Kim, Hui-Jeong;Gang, Eun-Hui;Lee, Jong-Ho;Kim, O-Yeon
Journal of the Korean Dietetic Association
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v.10
no.4
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pp.442-451
/
2004
Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 $\pm$ 0.35 days for the control group and 4.24 $\pm$ 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.
This study examined foodservice management performance in child-care centers and suggests ways in which meal service quality can be improved. Questionnaires were distributed to 51 child-care facilities. The majority of respondents were facility directors (dietitians) and their facility type was tax-paid (92.2%). The dietitian response rate was 51.0%, and the majority (96.2%) were hired with co-management status, visiting a facility once a week (76.0%). Only 52.1% of the facilities had menu planning by a dietitian, and improvements were needed in terms of planning menus with standardized recipes, especially for infant meals. The monthly food cost per child was 47,394 won, and the labor cost for a co-management dietitian was 3,670 won per child, indicating 21.8% and 1.8% of the tuition fee, respectively. Other necessary improvements included: more reliable food purchasing management, securing additional foodservice equipment, and better sanitation management. In addition, respondents rated the following as requirements to ensure high quality meal service: 'modernized foodservice equipment and facilities', 'government financial support', and 'information on nutrition and foodservice management provided by dietitians'. Based on the study results, the following are recommendations for improving meal service quality in child-care centers: Dietitian placement should be extended to facilities of over 50-capacity in addition to their current placement in facilities of over 100-capacity, and co-management dietitians should have their control span restricted to two facilities instead of five. Finally, nationwide nutrition support plans and nutrition education programs should be developed and implemented by dietitians, and their roles should be extended to foodservice mangers as well as nutrition teachers.
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.
This study aimed to assess the nutritional quality of breakfast among Korean school-aged children and adolescents depending on eating together as a family, based on the 2013-2014 Korea National Health and Nutrition Survey. One day 24-hour recall data of 1,831 children and adolescents aged from 6 to 17 years were collected. The nutritional quality of breakfast was analyzed and compared between Family Breakfast Group (FBG, n=1,410) and Eating-alone Breakfast Group (EBG, n=421). The results showed that age, family structure, number of family members, and frequency of breakfast were associated with eating breakfast as a family. The calorie intake from breakfast explained 19% and 16% of the daily intake for FBG and EBG, respectively. The percentages of children and adolescents consuming Vitamin A, Vitamin $B_1$, Vitamin $B_2$, Vitamin C, Niacin, and Iron less than 1/4 of the Estimated Average Requirements were significantly lower in FBG than in EBG. The average numbers of serving for "Grains" and "Vegetables" food groups and the average Dietary Diversity Score were significantly higher in FBG than in EBG. Overall, the results indicated that eating breakfast as a family is positively associated with nutritional quality of breakfast among Korean school-aged children and adolescents.
Kim, Eunjung;Chung, Sangwon;Hwang, Jin-Taek;Park, Yoon Jung
Journal of Nutrition and Health
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v.55
no.1
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pp.10-20
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2022
This article evaluated levels of Estimated Average Requirements (EARs), Reference Nutrient Intakes (RNIs), and Acceptable Macronutrient Distribution Ranges (AMDRs) of protein using the recently revised Dietary Reference Intakes (DRIs) for Koreans (2020). Dietary protein requirements are based on amounts sufficient to satisfy physiological demands to accomplish nitrogen equilibrium. The same principle was applied to estimate EARs and RNIs, for adults in DRIs conducted in 2015 and 2020 in Koreans. EAR was estimated to be 0.73 g/kg body weight/day, according to data (0.66 g/kg body weight/day) obtained using the nitrogen balance method and adjusted by efficiency of protein use (90%). RNI was calculated as EAR increased by an amount equal to twice the standard deviation of an age group so as to cover 97.5% of the group and was found to be 0.91 g/kg body weight/day. For weaned infants, children, and adolescents, growth requirement was added to estimate EAR. In particular, growth requirement was adjusted by efficiency of protein use in the revised EAR, which led to higher EARs for weaned infants, children, and adolescents of both genders as compared with 2015 DRIs. The AMDR for protein was set at 7%-20% of energy intake, which was the same as 2015 DRIs. Current, average protein intake by the Korean population is almost twice times the EAR, which suggests it might be better to increase the minimal margin for AMDR. However, it was not adjusted in this revision due to lack of evidence.
This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.
Objectives: This study intended to determine significant factors that influence the health-related quality of life ("HRQoL"; EuroQol 5 Dimension health-related quality of life (EQ_5D) & EuroQol visual analogue scale (EQ_VAS)) of the elderly in Korea. Methods: This study was based on 3,903 subjects aged 65 years or more who participated in the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2012. The HRQoL was analyzed by various factors (general characteristics, health habits, mental health, chronic diseases, nutrient intakes). SPSS statistics for complex samples (Windows ver. 21.0) was used. Results: The HRQoL was higher in the males, those with higher educational level or higher income level while it was lower in those belong to single households. In particular, the EQ_5D was significantly higher in the group who reported walking practice, moderate physical activity (male), and the group who reported no vigorous physical activity (female). The EQ_VAS was significantly higher in the group who reported walking practice. Both EQ_5D and EQ_VAS were significantly lower in the group with stress, melancholy, suicidal thinking, and osteoarthritis. EQ_5D was significantly lower in the group with < 75% Estimated Energy Requirements (EER) in energy intake, and with < Estimated Average Requirements (EAR) in iron or niacin intake. A stepwise regression analysis revealed that i) higher educational level (male), and good self-rated health status significantly increased the EQ_5D, ii) age, alcohol intake (male), melancholy (female), suicidal thinking, osteoarthritis, and niacin intake deficiency (male) significantly decreased the EQ_5D, iii) higher income level (male) and good self-rated health status significantly increased the EQ_VAS, and iv) age (male), stress, suicidal thinking (female) and osteoarthritis significantly decreased the EQ_VAS. Conclusions: This study suggested that general characteristics, mental health, osteoarthritis, and niacin intake were associated with the HRQoL. Prospective research of long-term control is needed to establish the causal relationship between factors and the HRQoL.
Antioxidants such as vitamin C and E may play a preventive role in the development of cancer and coronary heart disease. The status of vitamins C and E may be affected by lifestyle habits such as smoking , drinking, and exercise. These habits can modify the dietary requirements of vitamin C and vitamin E. the purpose of this study was to determine whether Korean young healthy men and women consume vitamins C and E in sufficient quantities relative to their lifestyle habits. Among the participants in this study, 52% of the men and none of the women were smokers. ; 84% of all subjects drank alcohol more than once a week ; and the men exercised more often than the women. The concentrations of serum total , HDL-, and LDL- cholesterol were higher in the women than in the men, but the serum triglyceride concentrations were higher in the men than in the women. The men consumed less satuated fat than the women (p<0.05) . The daily intakes of vitamin C for the men and the women were 47.1mg and 65.6mg, respectively. On the other hand , the daily vitamin E intake was higher in the men (11.8mg) than women(6.9mg). The serum $\alpha$-tocopherol concentrations of all subjects were in a normal range, and in no subjects were they below the minimum value of ranges. However, about 19% of male subjects and 10% of female subjects showed deficient status, although the mean serum vitamin C levels were normal . Lifestyle habits fo the sort mentioned above have little influence on the serum vitamin C and $\alpha$-tocopherol concentrations. The serum $\alpha$-tocopherol concentration had a positive correlation with total fat and alcohol consumption. The serum vitamin C concentration was positively associated with regular exercise, but it was negatively correlated with the number of cigarettes smoked. Meanwhile, the serum lipid persoxide concentration , the indirect index of oxidative stress, was influenced by certain variable such as body mass index , the number of cigarettes smoked , alcohol consumption, energy expenditure, vitamin C intake, and serum ${\gamma}$-tocopherol concentration. Serum lipid peroxide concentration was positively associated with body mass index, the number of cigarette smoked , serum triglyceride , and HDL-cholesterol concentration. In conclusion , the vitamin E requirements of the subjects were met by the Recommended Daily Allowance (RDA) regardless of lifestyle habits. However, serum vitamin C concentrations showed individual variation and was below the normal ranges. Smoking and exercise influenced serum vitamin C concentration. Therefore, a reevaluation of the requirements of vitamin C relative to lifestyle habits is necessary.
This study assessed the nutrient consumption of children from lunch at day care centers and kindergartens. A total of 184 lunch plates were selected in two child day care centers and two kindergartens in Seoul. Weights of the menus in planned meals were measured and amount of served and consumed lunches were calculated using a digital photography technique. Nutrients of the planned, served, and consumed lunches were assessed using CAN-Pro 4.0 and the Index of Nutritional Quality (INQ) was calculated for each meal. Compared with the estimated energy requirement for lunch for 3-5 year old children, the planned meals of the child day care centers and kindergartens contributed 42.8% and 98.8% of the daily energy requirements, respectively. At a child day care center, a served meal provided more nutrients than a planned meal since some children requested more servings after eating the served meals. This showed that the planned meal did not meet children's needs as well as the nutrient requirements. At the other child care center, children were served less than the planned meal by 6.8%, which resulted in serving less energy, calcium, potassium, and vitamin C than the required nutrients for lunch. Kindergarten A served meals with the energy requirement for lunch of 101.8%, but Kindergarten B served a meal with the energy requirement of 83.5%. Since the served portions were too small to meet nutrient requirements of the children, they consumed almost all the food served, and their nutrient consumption was similar to the nutrients served. Even though they consumed all the food served, their nutrient consumption did not meet their nutritional requirements. When assessed by INQ, the quality of the meal was good; children could consume enough nutrients when served proper quantity. Teachers who are responsible for serving meals need to be educated on proper portion sizes and how to encourage children to practice healthy eating. To promote healthy eating among children, parents need to provide children with messages consistent with what they have learned at institutions and to be a good role model in daily dietary life.
Hemoglobinemia is found in hemolytic anemia, paroxysmal nocturnal hemolobinuria and paroxysmal hemoglobinuria. Recently increasing use of extracorporeal circulation in cardiac surgery has stimulated the development of more precise methods for rapidly evaluating the formation and clearance of extracoporeal hemoglobin. A spectrophotometric method of analysis seemed to offer the best solution to the requirements. The method presented is on the basis of hemoglobin derivatives converted to cyanmethemoglobin, and the absorbance is measured in a spectrophotometer at 540 and 680 nm. The blank value ismeasured at 680 nm while the absorbance at 540 nm measures the hemoglobin derivatives. This method estimates all the hemoglobin derivatives such as oxyhemoglobin, carboxyhemoglobin, methemoglobin, sulfhemoglobin and hemialbumin. The method was tested in recovery experiments, which is given table 1. A good degree of correlation was obtained in a comparision with the method described by Crosby and Furth for non-hemolyzed serum. The spectrophotometric technique described offers many advantages in speed and simplicity over the chemical procedure.
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