• 대한지역사회영양학회지
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• 제15권4호
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• pp.445-459
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• 2010

This study was done to analyze the chronic diseases prevalence and dietary intake status according to the health related quality of life and to identify its significant properties. This study was conducted based on 2906 subjects ranging from 20~64 years old, out of 9704 total subjects from the 4th Korean National Health and Nutrition Survey in 2008. The average quality of life (QL) score was 0.915, where 983 subjects were below the average (low QL group) and 1923 subjects were above (high QL group). In the high QL group, there was more likely to be young, male, and with higher income and education. For high QL group, the self-related health score was high, and the subjective stress level was low. The prevalence of diabetes was significantly higher in the low QL group and anthropometric and biochemical measures were not shown differences between the two groups but waist circumference was significantly higher in the low QL group. The QL score was significantly negative correlated with the waist circumference and the body mass index. As for the recognition rate of Nutrition Guideline, there were no significant differences but high QL group had higher scores in "Eat a variety of foods", "Avoid too much Sodium", and "Enjoy meals and Eating a breakfast". Carbohydrate intake was significantly lower in the high QL group than in low QL group and the high QL group showed higher intake in legumes, meat and poultry, fruits, daily products and beverages. Overall results suggest that increased diabetes prevalence in people with low quality of life might be affected by the diets based on high carbohydrate, increased waist circumference, and lower rate of practice nutritional guideline.

• 보건교육건강증진학회지
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• 제31권5호
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• pp.109-120
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• 2014

Objectives: This study was to examine the associations between obesity level and major chronic diseases in older population in Korea, using different obesity indicators. Methods: Data was from the 2008 KloSA Biomarker pilot, a nationwide sample of 514 non-institutionalized subjects (age $63.6{\pm}9.8$ years; women 57.2%). Anthropometric information was collected by home visiting nurses. Portable bioimpedence devices(Omran HBF359) were used for measuring fat mass. Obesity cut-offs used the Asian criteria of $BMI{\geq}25$, $WC{\geq}90/85cm$, and $fat%{\geq}25/35$ for men and women. Chronic disease prevalence was defined by physician-diagnosed history of 8 specified diseases. Results: Prevalence of chronic diseases significantly increased with increment of obesity level by BMI, WC and fat %. Odds ratios of acquiring chronic diseases remained significant in the obese group (BMI OR 2.76, 95%CI 1.82-4.19; WC OR 2.73, 95%CI 1.81-4.11; Fat OR 1.87 95%CI 1.26-2.78), after adjusting for age, sex, marital status, education, work participation, household income, smoking, drinking, and exercise. Conclusions: Obesity measured by all three indicators, BMI, WC, and fat mass cannot be disregarded, accentuating the significant effect on increases in disease risks among older population. BMI and WC measure appeared better to assess the risks of chronic diseases.

• Clinical and Experimental Pediatrics
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• 제64권9호
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• pp.473-479
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• 2021

Background: Malnutrition has a high incidence among pediatric surgical patients and contributes to increased risks of postoperative complications and extended hospital stays. Purpose: The present study aimed to determine the influence of preoperative nutritional status on the postoperative outcomes of pediatric patients who underwent elective gastrointestinal (GI) surgery. Methods: This prospective observational study was conducted at Cairo University Specialized Pediatric Hospital. According to the designated inclusion criteria, 75 surgical cases of both sexes were included. A structured questionnaire was developed and administered. This questionnaire included 3 main sections: demographic data and nutritional status parameters at admission and discharge. Pre- and postoperative nutritional statuses were compared. Results: According to both the subjective global nutritional assessment and STRONGKIDS score Questioner, more than 60% of patients in the upper GI patient group were at risk of malnutrition. Wasting status was most common in the upper GI patient group (67%; vs. 39.1% in the lower GI group). Underweight status was more common in the hepatobiliary and upper GI patient groups (nearly 50% for each group) than in the lower GI group (30.4%). On the other hand, stunted patients had a higher incidence of complications and a prolonged hospital stay (P=0.003 and P=0.037, respectively), while underweight lower GI patients experienced a prolonged hospital stay (P=0.02). A higher proportion of patients with preoperative anemia than those without preoperative anemia required a blood transfusion (P=0.003). Conclusion: Nutritional assessment is a crucial component of pediatric surgical patient management. Both underweight and wasting statuses were more common among hepatobiliary and upper GI patients. Postoperative complications and a long hospital stay were more common among stunted patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제24권6호
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• pp.555-563
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• 2021

Purpose: The aim of this study was to evaluate the pancreatic fat fraction (PFF) using magnetic resonance imaging (MRI) in children with and without obesity and to correlate PFF with body mass index (BMI) z-score, hepatic fat fraction (HFF), and ultrasonography-derived pancreato-perihepatic fat index (PPHFI). Methods: This prospective study included 45 children with obesity and 19 without obesity (control group). PFF and HFF were quantitatively assessed using the abdominal multi-echo Dixon method for MRI. The PPHFI was assessed using transabdominal ultrasonography. Anthropometric, MRI, and ultrasonographic characteristics were compared between the two groups. Correlations between PFF, HFF, PPHFI, and BMI z-scores in each group were also analyzed. Results: The PFF, HFF, PPHFI, and BMI z-score were higher in the group with obesity than in the control group (PFF: 6.65±3.42 vs. 1.78±0.55, HFF: 19.5±13.0 vs. 2.31±1, PPHFI: 3.65 ±1.63 vs. 0.94±0.31, BMI z-score: 2.27±0.56 vs. 0.42±0.54, p<0.01, respectively). PFF was correlated with BMI z-scores, PPHFI, and HFF in the obesity group, and multivariate analysis showed that PFF was strongly correlated with BMI z-score and PPHFI (p<0.05). The BMI z-score was strongly correlated with PFF in the control group (p<0.01). Conclusion: These results suggest that MRI-derived PFF measures are associated with childhood obesity. PFF and PPHFI were also highly correlated in the obesity group. Therefore, PFF may be an objective index of pancreatic fat content and has the potential for clinical utility as a non-invasive biomarker for the assessment of childhood obesity.

• Nutrition Research and Practice
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• 제13권3호
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• pp.247-255
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• 2019

BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

• Nutrition Research and Practice
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• 제16권3호
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• pp.344-353
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• 2022

BACKGROUND/OBJECTIVES: Hydrolyzed formula is often fed to infants with gastrointestinal or immune issues, such as malabsorption or cow's milk allergy, because enzymatic treatment has rendered it more digestible and less allergenic than standard cow's milk formula (SF). Partially hydrolyzed formula (PHF) should be considered for those infants who are intolerant to extensively hydrolyzed formula. However, there are concerns about the nutritional insufficiencies of PHF. We aimed to evaluate the effects of PHF on the growth and health indicators in infants who were at high-risk of allergic disease and potential candidates for consuming PHF. SUBJECTS/METHODS: A total of 83 infants aged 0-2 mon with a family history of allergies were assigned to consume either PHF or SF until 24 weeks of age. Anthropometric measures were obtained at baseline, 12 weeks, and 24 weeks; blood samples were drawn and evaluated at the end of the study. RESULTS: No significant differences were observed in weight, height, and weight-for-height at any time point in each sex between the PHF and SF groups. At 24 weeks of age, the weight-for-age and height-for-age z-scores of the SF group were higher than those of the PHF group, but there was no significant difference in the weight-for-height z-score. There were no significant differences in levels of white blood cells, hemoglobin, ferritin, protein, albumin, aspartate aminotransferase, alanine aminotransferase, eosinophil cationic protein, and immunoglobulin E. CONCLUSIONS: In this study, there were no differences in growth and blood panels between the infants consuming PHF or SF. Therefore, infants who are unable to tolerate SF can be fed PHF without nutritional concerns about growth.

• 운동영양학회지
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• 제25권3호
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• pp.36-43
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• 2021

[Purpose] Exercise is a key factor in preventing obesity and metabolic syndrome. Sumo wrestlers increase their body size from childhood for athletic advantage; however, the risk of metabolic syndrome in junior sumo wrestlers is undetermined. Preventive measures against pediatric obesity should be initiated during childhood to prevent obesity in adulthood, considering its high global incidence. We comparatively evaluated the risk factors for metabolic syndrome in junior sumo wrestlers and children with obesity. [Methods] We enrolled 70 male children (age 9-17 years [sumo group, n = 14] and 9-14 years [other sports and non-exercise groups, n = 28 each]) and evaluated their anthropometric parameters (height, weight, body mass index z-score, obesity rate, waist circumference, waist to height ratio) and hematological parameters (total, low-density, high-density, and non-high-density lipoprotein-cholesterol; triglycerides; plasma glucose, and glycated hemoglobin levels). [Results] The BMI z-score, obesity rate, waist circumference (p < 0.05, along with the non-exercise group), and systolic blood pressure were significantly higher and the high-density cholesterol level was lower in the sumo group than in the other sports group (p < 0.05). The waist to height ratio was significantly higher in the non-exercise group than in the other sports group (p < 0.05). No significant difference was found in other blood lipid, plasma glucose (significantly lower level than the reference range in the sumo group, p < 0.05), and glycated hemoglobin (within the reference range in all groups) levels among the three groups. [Conclusion] Junior sumo wrestlers had a larger body size and higher blood pressure than children with obesity who exercised regularly. This provides direction for future research into targeted preventive interventions against metabolic syndrome for junior sumo wrestlers with large body size.

• 대한간호학회지
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• 제29권6호
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• pp.1179-1191
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• 1999

This study was conducted to identify appetite and nutritional status of 48 cancer patients who have been irradiated over 150$\textrm{cm}^2$ on chest or pelvic area over the three-month period. The data were gathered 3 phases, Each from initiation to completion of radiotherapy through the questionnaires of anorexia, the anthropometric and biochemical measures were used such as weight, TSF, MAC, MAMC, serum albumin and hemoglobin, TLC. Using SAS program, data were analyzed by percentage, Mean$\pm$SD, and two-way repeated measures ANOVA. The results were summarized as follows : 1. Eighty five percent(85%) of the subjects were aged from fifties to sixties. Cancers in the chest area occurred in 100% of men, 56% of the all subjects. The other 44% were pelvic cancer and 71% of the pelvic cancer occurred in women. 2. There were no significant differences in the appetite scores by all groups(characteristics). Changes of the appetite score over time were statistically significant by age, sex, cancer areas staging, treatment modality, and radiation dosage (F=4.0, p=.022; t=6.09, p=.003; t=4.90, p=.009; F=3.28, p=.042; t=5.04, p=.0084; t=4.76, p=.011). The appetite score on the 2nd phase (4 weeks after initiating radiotherapy) decreased from the 1st phase (initiating irradiation), and then increased on the 3rd phase (completing irradiation). 3. There were no significant differences in the body weight and MAMC by all characteristics, and no changes in the body weight and MAMC over time. However there were significant differences of TSF, MAC, level of hemoglobin, level of albumin, and TLC by all characteristics during the three phases. TSF of the men and the chest cancer were lower than those of the women and the pelvic cancer (t=73.20, p=.0001; t=22.91, p=.0001). And there was significant difference by cancer staging(F=3.19, p=.050). But there was no change in TSF over time. MAC of the men and the chest cancer were lower than those of the women and the pelvic cancer each(t=9.23, p=.004; t=17.85, p=.0001). But no change in MAC over time. Levels of hemoglobin had significant differences by age, sex and cancer areas; levels of hemoglobin of older than the fifties, men, and chest area were higher than those on the others(F=3.82, p=.029; t=21.75, p=.0001; t=8.71, p=.005). Levels of albumin were significant differences by sex and cancer areas; levels of albumin on women, and pelvic area were higher than those on the others(t=6.34, p=.015; t=15.23, p=.0003). While the levels of hemoglobin were changed over time, levels of albumin were not changed and within normal limit. TLC of the men was higher than women(t=5.05, p=.029). Changes in the level of hemoglobin over time were statistically significant according to sex, cancer areas, and radiation dosage(t=3.49, p=.035; t=3.36, p=.039; t=4.04, p=.021).

• Journal of Preventive Medicine and Public Health
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• 제30권2호
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• pp.308-326
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• 1997

본 연구는 1992년 당시 경기도 강화군 강화읍내에 거주하는 중학교 1학년에 재학중인 남자 335명과 여자 375명을 대상으로 5년간 혈압수준 및 변화에 대한 분포를 제시하고 혈압수준 및 변화의 결정 요인을 밝히고자 하였다. 혈압의 수준 및 변화와 관련된 요인으로는 신체적 요인, 혈청학적 요인 및 영양소 섭취요인을 조사하였다. 주요 연구결과는 다음과 같다. 1. 12세부터 16세까지 5년간 남자의 수축기혈압의 평균은 108.7mmHg에서 118.1mmHg로, 이완기혈압의 평균은 69.5mmHg에서 73.4mmHg로 증가하였으며 15세에 가장 높은 혈압수준을 보였다. 그러나 동기간 동안 여자의 수축기혈압의 평균은 114.4mmHg에서 113.5mmHg로, 이완기혈압의 평균은 75.2mmHg에서 72.1mmHg로 감소하였으며 13-14세 때에 가장 높은 혈압 수준을 보였다. 2. 남자의 5년간 신장, 체중, 신체비만지수 등은 계속 성장하였으나 여자는 15세를 기점으로 신체적 성장이 둔화되는 경향을 보였다. 한편 연령이 증가할 수록 남자의 혈청 총 콜레스테롤은 감소하고 중성지방은 증가하는 경향을 보였으나 여자에서는 특별한 변화가 없었다. 식이섭취에서는 지질의 섭취가 연령에 따라 약간 증가하는 경향을 보였으나 전반적으로 남녀 모두 에너지의 20% 정도였다. 3. 혈압수준과 체중, 신체비만지수, 피부두께 등은 남녀 모두 각 연령에서 통계학적으로 유의한 관련성이 있었다. 신체비만지수의 영향을 통제하였을 때 혈청 총 콜레스테롤은 남자에서 연령의 증가에 따라 수축기혈압과 음의 관계에서 양의 관계로, 여자의 경우에는 이완기혈압과 15-16세에서 양의 관련성을 보였다. 그리고 중성지방과 크레아티닌은 남자에서는 혈압과 양의 관련성을 보였으나 여자의 경우에는 관련성이 없었다. 한편 영양소 섭취와 혈압과의 관계는 성별-연령별로 일관성 있는 결과가 없었으나 남자의 이완기혈압과 단백질 섭취가 양의 관련성이 있었고 여자의 14세 때 수축기혈압과 비타민 A 섭취가 음의 관련성이 있었다. 4. 혈압변화와 신체비만지수의 변화, 혈청 총 콜레스테롤의 변화는 남녀 모두 양의 관련성을 보였으며 크레아티닌의 변화는 남자에서는 양의 관계를, 여자에서는 음의 관계를 보였다. 또한 남자에서 소디움 섭취가 높은 군이 계속해서 높은 혈압수준을 유지하였으며 여자의 경우에는 에너지에 대한 지질 섭취비율이 높은 군이 계속해서 낮은 혈압수준을 유지하여 성별에 따른 차이를 보였다. 전체적으로 성장기 혈압변화에 가장 큰 영향을 미치는 요인은 남녀 모두 신체비만 지수이었다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권1호
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• pp.30-38
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• 2009

목 적: 비만에서 발생하는 비알코올성 지방간질환은 대부분 무증상이어서 혈청 검사에서 간효소치 상승이 있거나 간초음파검사에서 지방간이 발견되는 경우에 이 질환에 대한 의학적 관심이 증가한다. 본 연구에서는 비만아와 과체중아에서 간세포손상을 반영하는 ALT 상승과 신체 계측치 및 생화학적 검사치들과의 관련성을 알아보고자 하였다. 방 법: 2006년 1월부터 2008년 6월까지 충남대병원 소아청소년과에서 비만 또는 과체중으로 진단받은 142예를 대상으로 신체 계측, 생화학 검사를, 간초음파검사는 일부 환자에서 시행하였다. ALT치를 기준으로 정상 군(I군)과 상승 군(II군)으로 분류하여 신체 계측치, 생화학 검사치, 간초음파 소견을 비교하였다. 바이러스간염, 약물 유발 간염, 대사이상 간염, 내분비 장애, 유전 질환이 있는 경우는 연구 대상에서 제외하였다. 결 과: 단순 비만아에서 간전이효소치의 상승은 전체의 54.2%에서 있었으며, 남녀별로는 남아 63.0%, 여아 26.5%에서 있었다. I군과 II군의 나이는 각각 11.4${\pm}$3.3, 11.7${\pm}$3.2세로 차이가 없었다. 성별 분포는 I군은 남아 40예, 여아 25예로 총 65예, II군은 남아 68예, 여아 9예로 총 77예로 양군 모두 남아가 통계적으로 유의하게 많았으며(p=0.003, 0.001) 남녀 비는 I군 1.6:1, II군 7.6:1로 II군에서 남아의 발생빈도가 4.8배 더 높았다. 신체 계측치는 허리둘레/키 비, 엉덩이둘레/키 비가 II군에서 통계적으로 유의하게 높았으며(p=0.001, 0.046), 키, 체중, 체질량지수, 허리둘레, 엉덩이둘레, 허리둘레/엉덩이둘레 비, 비만 정도는 양 군 간에 유의한 차이가 없었다. 생화학 검사치와 인슐린 저항성에서는 AST, ${\gamma}$-GT, 총콜레스테롤 수치가 II군에서 통계적으로 유의하게 높았고, AST/ALT비는 I군 1.10${\pm}$0.41, II군 0.55${\pm}$0.17로 II군에서 유의하게 낮았다(p<0.001, <0.001, <0.001). 중성지방, 고밀도지질단백 콜레스테롤, 저밀도지질단백 콜레스테롤 수치, 공복 시 인슐린 농도, 혈당, 인슐린 저항성 지표는 두 군 간에 통계적으로 유의한 차이가 없었다. 단변량 상관관계분석에서는 체질량지수, 엉덩이둘레/키 비, 허리둘레/키 비, ${\gamma}$-GT, 중성지방이 양의 상관관계를 보였다. 간초음파검사는 I군 11예, II군 32예에서 시행되었는데, 양 군 모두 경도의 지방간 소견이 가장 많았으며, 양 군 간에 지방간 빈도에는 통계적으로 유의한 차이가 없었다. 결 론: 비만아에서 허리둘레/키 비, AST, AST/ALT비, ${\gamma}$-GT, 총 콜레스테롤 농도가 ALT치가 정상인 군 보다 상승된 군에서 통계적으로 유의한 차이를 보였으며, 허리둘레/키 비와 ${\gamma}$-GT가 ALT 상승과 통계적으로 유의한 양의 상관관계를 보여 쉽게 측정할 수 있는 신체 계측치인 허리둘레/키 비를 ALT치가 상승된 비만아의 관리에 참고 자료로 이용해 볼 수 있겠다. 그러나 이에 대해서는 향후 더 많은 연구가 필요하다.