• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.3
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• pp.163-179
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• 2022

Although functional gastrointestinal disorders (FGIDs) are very common in pediatric patients, there is a scarcity of published epidemiologic data, characteristics, and management patterns from Saudi Arabia, which is the 2nd largest Arabic country in terms of area and the 6th largest Arabic country in terms of population, with 10% of its population aged <5 years. Functional constipation (FC) is an FGID that has shown a rising prevalence among Saudi infants and children in the last few years, which urges us to update our clinical practices. Nine pediatric consultants attended two advisory board meetings to discuss and address current challenges, provide solutions, and reach a Saudi national consensus for the management of pediatric constipation. The pediatric consultants agreed that pediatricians should pay attention to any alarming signs (red flags) found during history taking or physical examinations. They also agreed that the Rome IV criteria are the gold standard for the diagnosis of pediatric FC. Different therapeutic options are available for pediatric patients with FC. Dietary treatment is recommended for infants with constipation for up to six months of age. When non-pharmacological interventions fail to improve FC symptoms, pharmacological treatment with laxatives is indicated. First, the treatment is aimed at disimpaction to remove fecal masses. This is achieved by administering a high dose of oral polyethylene glycol (PEG) or lactulose for a few days. Subsequently, maintenance therapy with PEG should be initiated to prevent the re-accumulation of feces. In addition to PEG, several other options may be used, such as Mg-rich formulas or stimulant laxatives. However, rectal enemas and suppositories are usually reserved for cases that require acute pain relief. In contrast, infant formulas that contain prebiotics or probiotics have not been shown to be effective in infant constipation, while the use of partially hydrolyzed formula is inconclusive. These clinical practice recommendations are intended to be adopted by pediatricians and primary care physicians across Saudi Arabia.

• Nutrition Research and Practice
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• v.16 no.5
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• pp.646-657
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• 2022

BACKGROUND/OBJECTIVES: The doubly labeled water (DLW) method is the gold standard for estimating total energy expenditure (TEE) and is also useful for verifying the validities of dietary evaluation tools. In this study, we compared the accuracy of total energy intakes (TEI) estimated by the 24-h diet recall method with TEE obtained using the doubly labeled water method. SUBJECTS/METHODS: This study involved 71 subjects aged 20-49 yrs. Over a 14-day period, three 24-h diet recalls per subject (2 weekdays and 1 weekend day) were used to estimate energy intakes, while TEE was measured using the DLW method. The paired t-test was used to determine the significance of differences between TEI and TEE results, and the accuracy of the 24-h recall method was determined by accuracy predictions percentage, root mean square error, and bias. RESULTS: Average study subject age was 33.4 ± 8.6 yrs. The association between TEI and TEE was positive and significant (r = 0.463, P < 0.001), and the difference between TEI (2,084.3 ± 684.2 kcal/day) and TEE (2,401.7 ± 480.3 kcal/day) was also significant (P < 0.001). In all study subjects, mean TEI was 12.0% (307.5 ± 629.3 kcal/day) less than mean TEE, and 12.2% (349.4 ± 632.5 kcal/day) less in men and 11.8% (266.7 ± 632.5 kcal/day) less in women. Rates of TEI underprediction for all study subjects, men, and women, were 60.5%, 51.4%, and 66.7%, respectively. CONCLUSIONS: This study shows that 24-h diet recall underreports energy intakes. More research is needed to corroborate our findings and evaluate the accuracy of 24-h recall with respect to additional demographics.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.241-256
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• 2023

BACKGROUND/OBJECTIVES: Diabetes-specific oral nutritional supplements (ONS) have anti-hyperglycemic effects, while D-allulose exerts anti-diabetic and anti-obesity effects. In this study, we investigated the efficacy and safety of diabetes-specific ONS, including allulose, on glycemic and weight changes in overweight or obese patients with type 2 diabetes mellitus (T2DM). SUBJECTS/METHODS: A single-arm, historical-control pilot clinical trial was conducted on 26 overweight or obese patients with T2DM (age range: 30-70 yrs). The participants were administered 2 packs of diabetes-specific ONS, including allulose (200 kcal/200 mL), every morning for 8 weeks. The glycemic profiles, obesity-related parameters, and lipid profiles were assessed to evaluate the efficacy of ONS. RESULTS: After 8 weeks, fasting blood glucose (FBG) level significantly decreased from 139.00 ± 29.66 mg/dL to 126.08 ± 32.00 mg/dL (P = 0.007) and glycosylated hemoglobin (HbA1c) improved (7.23 ± 0.82% vs. 7.03 ± 0.69%, P = 0.041). Moreover, the fasting insulin (δ: -1.81 ± 3.61 μU/mL, P = 0.017) and homeostasis model assessment for insulin resistance (HOMA-IR) (δ: -0.87 ± 1.57, P = 0.009) levels decreased at 8 weeks, and body weight significantly decreased from 67.20 ± 8.29 kg to 66.43 ± 8.12 kg (P = 0.008). Body mass index (BMI) also decreased in accordance with this (from 25.59 ± 1.82 kg/m² to 25.30 ± 1.86 kg/m², P = 0.009), as did waist circumference (δ: -1.31 ± 2.04 cm, P = 0.003). CONCLUSIONS: The consumption of diabetes-specific ONS with allulose in overweight or obese patients with T2DM improved glycemic profiles, such as FBG, HbA1c, and HOMA-IR, and reduced body weight and BMI.

• Journal of Animal Science and Technology
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• v.47 no.6
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• pp.955-962
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• 2005

This study was conducted to examine the nutrient digestibility and ruminal fermentation characteristics in sheep fed diets containing four substitution levels of E. ulmoides leaves for rice straw. For the experiment, they were given a basal diet consisting of rice straw and concentrate at a 3:7 ratio (DM basis). The treatments were designed as a 4$\time$4 Latin square design with four sheep (50.2$\pm$1.6 kg body weight). Sheep were allotted in one of four treatments, which were designed to progressively substitute Eucommia ulmoides for 0, 3, 5 and 10% of rice straw in the basal diet. The digestibility of crude fat was significantly (p<0.05) improved by 12.5 to 17.5% in 3% and 5% air dried Eucommia ulmoides leaves compared with that in control. The digestibility of crude fiber in the 3, 5 and 10% treatments was significantly (p<0.05) higher than that of the control. Dry matter intake was highest (p<0.05) in sheep fed 10% air dried E. ulmoides). Retained nitrogen in the 3, 5 and 10% treatments was increased up to 97%, 173% and 192%, respectively, compared to that in control (p<0.05). Organic matter utilization was higer in 3% and 5% treatments than control (p<0.05). Purine derivatives and microbial nitrogen synthesis were significantly increased by the dietary substitution of 5 % E. ulmoides leaves (p<0.05) compared with control and the 3% treatment. Ruminal concentration of total-VFA was significantly (p<0.05) higher in sheep fed all levels of air dried Eucommia ulmoides than those of control. It is concluded that air-dried E. ulmoides leaves given to ruminants can increase nutrient digestibility and palatability and improve ruminal fermentation. Therefore, the 5 and 10% substitution of E. ulmoides for roughage are highly recommended to be used in practice.

• Journal of Nutrition and Health
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• v.53 no.3
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• pp.303-318
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• 2020

Purpose: This study examined the effects of nutritional education related to sugar in elementary school children on nutritional knowledge, attitude, and dietary behavior. Methods: A questionnaire survey on the knowledge, attitudes, and intake related to sugar was conducted on 572 students in grades 4-5, who were attending five elementary schools in Seoul and Gyeonggi-do. Results: Among the survey subjects, 270 (49.8%) were cognitive in education, and 302 (50.2%) were non-cognitive. The sugar-related knowledge score was 3.67 points in the cognitive education group, which was significantly higher than the 3.55 points in the non-cognitive group. The rate of checking the sugar content in the nutrition label was 31.2% in the cognitive education group, which was significantly higher than in the non-cognitive group, 15.4%. The cognitive education group had a higher intake frequency of unsweetened candy, jelly, and raw fruits, and higher sugar intake of unsweetened bread, white milk, and raw fruits than the non-cognitive group. In the case of the cognitive education group, the total knowledge score showed a positive correlation with the food behavior scores, and a negative correlation with the frequency of purchasing snacks after school, and the average sugar intake per day. In the cognitive education group only, the education of nutrition teachers was analyzed as a factor to reduce the total sugar intake. The cognitive group of sugar education tried to eat foods with a lower sugar content than the non-cognitive group, and nutrition education was an important factor affecting the sugar intake. Conclusion: To reduce the sugar intake of elementary school students, it will be necessary to practice oriented-nutrition education by nutrition teachers continuously. In addition, it is important to develop and disseminate various types of nutrition education materials related to sugar that can be utilized easily by nutrition teachers.

• Journal of Nutrition and Health
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• v.48 no.5
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• pp.441-450
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• 2015

Purpose: The purpose of this study was to investigate the effects of hypertension relevant nutrition knowledge on practices for prevention of hypertension in Chinese college students studying in South Korea. Methods: We conducted a survey of 276 Chinese students studying more than three months in Korean universities who were aged 19 and older about hypertension and sodium relevant nutrition knowledge, intake of salty processed food, hypertension prevention practices, and stages of behavior change for hypertension. Results: The average score on the questionnaire for hypertension relevant nutritional knowledge was 40.62 out of 50 points, and the average score for sodium relevant nutritional knowledge was 24 out of 30 points. Kimchi was the most frequently eaten salty processed food. The average score for hypertension prevention practices was 3.10 out of 5 points. The behavior change stages for prevention of hypertension were contemplation (47.1%), action (32.2%), and pre-contemplation (20.7%). The students received high scores on nutrition knowledge and showed significantly higher scores on the action stage than on pre-contemplation or contemplation. Nutritional knowledge of hypertension and sodium showed positive correlation with hypertension prevention practices, whereas negative correlation with salty processed food intake. Conclusion: Development of an education program for Chinese students in Korea on hypertension and sodium relevant nutritional knowledge is needed so that they can practice for prevention of hypertension.

• Journal of Nutrition and Health
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• v.55 no.2
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• pp.296-308
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• 2022

Purpose: To investigate the effect of a mother's modeling and feeding practices on the eating behavior of the children. Methods: From April to June 2018, 1,036 young children aged 2 to 6 years and their mothers in Gyeongsan, Gyeongsangbuk-do, were examined for their eating behavior and feeding practices using a verified dietary behavior test (DBT). The children's dietary behavior was classified into four categories: "access evasiveness", "sensory acuity", "hyperactivity", and "irregularity". The mother's eating behavior was classified into three categories: "pickiness", "negligence", and "irregularity", and feeding practice types were classified into two categories: "responsibility/monitoring", and "restriction/pressure". The differences between the groups were tested using the t-test, ANOVA, and Duncan's multiple range test. The influence of feeding practices on the children's eating behavior was analyzed by hierarchical regression analysis while controlling for the mother's modeling. Results: The problem rates of irregularity, negligence and pickiness in the mother's modeling were 33.7%, 22.8%, and 20.7%, respectively. An analysis of the mother's feeding practices revealed that responsibility/monitoring had a middle, high and low significance in 74.2%, 17.3%, and 8.5% of respondents, respectively and the risk rate of restriction/pressure when guiding children to eat was 15.3%. The problem rates for sensory acuity, access evasiveness, irregularity, and hyperactivity in children were 27.9%, 26.1%, 24.8%, and 22.0%, respectively. Among the four eating behavior characteristics of children, the child's access evasiveness and sensory acuity were more affected by their pickiness rather than the mother's feeding practices, and the child's hyperactivity was more influenced by feeding practices than the mother's eating behavior. The child's irregularity was similarly affected by the mother's eating behavior and feeding practices. Conclusion: Since the mother's eating behavior and feeding practices affect the children's eating behavior, a diet improvement program for children should consider not only the nutrition education of children but also the mother's eating behavior and provide the necessary intervention for feeding practices.

• Journal of Nutrition and Health
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• v.55 no.1
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• pp.174-187
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• 2022

Purpose: This study was performed to evaluate an education program for housewives to reduce sodium intake based on the social cognitive theory. Methods: Housewives (n = 387) received 2 education sessions focused on food purchase and cooking, and completed a questionnaire on their perceptions of environmental, cognitive, and behavioral factors and the stages of behavioral change to reducing sodium intake both before and after the education program. Results: After the education program, the recognition of social efforts for sodium reduction and sodium labeling and experience with low-sodium products increased. Positive expectancies for the prevention of osteoporosis by the reduction of sodium were enhanced while the main barriers in practicing sodium reduction decreased, especially 'interrupting social relationships when dining with others', 'bad taste', 'preference for soup or stew', and 'limited knowledge and skills to practice'. In addition, cognition and nutrition knowledge related to reducing sodium intake were improved on all scores, but the effect on self-efficacy and dietary behavior was limited to only a few items. The percentage of participants in the pre-action stage (including pre-contemplation, contemplation, and preparation stages) for reducing sodium intake decreased from 43.2% before education to 21.5% after education, while that in the action stage increased from 19.6% before education to 43.5% after education (p < 0.001). The education program had the most significant impact on participants who were in the pre-action stage and showed improved scores in all sections. Conclusion: These results suggest that a customized education program for housewives could be an effective tool to reduce sodium intake by improving personal expectancies, cognition, and nutrition knowledge regarding sodium reduction and enabling a greater section of the population to move to the action stage of reducing sodium intake.

• Journal of dental hygiene science
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• v.9 no.1
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• pp.145-151
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• 2009

The purpose of this study was to examine the correlation of oral health behavior, oral health state and PHP in an effort to facilitate the promotion of oral health and improve oral health care. The subjects in this study were patients who got a scaling at the oral hygiene practice lab in the department of dental hygiene in S college dental clinic from September 5 to December 1, 2007. The collected data were analyzed with SPSS WIN 12.0 program. The findings of the study were as follows: 1. The younger patients had a smaller number of FT index, and the older patients excelled the younger ones in oral health behavior involving the use of oral hygiene supplies, regular visit to dental clinics and dietary control. 2. The patients got 2.62 out of possible five points on oral health behavior, which indicated that their oral health behavior wasn't good enough. Those whose oral health behavior was better had a smaller number of DT index and a larger number of FT index. A better oral health behavior led to a lower PHP index. 3. There was a negative(-) interrelationship between oral health behavior and DT index, and oral health behavior had a positive(+) correlation with FT index. The oral health behavior had a negative(-) correlation to PHP index, which showed that a better oral health behavior led to a lower PHP index. The above-mentioned findings seem to suggest that oral health behavior is one of integral factors to affect oral health status and PHP index, and the kind of oral health education that could change oral health care attitude should be provided during scaling practice after grasping the actual oral health behavior of patients.

• Journal of Nutrition and Health
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• v.49 no.6
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• pp.459-470
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• 2016

Purpose: The purpose of the present study is to identify the relationship between practicing healthy diet and metabolic syndrome indicators in Koreans. Methods: This research is a cross-sectional study based on the 2013~2014 Korea National Health and Nutritional Examination Survey. This study investigated 6,748 adults aged 19 to 64 yr (19~49 yr: n = 4,230, 50~64 yr: n = 2,518) to examine practice of healthy diet and metabolic syndrome indicators. In this study, according to practicing healthy diet, we classified subjects into the "Practicing healthy diet (PHD)" group (19~49 yr: n = 1,782, 50~64 yr: n = 937) and "Non-practicing healthy diet (NPHD)" group (19~49 yr: n = 2,448, 50~64 yr: n = 1,581). PHD score was determined by adding the number of practicing factors: adequate fat intake, sodium intake ${\leq}2,000mg/day$, fruit & vegetable intake ${\geq}500g/day$, and using nutrition label information in food selection. Results: Female adults had a larger proportion of subjects who practiced a healthy diet compared to male adults (p < 0.001), and the percentages of 19~49 yr and 50~64 yr were 40.46% and 37.07%, respectively. The PHD group consumed significantly more calcium, vitamin $B_1$, $B_2$, and vitamin C density compared to the NPHD group. In 50~64 yr females, the subjects practicing healthy diet (PHD score ${\geq}2$) was inversely associated with risk of abdominal obesity (OR: 0.71, 95% CI: 0.54~0.93, p value = 0.0131) and metabolic syndrome (OR: 0.70, 95% CI: 0.52~0.94, p value = 0.0166) after adjustments for multiple confounding factors, compared with the lower PHD score (PHD score ${\leq}1$). Conclusion: Good dietary practice such as adequate fat intake, sodium intake ${\leq}2,000mg/day$, sufficient fruit & vegetable intake, and using nutrition label information in food selection could be useful in decreasing metabolic syndrome risk of Korean adults.