• Title/Summary/Keyword: Clinical nutrition management

검색결과 277건 처리시간 0.024초

폐경 후 골감소증 여성에 대한 12주간의 영양교육과 운동 중재 전.후 식품 및 영양소 섭취량 변화와 골밀도 지표 변화와의 관계 (The Association between Changes in Food and Nutrient Intakes and Changes in Bone Metabolic Indicators in Postmenopausal Women with Osteopenia after a 12-week Intervention of Nutrition Education and Aerobic Exercise)

  • 김서진;강서정;박윤정;황지윤
    • 대한지역사회영양학회지
    • /
    • 제18권3호
    • /
    • pp.213-222
    • /
    • 2013
  • Few studies investigated the effects of nutrition education and exercises in women with osteopenia. This study examined the relationship between changes in dietary intakes and changes in indicators related to bone health in postmenopausal women with osteopenia (-2.5 ${\leq}$ T-score ${\leq}$ 1) after a 12-week intervention. Thirty-one postmenopausal women aged > 50 years residing in Seoul were recruited and participated in nutritional education regarding bone health and general nutrition practices and aerobic exercises (three times a week; 60 min per session). Twenty-five subjects completed the study and were eligible for the analysis. Bone mineral density (BMD) at femoral neck was measured by dual energy x-ray absorptiometry. Serum calcium, osteocalcin, and intact parathyroid hormone (PTH) were also measured. Dietary intake was estimated by using a one-day 24 recall by a clinical dietitian. After 12 weeks, meat consumption increased (P = 0.028) but vegetable intake decreased (P = 0.005). Intakes of animal protein (P = 0.024), vitamin B1 (P = 0.012) and vitamin $B_2$ (P = 0.047) increased, and sodium intake decreased (P = 0.033). Intact PTH (P = 0.002) decreased and osteocalcin (P = 0.000) increased, however, BMD decreased (P = 0.000). Changes in mushroom consumption were positively correlated with femoral neck BMD (r = 0.673, P = 0.003). Changes in animal iron intake were negatively correlated with intact PTH (r = -0.488, P = 0.013) but were positively correlated with osteocalcin (r = 0.541, P = 0.005). These results suggested that the association between animal iron intake and biochemical markers of bone turnover may play an important role in bone metabolism. Further studies are needed to shed light on complicated mechanisms of diet, hormonal levels of bone metabolism, and bone density.

Short Bowel Syndrome as the Leading Cause of Intestinal Failure in Early Life: Some Insights into the Management

  • Goulet, Olivier;Nader, Elie Abi;Pigneur, Benedicte;Lambe, Cecile
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제22권4호
    • /
    • pp.303-329
    • /
    • 2019
  • Intestinal failure (IF) is the critical reduction of the gut mass or its function below the minimum needed to absorb nutrients and fluids required for adequate growth in children. Severe IF requires parenteral nutrition (PN). Pediatric IF is most commonly due to congenital or neonatal intestinal diseases or malformations divided into 3 groups: 1) reduced intestinal length and consequently reduced absorptive surface, such as in short bowel syndrome (SBS) or extensive aganglionosis; 2) abnormal development of the intestinal mucosa such as congenital diseases of enterocyte development; 3) extensive motility dysfunction such as chronic intestinal pseudo-obstruction syndromes. The leading cause of IF in childhood is the SBS. In clinical practice the degree of IF may be indirectly measured by the level of PN required for normal or catch up growth. Other indicators such as serum citrulline have not proven to be highly reliable prognostic factors in children. The last decades have allowed the development of highly sophisticated nutrient solutions consisting of optimal combinations of macronutrients and micronutrients as well as guidelines, promoting PN as a safe and efficient feeding technique. However, IF that requires long-term PN may be associated with various complications including infections, growth failure, metabolic disorders, and bone disease. IF Associated Liver Disease may be a limiting factor. However, changes in the global management of IF pediatric patients, especially since the setup of intestinal rehabilitation centres did change the prognosis thus limiting "nutritional failure" which is considered as a major indication for intestinal transplantation (ITx) or combined liver-ITx.

Feasibility Study of Early Oral Intake after Gastrectomy for Gastric Carcinoma

  • Jo, Dong-Hoon;Jeong, Oh;Sun, Jang-Won;Jeong, Mi-Ran;Ryu, Seong-Yeop;Park, Young-Kyu
    • Journal of Gastric Cancer
    • /
    • 제11권2호
    • /
    • pp.101-108
    • /
    • 2011
  • Purpose: Despite the compelling scientific and clinical data supporting the use of early oral nutrition after major gastrointestinal surgery, traditional bowel rest and intravenous nutrition for several postoperative days is still being used widely after gastric cancer surgery. Materials and Methods: A phase II study was carried out to evaluate the feasibility and safety of postoperative early oral intake (water intake on postoperative days (POD) 1-2, and soft diet on POD 3) after a gastrectomy. The primary outcome was morbidity within 30 postoperative days, which was targeted at <25% based on pilot study data. Results: The study subjects were 90 males and 42 females with a mean age 61.5 years. One hundred and four (79%) and 28 (21%) patients underwent a distal and total gastrectomy, respectively. The postoperative morbidity rate was within the targeted range (15.2%, 95% CI, 10.0~22.3%), and there was no hospital mortality. Of the 132 patients, 117 (89%) successfully completed a postoperative early oral intake regimen without deviation; deviation in 10 (8%) due to gastrointestinal symptoms and in five (4%) due to the management of postoperative complications. The mean times to water intake and a soft diet were $1.0{\pm}0.2$ and $3.2{\pm}0.7$ days, respectively, and the mean hospital stay was $10.0{\pm}6.1$ days. Conclusions: Postoperative early oral intake after a gastrectomy is feasible and safe, and can be adopted as a standard perioperative care after a gastrectomy. Nevertheless, further clinical trials will be needed to evaluate the benefits of early oral nutrition after upper gastrointestinal surgery.

제2형 당뇨병 환자의 영양소 섭취와 임상지표의 상관성에 관한 연구 (Study on the Correlation between the Nutrient Intakes and Clinical Indices of Type 2 Diabetes Patients)

  • 권지영;정혜연
    • 한국식품영양학회지
    • /
    • 제26권4호
    • /
    • pp.909-918
    • /
    • 2013
  • The objective of this study is to investigate the effects of dietary nutrient intakes for markers of blood glucose and inflammation which is important to the progress of type 2 diabetes and the development of its complications. For this study, 76 adults with diabetes (42 males, 34 females) were recruited from a group of patients who had visited the department of endocrine medicine. Data on anthropometric characteristics, clinical indices such as hemoglobin A1c (HbA1c) and C-reactive protein (CRP), and dietary nutrient intakes were collected. Our results have shown that 66% of subjects were either overweight or obese. Serum analysis indicates that levels of C-peptide, glucose, HbA1c, CRP, triglyceride, LDL-cholesterol were higher than normal range. Results from the dietary nutrient intake survey displayed that intakes of cholesterol and sodium were higher than Dietary Reference Intakes for Koreans. On the contrary, folate intake was lower than the guideline. Within the females, energy contribution from carbohydrate was higher than Korean Diabetes Association guideline. Statistical analysis has revealed a negative correlation between serum HbA1c level and dietary intakes of polyunsaturated fatty acid (PUFA), n-3 PUFA, ${\beta}$-carotene and vitamin E after adjustments for age, BMI, smoking habits, alcohol consumption, exercise and ingestion of diabetes mellitus medication (p<0.05). Serum CRP level was inversely associated with dietary intakes of carbohydrate, protein, vitamin C and fiber (p<0.05). Our results suggest that dietary nutrient intakes may influence the levels of HbA1c and CRP, and subsequently, it may help in the management/treatment of type 2 diabetes.

Early dropout predictive factors in obesity treatment

  • Michelini, Ilaria;Falchi, Anna Giulia;Muggia, Chiara;Grecchi, Ilaria;Montagna, Elisabetta;De Silvestri, Annalisa;Tinelli, Carmine
    • Nutrition Research and Practice
    • /
    • 제8권1호
    • /
    • pp.94-102
    • /
    • 2014
  • Diet attrition and failure of long term treatment are very frequent in obese patients. This study aimed to identify pre-treatment variables determining dropout and to customise the characteristics of those most likely to abandon the program before treatment, thus making it possible to modify the therapy to increase compliance. A total of 146 outpatients were consecutively enrolled; 73 patients followed a prescriptive diet while 73 followed a novel brief group Cognitive Behavioural Treatment (CBT) in addition to prescriptive diet. The two interventions lasted for six months. Anthropometric, demographic, psychological parameters and feeding behaviour were assessed, the last two with the Italian instrument VCAO Ansisa; than, a semi-structured interview was performed on motivation to lose weight. To identify the baseline dropout risk factors among these parameters, univariate and multivariate logistic models were used. Comparison of the results in the two different treatments showed a higher attrition rate in CBT group, despite no statistically significant difference between the two treatment arms (P = 0.127). Dropout patients did not differ significantly from those who did not dropout with regards to sex, age, Body Mass Index (BMI), history of cycling, education, work and marriage. Regardless of weight loss, the most important factor that determines the dropout appears to be a high level of stress revealed by General Health Questionnaire-28 items (GHQ-28) score within VCAO test. The identification of hindering factors during the assessment is fundamental to reduce the dropout risk. For subjects at risk, it would be useful to dedicate a stress management program before beginning a dietary restriction.

한국 성인의 치주질환 유병과 체질량지수 및 임상검사요인의 관련성 연구 국민건강영양조사 제6기 조사자료 (A study on the relationships between periodontal diseases, body mass index and clinical factors for Korean adults)

  • 김병식;이종화
    • 대한치과기공학회지
    • /
    • 제41권2호
    • /
    • pp.103-112
    • /
    • 2019
  • Purpose: This article tried to find the relations between periodontal diseases, body mass index and clinical level for Korean adults over the age of 19, utilizing data of the 6th national nutrition survey. Methods: In the collected data, 14,940 adults aged 19 years or older were included in the study to determine the relationship between the general health status of Korean adults and periodontal disease. Results: As the result, 28.6% of Korean adults had periodontal diseases, there were significant differences depending on gender, age, smoking, residential aria, education level, body mass index, HDL-cholesterol, leukocyte value and fasting blood sugar. When general factors were controlled for multiple logistic regression analysis, there was significance as BMI cross rate was 1.029(95% C1, 1.007-1.051). HDL-cholesterol cross rate was 0.989(95% C1, 0.980-0.999), leukocyte cross rate was 1.086(95% C1, 1.040-1.134) and fasting bloody sugar cross rate was 1.006(95% C1, 1.003-1.009), so there were significance. In conclusion, there was a significance relation between periodontal diseases, body mass index, HDL-cholesterol and fasting bloody sugar. Conclusion: Based on the results of this study, oral health education should be used to manage and maintain healthy oral cavity by improving periodontal disease management and awareness. In addition, it will be necessary to develop periodic oral examinations and age - specific oral health education programs, and it can be used as a basic data for public oral health plan.

The impact of probiotics and vitamin C on the prevention of upper respiratory tract symptoms in two preschool children cohorts

  • Zuzana Paduchova;Zuzana Nagyova;Duolao Wang;Jana Muchova
    • Nutrition Research and Practice
    • /
    • 제18권1호
    • /
    • pp.98-109
    • /
    • 2024
  • BACKGROUND/OBJECTIVES: The efficacy of Lab4 probiotic and vitamin C combination on the prevention of upper respiratory tract infections (URTIs) was investigated in two studies with children. Our objective was to pool dataset of 57 preschool children from the PROCHILD study (ISRCTN28722693) and the dataset of 50 preschool matched cohort from the PROCHILD-2 study (ISRCTN26587549) to evaluate the impact of probiotic/vitamin C combination on the prevention of upper respiratory tract symptoms and provide a more robust assessment of effect using detailed individual level data. SUBJECTS/METHODS: The children were supplemented daily for 6 months with either the multistrain probiotic (1.25×1010 cfu/tablet consisting of two strains of Lactobacillus acidophilus CUL21 and CUL60, Bifidobacterium bifidum CUL20 and Bifidobacterium animalis subsp. lactis CUL34) plus 50 mg vitamin C or a placebo. RESULTS: In the pooled analysis of the individual participant data (per protocol population), significant reductions were observed for the incidence (-25%; 95% confidence interval [CI], 0.66, 0.85; P < 0.0001) and duration (-14.9 days; 95% CI, -24.8, -5.1; P = 0.0030) of typical URTI symptoms in the active group compared with the placebo. The incidence rates of absenteeism from preschool (IR ratio, 0.75; 95% CI, 0.66, 0.86; P < 0.0001), paediatric visits (IR ratio, 0.56; 95% CI, 0.47; 0.68; P < 0.0001) and antibiotic usage (IR ratio, 0.53; 95% CI, 0.39, 0.71; P < 0.0001) were also significantly reduced. CONCLUSION: The pooled analysis findings of comparable preschool cohorts from two studies indicate that the supplementation with probiotic and vitamin C combination is beneficial in the prevention and management of URTI symptoms.

규칙적인 운동을 하는 성인 남녀의 체형인식 및 식생활 연구 (A study on body awareness and dietary life of adults who perform regular exercise)

  • 주민정;신윤진;김양하
    • Journal of Nutrition and Health
    • /
    • 제46권5호
    • /
    • pp.461-469
    • /
    • 2013
  • 본 연구는 2012년 9월 5일부터 10월 4일까지 1개월 간 서울에 위치한 스포츠센터에서 규칙적으로 운동을 하는 20~30대 남성 120명 여성 127명을 대상으로 체형인식, 운동 목적, 식생활 관련 지식 및 행태, 영양섭취 실태를 조사하였다. 비만 분포를 조사한 결과, 남성은 BMI 23 이상인 과체중 및 비만의 비율이 69.2%로 나타난 반면 여성은 25.2%로 나타나 성별에 따른 비만 분포의 유의적인 차이를 보였다 (p < 0.001). 현재 체형에 대한 만족도에서는 남성은 '보통이다' (40.8%)가 가장 높게 나타난 반면, 여성은 '약간 뚱뚱하다' (42.5%)가 가장 높게 나타나 남성에 비하여 여성의 현재 체형에 대한 만족도가 유의적으로 낮았다 (p < 0.001). 남성과 여성의 식생활 관련 지식 및 행태의 차이는 유의하지 않은 것으로 나타났다. 에너지섭취 비율은 남성의 경우 에너지필요추정량의 80.8%, 여성은 에너지필요추정량의 76.9%로 남녀 모두 미달되는 섭취량을 보였다. 또한 단백질섭취비율은 남성이 권장섭취량의 197.7%, 여성이 권장섭취량의 142.6% 수준을 섭취하는 것으로 나타나 남녀 모두 과잉섭취하고 있었다. 칼슘섭취비율은 남성과 여성에서 각각 권장섭취량의 63.5%, 72.1% 수준으로 나타나 모두 미달되었다. 체형인식에 따른 열량영양소 섭취량을 조사한 결과, 남성은 과체중으로 인식하는 경우가 저체중 및 정상체중으로 인식하는 경우보다 에너지와 탄수화물의 섭취량이 유의적으로 적었으며 (p < 0.01), 여성은 과체중으로 인식하는 경우와 저체중 및 정상체중으로 인식하는 경우의 열량영양소 섭취량이 유의적 차이가 없었다.

The Importance of Food Open Challenge Test in Atopic Dermatitis: The Comparison of Allergy History, Skin-Prick Test, and Specific IgE Detection

  • Noh, Geun-Woong;Ji, Eun-Jung;Park, Jung-Nan;Kim, Kyung-Hee;Do, Min-Hee;Lee, Eung-Kyung;Lee, Sang-Sun
    • Nutritional Sciences
    • /
    • 제2권2호
    • /
    • pp.119-124
    • /
    • 1999
  • Food allergies play an important role in Atopic Dermatitis (AD). Dietary manipulation is essential in the management of AD. However, there has been a paucity of data reporting the prevalence of food allergies in AD patients in Korea. In this study, the Food Open Challenge Tests (FOCT) were conducted to investigate food allergies in AD patients. The skin-prick test and the detection of specific IgE, as well as allergy history of patient were used to detect food allergies in all AD patients. Elimination diet was conducted for two weeks prior to FOCTs. The prevalence of food allergies by FOCT is as follows: milk (67.3%); chicken (64.2%); pork (62.8%); eggs (61.0%); beef(55.4%) ; wheat (52.0%) and soybean (45.2%). Allergenic food items in Korean AD patients were different from people in other foreign countries. The seven major foods those tested positively by FOCTs were completely eliminated from the replaced diets for two weeks, and were subsequently reintroduced one at a time. Results from FOCTs were not comparable with allergy history or skin-prick tests or specific IgE detection. The sensitivity and specificity of skin-prick tests and specific IgE detection were lower than FOCTs. Allergy history, skin-prick tests, and specific IgE detection are useful for the identification of food allergen but its clinical significance differed according to food items. Therefore, we conclude that even though a 10-day delay was necessary after food challenge, FOCT is a useful and valid method to confirm food allergies and may be essential for the effective control of food allergies for treatment of AD.

  • PDF

파킨슨병 환자의 영양 상태에 따른 식사의 질 및 삶의 질에 관한 연구 (Study on the qualities of diet and life in Parkinson's disease patients according to their nutritional status)

  • 윤재희;임현정;우미혜;안태범;조여원
    • Journal of Nutrition and Health
    • /
    • 제45권3호
    • /
    • pp.240-251
    • /
    • 2012
  • Assessment regarding the nutritional status of Parkinson's disease (PD) patients is important because their nutritional status influences the outcome of disease. The purpose of this study investigated the dietary habits, dietary quality, and quality of life for Korean PD patients according to their nutritional status. Seventy PD patients were recruited from K University Hospital (KMC IRB#0918-07) from February 2010 to October 2011. To diagnose PD, the United Kingdom Parkinson's Society Brain Bank standards were used by a neurology physician. The participants were interviewed and assessed using various tools, including a general questionnaire, anthropometrics, questionnaires for dietary habits, dietary diversity score (DVS), dietary variety score (DVS), diet quality index-international (DQI-I), beck depression inventory (BDI), the Korean version of mini mental state examination (K-MMSE), and 36-item short-form health survey (SF-36). The results of the study were as follows: 1) Most of the PD patients (69.0%) were at risk of malnutrition, and 8.5% and 22.5% of the subjects were malnourished and well-nourished, respectively. 2) Clinical symptoms (swallowing and chewing difficulties) were obvious, and the quality of diet (DDS, DVS, DQI-I) was low in the malnourished group (p < 0.01). 3) The malnourished group had significantly lower scores regarding SF-36 (quality of life) as well as that of cognitive function (p < 0.05). 4) The nutritional status of PD patients was significantly correlated with their depression (p < 0.05) and quality of life (p < 0.01). These results indicate that appropriate nutritional management will improve the nutritional status and quality of life as well as the cognitive function in Parkinson's disease patients.