The purposes of this study were to assess hospital foodservice quality and to identify causes of quality problems and improvement strategies. Based on the review of literature, hospital foodservice quality was defined and the Hospital Foodservice Quality model was presented. The study was conducted in two steps. In Step 1, nutritional standards specified on diet manuals and nutrients of planned menus, served meals, and consumed meals for regular, diabetic, and low-sodium diets were assessed in three general hospitals. Quality problems were found in all three hospitals since patients consumed less than their nutritional requirements. Considering the effects of four gaps in the Hospital Foodservice Quality model, Gaps 3 and 4 were selected as critical control points (CCPs) for hospital foodservice quality management. In Step 2, the causes of the gaps and improvement strategies at CCPs were labeled as "quality hazards" and "corrective actions", respectively and were identified using a case study. At Gap 3, inaccurate forecasting and a lack of control during production were identified as quality hazards and corrective actions proposed were establishing an accurate forecasting system, improving standardized recipes, emphasizing the use of standardized recipes, and conducting employee training. At Gap 4, quality hazards were menus of low preferences, inconsistency of menu quality, a lack of menu variety, improper food temperatures, and patients' lack of understanding of their nutritional requirements. To reduce Gap 4, the dietary departments should conduct patient surveys on menu preferences on a regular basis, develop new menus, especially for therapeutic diets, maintain food temperatures during distribution, provide more choices, conduct meal rounds, and provide nutrition education and counseling. The Hospital Foodservice Quality Model was a useful tool for identifying causes of the foodservice quality problems and improvement strategies from a holistic point of view.
The purpose of this study was to investigate Korean food adaption, eating behavior and dietary intakes of married female immigrants by age, number of residence years in Korea and level of income. The survey included 67 female marriage immigrants attending the Korean language class at the multicultural family support center within the northern part of Kyonggi province from October 2010 to July 2011. General characteristics, Korean dietary life adaptation, and eating behavior were collected and dietary intakes were assessed using 24-hour recall. The home countries with regards to all subjects were Vietnam (40.3%), China (23.9%), Japan (11.9%), Philippines (7.0%), and Mongolia (3.0%). Total energy intake was 1432.5kcal and there were significant differences in nutritional intake concerning vitamin B1 and vitamin B2 by age (p < 0.05). More than 50% of subjects did not meet estimated average requirements for calcium (56.7%), zinc (52.2%), vitamin C (55.2%), and folic acid (76.1%). Food adaptation scores were significantly correlated with general characteristics (age, residence year, drinking alcohol and acquisition of nationality), total scores of eating behavior, and nutritional intake (energy, protein, fat, fiber, calcium, phosphorus, sodium, potassium, niacin, vitamin E, and zinc). These results might suggest that the better their Korean food adaptation, the more desirable their eating behavior and nutritional status.
The objective of this study was to investigate the nutritional status, biochemical parameters, lipid and electrolytes concentrations of the enteral nutrition patients according to the duration of enteral nutrition. Eighteen neurosurgery patients in the intensive care unit (ICU) at K University Hospital were subjected in this study. The duration of enteral nutrition was classified into under or over six month of period. Anthropometric, biochemical, clinical, and dietary assessments were performed. Patients' intakes of energy and protein were insufficient, from 82% to 95% of their requirements. Mid-arm muscle circumference (MAMC) and mid-am muscle area (MAMA) were significantly lower in patients over six months of enteral nutrition than those in patients under six months. The subjects were malnourished as indicated by nutrition-related parameters such as hemoglobin, albumin, total lymphocyte count (TLC), tricep skinfold thickness (TSF), mid-arm circumference (MAC), MAMC, and MAMA. Serum chloride level of the patients eve, six months of enteral nutrition was lower (94.7 $\pm$ 3.4 mmo1/1) significantly as compared to that of patients (99.3 $\pm$ 3.5 mmol/ 1) under six months. Urinary sodium and chloride levels were lower in the longer time of enteral nutrition patients than those of shorter period of enteral nutrition patients (p < .05). While serum phospholipid level was higher in the patients over six months of enteral nutrition, other blood biochemical parameters and electrolyte concentrations did not show any differences with the duration of enteral nutrition. Neurosurgery patients in the ICU undergoing long-term enteral nutrition tube-feeding were malnourished and had a variety of metabolic complications. The duration of enteral nutrition could affect the patients' nutritional status, biochemical parameters, and electrolytes balance. The patients who require nutritional support over an extended time need the continuous follow-up care and monitoring by the nutrition support team for laboratory, clinical, and nutritional assessments.
BACKGOUND/OBJECTIVES: This study investigated nutritional status of the elderly with dementia in a care facility with the aim of improving the meal quality of the facility. SUBJECTS/METHODS: Data were collected from 30 dementia patients aged more than 65 years in a long-term care facility in Hongseong. The data were obtained from questionnaires and medical records. The food intake data was obtained using food photographs and the nutrient intakes were calculated using the CAN-Pro 5.0. The data were compared with the dietary reference intakes for Koreans (KDRIs). The nutrient density, diet quality such as nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ), as well as dietary diversity score (DDS) were evaluated. The data were analyzed using SPSS statistical programs. RESULTS: The average daily energy intakes for men and women were much lower than the estimated energy requirements of the KDRIs. The average intakes of energy and most nutrients in the general diet group were significantly higher than those of the other two groups. Significant differences in diet quality and diet diversity were observed according to the meal type groups. The NARs of some minerals (calcium, iron, and zinc) and vitamins (vitamin $B_6$ and folic acid) were less than 0.5 in all study groups. The NARs of protein, iron and MAR of the general diet group were significantly higher than those of the liquid diet group. The DDS scores of meats, fruits and diary food group were very low in all meal type groups, meaning that the diet qualities of the study subjects were not appropriate in all meal type groups. CONCLUSIONS: The food intakes of the study groups showed some limitations by a direct comparison with KDRIs because of the very low physical activities of the study subjects. The diet quality and diet diversity indices suggest the need for improvements in the nutritional quality in all types of diet. Overall, new intervention strategies targeting facility residents with dementia in Korea are needed as soon as possible.
당근 모상근의 생리학적 특성을 기존의 현탁 배양세포와 영양 요구성의 관점에서 비교, 고찰 하였다. 인산염과 질소원 등 무기 영양분의 영 향은 당근현탁세포에서와 통일하였고 모상근 성 장의 최 척 sucrose 농도는 7%로, 3 % sucrose 농도에서 최대 성장을 보인 현탁세포와는 다른 결과를 나타내였다. 이는 현탁배양세포는 미분 화된 상태로 세포 각각이 외부 환경과 접촉하고 있으므로, 분화되어 기관 스스로 세포 성장에 적합한 환경을 만드는 모상근보다 외부 환경에 민감하게 작용하여 나타나는 현상으로 해석되었다. Sucrose가 모상근의 성장에 미 치는 기작을 밝히기 위하여 삼투압 조절제인 mannitol을 배 지에 첨가하여 sucrose 농도가 생체중량과 건조 중량 각각에 미치는 영향을 고찰하였다. 모상근의 성장은 배지 내 sucrose 농도에 영향을 받았 고, sucrose 농도가 통 일할 때 건조중량 증가는 생체중량 증가보다 크게 나타났다. 따라서 모상 근 배양계에서 sucrose는 삼투압 조절제로서의 역할보다 주로 에너지원의 역할을 하는 것으로 판단되 었다.
Recently, the number of patients who received Bone Marrow Transplantation(BMT) has been increased dramatically and the diseases for which BMT if efficacious are increasing. Adequate nutritional card for BMT patients is crucial for the success of BMT because nutritional deficiency could provoke deteriorative effects. However, little is known about nutritional status among BMT patients in Korea. This study was conducted to assess oral and parenteral intake of BMT patients and compare the change of nutritional status before and after BMT. Twenty-two BMT patients who were admitted to the Severance hospital from December in 1995 to September in 1997 participated in the study. Total calorie requirements were calculated for each patients individually and nutritional support for each patients consisted of oral and parenteral feeding. To assess oral intake of BMT patients, each patients recorded the amount of food they have eaten from 6 days before BMT to 28 days after BMT. The medical records of each patients were used to assess parenteral intake. To compare the nutritional status before and after BMT, the results of anthropometric and biochemical test from 14 days before BMT to 28 days after BMT were used. At the time of admission, the patients were in allowable nutritional status and their total calorie intake was 93% of total calorie requirement. When the preparative regimen for BMT was started, the patients' oral intake was dramatically decreased below 400kcal/day. Even though their oral intake was increased after BMT, their oral intake at the 4th week after BMT was only 752kcal/d, which is only 35.8% of total calorie requirement. The patients' mean oral intake during BMT period (from 6 days before BMT to 28 days after BMT) was only 439kcal/d. Although Total Parenteral Nutrition(TPN) was added when the preparative regimen was started, the patients' mean total caloric intake during BMT period was 111% of basal energy expenditure and 83% of total calorie requirement. The mean total protein intake was only 58% of total protein requirement. In the comparison of nutritional status between pretransplant phase and posttransplant phase in BMT patients, their body weight and serum albumin level were significantly decreased(p<0.001). These results show inadequacies in nutritional intake among BMT patients, and indicate the need of TPN during BMT period.
Purpose: The consistent rise in the number of foreign students in Korea demands an accurate and detailed investigation into their dietary practices and nutritional status. For these international students, assimilation into new cultures can be stressful. The influence this process may have on dietary behaviors as well as overall health cannot be overlooked. Methods: The researchers in this study sought to investigate the nutritional status and dietary practices of Ghanaian students studying in Korea. A total of 81 Ghanaian male students with an average age of $29.4{\pm}4.0years$ were sampled between May and June 2016. Investigations were carried out on the general characteristics of the participants, their daily food and nutrient intakes using a 24-h dietary recall method, meal skipping practices, and the nutritional quality of their diets based on their meal skipping habits. Results: The study revealed that the daily nutrient intake of subjects did not fully meet the daily recommended nutrient intake (RNI) established by Ghanaian Ministry of Health and the World Health Organization (WHO) and Food and Agriculture Organization (FAO), particularly for energy, calcium, iron, zinc, and vitamin B2 requirements. The Nutrient Adequacy Ratio (NAR) for calcium was very low, posing a deficiency risk to the participants. Meal skipping practices among participants changed significantly after arriving in Korea. The study also compared the diet quality indicators (Nutrient Adequacy Ratio and Mean Adequacy Ratio) of those who skipped meals ${\geq}7times/week$ with those who skipped meals < 7 times/week. Participants who skipped meals ${\geq}7times/week$ were shown to have lower dietary intakes of vitamins B1 and B2 than those who skipped meals < 7 times/week. Conclusion: Ultimately, the study found that meal skipping among Ghanaian students was common, and their daily nutrient intakes did not meet the set dietary standards. Those who skipped meals ${\geq}7times/week$ had lower dietary intakes of vitamins B1 and B2 than those who skipped meals < 7 times/week. Based on our study findings, we recommend that nutrition education should be organized for the Ghanaian student community in Korea using our results as a template to draw up a nutrition program that is culturally appropriate.
Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.
This study was conducted on the nutritional status of 1,805 patients with allergic diseases (atopic dermatitis, allergic rhinitis, and asthma) aged 19 to 64 years according to their state of depression, based on the data from the Korea National Health and Nutrition Examination Survey (KNHANES). The Patient Health Questionnaire-9 (PHQ-9) was used to diagnose depression. Subjects with a score of 10 or more were categorized into the depression group (n=152) and the rest into the non-depression group (n=1,653). The results of this study were as follows: The proportion of women (75.7%) was higher than that of men (24.3%) in the depressed group (P<0.01). In terms of energy intake per 1,000 kcal, both men and women in the depressed group showed a lower energy intake than the non-depressed group and this intake was less than the estimated energy requirement (EER). The nutrient intakes of protein, calcium, phosphorus, iron, vitamin A, thiamine, riboflavin, niacin, folic acid, and vitamin C were below the estimated average requirement (EAR). Also, the intakes of fiber and potassium were less than the adequate intake (AI) (P<0.001). In the lifestyle parameters, the ratio of eating alone at lunch was 54.1%:33.1%, indicating that more than half of the depression group ate alone. In conclusion, it was observed that the nutritional status of allergic disease patients was imbalanced. The nutritional imbalance was due to insufficient energy intake and inadequate intake of nutrients, which was below the average requirements of vitamins and minerals and this was more evident in the depression group than in the non-depression group.
The consumption of a wide variety of food groups is considered one of the key components of nutritional adequacy. The 2005 Dietary Guidelines for Koreans includes the consumption of a variety of foods from diverse food groups as a component of a normal diet. A survey was conducted to evaluate the relationship between the dietary diversity of food groups and nutrient intake in elderly patients (age 65 and above) at a rural area in Korea (Inje). 296 subjects (111 male and 185 female) were probed in a 3 day 24-recall dietary survey. Subjects were grouped according to food group intake frequency, based on six food groups (grain, meat/fish/legume/egg, vegetable, fat/oil, dairy, fruit). Nutritional quality was evaluated according to the numbers of nutrients under EAR (Estimated Average Requirements), and MAR (mean adequacy ratios). The frequency of elderly subjects consuming a meat/fish/legumes/egg food group less than once per day was 29.4%. The frequency of elderly subjects consuming fat/oil food group less than once per day was 65.8%. The percentage of subjects who did not eat dairy food was 88.8%, and that of subjects who did not eat fruit was 57.5%. A stepwise multiple regression analysis was used to develop models relating nutritional quality to possible food group intake frequency factors. Using the number of nutrients under EAR as a dependent variable, the meat/fish/legume/egg food group intake frequency explained 9.9% of variance, followed by the grain group, fat/oil group, dairy group, and vegetable and fruit group (Model $R^2$=0.260). For mean nutrient adequacy ratio as a dependent variable, the model $R^2$ was 0.326. The results of this study suggest that a highly varied diet in elderly might be associated with better nutritional quality, as assessed by nutrient intake. Accordingly, dietary guidelines should take into consideration nutritional characteristics in order to improve intake from all major food groups and to provide a variety of foods in the diet.
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