• Clinical and Experimental Pediatrics
• /
• 제62권9호
• /
• pp.344-352
• /
• 2019

Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

• Journal of Nutrition and Health
• /
• 제47권4호
• /
• pp.247-257
• /
• 2014

우리나라 대다수 노인이 고 탄수화물 식사를 하고 있고, 고 탄수화물 식사가 만성질환의 위험과 관련될 수 있다고 보고되었다. 이에 본 연구는 한국 노인에서 탄수화물 에너지비 수준에 따른 만성질환 위험성을 파악하고자 2007~2009년 제4기 국민건강영양조사 자료를 이용하여 65세 이상 노인 3,917명을 대상으로 1일 에너지 섭취량이 500~5,000 kcal에 속하면서, 고혈압, 당뇨, 고지혈증, 뇌졸중, 심근경색 또는 협심증, 빈혈로 치료받는 자를 제외한 1,535명에 대한 자료를 분석하였다. 식사의 탄수화물 에너지비가 55~70%인 적정군과 70%를 초과한 과다군의 두 군으로 대상자를 분류하여 영양섭취상태와 만성질환의 위험 비율을 비교하였다. 모든 자료는 제4기 국민건강영양조사의 가중치를 적용한 후 성, 거주지역, 소득수준, 교육수준 또는 에너지 섭취량을 보정하여 일반선형모델을 사용하여 분석하였다. 만성질환 위험도는 로지스틱 회귀모형을 적용하여 만성질환 위험요인의 판별기준치에 따라 위험군의 백분율과 교차비를 구하고 ${\alpha}$ = 0.05 수준에서 유의성을 검토하였다. 1) 전체 대상자 중 탄수화물 과다군이 81.4%로 적정군에 비해 4배 이상 많았다. 과다군에 남자보다는 여자가 많았고, 읍면에 거주하고, 소득수준과 교육수준이 낮은 사람이 많았다. 2) 체질량 지수에서는 두 군 간에 차이가 없었으나, 체중, 허리둘레, 이완기 혈압이 과다군에 비해 적정군에서 높았다. 3) 탄수화물비 과다군에서 육류 및 난류, 우유 및 유제품, 주류의 섭취 빈도가 낮았고, 반면에 서류의 섭취 빈도는 높았다. 남자에서는 탄수화물 적정군에서 육류 및 난류의 섭취빈도가 높았고, 여자에서는 육류 및 난류 외에도, 우유 및 유제품, 스낵류, 해조류의 섭취 빈도가 적정군에서 높았다. 4) 탄수화물: 단백질: 지방 에너지비는 과다군 79.87: 11.66: 8.46, 적정군 64.88: 16.18: 18.94로 두 군 간에 탄수화물비 외에도 단백질비와 지방비에 큰 차이가 있었고, 에너지 섭취량은 과다군의 1,492 kcal에 비해 적정군이 1,722 kcal로 높았다. 조섬유, 칼륨, 비타민 A, 카로틴, 비타민 C섭취량은 두군 간에 차이를 보이지 않았으나, 나머지 영양소-단백질, 지방, 칼슘, 인, 철분, 레티놀, 티아민, 리보플라빈, 나이아신, 수분-의 섭취량이 탄수화물 적정군에서 높았다. 5) 영양소적정섭취비 (NAR)와 영양밀도지수 (INQ) 역시 비타민 C를 제외한 모든 영양소에서 탄수화물 적정군이 높았다. 성별로 분석하였을 때에도 전체 대상자에서와 비슷한 경향이었으나, 특히 칼슘, 리보플라빈의 영양소적정섭취비와 영양밀도지수가 여자 탄수화물 과다군에서 매우 낮았다. 6) 탄수화물 적정군에서 과다군에 비해 여성은 복부비만의 위험이 1.719배, 남자는 이상지질혈증의 위험이 2.094배 높았다. 이를 요약하면 탄수화물 과다군에서 동물성 식품의 섭취빈도가 낮고 에너지 및 다수 영양소의 섭취량이 낮아 영양부족의 우려가 있으나 빈혈 위험도에는 차이가 없었고, 남자에서는 이상지질혈증, 여자에서는 복부비만의 위험이 탄수화물 적정군에 비해 낮게 나타나서 탄수화물 과다군에서 만성질환의 위험이 높고 빈혈 위험이 높으리라는 연구 가설과는 일치하지 않는 결과를 나타내었다. 추후 이에 대한 확인과 함께, 노인 연령층을 일반 성인층에서 분리하여 만성질환 위험을 낮추는데 도움을 줄 수 있는 노인의 적정 탄수화물 에너지비 설정을 위한 연구가 필요하다.

• 대한가정학회지
• /
• 제36권12호
• /
• pp.201-216
• /
• 1998

This study was conducted to assess the nutrient intake and diet quality of college students in Seoul. Dietary survery data were obtained by 24-hour recall method from 774 students, 553 males and 191 females. Mean daily intake of energy was 2,480kcal with 56.4% of energy intake from carbohydrate, 14.6% from protein, and 25.5% from fat. Percentage of fat was higher than mean values of National Nutrition Survey(NNS), adults in rural area or younger students in previous studies. Mean daily intakes of calcium and vitamin A did not meet RDA levels in both sexes and intake of iron in females was insufficient to meet RDA level. The percentage of animal food to total food intake was 25% and consumption of meat, beverage and milk group was higher than those of National Nutrition Survey(NNS). When the consumption of 5 major food groups(grain, meat, milk, fruit, vegetable) were evaluated, 22% of students consumed all 5 groups and 47% consumed 4 groups, which show more balanced food group intake than adults in rural area. Food groups which were omitted frequently were milk and fruit. These results show that college students in Seoul consume better diet than subjects of National Nutrition Survey(NNS) or adults in rural area. However, high fat intake, low calcium and vitamin A intake and low iron level in women were observed. Majority(78%) of students had at least one food group omitted in their diet. Appropriate nutrition education may help to improve the quality of diet in these students.

• 대한지역사회영양학회지
• /
• 제10권4호
• /
• pp.525-535
• /
• 2005

This study was conducted to investigate the effect of a 3 week low calorie diet (LCD) and a 9 week of behavior modification (BM) program on the weight loss, mineral and vitamin status in 22 obese women. The subject were healthy, obese (PIBW> $120\%$) women aged 20 - 50 Yr and not taking any medications known to influence body composition, mineral or vitamin metabolism During the LCD program, subjects were provided commercial liquid formulas with 125 kcal per pack and were instructed to have a formula for replacement of one meal and at least one regular meal per day within the range of daily 800 - 1200 kcal intake. During the BM program the subjects weekly attended the group nutrition counseling session to encourage themselves to modify their eating behavior and spontaneously restrict their energy intakes. The BM program focused on stimulus control, control of portion sizes and modification of binge eating and other adverse habits. The initial mean energy intake of subjects was 2016.9 $\pm$ 129.8 kcal ($100.8\%$ of RDA) and dropped to 1276.5 $\pm$ 435.7 kcal at the end of a 3 week of LCD program and elevated to 1762 $\pm$ 329.3 kcal at the end of a 9 week of BM program. Carbohydrate, protein and fat intakes were significantly decreased at the end of the LCD but carbohydrate was the only macro nutrient that showed significant decrease (p < 0.05) at the end of the BM program compared to baseline. Calcium and iron intakes decreased significantly (p < 0.01, respectively) with no significant changes in other micronutrients at the end of the LCD. The mean weight of the subjects decreased from 73.8 $\pm$ 8.0 kg to 69.2 $\pm$ 7.7 kg with LCD and ended up with 67.7 $\pm$ 7.1 kg after 9 weeks of BM. The 3 weeks of LCD reduced most of the anthropometric indices such as BMI, PIBW, fat weight, wast-to-hip ratio and subscapular and suprailiac skinfold thickness. The 9 weeks of behavior modification showed slight change or maintenance of each anthropometric measurements. Weight loss and decreased WHR with the diet program induced significantly decreased systolic blood pressure. SGOT, SGPT and serum insulin levels with improved serum lipid profiles. Biochemical parameters related to iron status such as hemoglobin, hematocrit were significantly decreased (p < 0.01) at the end of the LCD. But their mean values were within normal range. The mean serum 25 (OH) vitamin $D_3$ level significantly increased after whole diet program. Serum folate level significantly decreased after 12 weeks of diet program. In conclusion 3 weeks of LCD brought 4.6 kg reduction in body weight without risk of iron, zinc or vitamin D deficiency and 9 weeks of the BM was effective to maintain nutritional status with slightly more weight reduction (1.5 kg). However calcium intake and serum folate should be monitored during the LCD and BM because of increased risk of deficiencies.

• 대한영양사협회학술지
• /
• 제7권3호
• /
• pp.258-266
• /
• 2001

The purpose of this study was to investigate the effect of dietary zinc on the carbohydrate metabolism and the serum content of magnesium and chromium in rats fed normal diet. Animals were divided into three groups by different dietary zinc levels which were low(15ppm), normal(30ppm) or high(60ppm). Serum glucose and Insulin concentrations were assessed by the glucose method and the radio immuno assay respectively. Serum zinc. magnesium and chromium contents were measured by Indectively Coupled Plasma(ICP). Results of the study were as follows : 1. Feed intake in a zinc deficiency group was significantly higher than that in other group, but the weight gain in high zinc diet group was significantly lower than in other groups. 2. There were no significant differences in liver, kidney and spleen weight. 3. Serum glucose, insulin and zinc concentrations were not significantly different among different dietary zinc groups, However serum magnesium and chromium concentrations were significantly decreased as the level of dietary zinc was increased.

• Journal of Nutrition and Health
• /
• 제40권2호
• /
• pp.172-181
• /
• 2007

This study was performed to evaluate served menu in Korean temples. Among available temples in the nation, 34 temples were carefully selected considering location and the gender characteristics. A five consecutive day menu was collected to analyse by interview between Jan 2004 and Aug 2004. Mean energy content of menu was 1633.8 kcal, with 67.3% of energy supplied by carbohydrate, 14.8% by protein and 17.9% by fat. Beans and bean products were the major contributing dishes for most nutrients. Contents of most nutrients except energy, protein and vitamin B were higher than RDA. Nutrient adequacy ratio (NAR) were 0.9-1.0 and mean adequacy ratio (MAR) was 0.9 for temples. Total number of dishes from menu was 7.3. Dietary variety score (DVS) was 26.4 and buddhist monk temples offered more diverse foods than buddhist nun temples. KDQI (Korean diet Quality Index), overall diet quality index were 0.67 and those of buddhist nun temples were better than those of buddhist monk temples. From the result of this study it was concluded that the temple diet is nutritionally well balanced, rich in dietary fiber and low in cholesterol. So it can be a healthy diet for the modern person. This is the very first study attempting the nationwide investigation of temple diet in Korea. It will be used as fundamental data to improve quality of diet to prevent modern chronic disease.

• Journal of Nutrition and Health
• /
• 제40권5호
• /
• pp.463-474
• /
• 2007

This study attempted to evaluate the effectiveness of nutrition education especially high nutrient density diet, which promotes low carbohydrate, high protein and fiber. Sixty nine college students participated in the 8 week weight management program with nutrition education. After the program, forty six experienced a small amount of weight loss (WL group, 1.3 kg), but twenty three did not (WG group). The WL group's dietary habits and diet quality improved significantly. The INQ of nutrients and MAR significantly increased only in the WL group. The total DQI-I score significantly increased from 71.1 to 75.3 in the WL group, but it did not in the WG group. The total dietary habit scores significantly increased in both groups, but the changes in the dietary habit scores were greater than the WG group in the WL group. After the program, total cholesterol and triglyceride level decreased significantly in the WL group (p < 0.05). These results show that nutrition education which focuses on a nutrient density diet could help improve dietary habits, diet quality, total cholesterol, and the triglyceride level in college women.

• Journal of Nutrition and Health
• /
• 제35권1호
• /
• pp.124-136
• /
• 2002

As the elderly population has increased in recent years in Korea chronic degenerative diseases prevalent in the aged have garnered attention in relation to food behavior. In general, dietary intakes of elderly Koreans were inadequate in quality as well as in quantity. Especially, intakes of Ca, vitamin A, and riboflavin along with total energy were insufficient. They tended to consume high carbohydrate and low fat energy rates which may be resulted from long standing vegetable-based flood patterns. Relationships between dietary intakes and indices of cardiovascular diseases revealed that blood pressures and serum lipids patterns tended to be poor in individuals having high abdominal fat accumulations which seemed to be related with dietary consumption of high carbohydrate and insufficient intake of many nutrients. These results suggested that a nutritionally balanced diet including animal sources floods is needed in order to prevent an abdominal obesity and cardiovascular diseases. The bone health status of the Korean elderly appeared poor. It was more serious in women recording a higher prevalence rate of osteopenia and osteoporosis than in men. There were strong associations between dietary factors and bone health status. Bone mineral density was found to be higher with higher intakes of protein energy rate, the total amount of feeds, and many nutrients including Ca and p, indicating that a good quality diet is essential in maintaining healthy bone status in later life. mental health condition of the elderly as measured by cognitive function and the degree of depression was also inadequate and had strong association with dietary consumption. The positive results were obtained in individuals having an adequate dict. Therefore, it could be summarized that the physical as well as mental health in elderly Koreans are highly related with their dietary patterns. Thus, the older adults need te consume nutritionally well balanced diet in sufficient amount, which contains various flood items including significant amounts of animal source floods in a daily diet in order to maintain healthy condition.

• Journal of Nutrition and Health
• /
• 제36권10호
• /
• pp.1061-1070
• /
• 2003

The purpose of this study was to investigate differences in the diet with the amount and the qualitative assessment of nutrient intakes by the economic level. Data from the 1998 Korean Health and Nutrition Survey were used. Using the poverty line based on the 1998 Korean minimum cost of living, Subjects (n = 10400) were classified into high class (36.1％), middle class (40.7％) and low class (23.1％). Chi-square-test and Analysis of Variance following Duncan's multiple range test were used to test the difference in nutrient intake pattern among three groups ($\alpha$ = 0.05). The amount of nutrient intake and nutrient intake adequacy were statistically different by the economic level (p<0.01). The ratio of energy intake from carbohydrate is higher than the criteria of WHO recommendation in all economic levels. Especially people in the low class depended much on the carbohydrate for the energy intake. The ratio of energy from the protein and fat are lower in the middle and low class than that of the high class. The Intake level of calcium and vitamin B$_2$ were lower than those of the Recommended Dietary intake level, regardless of economic status. It also showed differences in major food sources of nutrients by the economic level Consequently, it seems that the nutrition policy and program should be prepared according to their economic status. Also, there should more detailed studies to find out the nutrient intake pattern, their determinant, and health consequences.

• Journal of Nutrition and Health
• /
• 제19권1호
• /
• pp.16-22
• /
• 1986

This study was designed to investigate the nutritional effect of mugowrt powder supple mentation to rice diets with different protein levels. Thirty female albino rats weighing 39-43g were adopted for the feeding trial for 4 weeks. The different 5 kind of experimental diets were performed . Control diet was commercially available forage for rats, experimental diet (I-C) highly milled rice, (Ⅰ) highly milled rice 95% and mugwort powder 5%, (Ⅱ-C)highly milled rice 95% and milk casein 5%, and (Ⅱ) highly milled rice 90%, milk casein 5 % and mugwort powder 5%. Growth rate was remarkably high in the dietary group fed on highly milled rice supplemented with 5% mugwort powder (protein 8%) (P<0.05), but it showed the tendency to be rather low in the group fed on highly milled rice supplemented with 5% casein and 5% mugwort powder (protein 12%). Food efficiency as well as protein efficiency appeared similar to the growth rate. Hematodcrit level demonstrated the same tendency as growth rate, but hemoglobin content was observed to increase by diets supplemented with increasing amount of mugwort regardless of protein level. Each nutrient intake was increased by adding mugwort powder to diets after a week's feeding, but it was increased by 8% protein diet, and decreased by 12% protein diet in 3 weeks as well as 4 weeks after feeding . The absorption rate of carbohydrate and protein decreased by feeding mugwort supplemented diets regardless of protein level and feeding period, and that of lipid increased with 12% protein diet.