This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.
The purpose of this study is to describe the health behavior experience of middle-aged Korean women in rural areas, and to help understand their health practice, perceive their nursing needs and provide guidelines to developing appropriate nursing interventions. Method: The participants were 18 healthy middle-aged women living in rural areas, with no serious illness that require hospitalization. The data was collected through interviews and participant observation, analyzed by the grounded theory methodology of Strauss & Corbin(1997). The data collection period was from April to November of 2001. Result: Depending on the paradigm model, the central phenomenon was family-oriented pursuing of yangsaeng. The causal condition was less confidence on one's own health, responsibilities in caring for family. The contexts were cultural system. The intervening condition was information system, support system, limitation of approaching a medical institution. The action/ interaction strategies were yangsaeng through dietary practice, yangsaeng through promoting clothing and housing, yangsaeng through exercise, practice of folk therapy, yangsaeng through mental hygiene, and use of medical institution. The consequences were stabilization of body and mind, and stabilization of family. Conclusion: It is recommended for nurses to understand health behavior experience of middle-aged women, and provide nursing intervention with theoretical scheme and practical principles so that these women can pursue the family-oriented process of yangsaeng.
Park, Soo Jin;Lee, Seung Min;Kim, Seon Mee;Lee, Myoungsook
Nutrition Research and Practice
/
제7권2호
/
pp.139-145
/
2013
There is a lack of data on metabolic risk factors during pre-puberty, which is important for identifying the subgroups of youth, at whom early interventions should be targeted. In this study, we evaluated the prevalence of metabolic risk factors and its subsequent relations with dietary patterns in Korean pre-pubertal children through a cross-sectional sample (n = 1,008; boys = 513) of pre-pubertal children (aged 8-9 years) from a sub-study of the Korea Metabolic Syndrome Research Initiatives (KMSRI) in Seoul, Korea. Measures of anthropometry and blood pressure as well as fasting blood samples were used in the analysis. A three-day food records were collected. The metabolic syndrome was defined according to the age-adjusted National Cholesterol Education Program Adult Treatment Panel III guidelines. An added metabolic risk score was calculated for each subject by summing the quintile values of the five individual risk factors. Among the 5 risk components of metabolic syndrome, high waist circumference (WC) was the major factor (P < 0.001). A significant increasing trend of the added metabolic syndrome risk score was observed with the increase of WC (P (trend) < 0.001) among both genders. The cutoff point for high WC for pre-pubertal children was 61.3 cm for boys and 59.9 cm for girls. The prevalence of high triglyceride (TG) values was significantly higher in girls than it was in boys (P < 0.01). Girls in the highest quintile of balanced dietary pattern scores had lower TG values (P (trend) = 0.032) than did those in the lowest quintile. Moreover, girls in the highest quintile of western dietary pattern scores showed increasing trend for the added metabolic risk score (P (trend) = 0.026) compared with those in the lowest quintile. Adverse associations exist between western dietary patterns and the accumulation of metabolic risks among girls, not in boys, even during pre-puberty.
Noviana Astuti Irna Sakir;Su Bin Hwang;Hyeon Ju Park;Bog-Hieu Lee
Nutrition Research and Practice
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제18권1호
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pp.132-148
/
2024
BACKGROUND/OBJECTIVES: This study aimed to assess the current mean daily intake of 10 food groups, analyze the sociodemographic factors associated with food consumption, and determine the associations between food consumption/dietary intake and the prevalence rates of obesity, type 2 diabetes (T2D), and hypertension (HTN) in Jakarta, Indonesia. SUBJECTS/METHODS: A total of 600 participants aged 20-85 yrs were included in this cross-sectional study. Food consumption and dietary habits were assessed using a food frequency questionnaire. To determine the association between food consumption/dietary habits and the abovementioned diseases, logistic regression analysis was performed. RESULTS: The average vegetable and fruit intake was lower, while sugar and salt consumption were higher than that recommended by Indonesia's national dietary guidelines. A high intake of ultra-processed foods (UPFs) was associated with young age, men, "single" status, a high education level, and employment with a high monthly income. Obesity and T2D were positively correlated with high intakes of cereals and tubers, UPFs, sugars, fats, and oils. Conversely, an inverse association was found between legume, vegetable, and fruit consumption and obesity risk. An inverse correlation was also observed between vegetable consumption and T2D risk. Moreover, a high salt intake was inversely correlated with fruit consumption in terms of HTN risk. Non-indulgence in habitual late-night snacking and refrainment from consuming more than one dish at each meal were also negatively related to the prevalence of obesity, T2D, and HTN. Inverse correlations were also observed between the prevalence rates of T2D and HTN and abstaining from adding sugar to beverages. CONCLUSION: Foods high in fat, sugar, and sodium were strongly associated with the risks of obesity, T2D, and HTN. Additionally, poor eating habits were also associated with disease development.
This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P<0.001) and of depression (P<0.001) improved significantly and that dietary behavior scores also improved significantly (P<0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P<0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.
Many countries such as The Republic of Korea have established their own nutritional standards, collectively termed Nutrient Reference Values (NRVs), and they vary due to the science which was reviewed, the purposes for which they are developed, and issues related to nutrition and food policy in the country. The current effort by the Codex Alimentarius Committee on Nutrition and Foods for Special Dietary Uses (CNFSDU) to update the NRVs that were established following the Helsinki Consultation in 1988 represents an opportunity to develop a set of reference values reflecting current scientific information to be used or adapted by many countries. This paper will focus on possible approaches to selecting or developing reference values which would serve the intended purpose for nutrition labeling to the greatest extent possible. Within the United States, the Food and Drug Administration (U.S. FDA) is currently reviewing regulations on nutrition labeling to better address current health issues, and is expected to enter into a process in the next few months to begin to explore how best to update nutrient Daily Values (DVs), most of which are still based on the Recommended Dietary Allowances (RDAs) of the Food and Nutrition Board, U.S. National Academy of Sciences, last reviewed and revised in 1968. In this presentation, I review the current purposes in the U.S. for nutrition labeling as identified in the 1938 Food, Drug, and Cosmetic Act as amended, the scientific basis for current nutrition labeling regulations in the United States, and the recommendations made by the recent Committee on Use of Dietary Reference Intakes in Nutrition Labeling of the Institute of Medicine (2003) regarding how to use the DRIs in developing new DVs to be used on the label in the United States and Canada. Based on these reviews, I then provide examples of the issues that arise in comparing one approach to another. Much of the discussion focuses on the appropriate role of nutrient labeling within the Nutrition Facts panel, one of the three major public nutrition education tools in the United States (along with MyPyramid and Dietary Guidelines for Americans).
This study investigated the nutrition education realities and nutrition status of children in community child centers, by analyzing the status of nutrition education, nutrition quotient (NQ), and the level of maintaining dietary guidelines. The subjects were 173 children from grades 1 to 6, enrolled in community child centers, Jinju, Kyungnam. The NQ was examined by a questionnaire, which was a checklist of 19 food behavior items. The distribution of scores (out of 100) in the nutrition quotient were as follows: total score of NQ was 59.4, balance 56.6, diversity 60.6, moderation 65.6, regularity 60.9, and practice 56.7. Nutrition quotient was higher in the higher graders due to significant differences in the area of variety. The level of maintaining dietary guidelines was higher in girls, especially in the area 'eat politely with family', and higher amongst the upper graders in the area 'have safe snack wisely'. To improve the eating habits and nutritional status of the children in community child centers, their nutritional state should be checked with regular and systematic education, and their nutritional management should be pursued continuously. Since the assessment of the eating behaviors and the nutritional state of children is important at home as well as in schools and community child centers, nutritional education should be further extended to the parents and their care givers. This study can be implemented as basic material for the nutritional education of children, to minimize the dangers of malnutrition and to help build up the right eating habits amongst children in community child centers.
BACKGROUND/OBJECTIVES: The aim of this study was to analyze specific foods influencing absolute nutrient intake and between-person variations of nutrient intake among Korean preschoolers. SUBJECTS/METHODS: This study included 2,766 participants aged 1-5 years in the 2009-2013 Korea National Health and Nutrition Examination Surveys. Dietary data were obtained from a 24-h dietary recall method. Major food sources of absolute nutrient intake were evaluated based on percent contribution of each food. To assess the contribution of specific foods to between-person variations in nutrient intake, stepwise multiple regressions were performed and cumulative $R^2$ was used. RESULTS: White rice and milk were main food sources of energy, protein, carbohydrate, phosphorus, iron, potassium, thiamin, riboflavin, and niacin. The percentage of fat contributed by milk was 21.3% which was the highest, followed by pork, soybean oil, and egg. White rice accounted for 25% and 40% of total variability in total energy and carbohydrate intakes, respectively. About 39% of variation in calcium intake was explained by milk while 40% of variation in phosphorous intake was explained by cheese. The top 10 foods contributing to between-person variations in nutrient intakes were similar with food items that mainly contributed to absolute nutrient intakes. The number of foods explaining 90% of absolute amounts of nutrient intakes varied from 28 for vitamin A to 80 for iron. CONCLUSIONS: This study identified specific foods that contributed to absolute nutrient intakes and between-person variations in nutrient intakes among Korean preschoolers. Our findings can be used to develop dietary assessment tools and establish food-based dietary guidelines for young children.
BACKGROUND/OBJECTIVE: Even though the prevalence of metabolic syndrome in adolescents is increasing, little is presently known about this syndrome in adolescents. This study aimed to cluster metabolic risk factors as well as examine the associations between identified patterns and nutrient intake using data from the Korean National Health Examination and Nutritional Assessment (KNHANES). SUBJECTS/METHODS: A total of 2,958 subjects aged 10 to 18 years along with both biochemical and dietary data information were obtained from KNHANES 2007-2010. Six components of metabolic syndrome were used to identify any patterns via factor analysis. Individuals were categorized into quartile groups according to their pattern score. RESULTS: Three clustering patterns with high loadings were identified and named as follows: 1) high blood pressure, 2) dyslipidemia, and 3) glucose abnormality patterns. The high blood pressure pattern showed high loadings of systolic and diastolic blood pressures, the dyslipidemia pattern showed high loadings of triglyceride and HDL-cholesterol levels, and the glucose abnormality pattern showed high loadings of fasting blood glucose levels. Intakes of fat and riboflavin were significantly decreased, whereas those of sodium and niacin were significantly increased across the quartiles in the dyslipidemia pattern. No nutrient intake except that of thiamin was significantly associated with the high blood pressure or glucose abnormality pattern. CONCLUSION: Our findings show that metabolic syndrome risk factors in the Korean adolescent population are characterized by three distinct patterns, which are differentially associated with dietary factors. Characterizing metabolic risk factors and providing specific dietary guidelines for target groups are important.
Purpose: The aim of the study was to investigate the degree of stress and health promotion behavior, coping style and their relationship of university students. Methods: With a descriptive survey design, a self-report study was conducted and collected 174 responses from university students in Chungcheongnam-do. Descriptive statistics, and pearson's correlation were used to analyze data. Results: The mean score of stress was $63.1{\pm}15$. The relationship between health promotion behavior and coping style significantly correlated. Conclusion: This study also shows that coping style significantly correlated with walking day for more than 10 minutes, dietary practice guidelines score. Therefore, consideration of stress and coping style should be included in the development of a health promotion program for university students.
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