• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.93-103
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• 1997

Background : Malnutrition is a common finding in patients with chronic obstructive pulmonary disease, especially in the emphysema group. Although the mechanism of malnutrition is not confirmed, it is believed to be a relative deficiency caused by hypermetabolism due to increased energy requirements of the respiratory muscles, rather than a dietary deficiency. Malnutrition in chronic obstructive pulmonary disease is not a merely coincidental finding. It is known that the nutritional status correlates with physiologic parameters including pulmonary function, muscular power, and exercise performance, and is one of the important and independent prognostic factors of the disease. Methods : Patients with chronic obstructive pulmonary disease Yongdong Severance Hospital from May, 1995 to March, 1996 and age-matched healthy control group were studied. Survey of nutritional intake, anthropometric measurements and biochemical tests were done to assess nutritional status. Relationship between nutritional status and FEV1 (forced expiratory volume at one second), which was a significant functional parameter, was assessed. Results : 1) The patient group was consisted of 25 males with mean age of 66.1years and FEV1 of $42{\pm}14%$ of predicted values. The control group was consisted of 26 healthy males with normal pulmonary function, whose mean age was 65.0 years. 2) The ratio of calorie intake/calorie requirement per day was $107{\pm}28%$ in the patient group, and $94{\pm}14%$ in the control group, showing a tendency of more nutritional intake in patient group(B=0.06). 3) There were significant differences between the patient group and control group in percent ideal body weight(92.8% vs 101.6%, p=0.024), body mass index($20.0kg/m^2$ VS $21.9kg/m^2$, p=0.015), and handgrip strength(29.0kg vs 34.3kg, p=0.003). However, there were no significant differences in triceps skinfold thickness, mid-arm muscle circumference, albumin, and total lymphocyte count between two groups. Percentage of underweight population was 40%(10/25) in the patient group, and 15%(4/26) in the control group. 4) The percent ideal body weight, triceps skinfold thickness, and mid-arm muscle circumference had significant correlation with FEV1. Conclusion : The patients with chronic obstructive pulmonary disease showed significant depletion in nutritional parameters such as body weight and peripheral muscle strength, while absolute amount of dietary intake was not insufficient. Nutritional parameters were well correlated with FEV1.

• Journal of Nutrition and Health
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• v.43 no.2
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• pp.189-196
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• 2010

Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

• Therapeutic Science for Rehabilitation
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• v.8 no.3
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• pp.7-29
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• 2019

Objective: The purpose of this study is to analyze comprehensive lifestyle assessment and other assessments which evaluate essential lifestyle factors, including physical activity, nutrition and activity participation. Methods: To analyze the comprehensive lifestyle assessment, from January 2001 to June 2019, a literature search was conducted using the CINANL, NDSL, PubMed, and RISS databases. The search terms were 'lifestyle assessment' OR 'lifestyle profile' OR 'lifestyle test'. In terms of other assessments of essential factors of lifestyle, from January 2010 to June 2019, articles were searched using similar databases. The search terms were 'physical activity assessment' OR 'physical activity participation profile', 'nutrition assessment', 'activity participation assessment' OR 'activity participation and lifestyle'. Results: A total of 4,165 articles were obtained, and finally 31 articles were selected according to the inclusion criteria. Among 31 articles, there were five with comprehensive lifestyle assessments, and all of them were self-report questionnaires. The most popular assessments were the Health Enhancement Lifestyle Profile (HELP) and the Health-Promoting Lifestyle Profile (HPLP), which were used in three articles (33%). In terms of assessment of physical activity, the most frequently used evaluation method was the self-report questionnaire, which was used in seven articles (58%) followed by objective assessments, which were used in four articles (33%). It was demonstrated that the Mini-Nutritional Assessment (MNA) was the most frequently used for nutrition assessment in the elderly. There were five types of assessment tool used for activity participation. Among them, meaningful activity participation assessment (MAPA) was the most frequently used tool. Conclusion: As a result of the systematic review, it was found that there are 21 assessments related to the evaluation of lifestyle in the elderly. Most assessments employed the self-report questionnaire method and mainly evaluated frequency and duration of participation in drinking, smoking, exercise, nutrition and social activities. Assessments of essential lifestyle factors were the self-report questionnaire method and the participation and frequency of activity. Therefore, by analyzing assessment tools, types of items and measurement methods of comprehensive lifestyle assessments and other assessment of essential lifestyle factors, this study provides the basic data on which to develop a standardized assessment tool that can evaluate the multifaceted lifestyle profile of the elderly.

• Journal of the Korean Dietetic Association
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• v.18 no.2
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• pp.97-114
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• 2012

This study was performed to assess the nutritional status and hair mineral content of children with behavioral problems and compare the values with a gender, age-matched control group. The subjects were recruited from S elementary school children in Seoul, Korea. Students scored higher than 60 points were diagnosed with behavioral problems according to the Korean-Child Behavior Checklist. Nutritional assessment of the two groups (behavior problem group: male n=15, female n=24; $9.6{\pm}1.6$ years, control group: male n=16, female n=18; $9.5{\pm}1.9$ years) was performed using a nutritional survey and by measuring hair mineral contents. In the results, food frequency questionnaire analysis showed that the intakes of anchovy (P<0.05), soybean curb (P<0.01), radish (P<0.05), bean sprouts (P<0.05), spinach (P<0.05), carrot (P<0.05), pumpkin (P<0.05), lettuce (P<0.05), cabbage (P<0.01), apple (P<0.05), and milk (P<0.01) were higher in the control group than the behavior problem group, whereas intakes of ramyeon (P<0.05), cookies (P<0.05), and coke (P<0.01) were higher in the behavior problem group than the control group. Intakes of most nutrients such as plant-derived protein (P<0.05), fiber (P<0.05), plant-derived calcium (P<0.05), phosphorus (P<0.05), plant-derived iron (P<0.05), vitamin B2 (P<0.05), vitamin B6 (P<0.05), vitamin C (P<0.01), vitamin E (P<0.05), and folate (P<0.05) were significantly higher in the control group than the behavior problem group. Hair analysis showed that the levels of arsenic (P<0.05), mercury (P<0.001), uranium (P<0.05), iron (P<0.001), boron (P<0.01), and germanium (P<0.001) were lower, but the levels of phosphate (P<0.05), chromium (P<0.001), sodium (P<0.05), and sulfur (P<0.001) were higher in the behavior problem group than the control group. Conclusively, behavioral problems constitute a complicated condition in which nutritional factors may play major roles. However, it is still under investigation as to whether or not modification of dietary habits or nutritional supplementation can improve children's behavior, since symptoms require a broad understanding of the environmental and genetic interactions.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.304-319
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• 1996

It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calorie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis. which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon-rank sums test, Scheffe test, Kruskal-Wallis test and Pearson correlation coefficients. The results are following : 1. There was no significant difference in the calorie and protein intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea nitrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine increased significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However. each of biochemical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status measured with protein and calorie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

• Nutrition Research and Practice
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• v.14 no.1
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• pp.20-24
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• 2020

BACKGROUND/OBJECTIVES: Malnutrition has multiple impacts on surgical success, postoperative complications, duration of hospital stay, and costs, particularly for cancer patients. There are various nutrition risk screening tools available for clinical use. Herein, we aim to determine the most appropriate nutritional risk screening system for esophageal cancer (EC) patients in China. SUBJECTS/METHODS: In total, 138 EC patients were enrolled in this study and evaluated by experienced nurses using three different nutritional screening tools, the Nutrition Risk Screening 2002 tool (NRS2002), the Patient-generated Subjective Globe Assessment (PG-SGA), and the Nutrition Risk Index (NRI).We compared sensitivity, specificity, positive and negative likelihood ratios, and Youden index generated by each of the three screening tools. Finally, cut-off points for all three tools were re-defined to optimize and validate the best nutritional risk screening tool for assessing EC patients. RESULTS: Our data suggested that all three screening tools were 100% sensitive for EC patients, while the specificities were 44.4%, 2.96%, and 59.26% for NRS 2002, PG-SGA, and NRI, respectively. NRI had a higher positive likelihood ratio as well as a higher area under the receiver operating characteristic curve compared to those of NRS 2002 and PG-SGA; although, all three tools had null negative likelihood ratios. After adjusting the cut-off points, the specificity and accuracy for all tools were significantly improved, however, the NRI remained the most appropriate nutritional risk screening system for EC patients. CONCLUSIONS: The NRI is the most suitable (highest sensitivity and accuracy) nutritional risk screening tool for EC patients. The performance of the NRI can be significantly improved if the cut-off point is modified according to the results obtained using MedCalc software.

• Korean Journal of Community Nutrition
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• v.17 no.5
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• pp.543-554
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• 2012

This study was performed to investigate the satisfaction of body image, dietary habits, nutrition intake and dietary quality according to body image of university students (n = 290). The subjects (male = 178, female = 112) were classified to lean, normal and overweight/fat groups according to body image. The weight, body fat and body mass index (BMI) was significantly higher in the students who recognized their body image as 'overweight/fat'. The satisfaction of body image, interest of weight control and experience of weight control were significantly higher in students who recognized their body image as 'normal' in both the male and female subjects. The intakes of nutrients, dietary habits and life styles were not different according to body image. In the male subjects, the niacin intake density, the nutrient adequacy ratio (NAR) of vitamin B1 and the dietary diversity score (DDS) in the students who recognized their body image as 'overweight/fat' were significantly lower than in students who recognized their body image as 'normal' and 'lean'. In female subjects, no significant differences in nutrient intakes, NAR, MAR and DDS were observed according to body image. Future studies with a larger sample size are needed for further assessment of the relationship between nutritional status/diet quality and body image in university students.

• Korean Journal of Community Nutrition
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• v.11 no.1
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• pp.124-132
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• 2006

The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

• Journal of the East Asian Society of Dietary Life
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• v.13 no.1
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• pp.9-18
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• 2003

This study was conducted to investigate the nutritional knowledge, nutrients intake and the assessment of dietary behavior of old peoples living in Incheon area. Two hundred and three elderly were examined using the questionnaire. The results of this study are summarized as follows. 1. The old people was lacking in correct information about nutrition and diseases. 2. The nutritional knowledge scores of old women were higher than those of old men and the scores went up according to the amount of pocket money. 3. The amount of vitamin C and phosphorus intakes were higher than those of the RDA, protein intake reached the level of the RDA. The vitamin B$_2$intake, however, was below 75% of the RDA and that of calcium was very low in women, especially. 4. Most of subjects had a meal regularly three times a day and the skipping rate of breakfast was very low. Dey had a moderate meal volume and did not have an unbalanced diet. Dey nearly do not take the processed food, dine out and exceed in the cholesterol intake. 5. They took green and yellow vegetables and, milk and milk products relatively small. On the other hand, the intake of caffein beverage was relatively high. the rates of drinking and smoking were low. From these results, we may propose the conclusion as follows: The old people were much concerned about the nutrition and diseases, but they had no correct informations about them. Therefore, the program of nutrition and dietary behavior for their healthy elderly life had to be prepared and to be applied to them immediately.

• Journal of Community Nutrition
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• v.7 no.1
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• pp.3-7
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• 2005

This study was conducted to evaluate nutritional status of school children by biochemical assessment method. Subjects were 308 school children from 4th to 6th grade living in Bucheon city. Their blood glucose, total protein, albumin, total cholesterol, and triglyceride (TG) concentrations were determined. Mean blood glucose concentration was 77.56 mg/dl and $81.2\%$ of children had normal blood glucose concentration. The average proportion of hypoglycemia was $18.8\%$ among the three grades and prevalence of hypoglycemia in 4th grade school children was highest ($21.8\%$). Mean serum total protein and albumin levels were 7.14g/dl and 4.35g/dl, respectively, and all the subjects except only one were in normal range of total protein and albumin. Mean serum TG and total cholesterol concentrations were 145.82mg/dl and 94.50mg/dl. Serum TG and total cholesterol levels showed same pattern that the concentrations decreased in proportion to grade. Especially, there was significant difference between grades in serum total cholesterol. Furthermore, $11.7\%$ of 4th, $6.8\%$ of 5th, and $2.8\%$ of 6th grade school children have borderline hypertriglycemia or hypertriglycemia, risk factors of obesity or cardiovascular disease later in life. Taken together, there was conflict phenomenon that undernutrition of hypertriglycemia and overnutrition of hypertriglycemia existed together. Therefore, it is needed to develop discriminating and personalized nutritional feeding, counseling, and education program to cover the children of under- or over- nutritional status.