• Title/Summary/Keyword: Protein-energy malnutrition

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Effects of an Anabolic Steroid, Nandrolone Phenylpropionate, on Reductions in Body and Muscle Proteins Under the Dietary Regimens of Feeding a Low-Protein Diet and of 50% Food Restriction in Rats

  • Choo, Jong-Jae
    • Nutritional Sciences
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    • v.1 no.1
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    • pp.3-7
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    • 1998
  • The aim of the present investigation was to see whether an anabolic steroid, nandrolone phenylpropionate (NPP), exerts protienanabolic effects under such adverse nutritional conditions as protein deficiency and protein-energy malnutrition in male rats. feeding on a low-protein (8% casein) diet resulted in a marked reduction in body weight gain that was associated with reductions in body protein and protein content of gastrocnemius muscle. Administration of NPP (4 mg/kg body weight) did not alter muscle and body protein depletion induced by a low-protein diet. 50% food restriction caused reductions in body protein and in protein content of gastrocnemius muscle. These reductions were partially prevented by NPP (4 mg/kg body weight). Food restriction did not affect plasma concentration of corticosterone, insulin, or tetosterone plus dihydrotestosterone. On the other hand, neither plasma concentration of corticosterone nor insulin were affected by NPP. The present results show that anabolic steroids do not express anabolic effects under conditions of protein deficiency, but in protein-energy malnutrition, anabolic steroids exert their anabolic effects even in male rats.

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Nutritional Risk in Oncology Outpatients Receiving Chemotherapy (외래에서 항암화학요법을 받는 암환자들의 영양불량 위험도 연구)

  • Kim, Won-Gyoung;Park, Mi-Sun;Lee, Young-Hee;Heo, Dae-Seog
    • Korean Journal of Community Nutrition
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    • v.13 no.4
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    • pp.573-581
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    • 2008
  • Although it is well known that cancer patients suffer from malnutrition, there are few published studies on malnutrition in outpatients receiving chemotherapy in Korea. This study aimed to evaluate nutritional risk in oncology outpatients receiving chemotherapy and to show the baseline data to set up nutritional management programs for cancer patients. This is a retrospective observational analysis on 1,962 patients referred for nutritional education before or during chemotherapy at Seoul National University Hospital Cancer Center from January 2006 to May 2007. According to a malnutrition screening tool, the proportion of patients having malnutrition risk was 23.0%. In the case of upper gastrointestinal cancer, more than 50% of patients were assessed as being at the risk of malnutrition. They showed more than 7% weight loss compared to their usual body weight and poor oral intake; energy intake was less than 100% of Basal Energy Expenditure(BEE) and protein intake was less than or equal to 0.77 g/kg/d. However, only 6.3% of breast cancer patients had risk of malnutrition and their oral intake was better; energy intake was 121% of BEE, and protein intake was 0.90 g/kg/d. Outpatients receiving chemotherapy had different nutritional risk depending on their cancer site. Nutritional management program should be conducted differently, depending on the cancer site and upper gastrointestinal cancer patients at high risk of malnutrition should basically have nutritional assessment and intervention.

Dietary inflammatory index is associated with serum C-reactive protein and protein energy wasting in hemodialysis patients: A cross-sectional study

  • Kizil, Mevlude;Tengilimoglu-Metin, M. Merve;Gumus, Damla;Sevim, Sumeyra;Turkoglu, Inci;Mandiroglu, Fahri
    • Nutrition Research and Practice
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    • v.10 no.4
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    • pp.404-410
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    • 2016
  • BACKGROUND/OBJECTIVE: Malnutrition and inflammation are reported as the most powerful predictors of mortality and morbidity in hemodialysis (HD) patients. Diet has a key role in modulating inflammation and dietary inflammatory index (DII) is a new tool for assessment of inflammatory potential of diet. The aim of this study was to evaluate the application of DII on dietary intake of HD patients and examine the associations between DII and malnutrition-inflammation markers. SUBJECTS/METHODS: A total of 105 subjects were recruited for this cross-sectional study. Anthropometric measurements, 3-day dietary recall, and pre-dialysis biochemical parameters were recorded for each subject. Subjective global assessment (SGA), which was previously validated for HD patients, and malnutrition inflammation score (MIS) were used for the diagnosis of protein energy wasting. DII was calculated according to average of 3-day dietary recall data. RESULTS: DII showed significant correlation with reliable malnutrition and inflammation indicators including SGA (r = 0.28, P < 0.01), MIS (r = 0.28, P < 0.01), and serum C-reactive protein (CRP) (r = 0.35, P < 0.001) in HD patients. When the study population was divided into three subgroups according to their DII score, significant increasing trends across the tertiles of DII were observed for SGA score (P = 0.035), serum CRP (P = 0.001), dietary energy (P < 0.001), total fat (P < 0.001), saturated fatty acids (P < 0.001), polyunsaturated fatty acids (P = 0.006), and omega-6 fatty acids (P = 0.01) intakes. CONCLUSION: This study shows that DII is a good tool for assessing the overall inflammatory potential of diet in HD patients.

Characteristics in Nutritional Status of Patients on Hemodialysis and Continuous Ambulatory Peritoneal Patients in Chonbuk Area (전북지역 혈액투석 환자와 지속성 외래 복막 투석 환자의 영양상태 비교)

  • 김선형;김숙배
    • Journal of Nutrition and Health
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    • v.36 no.4
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    • pp.397-404
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    • 2003
  • The present study was designed to compare the nutritional status of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients. Subjects were 58 HD patients (male/female = 29/29) and 33 CAPD patients (male/female = 23/10) undergoing dialysis treatment in Artificial Kidney Unit of Chonbuk National University Hospital. For nutritional assessment, %IBW (ideal body weight), %TSF (tricep skin fold), %MAC (mid arm circumference), %MAMC (mid arm muscle circumference), serum albumin, serum transferrin, TLC (total lymphocyte count), SGA (subjective global assessment) and estimated energy and protein intakes by 1-month food frequency method were used. Between HD and CAPD group, mean age (50 $\pm$ 12 vs. 52 $\pm$ 12 yr), dialysis durations (37 $\pm$ 36 vs. 30 $\pm$ 26 mon), dietary energy intakes (28.3 $\pm$ 9.0 vs. 28.8 $\pm$ 8.6 kcal/kg/day), dietary protein intakes (1.1 $\pm$ 0.4 vs. 1.2 $\pm$ 0.3 g/kg/day) and incidence of co-morbid conditions (69.0% vs. 69.7%) were not significantly different. Data by using SGA showed a higher incidence of malnutrition in CAPD patients (45.6%) than in HD patients (36.2%). %IBW (p < 0.001), %TSF (p < 0.001) and %MAC (p < 0.001) were higher in CAPD patients than were in HD patients. But serum albumin (p < 0.001) and transferrin (p < 0.001) were significantly lower in CAPD patients than were in HD patients. A higher incidence of malnutrition was shown in CAPD Patients than in HD Patients due to different dialysis type. A significant finding was that CAPD showed protein deficient malnutrition and HD did calorie deficient malnutrition. It suggests that an adequate dietary intake considering dialysis type prevents a prevalence of malnutrition.

Nutritional Assessment of the Hemodialysis Patients (혈액투석중인 만성신부전환자의 영양상태에 관한 연구)

  • 김성미
    • Journal of Nutrition and Health
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    • v.33 no.2
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    • pp.179-185
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    • 2000
  • This study investigated the nutritional status of 33 hemodialysis patients. Their weight, height, triceps and mid-arm circumference were measured and their dietary intake and blood profiles evaluated. The subjects were 57.1$\pm$11.9 years old. The energy intakes of men and women were 61% and 68% of RDA, respectively. The men and women's intake of protein was 0.93g/IBWkg/d and 0.99g/IBWkg/d, respectively. According to the distribution of BMI, 22.2% of the men and 73.3% of the women were underweight. A total of 5.6% of the men were overweight, versus none of the women. The serum albumin levels of the men and women were 3.56 and 3.52g/dl, respectively. The serum cholesterol levels of the men and women were 134.1 and 148.5mg/dl, respectively. The subjects were divided into three groups according to the level of albumin, and their intakes of nutrients were compared with one another. The group with high levels of albumin did not show higher energy and protein intake than the other groups but the serum total protein level was significantly higher. When the nutritional status of the patients was evaluated by weight and serum albumin level, 6.0% of them showed kwashiorkor-type malnutrition and 75.8% of them showed mild malnutrition.

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Copper Deficient Anemia in Severe Protein-Energy Malnutrition due to Child Abuse (아동학대로 인해 발생한 중증 단백-에너지 영양실조 환아에서 동반된 구리결핍증 빈혈 1예)

  • Byun, Sung-Hwan;Jeon, Je-Deok;Chang, Soo-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.10 no.1
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    • pp.60-65
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    • 2007
  • An unconscious 5-year-old girl was admitted to the Intensive Care Unit. She was neglected by her parents; she suffered from inadequate nutritional, medical and emotional care. The girl appeared to be emotionally detached, dehydrated and malnourished; she had edematous extremities, moderately bruised skin and brittle coarse hair. Laboratory testing showed electrolyte imbalance, anemia, pneumonia, copper deficiency, and liver dysfunction in addition to severe protein-energy malnutrition (PEM). Medical intervention was followed by improvement of most of the symptoms. During the rehabilitation phase, the patient showed a voracious appetite and gained weight too fast. The liver became enlarged and the patient developed a mild fever due to excessive nutrition. The microcytic anemia with severe PEM did not responded to iron supplementation possibly due to the copper deficiency. Addition of copper without zinc and iron helped to improve the anemia. The patient was discharged to a childcare center where she received cognitive and psychosocial therapy.

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A study on Nutritional status and Support in Critically ill patients (서울시내 1 개병원 중환자의 영양상태와 영양지원 실태에 관한 연구)

  • Choe, Mi-Suk;Kim, Jeong-Nam
    • Journal of the Korean Dietetic Association
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    • v.1 no.1
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    • pp.21-30
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    • 1995
  • Critically ill patients admitted in ICU and NCU were studied with respect to their nutritional status and support to them at initial period, and the effect of nutritional support after 3 weeks. The nutritional support was supplied to these patients with the enteral and parenteral nutrition. The results of biochemical test and status of nutritional support on 52(29 males, 23 females) critically ill patients were based on medical records and the anthropometry was measured on 28 patients. The subjects were in mild malnutrition. Their initial calorie intakes were 85% of BEE, 57% of total energy requirements and 49% of protein requirement were provided. Two groups, one group of serum albumin level more than 3.5g/dl and the other group of serum albumin level less than 3.5g/dl, were significant different in total calorie and protein intakes. After 3 weeks, inappropriate nutritional support in the group of normal nutrition results in significant decreasing of serum albumin level but, there were no changes in the group of malnutrition. Nutritional support is one of the mainstays in the management of these critically ill patients and is aimed at preventing malnutrition. Therefore, timely nutritional support is heavily required in cases of critically ill patients whether their initial nutritional status is normal or not.

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A Study on the Dietary Intake and the Nutritional Status among the Pancreatic Cancer Surgical Patients

  • Kang, Jimin;Park, Joon Seong;Yoon, Dong Sup;Kim, Woo Jeong;Chung, Hae-yun;Lee, Song Mi;Chang, Namsoo
    • Clinical Nutrition Research
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    • v.5 no.4
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    • pp.279-289
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    • 2016
  • The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts. The rates of malnutrition at admission were 45.1% (14/31) and 28.9% (9/31) by NRI and MUST method, respectively, but those were increased to 87% (27/31) and 86.6% (26/31) after operation on discharge. The median values of daily intake of energy, carbohydrates, fat, and protein were 588.1 kcal, 96.0 g, 11.8 g, and 27.0 g, respectively. Most patients (n = 20, 64.5%) experienced two or more symptoms such as anorexia, abdominal bloating and early satiety. There were negative correlations between C-reactive protein (CRP) levels and the intake of total energy, protein, fat, and zinc. The rates of malnutrition were increased sharply after surgery and the dietary intake also influenced the inflammatory indicators. The results suggested that need of considering special therapeutic diets for the patients who received pancreatic surgery.

Assessment of Malnutrition of Dialysis Patients and Comparison of Nutritional Parameters of CAPD and Hemodialysis Patients

  • Wi, Jin Woo;Kim, Nam-Ho
    • Biomedical Science Letters
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    • v.23 no.3
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    • pp.185-193
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    • 2017
  • Malnutrition is common and the major risk factor of mortality of end stage renal disease (ESRD) patients. The aim of this study is to assess nutritional status of malnutrition patients on dialysis by various methods and compare nutritional parameters of continuous ambulatory peritoneal dialysis (CAPD) patients with hemodialysis patients. 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD and 71 hemodialysis patients were investigated by anthropometry, biochemical study, diet analysis and questionnaires. Malnutrition patients were selected by body mass index (BMI), serum albumin and pre-albumin based on International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria for protein-energy wasting and compared with non-malnutrition patients. In comparison of CAPD and hemodialysis patients, most anthropometric values showed no significant difference except total body water (TBW). TBW was lower in CAPD patients (P=0.024). Although serum albumin was slightly higher in hemodialysis patients (P=0.047), pre-albumin were significantly higher in CAPD patients (P=0.000). Serum blood urea nitrogen (BUN) was higher in hemodialysis patients (P=0.000). In diet analysis, Total calorie (P=0.000) and total cholesterol (P=0.012) intakes were higher in CAPD patients. Mean subjective global assessment (SGA) grade was higher in CAPD patients (P=0.003). Several nutritional parameters of CAPD patients were better than hemodialysis patients implying more intensive therapeutic approach may be needed for hemodialysis patients. We have to understand multiple factors contributing malnutrition of ESRD patients and individualized therapeutic approach is needed.

A Study of the Nutritional Status, Nutritional Knowledge, and Dietary Habits of the Hemodialysis Patients (혈액투석 환자의 영양상태, 영양지식도 및 식습관에 대한 연구)

  • 김양하;서혜정;김성록
    • Journal of Nutrition and Health
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    • v.34 no.8
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    • pp.920-928
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    • 2001
  • Malnutrition is a common problem in patients undergoing maintenance hemodialysis(HD) and compromised food intake is an important cause. Malnutrition is one of the important factors influencing mortality in chronic HD patients. We investigated the nutritional parameters of 50 Korean HD patients(mean age: 46.9 $\pm$ 10.3y, men : 23, women : 27) by measuring anthropometric and biochemical blood indices and assessing food intake using 24-h recall method. Also we administered two questionnaires, one for assessing nutritional knowledge about renal disease and dietary therapy, the other for measuring dietary habits related to dietary therapy. According to the distribution of BMI, 21.3% of HD patients were underweight. The hematological values of HD patients, such as plasma hemoglobin, hematocrit, and total lymphocyte count were below the normal range. The serum cholesterol levels were 133.2 $\pm$ 30.5mg/dl. HD patients took energy and protein only 77.5% and 83.1%, respectively, of their RDA. There were significantly positive correlations between nutritional knowledge and intake of nutrients, such as energy, fat, cholesterol, iron, potassium, vitamin B$_1$, vitamin B$_2$, and niacin. Also, there was a significantly positive correlation between nutritional knowledge and dietary habits(r = 0.317, p < 0.05). In conclusion, Korean HD patients showed mild malnutrition and suboptimal nutrition intake. It can be postulated that the dietary intake can be increased by nutrition education improving nutritional knowledge and correcting the dietary habits of HD patients.

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