Purpose: To assess the prevalence of malnutrition in gynecologic cancer patients using the Scored Patient-Generated Subjective Global Assessment (PG-SGA) questionnaire. Materials and Methods: A total of 97 gynecologic cancer patients who never had any treatment but were planned for surgery were enrolled. The patients were asked to complete the scored PG-SGA form before the treatment was started. Attending physicians were also asked to complete other information in the PG-SGA form. Total scores were calculated and the patients were classified into 3 nutritional status levels. Results: Mean age was 54 years. Postoperative diagnoses were endometrial cancer in 42 cases (43.2%), ovarian cancer in 29 cases (29.9%), and cervical cancer in 26 cases (26.8%). Mean PG-SGA score was 5.2+4.7. Malnutrition (PG-SGA B and C) was found in 52 patients (53.6%, 95% CI 43.7% - 63.2%). Preoperative BMI, hemoglobin, serum albumin, and cancer stage were not significantly associated with nutritional status. Malnutrition was significantly more common among patients diagnosed with ovarian cancer, compared to other types of cancer (79.3% vs. 42.6%, p 0.004). Conclusions: Prevalence of malnutrition among gynecologic cancer patients was 53.5%, according to the scored PG-SGA. Malnutrition was significantly more common among patients with ovarian cancer.
Objectives: Increasing salt preferences with age are said to increase preferences of salty foods, thereby leading to greater sodium consumption, which has further implication for hypertension. This study examined the link between preference of salty taste and dietary factors and health-related risk factors in Korean elderly people. Methods: We studied 312 elderly individuals aged > 65 years (male, 100 and female, 212). With each subject, pleasant concentration of NaCl was estimated using the sip-and-spit method. Dietary habits, food preferences, consumption frequencies, anthropometric and biochemical assessment were assessed. Results: The pleasant salt concentration was significantly increased in individuals older than 75 years (p < 0.05). Subjects who liked high concentration of salt showed significantly higher preferences for salty foods (p < 0.001). Results showed significant effects (p < 0.01) of fruit & fruit juice consumption frequencies, MNA (mini-nutritional assessment), cognition score, BMI, body fat %, waist circumference, arm circumference, calf circumference, vitamin D level that subjects who likes low salty taste were higher than subjects who likes high salty taste. Conclusions: The preference for salty taste in the elderly was not correlated with hypertension. But, increased preference for salty taste with age and increased salty food preferences may result in higher sodium consumption. Therefore, nutritional education regarding lowering salt preference and favorable behaviors of low-salt diet is needed to improve the quality of life in the rural elderly.
Purpose: Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults. Methods: A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2. Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older). Results: A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group. Conclusion: Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.
Objectives: This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen's Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated. Results: Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI. Conclusions: NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.
We examined the obesity levels and dietary habits of 323 college students taking the course 'Health and Diet' as a part of their nutritional education. The average percentages of body fat, BMI and RBW for subjects in this study were 16.7%, $21.5kg/m^2$ and -1.2% in male students and 27.3%, $21.2kg/m^2$ and 1.0% in female students, respectively. BMI and RBW indicated fewer cases of obesity among female students than BIA did. The average intake of energy by subjects was lower than the RDA of energy. In particular, the average intakes of calcium, iron, and vitamin A by female students were much lower than the RDA of energy. In particular, the average intakes of calcium, iron, and vitamin A by female students were much lower than the RDAs of each of those nutrients. The percent RDAs of nutrient intakes of energy, protein, thiamin, and riboflavin were lower in under weight students than in students of normal and over-weight. Female students were found to skip meals and consume sweet foods more frequently than male students. The obesity levels of students related to the number of meals eaten per day as well as the frequency of consuming sweet foods. Although, it was not possible to determine statistically, the levels obesity also seemed to correspond to the speed at which meals were eaten as well as the frequency of eating salty foods. These results suggest that in order to assess obesity properly, more research that focuses on subjects' gender should be conducted. In addition, nutritional education should emphasize the importance of intakes of energy and phosphorus for male students, and the danger of iron and calcium deficiencies for female students. We should also educate students about dietary habits which contribute to obesity such as overeating and the intake of sweet foods.
This research was performed to investigate the effects of NEP (Nutritional Education Practice) program developed by KHyDDI (Korea Hypertension Diabetes Daegu Initiative) for hypertension and diabetes patients. The subjects were 116 patients (hypertension 70, diabetes 46) who had completed basic education program at the education information center and four-session program was implemented for them. Nutrient intake was analyzed and compared before and after the program by 24-hr recall method and evaluate weight, waist circumference, body fat, blood pressure and eating habits in terms of nutrition knowledge, eating behavior, salty taste assessment. The improved results after the program were observed in weight, waist circumference, body fat ratio, blood pressure, slightly salty taste in salty taste assessment, nutrition knowledge, eating behavior, sodium, energy, carbohydrate and protein intake ratio to total energy (p < 0.001). Therefore, this program is effective in the improvement of weight, waist circumference and eating behavior, and the continued management would lead to the prevention of cardio-cerebrovascular diseases in the community.
Objectives: The objective of this study was to revise the target pattern in food guidance system for adolescents' balanced menu planning. Methods: The food groups in the target pattern were divided into detailed food items, and intake number were assigned to each food items based on the revised standard food composition table. The validity of revised target pattern was examined. Menu planning according to the revised target pattern was made available to 305 male and female middle school students and the nutritional assessment of the menu plan were carried out using SPSS WIN 12.0. Results: The energy contents, energy contribution ratios of carbohydrate, fat, and protein, and 4 minerals' and 6 vitamins' contents of the revised target pattern were adequate. The average energy contents of the menu planned according to revised target pattern were 400~500 kcal higher than that of the revised target pattern when the revised standard food composition was applied. The energy contribution ratios of fat were 28.9%, close to maximum of acceptable macronutrient distribution range (AMDR) (30%), and that of carbohydrate were 54.5%, lower than minimum of AMDR (55%). The nutrient adequacy ratios (NARs) of calcium and vitamin C were less than 1.0. According to index of nutritional quality (INQ) of food items, kimchi, milk dairy products, and soybean curd were energy efficient source for calcium, kimchi, fruit, vegetable and seaweed were energy efficient source for vitamin C, with INQ of food items were higher or close to 2.0. Kimchi was the best energy efficient source of calcium and vitamin C. Conclusions: Revised target pattern based on the adolescent's foods intake was not good enough for balanced menu planning by adolescents, because what they ate and what they wanted to eat were very much different. Detailed guidance for food selection is necessary in each food items.
Various types of functional foods for health (FFH) are popularly used among adolescents. We surveyed 858 students, $15.0 \pm$ 1.6 (14-18) years of age, attending general junior or senior high schools in Korea for FFH use and significant variables for their FFH use including demographic characteristics, food consumption frequency and nutritional beliefs. The use prevalence of FFH was $47.8\%$, and among all types of FFH, nutritional supplements were taken most frequently, followed by red ginseng products > enzyme containing products > plant extract-fermented products. FFH use was higher in older aged-group, subjects lived in small or middle city, and those from families with a high socioeconomic status in comparison to each corresponding group. Health concern on offsprings by parents and usage ratio of FFH by family was higher in users than in nonusers of FFH. Total score of dietary assessment was higher in users than in nonusers of FFH, and users had a more positive view concerning the potential health benefit of FFH than did nonusers. Most users of FFH took FFH when they were healthy ($50.7\%$) , and they did not feel special effects through the FFH use ($57.1\%$) . Most users of FFH got the information on FFH through family and relatives ($61.5\%$) , and most of them purchased FFH at pharmacy or oriental medicine clinics ($55.1\%$) . FFH users preferred vitamin C-and Ca-supplements most among the vitamin mineral supplements belonged to FFH. Given the widespread use of FFH by adolescents, the reasonable use of these products for the contribution to their overall health and well-being is a subject that is emphasized in nutrition education for them. (Korean J Nutrition 38(10) : 864$\sim$872,2005)
BACKGROUND/OBJECTIVES: Adequate dietary fatty acid intake is important for toddlers between 12-24 months of age, as this is a period of dietary transition in conjunction with rapid growth and development; however, actual fatty acid intake during this period seldom has been explored. This study was conducted to assess the intake status of n-3 and n-6 polyunsaturated fatty acids by toddlers during the 12-24-month period using 2010-2015 Korea National Health and Nutrition Examination Survey data. SUBJECTS/METHODS: Twenty-four-hour dietary recall data of 12-24-month-old toddlers (n = 544) was used to estimate the intakes of ${\alpha}$-linolenic acid (ALA; 18:3n-3), eicosapentaenoic acid (EPA; 20:5n-3), docosahexaenoic acid (DHA; 22:6n-3), linoleic acid (LA; 18:2n-6), and arachidonic acid (AA; 20:4n-6), as well as the major dietary sources of each. The results were compared with the expected intake for exclusively breastfed infants in the first 6 months of life and available dietary recommendations. RESULTS: Mean daily intakes of ALA, EPA, DHA, LA, and AA were 529.9, 22.4, 37.0, 3907.6, and 20.0 mg/day, respectively. Dietary intakes of these fatty acids fell below the expected intake for 0-5-month-old exclusively breastfed infants. In particular, DHA and AA intakes were 4 to 5 times lower. The dietary assessment indicated that the mean intake of essential fatty acids ALA and LA was below the European and the FAO/WHO dietary recommendations, particularly for DHA, which was approximately 30% and 14-16% lower, respectively. The key sources of the essential fatty acids, DHA, and AA were soy (28.2%), fish (97.3%), and animals (53.7%), respectively. CONCLUSIONS: Considering the prevailing view of DHA and AA requirements on early brain development, there remains considerable room for improvement in their intakes in the diets of Korean toddlers. Further studies are warranted to explore how increasing dietary intakes of DHA and AA could benefit brain development during infancy and early childhood.
BACKGROUND/OBJECTIVES: In Korea, studies of diet in elementary school children are hindered by the need for a comprehensive dietary assessment tool. Thus, the aim of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for Korean elementary school children. SUBJECTS/METHODS: The 24-h recall data for 1,624 subjects aged 6-11 yrs from the seventh Korea National Health and Nutrition Examination Survey were used to extract the items included in the questionnaire. The FFQ items were developed by selecting major dishes based on the results of nutritional contribution and between-person variability for energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C). We selected the major dishes with over 90% of the total contribution to each nutrient and with over 90% of the accumulated R2 for each nutrient. Among the 452 dishes, we selected 248 dishes contributing more than 1% of the total consumption. RESULTS: Finally, the FFQ included 107 items combined from 248 dishes based on nutrient profile and recipe. The FFQ items accounted for an average of 88.6% of the energy, 14 nutrient intakes, and 91.4% of the between-person variability. Quantities of dietary intake were assessed by 9 categories of frequency and 3 categories of portion size. Percentages of coverage for energy, protein, fat, carbohydrate, and calcium were 90.2%, 87.8%, 89.9%, 90.8%, and 88.7%, respectively. CONCLUSIONS: We developed a dish-based, semi-quantitative FFQ comprising 107 items for Korean elementary school children aged 6 to 11. Further studies are needed to evaluate the reproducibility and validity of this FFQ for elementary school children.
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