Kim, Hyun Ja;Lee, Yeon-Kyung;Koo, Hoseok;Shin, Min-Jeong
Nutrition Research and Practice
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제16권sup1호
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pp.70-88
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2022
Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake-response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong. However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.
The purpose of this study was to examine the association nutrition education experience in regards to metabolic risk and nutrition intake in Korean adult male using the 2016~2017 Korea National Health and Nutrition Examination Survey as the reference. The study involved a total of 1,978 male subjects aged 40~64 who were classified into the 2 groups based on their nutrition education experience: Educated group (n=88) and non-educated group (n=1,890). The household income and education level of educated group were higher than those of the non-educated group. The two groups showed no significant difference in the level of fasting blood sugar, blood lipid profile including total cholesterol and triglyceride, LDL-cholesterol, and hypertension. Vitamin C intake of the educated group (127.5 mg) was higher compared to the non-educated group (88.2 mg) (p<0.05). The percentage of the subjects utilizing nutritional labels was higher in the educated group. The nutrition education experience was inversely proportional to lower Odds Ratio in hyperLDL-cholesterolemia (OR: 0.47, 95% CI: 0.36, 0.84) and HypoHDL-cholesterolemia (OR: 0.57, 95% CI: 0.37, 0.87). This result indicates that nutritional education can be used as an effective tool to avert chronic diseases and develop healthy eating habits.
"본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함.
Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.
Underreporting patterns by the level of obesity have not been fully assessed yet. The purpose of this study was to examine the differential underreporting patterns on cardiovascular risk factor, macronutrient, and food group intakes by the level of Body Mass Index (BMI). We analyzed cross-sectional baseline nutritional survey data from the population-based longitudinal study, the Healthy Women Study (HWS) cohort. Study subjects included 538 healthy premenopausal women participating in the HWS. Nutrient and food group intakes were assessed by the one-day 24-hour dietary recall and a semi-quantitative food frequency questionnaire, respectively. The ratio of reported energy intake (EI) to estimated basal metabolic rate (BMR) was used as a measure of relative energy reporting status and categorized into tertiles. Overweight group ($BMI{\geq}25kg/m^2$) had a higher ratio of EI to BMR (EI/BMR) than normal weight group ($BMI<25kg/m^2$). Normal weight and overweight groups showed similar patterns in cardiovascular risk factors, nutrient intake, and food group intake by the EI/BMR. Fat and saturated fat intakes as a nutrient density were positively associated with the EI/BMR. Proportion of women who reported higher consumption (${\geq}4\;times/wk$) of sugar/candy, cream and red meat groups was greater in higher tertiles of the EI/BMR in both BMI groups. Our findings suggest similar patterns of underreporting of cardiovascular risk factors, and macronutrient and food group intakes in both normal and overweight women.
Purpose: This study is based on the results of previous studies that falls, which is a frequent social problem, causes physical, mental and social health problems in the elderly. In order to identify risk factors for falls in the elderly, this study derives a relationship with oral health and proposes the necessity of oral health care as part of countermeasures to prevent falls in the elderly. Methodology: The final 6,936 people were analysed using the 2018 Korean Longitudinal Study of Ageing(KLoSA) survey data, and the analysis was conducted using the multiple logistic and multiple regression analysis to investigate the relationship between Geriatric Oral Health Assessment Index (GOHAI) and falls experience. Findings: As a result of the analysis in this study, the number of falls experiences and whether or not falls were higher in the elderly female group than in the male group. The likelihood of falls experience has been statistically reduced as Geriatric Oral Health Assessment Index increases by one unit.(OR : 0.991) The number of falls has also been statistically reduced as Geriatric Oral Health Assessment Index increase by one unit.(B : -0.001) Practical Implications: The results of this study, which showed that higher Geriatric Oral Health Assessment Index was lower risk of falls, explained by the connection that oral health may affect nutritional intake, which leads to sarcopenia and physical loss, which in turn increases the risk of falls. As a way to solve the fall problem, efforts should be made to improve the oral health of the elderly, and furthermore, the importance of nutrition management thorugh oral health care of the elderly is increasd.
We carried out a case-control study to investigate protective effect of lactating against breast cancer in Korea. Cases (n=108) were the newly histologically identified breast cancer between December 1997 and August 1999. Hospital-based controls were selected by frequency matching method with age ($\pm$4 age) and menopausal status from the patients at the same hospital in the plastic surgery, general surgery and opthalmology department. Interviews included information on general characteristics of subjects, disease history, family history of breast cancer, vitamin supplementation, alcohol intake, food intake, and reproductive factors as well as lactation history. Odds ratio (OR) and 95% Confidence Intervals (CI) were calculated by using unconditional logistic regression. Age distribution of case control subjects were similar. Late menarche age $\geq$ 17 in premenopausal women was related to the lower risk of breast cancer OR = 0.41, 95% CI = 0.28-0.91. Family history of breast cancer was related to the higher risk of breast cancer only in premenopausal women (OR = 2.07, 95% CI = 1.35-2.71). Higher body mass index mass index (> 30) were associated with higher risk of breast cancer in postmenopausal women. For premenopausal women, women who had lactated $\geq$ 12 months to the first child had a significantly lower risk (OR = 0.53, 95% CI = 0.24-0.97) than the women had no breast feeding experience. However, results from postmenopausal women did not show an association with decreased breast cancer risk. These findings suggest that lactation may be a protective factor of breast cancer in Korean women.
The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.
The purpose of this study was to evaluate alcohol consumption and nutritional status in patients with alcoholic liver disease. The subjects were 80 patients with alcoholic liver cirrhosis and 12 patients with alcoholic fatty liver. Also 57 alcoholics without liver disease, 32 patients with viral liver cirrhosis and 194 normal men were included as control groups. Data on anthropometric index, socioeconomic status, alcohol consumption, dietary habits and dietary intakes were collected by individual interview. Alcoholic liver disease group had significantly lower triceps skinfold thickness and mid-uppr-arm circumferences than other groups. Socioeconomic status of alcholoci subjects was middle class or lower than that. The amount, duration and frequency of alcohol consumption were significantly higher and the quality of side dishes consumed with alcoholic beverage was significantly poorer in patients with alcoholic liver cirrhosis than others. Patients with alchololic liver disease ingested approximately 40% of daily caloric intake as alcohol and all alcoholic subjects had lower average intakes of protein, carbohydrates, fat, vitamins and minerals as compared with Korean adult average intakes. The results suggest that alcohol and poor dietary intake could cause malnutrition and might be two of the important risk factors to develop alcoholic liver disease in alcoholics. But other factors like genetic and immunological factors should be also considered in elucidating the causes of alcoholic liver disease. An extensive nutritional education should be emphasized for alcohol consuming population to prevent development of alcoholic liver disease.
The purpose of this study is to investigate the proportion and associated risk factors of hypertriglyceridemia in rural Vietnamese women. Research data were collected as part of the Korean Genome and Epidemiology Study (KoGES). A cross-sectional study of 957 Vietnamese women in their 20 to 30s was conducted in rural areas of Bavi, Vietnam. Subjects were classified as hypertriglyceridemic (serum TG ${\geq}$ 150 mg/dL). Demographic, socio-economic details, anthro-pometric measurements, and blood profiles were recorded. The proportion of hypertriglyceridemic subjects was 22.0%, and the mean age of hypertriglyceridemics subjects was older than that of normo-triglyceridemic subjects (p < 0.05). In hypertriglyceridemic subjects, height, HDL-cholesterol, and LDL-cholesterol were significantly lower, compared to subjects with normo-triglyceridemia, while weight, body mass index, waist hip ratio, body fat %, blood pressure, fasting blood sugar, total cholesterol, and atherogenic index were higher, compared to those with normo-triglyceridemia. Intake of cereal and cereal products, total plant food, and cereal/potato fiber in subjects with hypertriglyceridemia was significantly higher, compared to normo-triglyceridemic subjects. Hypertriglyceridemic subjects had a significantly lower intake of animal calcium and retinol than normo-triglyceridemic subjects. Significant positive relationships were observed between the prevalence of hypertriglyceridemia and consumption of total plant food [OR (95% CI) for the highest tertile, compared to the lowest: 1.764 (1.131-2.750); p for trend = 0.008] and crude fiber [OR (95% CI) for the highest tertile compared to the lowest: 1.651 (1.092-2.497); p for trend = 0.027]. In addition, a significant inverse relationship was observed between the prevalence of hypertriglyceridemia and cholesterol intake [OR (95% CI) for the highest tertile, compared to the lowest: 0.601 (0.400-0.901); p for trend = 0.012]. These findings may provide basic data for use by policymakers and dieticians in future development of nutrition and health programs to encourage healthier eating habits, and to prevent hypertriglyceridemia advancing cardiovascular disease in rural Vietnamese women.
In Korea, the practice of nutrition education program at the worksite has not yet been implemented, especially for the workers who are at risk for health. Accordingly, the worksite nutrition program, education, and nutrition counseling are necessary. In this study, the worksite nutrition program was developed from June, 1997 to May, 1998. For this program, we surveyed the workers' age and the levels of education, income and physical activity. We developed the proper dietary intake questionnaire to evaluate the employees' nutritional status and the nutrition index which is a simple tool to assess nutrient intakes of the employees at the worksites. To demonstrate the validity of the developed nutritional assessment tools, the CAN(Computer Aided Nutritional) program and Hyunmin system developed by the Korean Nutrition Society and the Korean Dietetic Association respectively, were used as references. The result of the validity test for the dietary assessment method that we have been developed revealed that the method was valid showing no significant difference among the various methods. However, the carbohydrate intake measured by the CAN program was higher than those of others. The validity test results for the nutrient index method showed that there was no significant difference among the methods, except the carbohydrate intake measured by the Hyunmin system was lower that those of others. As a result, we concluded that the dietary assessment methods that we had been developed, were valid method to measure the nutrient intakes of the employees at the worksites.
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