• Journal of Nutrition and Health
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• v.42 no.3
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• pp.234-245
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• 2009

Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Korean Journal of Community Nutrition
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• v.11 no.6
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• pp.779-784
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• 2006

Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

• The Korean Journal of Food And Nutrition
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• v.8 no.4
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• pp.344-356
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• 1995

This study was performed to Investigate the nutritional knowledge and dietary patterns of 450 high school girls in some areas of Seoul. The survey conducted from September 20 to 25, 1993. The results obtained were summarized as follows ; The average height and weight of the subjects were 160.2$\pm$5.Ocm and 52.3$\pm$6.7kg respectively. The average obesity index of the subjects was 96.8$\pm$11.7%. Menarche was at 13 years of age in 35.6% of the subjects and at after 14 years of age in 37.3% of them. The average score of nutritional knowledge was 60.04 $\pm$ 14.49 and the average score of Perceived nutritional knowledge was 83.9$\pm$ 14.44. The mean score of nutritional knowledge was 49.61 $\pm$ 13.45. 35.6% of subjects ranked lecture of score as their primary sources of nutritional information. Major dietary problems of subjects were eating rapidly, skipping breakfast, unbalanced Inlet and choice of snacks according taste. Underweight group showed significantly higher than other groups In unbalanced diet(P<0.01) and showed significantly higher than other groups in taking a medicine(P<0.001). Obese group showed significantly lower than other groups in remaining meals and unbalanced diet (P<0.05) and showed significantly higher than other groups In voereating.

• Journal of Korean Academy of Nursing
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• v.33 no.4
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• pp.478-487
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• 2003

Purpose. The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy. Design. A correlational and crossectional study design was used. Method. One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index. Results. The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. Conclusion: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

• Journal of the Korean Society of Food Culture
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• v.24 no.6
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• pp.793-804
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• 2009

This study was conducted to investigate the change in the anthropometric values, biochemical index, nutritional knowledge, food habits and nutrient intakes in obese children after a weight control program. The subjects of the study were 22 obese children with an obesity index over 120%. The children that participated in this study took nutritional education for weight control along with exercise once a week. The weight control program was conducted for 10 weeks. The BMI, WHR (Waist-Hip ratio), body fat (%) significantly decreased at the end of the weight control program. Total cholesterol and LDL cholesterol were also significantly decreased. The nutritional knowledge scores and knowledge score about obesity were slightly improved. Energy intake significantly decreased from 1768 to 1421 kcal. Intake of Ca, Na, K, vitamin A, vitamin $B_6$, vitamin C and folate increased, while intakes of P, Zn, vitamin $B_1$, vitamin $B_2$, vitamin E and niacin decreased. The distribution of energy intake was significantly changed for the better. The percent fat consumed decreased from 26.5 to 19.7%. In addition, the distribution of energy intake in the meals was changed, where the percent calories consumed during lunch significantly increased from 31.4 to 40.1% and the calorie percentage consumed from snacks significantly decreased from 17.6 to 10.7%. In conclusion, the nutritional education in the weight control program, which was conducted for 10 weeks, was effective in improving the anthropometric values, biochemical index and nutrient intake although nutrition knowledge and eating behaviors only changed slightly. Thus, nutritional weight control programs for obese children should be continuously provided under the proper cooperation of a nutritional teacher at elementary schools.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.1
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• pp.92-102
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• 2007

Purpose: This study was conducted to evaluate nutritional status, and the effects of lifestyles and depression on nutritional status of elderly people (NSE). Method: The participants were 280 elders who visited the Y city Senior Welfare Center between August 2006 and October 2006. Data were collected using a structured questionnaire that included general characteristics, lifestyle checklist, depression scale, and nutritional risk index. Also, Body Mass Index (BMI) was calculated from height and weight. T-test, ANOVA, Duncan test, Pearson coefficients correlation and stepwise multiple regression were used to analyze the data using the SPSS Win 12.0 program. Results: The NSE mean score was mid level at 5.03 BMI was 23.42 which indicates overweight. Depression was the factor that influenced the nutritional risk index most strongly, accounting for 17.3% of the total variance in the NSE. A combination of significance of health, concerns about health, housing, condition of teeth, activity, and smoking pattern accounted for 29.8% of the variance in the NSE. Condition of teeth accounted for only 3.8% of the variance in BMI. Conclusion: It is necessary to be aware that variance in the NSE can be affected by several factors including depression and lifestyle and that depression is strongly related to poorer NSE.

• Journal of Nutrition and Health
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• v.34 no.1
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• pp.79-88
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• 2001

Management of nutrient intakes through behavior-mordification can be important for improving exercise performance in athletes. The purpose of this study was to determine the effectiveness of nutritional counseling for improving exercise performance capability in athletes. The subjects were seven golfers and fourteen ju-do athletes from Hoseo university, and they have nor received professional hel[ from dieticians. Prior to nutritional counseling, their dietary intakes, lifestyles and dietary habits were evaluated. Nutritional counseling sessions were conducted by a trained dietician every 2-3 weeks for 3-4 month. After 5 counseling sessions, nutrient intakes, lifestyle and dietary habits were re-evaluated. Exercise performance capability was measured by maximal exercise stress test using treadmills. Individual data were assessed as quality index represents the better nutritional status. The common dietary and lifestyle problems were overeating binging, overeating, snacking and drinking alcohol prior to the nutritional counseling. After counseling sessions, the quality index of dietary habits seemed to decrease, especially in ju-do athletes, representing nutritional problems were resolved. Body fat and body mass index decreased in ju-do athletes, but not in golfers. Both athletes have shown to increase oxygen uptake at anaerobic threshold and maximal oxygen uptake status, which represents that the athletic performance capacity was improved after counseling sessions. Their respiratory quotients were decreased. In conclusion, nutritional counseling sessions over five times are an effective and efficient approach to change dietary habits to improve exercise performance capacity. Furthermore, clients can have good dietary habits and learn how to manago muscle strength by behavior modification through multiple nutritional counseling sessions. (Korean J Nutrition 34(1):79-88, 2001)

• Journal of Nutrition and Health
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• v.37 no.3
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• pp.210-222
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• 2004

In recent years, the number and proportion of Korean elderly have grown rapidly, and elderly individuals show a disproportionate risk for poor nutritional status. The purpose of this study was to examine the relationship of sociodemographic background to nutrient intake of persons 65 years of age or older, living in 15 cities in Korea. Data on 1973 subjects (603 males, 1370 females), who participated in the Korean Elderly Nutrition Survey (2000), were analyzed. Their mean age was 72.3 years and their mean body mass index (BMI) was 24.2 kg/$m^2$. Basic sociodemographic data were obtained through personal interviews. The 98-item semi-food frequency questionnaire, developed and previously validated for Korean middle-aged and elderly subjects, was administered. “Percentage of subjects who consumed under 75％ Korean RDA,” “number of nutrients consumed below 75％ Korean RDA,” “mean nutrient adequacy ratio,” and “nutrient density” were used to determine nutritional status. Male elderly had better nutritional quality than female elderly. Nutritional quality decreased with age, especially in older elderly (over 75). Elderly who were underweight (BMI 〈 20 kg/$m^2$) showed poorer nutritional quality than those who were normal weight (BMI 20∼25 kg/$m^2$) and overweight (BMI $\geq$ 25 kg/$m^2$). Elderly who lived alone had significantly poorer nutritional quality than those who lived with a spouse, and/or with children. Lower education level and economic dependence also showed lower nutritional quality. A stepwise multiple regression analysis was performed to examine the effects of specific sociodemographic factors on nutritional quality. For number of nutrients under 75％ RDA as a dependent variable, education level explained 4.8％ of the variance, followed by living status, age, body mass index, gender, and living expense support (Model $R^2$ = 0.091). For mean nutrient adequacy ratio as a dependent variable, model $R^2$ was 0.098. Therefore, sociodemographic variables such as gender, age, body mass index, living status, educational level, and economic status influenced elderly nutrition status. These results indicate that an elderly nutrition intervention should focus on subjects who are poorly educated, living alone, age 75 or older, and/or underweight.

• Journal of Gastric Cancer
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• v.22 no.1
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• pp.56-66
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• 2022

Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.