Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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The Assessment for Nutrient Intakes of Korean Patients with Heart Failure

우리나라 일부 심부전 환자의 영양소 섭취량 평가 연구

  • Lee, Hye-Ran (Department of Food and Nutrition, Korea University) ;
  • Kang, Bo-Rum (Department of Food and Nutrition, Korea University) ;
  • Chung, Hye-Kyung (Department of Nutrition Services, Youngdong Severance Hospital, Yonsei University College of Medicine) ;
  • Do, Hyun-Joo (Department of Food and Nutrition, Korea University) ;
  • Shim, Jee-Seon (Division of Chronic Disease Surveillance, Korea Centers for Disease Control and Prevention) ;
  • Bae, Soon-Hwa (Department of Food and Nutrition, Yeungnam University) ;
  • Kang, Seok-Min (Yonsei Cardiovascular Research Institute, Yonsei University College of Medicine) ;
  • Shin, Min-Jeong (Department of Food and Nutrition, Korea University)
  • 이혜란 (고려대학교 식품영양학과) ;
  • 강보름 (고려대학교 식품영양학과) ;
  • 정혜경 (연세대학교 의과대학 강남세브란스병원 영양팀) ;
  • 도현주 (고려대학교 식품영양학과) ;
  • 심지선 (질병관리본부 만성병 조사팀) ;
  • 배순화 (영남대학교 식품영양학과) ;
  • 강석민 (연세대학교 의과대학 심혈관연구소) ;
  • 신민정 (고려대학교 식품영양학과)
  • Received : 2009.01.12
  • Accepted : 2009.08.31
  • Published : 2010.06.30
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Abstract

The prevalence of heart failure (HF) is increasing globally and growing evidence has shown that dietary factors play an important role in preventing and improving prognosis of HF. However, little data on nutrient intake in Korean HF patients which are available to develop dietary guidelines for HF. The aims of this study were to estimate nutrient intake in 78 HF patients and evaluate whether the estimated nutrient intake is appropriate compared to dietary reference intake for Koreans. Data are presented as the ratio of actual intake and estimated average requirement (EAR) for each nutrient. The result showed that the average nutrient intakes including total energy and protein met EAR in total patients. However, the deficiencies in mineral and vitamin intakes were found. Moreover, the proportion of subjects with lower intake than EAR was substantial. The results showed that the proportion of male HF patients with inferior intakes to EAR in calcium, potassium (compared to adequate intake: AI), folate and vitamin $B_{12}$ were 38%, 79%, 38%, and 65%, respectively. Also, the proportion of female HF patients with inferior intakes to EAR in calcium, potassium (compared to AI), folate and vitamin $B_{12}$ were 35%, 88%, 38% and 40%, respectively. In particular, the elderly with HF ($\geq$ 70 yrs, n = 28) showed more serious deficiencies in calcium, potassium (compared to AI), folate and vitamin $B_{12}$. In summary, the intakes of potassium, calcium, folate, and vitamin B12 were not sufficient to meet EAR in HF patients. Furthermore, the proportions of subjects with lower intake than EAR in these nutrients were substantial, raising the possibility that these micronutrients may be involved in the pathogenesis of HF. Practical dietary guideline for HF patients is needed to improve prognosis of HF.

본 연구에서는 우리나라 심부전 환자 78명을 대상으로 식이 섭취 빈도법을 통한 영양소 섭취량 조사를 시행하여 한국인 영양섭취기준과 비교하였으며 그 결과는 다음과 같았다. 1) 에너지와 단백질, 철분의 평균 섭취량은 한국인 영양섭취 기준에 비해 충분히 섭취하고 있었으나 나트륨 섭취가 과다하고, 칼륨 섭취가 부족한 불균형의 영양문제가 파악되었다. 2) 칼슘의 섭취가 부족한 환자들이 상당수 존재하여 심부전 환자의 골연화증 및 골다공증 위험이 높을 가능성이 있음을 확인하였다. 3) 비타민 $B_{12}$, 엽산의 섭취가 부족하며, 이외 리보플라빈, 나이아신 등의 비타민 섭취 부족의 가능성이 있음을 확인하였다. 4) 70세 이상의 고령 환자에서도 칼륨, 칼슘, 비타민 $B_{12}$, 엽산의 섭취가 부족한 것으로 나타났고 이러한 부족 현상은 고령 환자에서 더욱 심각한 것으로 파악되었다. 위의 결과로 보아 국내 심부전 환자의 경우 무기질, 비타민 등의 미량 영양소의 섭취 부족이라는 영양문제가 존재하고 있었다. 따라서 이러한 영양 결핍 문제가 지속된다면 심부전 환자의 장기적인 예후에 영향을 미칠 수 있을 것이므로 영양섭취 부족을 해결하기 위한 다각적 측면에서의 영양 섭취 평가 및 영양관리 대책과 지침이 마련되어야 할 것이다.

Keywords

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