 24-hour dietary and physical activity recall was done by a nutritionist and a specific individualised plan was provided based on current intake. Wherever applicable paired ‘t’ test & univariate regression analysis were carried out between anthropometric, biochemical and dietary variables. The mean follow up was 12 months.Results: There was a significant positive association between BMI, percent body fat and WC, but not with WHR. On 24-hour dietary recall done during follow up, individuals in all the BMI groups consumed diets that closely matched international dietary recommendations for diabetes in terms of fibre intake, carbohydrate:protein:fat ratio. Patient's blood glucose profiles improved with a decrease in fat intake, without significant weight-loss. The mid-arm-circumference remained same through the study period.Conclusion: Clinical nutrition programs should utilize anthropometric data like WC & MAC along with dietary recall. Appropriate counselling with balanced diet beyond calories should be provided to achieve a decrease in fat mass without a decrease in mid-arm-circumference to maintain the protein mass. This data compares favourably with the Finnish Diabetes Prevention Study (DPS).