• Journal of Community Nutrition
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• v.2 no.1
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• pp.12-26
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• 2000

In Japan, a new nursing insurance system was enforced in April 2000, where premiums were paid according to the level of necessary care. Our project, Nutrition Care and Management(NCM) for the elderly was started in 1995, funded by the Ministry of Health and Welfare of Japan. The NCM project was to provide appropriate nutrition care for the elderly and to see that it effectively functions as part of the health care services. There were 4 stages to the project : the first stage was to find out the PEM status among the elderly patients in hospital and home-care settings in Japan. The 2nd stage was to develop and evaluate nutritional assessment methods, anthropometry, resting energy expenditure measuring methods using of portable indirect calorimeter, and the convenient protein energy intake assessment methods, etc. for the elderly patients with PEM risk. The 3rd stage was to examine the effectiveness of the nutrition care plan induced of protein energy supplement and team care in improving nutrition among the elderly patients. The last stage was to develop the NCM set for the elderly patient based on the past three years of scientific evidence. it is expected that the NCM system for the elderly will provide adequate nutritional care management, improve the elderly care environment and create effective resource management.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.1
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• pp.39-48
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• 2015

This study aimed to compare and evaluate nutritive conditions of the female elderly (2,893 people) based on a national health nutrition survey and health-related factors influencing nutritional intake. The results are as follows.- Average age of all subjects was $72.12{\pm}5.2$ old. BMI ($24.48{\pm}3.3kg/m^2$) and waist size ($83.9{\pm}9.5cm$) of urban elderly was larger ($23.74{\pm}3.3kg/m^2$, $82.28{\pm}9.9cm$) than that of rural elderly. MAR[4] and MAR[10] were also higher in urban elderly than rural elderly. The results of multiple regression analysis showed that factors influencing poor nutrition of elderly subjects were increasing age, smoking, and self-rated health. Old-old and current smokers were associated with a higher likelihood of poor nutrition (OR 1.82, 95%CI 1.43~2.30) and (OR 3.40, 95%CI 2.17~5.33) elderly female subjects in urban areas. Smoking (OR 2.29, 95%CI 1.33~3.95), poor self-rated health (OR 1.55, 95%CI 1.11~2.16), over nine hours of sleep per nighting (OR 1.72, 95%CI 1.17~2.53) and stress (OR 1.46, 95%CI 1.10~1.92) of elderly female subjects in rural areas were associated with higher likelihood of a poor nutrition. In conclusion, rural elderly are more influenced by poor health practice behaviors (self-rated health, sleeping stress) and psychological factors. Nutrition status of the rural elderly is worse than that of the urban elderly. To reduce nutritional risk of Korean elderly, especially rural elderly, active nutrition arbitration should include psychological environmental factors.

• Korean Journal of Community Nutrition
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• v.3 no.3
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• pp.410-422
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• 1998

To promote health status, strategies and interventions to improve nutrition should be based on the proper diagnosis of the subject's eating patterns. The elderly usually have traditional food habits and preferences, and it is very difficult to change them. This study was designed to identify dietary behavior and food preference of the elderly, in order to provide baseline data for the Elderly Nutrition Intervention Program for the Public Health Center. A survey questionnaire was made for use by trained interviewers to query 151elderly people from 5 community elderly centers located in Suwon, Korea. The majority of them ate regularly and partook of all available side dishes. Their major dietary problems were frequent consumptions of salty foods, and eating too quickly. They consumed grains and vegetables regularly, but seldomly ate dairy products, fruits, meat and food prepared with oil. They also tended to eschew ready made processed food, high cholesterol food, and fast food. Also they did not dine out as much as younger people. Desirable eating habit score were not significantly influenced by socioeconomic variables and nutrition-related characteristics. These included nutrition knowledge, Nutritional Risk Index(NRI) and a score of health concerns. However, meal balance scores were significantly higher in the younger group(p<.05), the higher household income group(p<.05). According to stepwise multiple regression analysis, NRI was the most important determinant of a desirable eating habit score for the male elderly, whereas the score of health concerns was mo9st important for female elderly subjects. The greatest predictor of the meal f balance score was nutrition knowledge. The elderly liked sweet tasting food, grains, rice, stews and Korean style soups. They disliked sour food, dairy products, processed food, and bread. The results indicate that the Elderly Nutrition Education Program should focus on increasing consumption of dairy products, fruits and food with oil, prepared by traditional Korean cooking methods. It also suggests that the program planning should consider the socioeconomic status of the elderly, such as income and education level, as well as concern for health.

• Korean Journal of Community Nutrition
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• v.16 no.6
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• pp.716-729
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• 2011

This study aimed to plan nutrition support programs for the elderly living alone whose nutrition status were seriously concerned, conducted seven stages nutrition intervention program on a trial basis, and evaluated the effectiveness of the program of the Elderly Nutrition Support Project. Subjects were selected for personalized nutrition management based on nutritional risk score and nutrition intervention were tailored to the problems occurred. The elderly nutrition support program targets were 44 senior citizens who lived alone with low income. The 33 (as Type 1) of the subjects with whom milk, tofu, seaweed, eggs, black beans have been supported, and also provide nutrition education, and the rest 11 persons (as Type 2) to whom food was not supported but provide nutrition education programs. As a result, all subjects showed that compared with pre and post program implementation, their daily exercise time and milk and protein consumption level were increased and some improvement was observed regular meals consumption and low-salt diets. Their nutrient intake level such as calories, protein, calcium, iron improved after implementation. In addition, NSL DETERMINE scores significantly improved from 13.21 to 7.24 in Type 1 and 11.27 to 9.91 in Type 2. As positive dietary behavioral changes were observed as in that they purchased more protein and calcium rich foods.

• Journal of Community Nutrition
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• v.2 no.1
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• pp.71-84
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• 2000

This paper presents the status of nutrition education for older adults in Korea, and examines considerations in developing effective nutrition education programs for the elderly based on literature reviews. Finally, strategies of nutrition education for older adults in Korea are examined. Status of nutrition education were examined by surveying 90 senior centers, and 46 public health centers providing nutrition services. Most senior centers(96%) provided health education programs, however, nutrition was only a part of health programs. Among the 41 public health centers which responded to the survey, 73.1% provided nutrition education for older adults. The frequently covered topics were prevention & management of hypertension/stroke, diabetes, nutritional management during later adulthood, and osteoporosis. Common barriers in planning and implementing elderly education were; lack of educational materials for older adults, reliance on lectures, difficulty in following-up. To develop effective nutrition education, four stages consisting of needs assessment, planning and implementation of programs, and evaluation should be carefully done. Needs assessment might be done using quantitative or qualitative assessment. Factors influencing nutrition behavior of older adults can be systematically examined using a theoretical approach such as the PRECEDE-PROCEED framework. Qualitative methods, such as focus group interviews, also provide insightful information regarding the needs of older adults. In planning nutrition education programs, physical and pshychological changes associated with aging should be considered. Literature regarding elderly education suggest that active participation or participatory learning is also effective for older adults. Educational materials are developed following the principle of KISS and pre-tested. Program evaluation has been rarely done in practice, although it provides valuable feedback to the program. Strategies for developing nutrition education for Korean elderly include; performing needs assessment, developing a standard program by topics in a logical and systematic way, developing programs for subgroups of elderly, applying diverse education methods developing educational materials for the elderly, evaluating programs using simple tools, and delivering a nutrition program as a part of health promotion program. Finally, the interaction and communication between researchers and practitioners is strongly recommended to ensure better nutrition education and services to the elderly.

• Preventive Nutrition and Food Science
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• v.9 no.4
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• pp.389-396
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• 2004

With the increase of elderly people, educators have begun designing experiences to prepare students to work with elderly group. The purpose of this study is to evaluate the knowledge and attitude of students majoring in food and nutrition for the elderly and their intentions to provide services for the elderly. The knowledge level of the students was in a medium range, and no relationship was found between knowledge and attitudes using Pearson correlation. The knowledge did not significantly differ across gender and academic level when compared using t-test and ANOVA, but knowledge level was significantly different based on residential experiences with elderly over 65 years of age (p < 0.05). Students had neutral attitudes toward working with elderly employees and working for elderly. Students had positive intentions to work with elderly employees, seek employment in an organization for elderly clients/customers, and seek opportunities for positive social interaction with the elderly. However, students do not have positive work preference with elderly employees. As a result of multiple regression analysis, it was found that knowledge was not a predictor of intentions to provide services to the elderly. However, attitudes toward working with elderly employees, attitudes toward elderly, residential experiences with elderly > 65 years have been predicted the intentions to work with elderly employees. Attitudes working with elderly employees and attitudes toward elderly influenced the intentions to work in the organizations to provide services to elderly. This study can be identified the need for additional didactic preparation and experiences to prepare students to work with elder aging population.

• Journal of the Korean Dietetic Association
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• v.3 no.2
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• pp.197-210
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• 1997

Low energy intakes, poor nutritional quality, and low food diversity are among the factors affecting the nutritional status of elderly in Korea. Therefore, a nutrition counseling and education program was conducted to promote dietary change and to improve nutritional status of elderly. The 7 step program consisted of a individual nutrition counseling and weekly or biweekly group nutrition education programs. Pre- and post-test measurings of dietary behaviors, attitudes, nutrition knowledge, and 24-hour dietary recall data were collected. Positive changes in the attitude related to diet were noted, whereas nutritional knowledge scores were not improved. Significant increases were noted in the frequency of vegetable consumption in female and diversity of food consumption in male. The densities of vitamin C(male & female), $B_1$, $B_2$, and niacin, calculated using the INQ(Index of Nutritional Quality), were significantly improved by nutrition counseling and education programs. These results suggest the appropriateness of nutrition intervention programs for the improvement of elderly nutrition.

• Journal of Community Nutrition
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• v.3 no.2
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• pp.103-109
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• 2001

With a continuous and steep increase in life expectancies, Korean society is expected to enter the aged society by year 2020. And as the number of elderly increases, the burden of medical and health care expenses for them becomes greater in every developed society. Hence, the preventive approach for chronic degenerative diseases remains to be the best solution for the above-mentioned problem and warranting optimal nutrition would be one of the most important approaches. We performed a nutrition survey on 585 older adults of 50 years of age and older, residing in 3 metropolitan areas including Daejun, Daeku and Kwangju. Anthropometry, including body composition analysis based on the bioelectrical impedance analysis using InBody 3.0 and dietary intake survey by semi-quantitative flood frequency questionnaires, were used in collecting data. As one of the most important factors affecting the health and nutritional status of the elderly, we focused on living arrangements. Analyses were performed on the data from 550 subjects only, after excluding statistical outliers. Three hundred and sixty-eight of them(66.9%) were female and the number of elderly(65 years of age and older) was 485. According to the statistical analyses, the female elderly were more vulnerable to malnutrition than the male elderly. And the older they befame, the less adequate they were in nutrient intake. In addition to this, the elderly living alone showed the poorest patterns of nutrient intake and anthropometry. Although the exact effect of living alone could differ among different sex-age groups, the fact that the elderly living alone is vulnerable to malnutrition would remain concrete. This raises the utmost necessity of nutrition intervention to be devised and directed to the targeted population, namely the living-alone elderly from the government level. The intervention may include nutrition education, nutrition counseling and support In forms of meal service by networking the efforts of central as well as local governments to ensure the good health of the Korean elderly.

• Korean Journal of Community Nutrition
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• v.24 no.4
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• pp.309-320
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• 2019

Objectives: This study was undertaken to compare dietary life of the elderly living alone and in a family, and to compare differences based on gender, for the 2013-2016 Korea National Health and Nutrition Examination Survey (KNHANES). Methods: The subjects included 2,612 elderly people aged over 65 years who participated in the health survey, health examination and nutrition survey. Subjects on a diet therapy were excluded. This study analyzed the general characteristics, dietary habits, daily energy and nutrient intakes, CPF ratio, estimated average requirement (EAR), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR), index of nutrient quality (INQ), and food consumption of the elderly living alone and in a family. We also compared the differences based on gender. Results: Daily intake of food, water, dietary fiber, potassium, retinol, and riboflavin were low in the male elderly subjects living alone. The elderly living with family revealed higher NAR and MAR as compared to the elderly living alone. Although all MAR values were <1, the elderly living alone had lower values. Considering the intake of food, the consumption of seaweed, fish and shellfish, and oils (animal) was higher in elderly men living with families, whereas women living with families consumed more vegetables, fruits, seaweeds and seafood, as compared to their counterparts living alone. Furthermore, analyzing the foods consumed by the elderly people living alone, female subjects consumed more seaweed, milk and animal oil as compared to male subjects. Conclusions: The results of this study indicate that the elderly living alone have poor nutrient intake as compared to the elderly living with families. Based on this research data, we recommend that it is necessary to improve the health and nutritional status of the elderly living alone.

• Korean Journal of Community Nutrition
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• v.4 no.2
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• pp.207-218
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• 1999

The increased number of elderly in Korea presents great challenges for community nutrition programs. Strategies to enhance elderly nutrition are needed, as well as dietary advice that are reality-based and tailored to the need of the elderly. The purpose of this study was to evaluate the overall effectiveness of an elderly nutrition improvement program(ENIP), by assessing changes in nutrition knowledge, attitudes, and behavior after program completion. ENIP was conducted in Suwon for 4 months in 1998 at 5 centers for the elderly. The program provided individual nutrition counseling and brief biweekly group education sessions. To stimulate participation and motivation, the elderly in two centers were served free milk packs(200ml) three time a week during the program(milk＋education group), and the elderly in 3 other centers were served yoghurt on the program day(education group). Altogether, 102 subjects finished the program(milk＋education group 67 ; education group 35). Data about nutrition knowledge, dietary attitudes, diet records(24 hour recall) and dietary habit was collected before(baseline) and after the program(follow-up). The Drop-out rate for the milk＋education group(2.9%) was significantly lower than that for the education group(30.0%)(p<.001). The Nutrition Knowledge fo females milk＋education group increased significantly after the program, but no significant differences were observed in other groups. Over 60% of all the elderly showed positive responses to the healthy eating attitudes. Energy, protein, vitamin A, riboflavin, Calcium and Potassium intakes improved in the male milk＋education group. The Vitamin C intake improved in the male education group. Energy and vitamin A intakes improved in the female milk＋education group and energy, vitamin A, thiamin, riboflavin, niacin, Ca nad P in the female education group. A stepwise multiple regression analysis was performed to examine the effects of food intake changes on overall nutrient quality. For all elderly, the fish intake explained 12.6% of the variance, followed by candy intake and vegetable intake(model $R^2$=19.6%). Dietary habits such as meal time regularity and salty food reduction were markedly improved in both groups. Sixty-one percent of the milk＋education subjects stated their participation was voluntary and active, while 51% of education subjects did. Sixty four percent of the subjects stated their interest on diet increased remarkably through program participation. Considering the results, it is conjectured that ENIP had a great impact on nutrient intake, dietary attitudes and habits. Milk supplement showed no direct effects on elderly nutrition improvement, but it encouraged the program by reducing drop-out rates and inducing voluntary participation. Therefore milk supplement could enhance the community nutrition education program. Moreover it is strongly suggested that the ENIP be expanded to other communities.