• Nutrition Research and Practice
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• v.15 no.6
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• pp.703-714
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• 2021

BACKGROUND/OBJECTIVES: A dietary restriction on the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) has been reported to be effective in the treatment of gastrointestinal (GI) tract complications. Enteral nutrition (EN) is widely used for patients who cannot obtain their nutritional requirements orally, but many studies have reported EN complications, especially diarrhea, in up to 50% of patients. SUBJECTS/METHODS: We performed a single-center, non-randomized, controlled trial to determine the effects of a low-FODMAP enteral formula on GI complications in patients in intensive care units (ICUs). Patients in the ICU who needed EN (n = 66) were alternately assigned to the low-FODMAP group (n = 33) or the high-FODMAP group (n = 33). RESULTS: Anthropometric and biochemical parameters were measured, and stool assessment was performed using King's Stool Chart. We excluded patients who received laxatives, GI motility agents, proton pump inhibitors, antifungal agents, and antibiotics other than β-lactams. There were no differences in GI symptoms during 7 days of intervention, including bowel sound, abdominal distension, and vomiting between the 2 groups. However, diarrhea was more frequent in the high-FODMAP group (7/33 patients) than the low-FODMAP group (1/33 patients) (P = 0.044). CONCLUSIONS: Our results suggest that a low-FODMAP enteral formula may be a practical therapeutic approach for patients who exhibit enteral formula complications. Our study warrants further randomized clinical trials and multicenter trials.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.6
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• pp.555-563
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• 2021

Purpose: The aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI). Methods: This prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed. Results: The PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01). Conclusion: These results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.

• Clinical and Experimental Pediatrics
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• v.62 no.2
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• pp.48-54
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• 2019

Purpose: Liver metabolism plays a pivotal role in the development of metabolic disorders. We aimed to investigate the clinical and laboratory risk factors associated with alanine aminotransferase (ALT) levels in young adolescents from an urban population in Korea. Methods: A population of 120 apparently healthy adolescents aged 12-13 years was included in the cross-sectional design study; 58 were overweight or obese and 62 were of normal weight. We estimated anthropometric and laboratory measurements, including waist-to-height ratio, blood pressure, insulin sensitivity, aspartate aminotransferases (AST), ALT, and lipid profiles. Results: The mean ages of the overweight or obese and normal weight participants were $12.9{\pm}0.3$ and $13.0{\pm}0.3years$, respectively. Height, weight, body mass index, waist circumference, waist-to-height ratio, systolic and diastolic blood pressure, AST, ALT, total cholesterol, low-density lipoprotein-cholesterol, triglyceride, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR) score were significantly higher and the high-density lipoprotein-cholesterol and quantitative insulin-sensitivity check index were significantly lower in the overweight/obese participants in comparison to the normal-weight participants (all P<0.05). In multivariate linear regression analysis, waist-to-height ratio, systolic blood pressure, and HOMA-IR score were independently and positively associated with serum ALT levels. Conclusion: Screening for ALT levels in adolescents may help to differentiate those at risk of metabolic abnormalities and thus prevent disease progression at an early age.

• Nutrition Research and Practice
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• v.13 no.5
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• pp.410-414
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• 2019

BACKGROUND/OBJECTIVES: Several nutritional screening tools were recently developed to screen the risk of malnutrition in hospitalized children, but have not been validated in Asia. We compared four nutritional screening tools for pediatric patients in evaluating nutritional risks in newly hospitalized children. SUBJECTS/METHODS: Medical records of newly admitted pediatric patients between June 2016 and May 2017 at two tertiary hospitals were reviewed. Initial information by nurses and hospital records by doctors on baseline demographic, clinical, and anthropometric data at admission were collected in all subjects. Nutritional risks were evaluated using four nutritional screening tools including the pediatric nutritional risk score (PNRS), the screening tool for the assessment of malnutrition in pediatrics (STAMP), the paediatric Yorkhill malnutrition score (PYMS), and the screening tools for risk of nutritional status and growth (STRONGkids). RESULTS: A total of 559 patients (310 boys and 249 girls, mean age $6.3{\pm}5.5years$) were recruited. Patients in medical and surgical departments were 469 (83.9%) and 90 (16.1%), respectively. The prevalence of patients at risk of malnutrition were 31.1% for low risk, 52.2% for medium risk, and 16.6% for high risk by PNRS; 11.4%, 39.7%, and 48.8% by STAMP; 26.5%, 25.4%, and 48.1% by PYMS; and 35.6%, 58.9%, and 5.5% by STRONGkids. PNRS versus STRONGkids and STAMP versus PYMS showed moderate agreement (kappa = 0.566 and kappa = 0.495, respectively). PYMS and STAMP revealed a relatively high sensitivity of 87.8% and 77.6% for wasting. CONCLUSION: Different nutritional screening tools revealed considerably different results in evaluating nutritional risks in newly hospitalized children. Since pediatric patients are at risk of malnutrition at admission and during hospitalization, screening tools should be applied properly according to the situation of each hospital.

• Korean Journal of Community Nutrition
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• v.27 no.4
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• pp.286-295
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• 2022

Objectives: Sarcopenia is one of the most representative factors of senescence, and nutritional status is known to affect sarcopenia. This study was performed to analyze the relationships between energy and protein intake and sarcopenia. Methods: The study subjects were 3,236 individuals aged ≥65 that participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 ~ 2011. General characteristics and anthropometric and 24-hour dietary recall data were analyzed. Sarcopenia was diagnosed using a formula based on appendicular skeletal muscle mass (ASM) and body weight. Logistic regression was performed to determine relationships between sarcopenia risk and energy and protein intakes. Results: For energy intake, the odds ratio (OR) of sarcopenia in women was significantly higher those with the lowest intake [OR = 1.680, 95% confidence interval (CI) = 1.213-2.326] than those with the highest intake (P for trend = 0.001). Regarding protein intake per kg of body weight, the odds ratio of sarcopenia was significantly higher for those that consumed < 0.8 g/kg of protein daily than those that consumed > 1.2g/kg for men (OR = 2.459, 95% CI = 1.481-4.085) and women (OR = 2.178, 95% CI = 1.423-3.334). Conclusions: This study shows a link between sarcopenia and energy and protein intake levels and suggests that energy and protein consumption be promoted among older adults to prevent sarcopenia.

• Nutrition Research and Practice
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• v.16 no.4
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• pp.450-463
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• 2022

BACKGROUND/OBJECTIVES: Adolescents who skip breakfast have an increased prevalence of chronic diseases. Thus, we aimed to evaluate whether the intake of rice-based breakfast had positive effects on blood glucose indices and to determine the possibility of diabetes prevalence in Korean youths who habitually skip breakfast. SUBJECTS/METHODS: In this randomized parallel-group controlled trial, 81 subjects who were suitable for compliance among 105 middle-and high-school students aged 12-18 years who usually skipped breakfast were included in this study (rice-meal group [RMG], n = 26; wheat-meal group [WMG], n = 29; general-meal group [GMG], n = 26). The RMG and WMG received a rice-based breakfast and a wheat-based breakfast for 12 weeks, respectively. The anthropometric indices, blood glucose indices, and metabolites were measured at baseline and the endpoint, respectively. RESULTS: The mean body weights in the RMG, WMG, and GMG groups at the endpoint were 62.44 kg, 61.80 kg, and 60.28 kg, respectively, and the mean body weights of the WMG and GMG groups at the endpoint were significantly higher than that at baseline (P < 0.05). The levels of fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly decreased in the RMG group at the endpoint compared to baseline (P < 0.05, P < 0.05, respectively). The levels of tryptophan and tyrosine in the WMG group at the endpoint were significantly higher than that those at baseline (P < 0.01, P < 0.05, respectively). CONCLUSIONS: Rice-based breakfast has positive effects on fasting insulin levels and HOMA-IR in Korean adolescents who skip breakfast. Additionally, it was found that a skipping breakfast could increase the prevalence of diabetes in adolescents who skip breakfast. Therefore, in addition to reducing breakfast skipping, it is vital to develop a rice-based menu that fits teenage preferences to prevent chronic diseases such as diabetes.

• Korean Journal of Exercise Nutrition
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• v.13 no.2
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• pp.101-107
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• 2009

The objectives of this study were to investigate 1) the nutritional knowledge, 2) the use of nutritional supplements, and 3) nutrient intakes of male elite bodybuilders (n=20). Participants carried out a comprehensive survey, anthropometric assessment, and 1 day food record. Daily nutrient intakes of the subjects were analyzed using Computer Aided Nutritional Analysis Program (Can-pro 3.0). The mean age of the subjects was 23.4 years. The mean duration of exercise was 5.3 years. The average scores of nutritional knowledge were 71.0%. The subjects were gathered nutrition information from nutrition book (65%), mass communication (50%), friends (50%) and coach (30%) in order. Ninety percentage of the subjects reported that they were taking nutritional supplements. Major reasons for taking nutritional supplements were to improve performance and to build-up muscle. The most frequently taken nutritional supplements were protein powder (85%), multivitamin/mineral (75%), BCAA (60%) and glutamine (55%) in order. The average daily energy intakes of the subjects were 4,248.7 kcal. The mean intake of protein was 370.3 g/day (3.93 g/kg BW). The ratio of total energy intake from carbohydrate, protein and lipid was 51 : 34 : 15. The intakes of most vitamin and minerals through food and nutrition supplements were much higher than those of each nutrient of the RDAs. Especially, vitamin B complex and vitamin C intakes were ranged from 500 to 3,000% of KNHNES. More research needs to be conducted to determine the optimal amounts of carbohydrates, protein, lipid and micro-nutrients for the bodybuilders.

• Clinical Nutrition Research
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• v.12 no.3
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• pp.218-228
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• 2023

Recent studies have evaluated the association between specific beverage intake and metabolic risks in adults. However, more evidence is needed to examine the association between the Healthy Beverage Index (HBI) and metabolic factors. Therefore, this study investigated the relationship between HBI and metabolic factors in adults. In this cross-sectional study, 338 overweight and obese individuals living in Tabriz, Iran were selected. Data on beverage consumption, demographics, physical activity, and anthropometric characteristics were evaluated using validated standard protocols. The predefined HBI was calculated based on previous studies. The mean value of HBI index among all of the participants was 59.76 ± 6.51. Those at the higher HBI scores had significantly lower waist circumference, waist-to-hip ratio, fat mass, and weight (p < 0.05). HBI and triglyceride scores also had a significant relationship. It has been shown that at higher HBI scores compared to lower scores, high-density lipoprotein cholesterol levels increase while homeostatic model assessment for insulin resistance, low-density lipoprotein cholesterol, total cholesterol, and blood pressure decrease. HBI scores higher among Iranian adults were associated with a better chance of losing weight and weight loss and a better lipid profile, and lower blood pressure. Therefore, HBI can be a useful and helpful tool for assessing the overall quality of beverages adults consume. However, further studies are warranted to confirm the possible health effects of healthy beverage index.

• Clinical Nutrition Research
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• v.11 no.1
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• pp.62-73
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• 2022

An insufficient intake of magnesium may be associated with the development of chronic obstructive pulmonary disease (COPD). We aimed to determine the relationship between health related quality of life (QoL), anthropometric indices and nutritional status with dietary magnesium intake in COPD patients. Sixty-one COPD patients participated in this cross-sectional study. QoL and nutritional status were assessed. Furthermore, body composition, calf circumference, and muscle strength were measured; equations were used to calculate fat-free mass index, body mass index, and muscle mass value. Dietary magnesium intake was assessed by three 24-hours recalls and magnesium intake was categorized as ≤ 188.08 mg/day (A group) and > 188.08 mg/day (B group). The χ², independent-sample t-test and Mann-Whitney test were used for statistical analysis. The p values less than 0.05 were considered significant. Of QoL assessments the total and impact mean scores of St. George's respiratory questionnaire in the B group were significantly lower than the means of the A group (p value = 0.007 and 0.005, respectively). The instrumental activity of daily living score was significantly improved in patients with higher consumption of dietary magnesium (p = 0.02). Participants had a significantly lower mean score of patient-generated subjective global assessment in the B group compared to the A group (p = 0.003). Higher intake of dietary magnesium can lead to improve QoL and nutrition status.

• Clinical Nutrition Research
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• v.11 no.4
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• pp.241-254
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• 2022

Polycystic ovary syndrome (PCOS) is a heterogeneous clinical syndrome. Recent studies examine different strategies to modulate its related complications. Chlorogenic acid, as a bioactive component of green coffee (GC), is known to have great health benefits. The present study aimed to determine the effect of GC on lipid profile, glycemic indices, and inflammatory biomarkers. Forty-four PCOS patients were enrolled in this randomized clinical trial of whom 34 have completed the study protocol. The intervention group (n = 17) received 400 mg of GC supplements, while the placebo group (n = 17) received the same amount of starch for six weeks. Then, glycemic indices, lipid profiles, and inflammatory parameters were measured. After the intervention period, no significant difference was shown in fasting blood sugar, insulin level, Homeostasis model assessment of insulin resistance index, low-density lipoprotein, high-density lipoprotein, Interleukin 6 or 10 between supplementation and placebo groups. However, cholesterol and triglyceride serum levels decreased significantly in the intervention group (p < 0.05). This research confirmed that GC supplements might improve some lipid profiles in women with PCOS. However, more detailed studies with larger sample sizes are required to prove the effectiveness of this supplement.