"본 논문은 대한외과학회지 2006년 제70권제1호에 실렸던 논문으로 대한외과학회 편집위원회 승인을 득하고 본 협회지에 게재함.
Purpose: Malnutrition has been frequently reported for patients on their admission to the hospital and it has been associated with an increase in morbidity, mortality and the length of the hospital stay. Although a number of screening tools have been developed to identify those patients at risk for malnutrition, there is no' gold standard' for defining malnutrition and the malnourished patients remain largely unrecognized. The aim of this study is to evaluate the efficacy of a nutritional screening tool for use in Dankook University Hospital. Methods Nutritional evaluation was performed for 53 patients who were admitted to the department of surgery and internal medicine between October and December 2004. The screening tool was completed by the ward nurse and the nutritional support team nurse on the same patients within24 hours of admission. The nutritional support team nurse performed the full assessment. The screening sheet included 4 questions regarding body mass index, recent unintentional weight loss, food intake and disease severity. Each answer was scored and a total of 5 was tested as the criterion fey malnutrition. The full assessment included current body weight, recent weight loss, triceps skinfold thickness, mid-arm muscle circumference, serum albumin)in and total lymphocyte count. Malnutrition was defined by 3 or more values below the reference values. The reliability of the screening tool was assessed using kappa statistic. Sensitivity, specificity and accuracy were calculated to evaluate the validity of the screening tool. The receiver operating characteristic(ROC) curve was drawn to choose a cutoff valve that maximizes sensitivity and specificity. Results' The level of agreement between the ward nurse and the NST nurse was good for BMI and food intake and moderate for weight loss and disease severity. The full assessment identified7 patients(13.2%) as malnourished. The screening sheet had a sensitivity of 86% and a specificity of 80%. According to the ROC curve, a score of 5 points provided the best validity. Conclusion The nutritional screening tool is reliable when completed by different observers and it is valid for nutritional assessment.
The purpose of this study is to evaluate the nutritional status of protein and lipids in the patients with alcoholic liver disease, to find an effective way of dietary management for patients with alcoholic liver disease and to obtain the materials for nutritional education for alcoholics. The subjects consist of 80 patients with alcoholic liver cirrhosis(ALC) and 12 patients with alcoholic fatty liver(AFL). The control group included 57 alcoholics without liver disease(A), 32 patients with viral liver cir rhosis(VLC) and 194 normal(NL). Biochemical evaluation of nutritional status was performed by ana lyzing the profiles of protein and lipids in blood samples. The results are summarized as follows: 1) The frequency of subjects below the normal range of serum total protein was 26.3% in ALC, 16.7% in AFL and 3.5% in A. Serum albumin was lower in 41.3% of ALC. 2) The alcoholics without liver disease showed significantly higher level of serum triglycerides, total cholesterol and LDL cholesterol than the other groups. The alcoholic subjects had lower HDL cholesterol than normal subjects. Overall, the protein and lipids status of the alcoholic subjects in this study was evaluated to be very poor on the basis of biochemical assessments. The results suggest that alcohol abuse and poor dietary intake could cause malnutrition. An extensive nutritional education should be emphasized for the alcohol consuming population. High quality of protein and other dietary intakes from early stage of the disease may be effective in nutritional therapy for the patient with alcoholic liver disease.
Background: New alternative types of pet foods such as raw and cooked homemadestyle diets containing human food ingredients have been introduced due to a trend of pet humanization and diversification of consumer needs. Objectives: To evaluate nutritional adequacy of new alternative types of dog foods containing human food ingredients as maintenance diets for dogs. Methods: Eleven homemade-style foods for adult dogs were purchased from online channel in Korea and analyzed to evaluate nutritional adequacy for adult dogs. Nutrients analyzed included crude protein, amino acids, crude fat, fatty acids, and minerals. Results: Crude protein and amino acids in all products satisfied Association of American Feed Control Officials (AAFCO) requirements. Crude fat in one of 11 products did not meet AAFCO requirements. The most deficient minerals were selenium (10 of 11, 90.9%), copper (five of 11, 45.5%), zinc (five of 11, 45.5%), potassium (three of 11, 27.3%), calcium (three of 11, 27.3%), iron (two of 11, 18.2%), and magnesium (one of 11, 9.1%). Six products were not in the range of the recommended Ca:P ratio in AAFCO dog food maintenance nutrient profiles. Conclusions: This study performed nutritional evaluation of raw and cooked homemadestyle foods as maintenance diets for adult dogs. Some nutritional inadequacies were observed including some minerals, Ca:P ratio, and omega-6:omega-3 fatty acid ratio, although three products (26.2%) satisfied the AAFCO standard except selenium. Overall, the data suggest a need for accurate nutritional adequacy statement for consumers based on proper methods to validate the formula.
The purpose of this study was to investigate the related factors to nutritional supplements intake of elementary school student aged 7 to 12 years in Incheon area. The subjects were 631 mothers of elementary school students and cross-sectional study was conducted by a self-administered questionnaire. In view of the relation with general circumstances, taking nutritional supplements was shown to be significantly associated with general and socio-demographic factors such as father's job, mothers concern about children's academic record, family's monthly income and food cost, and the experience of other family members' taking nutritional supplement. In view of the relation with anthropometric and health-related factors, taking nutritional supplement was associated with elementary school student' weight obesity index, mothers evaluation of children's height and weight mother's concern about health and growth of children, and ,disease of children. In view of the dietary behavior-related factors, taking nutritional supplements was associated with skipping breakfast, food habits, and mothers beliefs and attitude about nutrition and nutritional supplements. However, it was shown that mothers nutritional knowledge did not affect taking nutritional supplements. Therefore, it may be suggested that general and socio-demographic factors, anthropometric and health-related factors, dietary behavior-related factors, and mother's nutritional beliefs and attitude are important determinants in children's taking nutritional supplements.
Purpose: The purpose of this study was to evaluate preoperative nutritional status in elderly patients with orthopedic surgery and identify related factors for malnutrition risk. Methods: This study enrolled 337 patient's medical record who underwent orthopedic surgery in hospital between January and December 2015. Data was collected retrospectively. Nutritional status was evaluated by using the Nutritional Risk Screening 2002. Multivariable logistic regression analysis was used to identify independent related factors for malnutrition risk. Results: Malnutrition risk developed in 58 patients (17.2%). Logistic regression analysis identified low physical activity, visual impairment, depression, sleep disorder, low serum calcium level, and low serum albumin level as related factors. Conclusion: Orthopedic surgery in elderly patients was associated with high risk of preoperative malnutrition. The results of this study suggest that evaluating the nutritional status and related factors should be done with preoperative status of elderly patients. At the same time, interventions for nutritional care should be adjusted to meet the nutritional needs of individuals and decrease the risk of malnutrition.
The purpose of this study was to present the basic data for the education of nutrition to female teachers by surveying the degree of nutritional knowledge, the attitute toward nutrition and eating habits of the female teachers, and analyzing the present dietary food. 1. The average score of their nutritional knowledge was 17.53 (the highest mark was 25) and the percentage of the right answers was 73.6. 2. The nutritional knowledge was related to their ages, and whether or not they majored in domestic science. Younger and domestic science majors scores of nutitional knowledge were shown to be higher. 3. They had dinner more regularly than breakfast or lunch and the score of nutritional knowledge was higher in proportion to the regularity of their breakfasts. As nutritional knowledge was reflected in their daily lives and bread was used as a substitute of their meals, the degree of their nutritional knowledge was higher. 4. For self evaluation of nutritional knowledge, the higher the score of their nutritional knowledge was, the more they thought they knew and those with high scores seemed to get information about nutrition through specialized books and cookbooks.
Long-term hemodialysis(HD) patients manifest various signs of protein and caloric malutrition due to poor intake of nutrients and other causes. Poor nutritional status increases the mortality and morbidity rates in HD patients. Thus, mataintnance of adequate nutritional status has been a major task in taking care of patients receiving HD. This study was to evaluate the nutritional status of HD patients and to clarify the degree of nutritional deficit based on usual dietary intake, anthropometric and biochemical indicators. Sixty HD patients comprised a HD group, while the control group consisted of 60 healthy adults whose age and sex matched those of the HD group. Nutritional status was evaluated by dietrary intake using instant nutritional scale, anthropometric measures, serum protein concentrations and the number of lymphocytes. The data were analyzed by using Chi-square test and unpaired t-test. The results are as follows. 1. Regarding usual dietary intake of HD group. 1) Estimated caloric intake was significantly lower than the recommended daily allowance(RDA) and among them, 35% were taking calories less than 85% of the RDA. 2) Estimated protein intake was significantly higher than the RDA and among them 40% were taking protein more than 115% of the RDA. 3) Estimated fat intake was lower than the RDA. 4) Vitamin A, B, $B_1,\;B_2$, C and niacin in take was lower than the RDA respectively. 5) Estimated ferrous intake was within the normal limit the RDA while estimated calcium intake was higher than the RDA. 6) Both calorie and protein intake were higher for the 10 patients who had been under continuous ambulatory peritoneal dialysis than for the patients under HD from the beginning. 2. Regarding anthropometric measures : 1) Body mass index(BMI), midarm circumference(MAC), and triceps skinfold thickness(TSF) were lower in the HD group than in the control group. 2) Among HD group, 47.1% were within the normal limit of BMI, while 86.7% were within the same limit in the control group. 3) Among HD group, 35.0% were within the normal limit of MAC, while 83.3% were within the same limit in the control group. 4) Among HD group, only 8.3% were normal, 30.3% were mild deficit status of TSF, while 50% were normal and 48.3% were mild deficit status in the control group. 3. Regarding biochemical laboratory tests 1) Albumin, transferrin concentrations and the number of lymphocytes were lower in HD group than in the control group. 2) Among HD group, 98.3% were within the normal limit of albumin concentration and all were within the same limit in the control group. 3) Among HD group, only 11.7% were within the normal limit of transferrin concentration, while 81.7% were within the same limit in the control group. 4) Among HD group, 25% were within the normal limit, while 93.3% were within the same limit in the control group. The above findings suggest that HD patients were in nutritional deficit status. Adequate diet therapy and periodical evaluation of the nutritional status in HD patients are needed. Accordingly, it turned out that anthropometric measures were very reliable parameters and easy to use to evaluate nutritional status. So nurses are encouraged to adopt anthropometric measures to examine nutritional deficit status of HD patients.
Over the past two decades in the United States, social marketing has become an increasingly popular means of delivering nutrition education for the purpose of eliciting a specific behavior change. This manuscript defines social marketing via traditional marketing concepts and jargon, as well as through a communications strategy that can be used to guide message and campaign development. Research and evaluation strategies necessary to support the development and assessment of campaign promotions, is discussed. Four campaigns implemented in the United States, and one campaign implemented in Indonesia, are discussed in terms of the strategies presented. These campaigns illustrate how this educational technique and an array of assessment approaches have been applied to varied nutritional issues across diverse target audiences and settings. Practical recommendations, as well as discussion of issues regarding the advantages and disadvantages of using social marketing as an educational strategy, campaign sustainability, and philosophical considerations regarding the use of this educational approach, are addressed.
This research was designed to develop a computer program and evaluate the nutritional balances especially the balance of fatty acids, amino acids and antioxidant vitamins for convenience foods. The Korean convenience food, Kimbab purchased from markets was evaluated by using the self-developed computer program. Contents of calories, protein and calcium were lower$(1/3^{\circ}{\neq}1/2)$ than the recommended levels of Korean adult woman, and the carbohydrate/ protein/ fat(CPF) energy ratio was 70: 13: 17. The mean P/ M/ S ratio was 2.2/ 1.4/ 1 and that of ${\omega}6/\;{\omega}3$ fatty acids was 17.9/ 1, which was higher than the desirable ratio of $4{\sim}8/\;1$. Average essential amino acid balance of market-Kimbab samples was within the desirable range even though the absolute amount of protein was lower than the recommended level. Contents of antioxidant vitamins (A, C &E) were lower than recommended levels. Two kinds of nutritionally adjusted Kimbab menu were established by self-developed computer program. Some of major changes was adding food ingredients such as tuna fish and perilla leaf cooked with sesame oil and soybean oil to increase ${\omega}3$ series fatty acids. Some fruits and milk were also added to the menu. The adjusted CPF ratios was 63: 15: 22 and the new values for P/ M/ S and ${\omega}6/\;{\omega}3$ fatty acids ratios were 1.0/ 1.2/ 1/0 and 6.1/ 1 respectively. In sensory evaluation of two kinds of adjusted Kimbab, the taste and overall estimation scores were higher than unadjusted Kimbab. The computer program developed in this study might be used as a tool for the evaluation of nutritional balance of other convenience foods and menu planning.
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