Here is an answer without modulo 2 and pure bash, which works with negative percentage:  
echo "$(( 200*item/total - 100*item/total ))"
We could define a generic integer division that rounds to the nearest integer and then apply it. 
function rdiv {
   echo $((  2 * "$1"/"$2" - "$1"/"$2" ))
}
rdiv "$((100 * $item))" "$total"
In general, to compute the nearest integer using float to int conversion, one can use, say in Java : n = (int) (2 * x) - (int) x; 
Explanation (based on binary expansion): 
Let fbf(x)  be the first bit of the fractional part of x, keeping the sign of x. Let int(x) be the integer part, which is x truncated toward 0, again keeping the sign of x.  Rounding to the nearest integer is 
round(x) = fbf(x) + int(x).
For example, if x = 100*-30/70 = -42.857, then fbf(x) = -1 and int(x) = -42.
We can now understand the second answer of Michael Back, which is based on modulo 2, because:
fbf(x) = int(2*x) % 2 
We can understand the answer here, because:
fbf(x) = int(2*x) - 2*(int(x))
An easy way to look at this formula is to see a multiplication by 2 as shifting the binary representation to the left. When we first shift x, then truncate, we keep the fbf(x) bit that we lose if we first truncate, then shift.   
The key point is that, in accordance with Posix and the C standard, a shell does a "rounding" toward 0, but we want a rounding toward the closest integer. We just need to find a trick to do that and there is no need for modulo 2.