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Protein Intake Recommendation for Korean Older Adults to Prevent Sarcopenia: Expert Consensus by the Korean Geriatric Society and the Korean Nutrition Society

  • Jung, Hee-Won;Kim, Sun-Wook;Kim, Il-Young;Lim, Jae-Young;Park, Hyoung-Su;Song, Wook;Yoo, Hyung Joon;Jang, HakChul;Kim, Kirang;Park, Yongsoon;Park, Yoon Jung;Yang, Soo Jin;Lee, Hae-Jeung;Won, Chang Won
    • Annals of Geriatric Medicine and Research
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    • v.22 no.4
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    • pp.167-175
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    • 2018
  • Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.

Development and Effects' Analysis of Nutrition Education Pamphlet for the Lower Grades Elementary Students - Focused on Individual Daily Needed Food Exchange Units - (초등학교 저학년용 영양교육 소책자 개발 및 효과 분석 - 개인별 맞춤형 하루 필요 식품군 단위수 교육을 중심으로 -)

  • Son, Min-Jung;Cho, Young-Sook;Kim, Se-Na;Seo, Hye-Ji;Kim, Sook-Bae
    • Korean Journal of Community Nutrition
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    • v.16 no.6
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    • pp.647-660
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    • 2011
  • The purpose of this study was to investigate effects of nutrition education program and pamphlet for the lower grades elementary students focused on individual daily needed food exchange units using Food Exchange System. Program consisted of four lessons (40 min/lesson), "5 major nutrients & function", "6 food group and sources", "daily needed food exchange units for normal body weight", and "smart snack choice and exercise". Pamphlet as activity book was developed for the program. The subjects were 3rd grade elementary students (educated group, 31 vs. non-educated group, 31). Educated group were lessoned as group and/or individual. We examined the differences in nutrition knowledge, dietary attitudes, dietary intakes and satisfaction of the program and pamphlet. In educated group, there were positive improvements on nutrition knowledge score "function and foods of 5 nutrients" and on dietary attitudes "type of breakfast and snacks". In the evaluation of dietary intakes according to KDRI, there were positive improvements on intakes level of riboflavin, vit. C, folate, Ca, P, Fe and Zn in educated group. In satisfaction with the program and pamphlet, contents, font size, visual, figure, difficulty and program curriculum were over 2.90/3.0. It showed that the developed nutrition education program and pamphlet focused on individual daily needed food exchange units using Food Exchange System improved nutrition knowledge, dietary attitudes and nutrients intake level in the lower grades elementary students.

The High-density lipoprotein (HDL) cholesterol and related factors in Korean middle-aged (한국 중년의 고밀도지단백(HDL) 콜레스테롤과 관련요인)

  • Kim, Sang-Lak;Kam, Sin;Kim, Myung-Gwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.423-432
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    • 2018
  • The purpose of this study was to provide basic data to promote health in middle-aged Koreans (40-59 years old) by understanding health behaviors that affect high-density lipoprotein (HDL) cholesterol level among various health behaviors. In a national health and nutrition survey, raw data combined on a total of 7,406 persons, IV-3 (2009), V-1 (2010), V-2 (2011), V-3 (2012), and VI-1 (2013), were selected as the final analysis subjects. HDL cholesterol was divided into two groups: less than 40 mg/dl and more than 40 mg/dl. The results of multiple logistic regression analysis were as follows: OR=3.916 for males, OR=3.439 for normal than low weight, OR=7.336 for obesity than low weight, OR=1.629 for alcohol consumption, OR=1.498 for smokers, OR=1.426 for don't practice moderate physical activity, OR=1.264 for no walking exercise, OR=1.510 for carbohydrates normal intake than low intake, OR 1.787 for carbohydrates over intake than low intake when HDL cholesterol increased from 40 mg/dl to less than 40 mg/dl. Korean middle-aged high-density lipoprotein (HDL) cholesterol levels should be increased to maintain proper health through aerobic exercise, smoking cessation, proper drinking habits, obesity relief, healthy eating out, and healthy food choices. This requires continuous publicity and education within the community, and a social environment should be built that enables health behavior to be practiced in daily life.

Treatment of Obese Women with Low Calorie Diet, Aerobic Exercise and Behavior Modificaiton (저열량균형식, 운동 및 행동수정에 의한 비만여성의 치료에 관한 연구)

  • 장경자
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.4
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    • pp.510-516
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    • 1995
  • A multidisciplinary weight control program was conducted for obese women. The major components of the program included low calorie diet therapy, exercise, behavior modification and nutritional education and counseling. Sixteen healthy volunteers in excess of body fat, above 30%, were enrolled in the group support program. But 5 person were dropped out in the 2nd week of treatment. During the 1st week of group orientation, individual cause of obesity was assessed through a computer program including survey of dietary intake, activity, eating habits and life styles. During the 5 weeks of treatment, 4.8kg of average weight loss was accomplished using a following program ; low calorie diet(1200kcal/day with all essential nutrients), low impact aerobic exercise(50~60% of $VO_{2max}$, 1 hour/day in a group, 3~5 days/week), behavior modification of individual life styles and eating habits causing obesity and nutritional education concerning nutrition, role of exercise such as brisk walking, importance of slow eating in regular meal pattern and internal motivation for weight reduction, health risk of obesity and rapid weight loss, weight recycling and yo-yo syndrome, etc. Nutritional conseling was conducted 3 times per week with checking self-records of foods, activity, emotional state and tiredness. Before and immediately after 5 weeks of treatment, blood pressure, fasting blood glucose, cholesterol and triglyceride were measured and comparied with paired t-test. After 5 weeks of treatment, body weight, body mass index, body fat and circumferences of waist, upper arm and hip were significantly decreased. Also LDL-cholesterol was significantly decreased after obesity treatment.

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Childhood Obesity of Elementary School Students in Kangnung and Seoul Areas -Effects of Area and Parental Socio.Economic Status- (강릉과 서울의 일부 초등학교 고학년 아동의 비만 발생에 관한 연구 -지역 및 부모의 사회.경제적 수준이 미치는 영향-)

  • 김은경;최양숙;조운형;지경아
    • Journal of Nutrition and Health
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    • v.34 no.2
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    • pp.198-212
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    • 2001
  • This study was designed to compare the prevalence rate of obesity, food attitude, food frequency and food habits between children in Kangnung and Seoul areas. 1,005 children aged 9-12 were included in this study. They were composed of 343 children living in Kangnung from one elementary school, and 662 children in Seoul from two elementary schools. The body weight, height, waist and hip circumferences of children were measured and food frequency scores of Korean and Western foods were examined by questionnaire. And questionnaires about food attitude, food habits and life style were administered to the mother of each child. There was no significant difference in body weight and obesity index among three groups(one school of Kangnung area and two schools of Seoul area). The male children\`s prevalence rates of obesity in Kangnung and two schools(A, B) of Seoul were 10.3%, 10.3% and 7.3%, respectively. Female children\`s prevalence rate were 5.4%, 4.7%, and 6.3%, respectively. Children in Seoul turned out to more frequently eat such Korean foods like pulkogi, kalbi and fried rice and such western foods like butter, margarine, hamburger, pizza, and fried chicken. Children in Seoul had more tendency to eat regularly and spent less time in sleeping and watching TV and more time in exercise than the respondents in Kangnung. The obesity index of parents had a significantly positive correlation with that of children. These results suggest that children in Seoul have tendency to eat high-energy food frequently and to have more energy expenditure than children in Kangnung. In conclusion, further studies on the evaluation of energy intake and energy expenditure of obese and normal children different in area should be conducted. (Korean J Nutrition 34(1) : 198∼212, 2001)

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A Comparison Study on Interest of Dietary Life Behavior, Nutrient Intake and Health between Full-Time and Working Housewives (전업 주부와 직업주부의 식생활, 영양소 섭취상태 및 건강에 대한 관심도 비교 연구)

  • Shin, Kyung-Ok;Yoon, Jin-A;Lee, Jun-Sik;Chung, Keun-Hee;Choi, Soon-Nam
    • Journal of the Korean Society of Food Culture
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    • v.25 no.3
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    • pp.285-295
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    • 2010
  • The purpose of this study was to compare the awareness of dietary patterns and health of full-time and employed housewives. The investigation gathered information on general characteristics, dietary lifestyle, nutritional status, and health by questionnaire as well as anthropometric measurements. The subjects included housewives living in Seoul and Gyeonggi Province (86 full-time and 127 working housewives) during November 2009 to January 2010. The average age, height, and weight of the housewives were $45.8{\pm}7.6\;yr$, $161.0{\pm}8.4\;cm$, and $55.7{\pm}6.3\;kg$, respectively. The average monthly income of the households was 3 million to 5 million won (31.4% full-time and 37.0% working housewives), and their average food expense was 200,000 to 500,000 won (46.5% full-time and 48.1% working housewives). More than 90% of the studied homes were nuclear families and the most common number of children was 2 to 3 (79.1% full-time and 76.4% working housewives). The ratio of employed housewives who ate regular meals was 35.4%, but that of the full-time housewives was 48.2% (p<0.05). Of the working housewives, 7.1% never ate breakfast and the primary reason for skipping breakfast was 'busy in the morning' (61.1%). The type of food that the housewives preferred when eating out was Korean food, both for the full-time and employed housewives (76.0%). All the housewives overate calories and the full-time housewives ate more protein, fat, vitamin A, vitamin B1, vitamin B6, niacin, vitamin C, vitamin E, folic acid, and cholesterol than the employed housewives (p<0.05). Both the full-time and employed housewives were more satisfied with supper than with other meals. About 30.6% of the full-time and 33.9% of the working housewives had no interest in health, but answered that regular exercise was very important for health (33.3% full-time and 39.7% working housewives). In conclusion, working housewives have poor dietary habits and nutrient intakes, thus substantial measures to improve these problems are urgently needed.

Development and Effects' Analysis of Nutrition Education Pamphlet for the Higherr Grades Elementary Students -Focused on Individual Daily Needed Food Exchange Units- (초등학교 고학년용 영양교육 소책자 개발 및 효과 분석 - 하루 필요 식품군 단위수 교육을 중심으로 -)

  • Lim, Eun-Su;Cho, Young-Sook;Kim, Se-Na;Kim, Sook-Bae
    • Korean Journal of Community Nutrition
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    • v.17 no.6
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    • pp.689-706
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    • 2012
  • The purpose of this study was to evaluate effects of a nutrition education focused on Food Exchange System for the higher grades elementary children. Nutrition education lessons (40 min/lesson, 4 times), '5 major nutrients and functions', '6 food groups', 'daily needed energy and food exchange units', 'good choice of snacks and balanced exercise' were provided to elementary students (5th grade students). This research was based on the data from two groups of elementary school children in the 'education' group (n = 31) and 'non-education' group (n = 31). We assessed the changes in dietary attitude, food habit and nutrition knowledge using questionnaire and nutrient intake using 24hr recall method by nutrition education using the developed pamphlet. After education, there was a significant difference in the dietary attitude score only in attitude of 'balanced meal' (p < 0.001) in the education group compared to the non-education group. In food habit, there were significant positive changes in the type of breakfast and in the priority of choosing snack in the educated group. In nutrition knowledge, there were significant increases in scores of 'function of carbohydrate' (p < 0.05), 'function of fat' (p < 0.01), 'function of vitamin' (p < 0.01), 'foods of carbohydrate' (p < 0.01), and 'foods of vitamin' (p < 0.01) in the educated group. After education, carbohydrate: protein: fat (CPF) ratio was significantly different between the two groups (education group, 59 : 16 : 26 vs. non-education group, 63 : 15 : 23). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), there were significant positive effects in energy (p < 0.05), thiamin (p < 0.05), riboflavin (p < 0.05), vitamin C (p < 0.05), phosphorus (p < 0.01), Fe (p < 0.01) and zinc (p < 0.01) in the education group compared to the non-education group. In conclusion, the developed 4 times' nutritional education pamphlet focused on individual daily energy requirements and food exchange units using food exchange system for higher grades' elementary student may positively change nutrition knowledge and dietary intakes.

Effects of sun exposure and dietary vitamin D intake on serum 25-hydroxyvitamin D status in hemodialysis patients

  • Lee, Yeon Joo;Oh, Il Hwan;Baek, Hee Jun;Lee, Chang Hwa;Lee, Sang Sun
    • Nutrition Research and Practice
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    • v.9 no.2
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    • pp.158-164
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    • 2015
  • BACKGROUND/OBJECTIVES: Vitamin D deficiency is common in hemodialysis patients. The aim of this study was to identify whether or not sun exposure and dietary vitamin D intake have effects on serum 25-hydroxyvitamin D (25(OH)D) status in hemodialysis (HD) patients. The objective was to identify the main determinants of serum vitamin D status in the study subjects. SUBJECTS/METHODS: A cross-sectional study of 47 HD patients (19 males and 28 females) was performed. We assessed serum 25(OH)D and $1,25(OH)_2D$ levels between August and September 2012 and analyzed the prevalence of vitamin D deficiency in HD patients. To evaluate the determinants of serum 25(OH)D levels, we surveyed dietary vitamin D intake, degree of sun exposure, and outdoor activities. To compare biological variables, serum 25(OH)D was stratified as below 15 ng/ml or above 15 ng/ml. RESULTS: Mean 25(OH)D and $1,25(OH)_2D$ levels were $13.5{\pm}5.8ng/ml$ and $20.6{\pm}11.8pg/ml$, respectively. The proportions of serum 25(OH)D deficiency (< 15 ng/ml), insufficiency (15-< 30 ng/ml), and sufficiency (${\geq}30ng/ml$) in subjects were 72.4%, 23.4%, and 4.3%, respectively. Prevalence of vitamin D deficiency in female patients was 78.6%, whereas that in males was 63.2% (P = 0.046). Vitamin D intake and sun exposure time were not significantly different between the two stratified serum 25(OH)D levels. Dietary intake of vitamin D did not contribute to increased serum 25(OH)D levels in HD patients. The main effective factors affecting serum 25(OH)D status were found to be the sun exposure and active outdoor exercise. CONCLUSIONS: Hypovitaminosis D is common in HD patients and is higher in females than in males. Sun exposure is the most important determinant of serum 25(OH)D status in HD patients.

Effects of Carnosine Supplementation on Carnosine Concentrations in Muscles and Blood Biochemical Indices of Rats

  • Yi, Hae-Chang;Kim, Mi-Young;Choi, Chang-Sun;Kim, Young-Nam;Han, Chan-Kyu;Lee, Bog-Hieu
    • Food Science of Animal Resources
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    • v.32 no.5
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    • pp.584-590
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    • 2012
  • This study evaluated the effects of carnosine supplementation on carnosine concentration in muscles and blood biochemical indices of rats. Thirty-two eight-week-old Sprague-Dawley male rats were randomly divided into a control group (CON) as well as three carnosine-treated groups. The carnosine-treated groups included groups fed diets composed of 0.01% carnosine (LC), 0.1% carnosine (MC), and 1.0% carnosine (HC). Body weight gain, food intake, feed efficacy rate, protein efficacy rate, and organ weights were not significantly different among the groups. In all groups, the mean carnosine levels in gastrocnemius muscles were higher than the mean carnosine levels in soleus muscles. Carnosine concentrations in soleus muscles and gastrocnemius muscles were significantly higher in the HC group compared to all other groups (p<0.05). Serum triglyceride and LDL-cholesterol concentrations in all of the carnosine-supplemented groups were significantly lower than those of the control group (p<0.05), while HDL-cholesterol levels were significantly higher than those of the control group (p<0.05). Aspartate aminotransferase levels in rats supplemented with carnosine were significantly higher than those of the control group. In conclusion, diets supplemented with high levels of carnosine can increase carnosine concentrations in skeletal muscles, which might contribute to increased exercise capacity. Furthermore, these findings suggest that high levels of dietary carnosine improve the lipid profile of rats by lowering blood LDL-cholesterol and increasing HDL-cholesterol levels.

Analysis on Nutrient Intakes and Eating Behaviors of Female Students Visiting Nutrition Counselling Office (체중조절 내담자의 영양섭취 및 식행동 실태 분석)

  • 이보숙;권순형;허채옥;조경련;이영순;김명자;임호남
    • Journal of the East Asian Society of Dietary Life
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    • v.12 no.5
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    • pp.352-363
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    • 2002
  • The purpose of this study was to analyze health-related habits, weight control experience and body composition of 344 female students visiting nutrition counselling office. Dietary habits of the subjects were assessed by means of interview with questionnaire and nutrient intakes were evaluated by the simple dietary assessment method. Weight and height were measured to get body mass index(BMI) and waist-hip ratio and their body composition were measured by Inbody 3.0. The obtained results were as follows: 1) Among students, 14.5% were exercising on a regularly basis, of which the exercises were walking and gymnastic exercise(22.1%), jogging(14.1%), and rope-skipping(4.7%), 48.4% of students were little drinking and 30.5% were once a week and smokers were 4.1%. 2) 28.3% of students were little having breakfast and 15.1% were once or twice a week. Two third of total students were not having breakfast regularly. Also only 59.6% of students were having dinner everyday, which means many of them were even skipping dinner. The reasons why they were not having breakfast were because they don't have enough time to eat(66.0%) and for a diet(2.8%) and the reasons for skipping dinner were because they were not hungry(23.0%), for the weight loss(18.2%). It was shown that they would skip dinner rather than breakfast for a weight control. 51.6% of students were taking snack 1~2 times a day and 5.3% were having little snack. 55.4% of students were dining out once a day and 15.4% more am 2 times a day. 3) 46.7% of students were already experiencing weight control before visiting the counselling office. 78.5% of students tried on one kind of weight control method, 11.4% on two kinds, and 10.1 % on more than three kinds. The method they tried for a weight control most was the one food diet using egg, fruits and beans, which is the most popular among them, and the next were an aerobic exercise(23.6%). a diet tried by a famous entertainer (15.5%), and the fasting(14.5%). 4) The average BMI was 21.2 and the body fat rate was 28.1%. As a result of grouping BMI, 12.8% were underweight 67.6% normal weight 11.6% overweight and 8% obesity. Less than standard for the body fat rate were 0.6%, 50.6% standard, 48.5% more than standard. 49.2% of students as normal weight on a BMI were assessed the so-called "skinny obesity. 50% of consulted students situated fat intra-abdominally at the umbilical level(WHR>0.8). 5) The energy intake was 76.6$\pm$17.8% of RDA and constituent ratio of carbohydrate, fat and protein were 64.2$\pm$5.2%, 21.6$\pm$3.7% and 14.3$\pm$2.3%, respectively, which is little over of 20% of recommended ratio of fat. Protein and niacin intake were more than 90% of RDA and riboflavin and vit. C were taken more than 100% of RDA. But Fe intake was 69.4$\pm$19.3%, Ca 76.6$\pm$23.6%, which were the least constituents. There was not remarkable significance between energy intake and nutrient density based on the groups of underweight, normal weight, overweight and obesity of BMI. 6) It was shown that body fat rate had remarkably significant correlation(p<0.000) with BMI(r=0.760) and WHR(r=0.817) respectively, but body fat rate was more correlated with WHR than with BMI. There was not much significant difference between body fat rate and WHR whether they exercised or not. However. BMI was significantly higher in the exercise group because one who showed higher BMI started to exercise since they looked fat in appearance and perceived as they were fat. fat.

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