The purpose of this study was to develop a nutrition education program for dietary salt reduction using various nutrition education materials. The effect of a 5-week nutrition education program on salty taste assessment, nutrition knowledge, salt attitude for a high-salt diet, salt content in food, and individual satisfaction with the salt concentration of meals during the education period was evaluated. Nutrition education materials included two animations, a pamphlet, panels, and a website, as well as other training resources. Subjects participating in this study were 335 employees (164 male, 171 female) at 15 foodservice operations in Daegu. Preference for higher levels of salty taste and food containing higher amounts of salt were lowered. Knowledge regarding the necessity for dietary salt reduction was higher (p < 0.001) than before nutrition education, and salt content in a meal was reduced. As the program progressed, average salt concentrations of soups were significantly lowered (p < 0.05), and there was greater satisfaction with the lower concentration (p < 0.001). This was a positive indication of the program's success. In addition, it was found that subjects who participated in the program several times have changed their preference to lower levels of salty taste and have increased their nutrition knowledge (p < 0.05, p < 0.001). Thus, the positive effect of this 5-week nutrition education program developed for, and applied to, foodservice employees, concerning dietary salt reduction was confirmed.
Cheese is generally considered a safe and nutritious food, but foodborne illnesses linked to cheese consumption have occurred in many countries. Several microbial risk assessments related to Listeria monocytogenes, Staphylococcus aureus, and Escherichia coli infections, causing cheese-related foodborne illnesses, have been conducted. Although the assessments of microbial risk in soft and low moisture cheeses such as semi-hard and hard cheeses have been accomplished, it has been more focused on the correlations between pathogenic bacteria and soft cheese, because cheese-associated foodborne illnesses have been attributed to the consumption of soft cheeses. As a part of this microbial risk assessment, predictive models have been developed to describe the relationship between several factors (pH, Aw, starter culture, and time) and the fates of foodborne pathogens in cheese. Predictions from these studies have been used for microbial risk assessment as a part of exposure assessment. These microbial risk assessments have identified that risk increased in cheese with high moisture content, especially for raw milk cheese, but the risk can be reduced by preharvest and postharvest preventions. For accurate quantitative microbial risk assessment, more data including interventions such as curd cooking conditions (temperature and time) and ripening period should be available for predictive models developed with cheese, cheese consumption amounts and cheese intake frequency data as well as more dose-response models.
This study was carried out to provide a basis for the development of a safety manual for kitchen accident prevention by identifying the safety situation and awareness through risk assessment of kitchen areas. The study was conducted in two phases. First, kitchen accidents and area risk assessment were investigated from February 2014 to September 2014, after which safety awareness of hospital foodservice employees was assessed in a survey. The results of this study were as followes. All of the respondents were women. The evaluation point of kitchen area risk assessment was reduced by 14%. After improvement, an initial score of 108 points decreased to 93 points. The number of accidents was also reduced by 78%; 14 accidents were decreased to three. The most common area of accidents was the kitchen area (58.8%), and burns was the most common accident (35.3%). Most of the employees deemed "enough staff" as the most major factor for good foodservice. "High indoor temperature and poor ventilation in the kitchen area" was chosen as the most common problem in the foodservice workplace. Taken together, our study quantitatively evaluated safety issues in hospital foodservice kitchen areas and provides a basis for the development of a safety manual for kitchen accident prevention.
It is very important to screen the elderly for nutritional risk, because nutritional status is a critical factor to maintain their health. Some nutrition checklists used in Korea for the elderly are from other countries. Reliability of those checklist in Korea is not studied enough. This survey was done for the elderly over 65-years-old who live in Hong-cheon, An-dong, Dam-yang and Yeon-gi in Korea (subject; summer: 146, winter: 145) to study the reliability of DETERMINE checklist which is adopted widely in Korea. Using the score of DETERMINE checklist, the elderly were divided as high, middle and low risk groups. For nutritional assessment for those elderly, dietary assessment using 24 recall, anthropometry, biochemical assessment and health condition were used. Results for the checklist showed that percentage below EAR for energy intake and protein intake in winter were higher in the high risk group than other groups. The intakes of phosphorus and iron and most vitamins were below the DRI. The percentage of subjects with intake below DRI was highest in the high risk group. Sensitivity, specificity, and positive predictive values using the DETERMINE were calculated using 6 point as a cut-off point. Subjects were divided into two groups by MAR (MAR < 0.75:undernutrition, MAR < 0.75 : normal). Sensitivity recorded 49.4% and 34.3%, specificity did 61.9% and 65.4 and Positive predictive value did 62.1% and 46.0% each for summer and winter. Results of screening using DETERMINE Checklist were not matched with dietary assessment but not with anthropometric and biochemical measurement. In conclusion DETERMINE 'Checklist' is shown be a good screening tool for finding out risk groups for dietary intake in the elderly, It needs to verify reliability and validity through large-scale survey.
The purpose of this study was to assess and evaluate salty taste preferences. Samples for the salty taste test were made by adding sodium chloride to soybean sprout soup at five different concentrations: 0.08% (unsalty) ; 0.16% (slightly unsalty) ; 0.31% (neither unsalty nor salty) ; 0.63% (slightly salty) ; and 1.25% (salty). Over 4,210 subjects were randomly selected and tested over a three-year period from 2005 to 2007 in Daegu. The results of the taste test were as follows: Forty-five percent of the subjects preferred soup with a salty taste and slightly salty taste. Most subjects preferred soup with a 0.31% concentration of sodium chloride. There were positive relationships between intensity and preference in 0.08%, 0.16%, and 0.31% concentrations, but there were negative relationships between intensity and preference in 0.63% and 1.25% concentrations (p<0.01). Upon examining a relationship between the taste assessment results and salty eating attitude scores, it was found that the subjects who preferred slightly salty and salty taste showed higher total scores in terms of habitual preference for/enjoyment of eating salty foods than the other groups. Comparing the taste test results with the subjects' stated preference, it was found that 70.3% of the subjects who were classified as preferring salty taste recognized this preference and 53.3% of the subjects who were classified into the population than tends to eat slightly salty food responded that they also tend to prefer a salty taste. Based on these results, this salty taste assessment study can be used as a practical and useful nutrition education tool for assessing and possibly reducing salt intake.
Objectives: The valid assessment of food and nutrients intakes using appropriate dietary intake method is necessary to improve the nutritional status of the hemodialysis (HD) patients. This study was conducted to compare the method between newly developed, semi-quantitative food frequency questionnaire (Semi-FFQ) and 7-day dietary records (7-DRs) for hemodialysis patients. Methods: We conducted both methods on 53 maintenance HD patients in two university hospitals. We calibrated the frequency, portion size and daily intake of 47 food items reported in Semi-FFQ. The food and nutrients intake was compared and the correlation of the two methods was analyzed. Also each nutrient intake was compared to recommended dietary allowance for Korean (KDRIs) and recommended nutrient reference value for HD patients. Results: Energy and energy-yielding nutrients intakes were significantly higher in the two methods (p<0.01). These support the possible reliability between Semi-FFQ and 7-DRs that is similar with regard to most mineral and vitamin intakes. Thus, the Semi-FFQ used in this study for the assessment of nutrient intakes of HD patients can be reliable for the assessment of the nutrient intake along with the 7-DRs. The correlation coefficients were higher for foods consumed daily, such as steamed rice, meat and chicken, bean, egg, milk, coffee and alcohol than for those of foods eaten rarely (p<0.01). Conclusions: The Semi-FFQ used in this study can be a reliable tool for the assessment of the HD patients' nutrient intake along with the 7-DRs, despite its limitations.
In this study, a microbial risk assessment was performed for the bacteria Vibrio parahaemolyticus, which causes a foodborne illness following the consumption of Jeotgal, a fermented seafood in South Korea. The assessment comprised of six stages: product, market, home, consumption, dose-response, and risk. The initial contamination level (IC) was calculated based on the prevalence of V. parahaemolyticus in 90 Jeotgal samples. The kinetic behavior of V. parahaemolyticus was described using predictive models. The data on transportation conditions from manufacturer to market and home were collected through personal communication and from previous studies. Data for the Jeotgal consumption status were obtained, and an appropriate probability distribution was established. The simulation models responding to the scenario were analyzed using the @RISK program. The IC of V. parahaemolyticus was estimated using beta distribution [Beta (1, 91)]. The cell counts during transportation were estimated using Weibull and polynomial models [δ = 1 / (0.0718 - 0.0097 × T + 0.0005 × T2)], while the probability distributions for time and temperature were estimated using Pert, Weibull, Uniform, and LogLogistic distributions. Daily average consumption amounts were assessed using the Pareto distribution [0.60284,1.32,Risk Truncate(0,155)]. The results indicated that the risk of V. parahaemolyticus infection through Jeotgal consumption is low in South Korea.
Purpose: Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. Methods: This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. Results: A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), mid-upper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). Conclusion: In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.
Purpose: This study was performed to identify the pre-and post-transplant nutritional assessment for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Methods: The subjects of this study were 25 patients undergoing allogeneic HSCT. The data collection was performed from January 31st to March 31st, 2011. The Patient-Generated Subjective Global Assessment (PG-SGA), anthropometrics and biochemical test were collected from the time they entered the isolation unit until they left. Results: Pre-transplant nutritional assessment status indicated moderate malnutrition which scored $7.32{\pm}1.68$ in PG-SGA. There were 22 patients (88.0%) with moderate malnutrition and 3 patients (12.0%) with severe malnutrition. Post-transplant nutritional assessment indicated severe malnutrition status which scored $11.92{\pm}3.26$ in PG-SGA. Pre-and post-transplant nutritional assessment displayed significant differences (p<.001) in PG-SGA score. Hematopoietic stem cell transplantation led to a deterioration of patients' nutritional status. Pre-transplant patients were already in malnutrition status and patients undergoing allogeneic HSCT were at risk for malnutrition. Conclusion: Pre-and post-transplant patients were categorized as having undernutritional and malnutritional status. Pre-transplant nutrition status impacted on post-transplant nutritional status. Health care personnel should pay attention to patient's nutrition status when undergoing allogeneic HSCT with appropriate nutritional assessment tools.
Several self-administered dietary assessment questionnaires have recently been developed, validated, and used in nutritional epidemiological and clinical studies in Japan. This article describes recent evidence on development and validation of them. After extensive search of published articles both in English and Japanese languages, we identified 25 articles on 13 questionnaires of which validation studies have existed. Number of foods/menus assessed varied from 31 to 169 according to questionnaires. Eleven questionnaires were food frequency type, either with fixed portion size or semiquantitative, and two diet history types. All the 13 questionnaires were validated against intakes assessed with dietary record or 24-hour recall, and only two with biomarkers. Number of subjects used in the studies was between 23 and 350. All the studies used adult subjects. In the studies with dietary record or recall, the correlation coefficient for or orgy intake was between 0.22 and 0.65 (median = 0.44). Median correlation coefficient for nutrients was between 0.21 and 0.61. In the studies with biomarkers, serum marine-origin n-3 polyunsaturated fatty acids and carotenes, and urinary potassium seemed useful biomarkers. In conclusion, recent progress of this field in Japan is remarkable. But more research is needed for validation studies with biomarkers, and the development and validation of questionnaires for children and elderly subjects. (J Community Nutrition 5(2) : 83∼92,2003)
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