A tailored automated nutrition screening tool for rapid identification of risk in acute-care hospital settings.

Malnourishment is prevalent in hospitalized patients and associated with adverse medical outcomes. Thus, nutrition screening to identify high-risk patients is widespread. However, no single universal tool has been shown to be suitable for all hospital departments. To address this challenge, a novel, tailored, electronic tool for nutritional screening was developed and evaluated. The Rambam Automated Nutrition Computerized Screening tool efficiently screens all newly admitted patients and does not rely on self-reported height and weight estimates. Validation was carried out in medical wards (n=94), and compared to the Malnutrition Universal Screening Tool, length of stay and an independent assessment by a professional dietician. Results from this research support the use of automated, flexible tools that instantaneously incorporate relevant available data from the electronic health record. Tools that are adaptable to meet the needs of individual hospital departments, can save valuable time and ensure full screening of all admitted patients.

Osteocalcin is independently associated with body mass index in adolescent girls.

OBJECTIVE: Osteocalcin is a bone-related protein, recently found to correlate with body mass index (BMI), waist circumference, fat percentage and metabolic syndrome in adults. The aim of this study was to determine the relationship between osteocalcin and BMI in adolescence, a time of significant bone accrual, while considering possible confounders related to bone and body composition. METHODS: We analyzed data from 160 female adolescents (mean age 15.1 ± 0.7 years), which were divided into tertiles by osteocalcin levels. Across these three groups, we examined the differences in BMI with relation to age, total daily energy intake, calcium intake, physical activity (PA), total body bone mineral density, parathyroid hormone (PTH), 25(OH)-vitamin D, bone alkaline phosphatase and body fat percentage. RESULTS: Mean BMI values differed significantly between participants in the three osteocalcin tertiles, including after adjustment for age, PA, PTH, energy and calcium intakes. Post-hoc analysis revealed that girls in the highest osteocalcin tertile, had a significantly lower BMI than those in the two lower ones (19.3 ± 2.2 vs. 20.6 ± 3.0 and 20.7 ± 2.9 kg m(-2), respectively, P = 0.018). There was no significant difference in energy and calcium intakes, bone mineral density, 25(OH)-vitamin D levels and PTH between study groups. CONCLUSIONS: In female adolescents, BMI is inversely related to osteocalcin, even after consideration of several factors that may affect bone and fat mass. As bone mineral density, 25(OH)D and PTH did not differ between groups, it is possible that the relation between osteocalcin and BMI could be unrelated to bone tissue itself.

Calcium intake and bone mass development among Israeli adolescent girls.

OBJECTIVE: To determine the possible relationship between food and life style habits and bone health in adolescent Israeli females. METHODS: 2,000 adolescent Israeli Jewish and Arab high-school girls (mean age 14.5) completed a semi-quantitative food frequency questionnaire and a personal history questionnaire. 27 food components were calculated for each subject. Bone mineral content and density were determined for 112 subjects with calcium intake below 800 mg/day. RESULTS: Average calcium intake was found to be 1,260 mg/day, but 20% of all girls had a calcium intake below 800 mg/day. All low-energy diets were very low in calcium, as mean calcium intake per 1,000 calories was 411 128 grams. A large percentage of diets with less than 800 mg calcium were also deficient in phosphorus (95.2%), magnesium (84.8%). iron (90.5%) and zinc (100%). Due to differences in food sources. Jewish girls had more phosphorus in their diet, but less magnesium and iron compared to Arab girls. Calcium and zinc deficiencies in Jewish and Arab diets were similar. A negative correlation was found between body mass index (BMI) and age at menarche for all girls in the study. Bone mineral density (BMD) measured for girls with calcium intake below 800 mg/day distributed normally around the average when compared to age matched controls despite their low calcium intake. There was a strong positive correlation between BMD and bone mineral content (BMC) at all sites and body weights. CONCLUSIONS: Low calcium intake, other nutritional deficiencies and delayed menarche due to low-energy diet in the growing period and in adolescence may prevent the formation of healthy bones. There is no evidence of lower bone mass among the low calcium intake group in the study population at this stage. It remains to be documented if the window of opportunity for optimal bone accretion for this group will be missed in the future. possibly leading to increased risk of osteoporosis.