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.
Patients undergoing peritoneal dialysis are at risk for protein-energy malnutrition because of nutrient losses during dialysis. This study determined the nutritional status of patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Forty-four patients receiving CAPD were divided into two groups according to dialysis period. We investigated the nutritional status of the patients by measuring anthropometric and biochemical parameters, as well as food intake, self-appetite, dietary habits, a subjective global assessment, and a total nutritional status assessment. Group I subjects (7 males, 13 females) had received dialysis for < 2 years, whereas the group II subjects (18 males, 6 females) received dialysis for ${\geq}$ 2 years. Energy intake with added dextrose in the dialysate per kg of body weight was $30.3{\pm}5.8$ kcal in group I and $29.0{\pm}8.1$ kcal in group II. The average protein intake per kg of weight was $1.0{\pm}0.3$ g in group I and $1.0{\pm}0.4$ g in group II, which were less than the recommended protein intake for patients undergoing CAPD (1.2-1.5 g/kg). Mean serum albumin level was significantly lower in group II than that in group I (p < 0.05). A recent self-appetite score was significantly higher in group II than that in group I (p < 0.01). The dietary habits score was significantly lower in group II than that in group I (p < 0.05). The subjective global assessment was significantly higher in group I (85.0%) than that in group II (54.2%) under normal nutrition status (p < 0.05). The dialysis period was significantly and negatively correlated with the subjective global assessment (r = -0.502, p < 0.01) and the total nutritional status assessment (r = -0.575, p < 0.01). These results demonstrated that patients undergoing CAPD for ${\geq}$ 2 years had worse nutritional status than those who had been undergoing dialysis for < 2 years. Good nutritional status can predict the long-term survival of patients undergoing peritoneal dialysis. Additionally, the exact evaluation of nutritional status before 2 years will be important to maintain long-term dialysis therapy in patients undergoing CAPD.
The purpose of this study was to assess the biochemical nutritional status of the long-lived elderly. The subjects of the study were 148 elderly people of age over 85 years living in Kyungpook Sung-Ju area who have no problem in daily living. The anthropometric measurement and biochemical assessment of the blood sample were carried out. The subject group for this study was composed of 25.9% males and 74.1% females, the average age being 87 years old. The mean Body Mass Index(BMI) of the male and female subjects were 20.7 and 21.2 respectively. The average body fat amounts of the male and female were 21.4% and 29.8% respectively, and the average waist/hip ratios were 0.9 and 0.7 respectively. The mean levels of the total blood protein and albumin of the subjects were in the normal ranges. The mean levels of serum cholesterol and triglyceride were 167.9mg /dL and 123.9mg/dL respectively. The mean levels of the subjects below normal range of hemoglobin were 63.5%. Serum levels of antioxidant nutrients were very poor. The mean levels of serum lipid peroxidation products were 3.3nmol/mL. BMI and WHR were positively correlated with the serum cholesterol levels. The resuts showed that the long-lived elderly had good nutritional status except for antioxidant nutrients status. In addition antioxidant supplement for long-lived elderly may be effective to maintain healthy life in later years.
The concentrations of the immunological substances in breast milk and nutritional status were studied in healthy Korean women of middle socioeconomic class. The subjects were recruited at random from obstetric clinics in Seoul. The nutrients intake, prepregnancy BMI, maternal weight gain during pregnancy were studied. The concentrations of lactoferrin(LF), lysozyme(LZ), sIgA, IgG and C3 in colostrum, in transitional milk, and in mature milk, were measured. To elucidate the effect of nutritional status on immunological substances, each components was compared on the basis of either BMI, weight gain, or protein intake. The highest concentrations of the substances were found in colostrum and decreased as lactation progressed. The decline was more prominent in IgG, C3 and sIgA, and less significant in LZ and LF. The colostrum of standard weight gain group showed higher concentrations compared to lower weight gain group. This difference became smaller as the lactation progresses. BMI and nutrient intake status had less significant effect. Lower sIgA was found in lower BMI, in lower weight gain, and lower protein intake groups compared to standard groups, which indicates sIgA is the most affected substance among the measured by nutritional status.
A community-based longitudinal study was conducted in the Manya Krobo District of the Eastern Region of Ghana with the objective of assessing how caregiving practices influence nutritional status of young children in Ghana. The study subjects were one hundred mothers with infants between the ages of 6 and 12 months. Each child was visited at home monthly for a period of six months. On each visit, information was collected on caregiver household and personal hygiene, child's immunization status, child's dietary diversity, caregiver responsiveness during feeding, caregiver hygienic practices related to feeding and child's weight and length. At the end of the study, summary scores were generated for each variable and quality of care practice determined based on their distribution. Classification of child nutritional status was based on z-scores for both weight-for-age and length-for-age. The results revealed that caregivers who exhibited better quality of care practice had well-nourished children. Such caregivers were more likely to practice good household and personal hygiene than those of poorly nourished children (97.1% vs 31.8%, p<0.001). They were also more likely to complete their children's immunization schedules (88.2% vs 62.2%, p<0.001), provide good quality diets from highly diversified sources (79% vs 23%, p<0.001), exhibit high responsiveness during feeding (100% vs 22.7%, p<0.001) and feed under hygienic conditions (100% vs 22.7%, p<0.001). Based on the findings it was concluded that good caregiving practices are associated with improved child nutritional status.
Purpose: The purpose of this study was to examine the effects of an individualized nutritional education programs on nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy. Methods: Forty patients with colorectal cancer (19 experimental and 21 control patients) were recruited from a chemotherapy ward at S University Hospital in Seoul, Korea. The experimental group received two individualized nutritional counseling sessions and two telephone counseling sessions over 6 weeks. The control group received nutritional counseling after completion of data collection. Nutritional education included general guidelines for food intake while receiving chemotherapy, dietary guidelines for patients with colorectal cancer, daily meal schedules to overcome cancer, and dietary guideline for each chemotherapy side effect. Data were analyzed using ${\chi}^2$-test and t-test with the SPSS program 17.0. Results: Two group comparison revealed that the experimental group had significantly improved calorie (p=.038) and total protein intake (p=.001), and serum albumin percentage change (p=.040). Body weight did not increase but remained the same as the baseline in both groups. Conclusion: Study results indicate that this individualized nutritional education programs are effective in enhancing nutrient intake and nutritional status of patients with colorectal cancer who are undergoing palliative chemotherapy.
Purpose: This study was to evaluate the nutritional status of low-income elders in urban areas and factors affecting their nutritional risk. Methods: A cross-sectional analysis was conducted. The subjects were 300 elders selected from home visiting clients of DongJack Public Health Center. Data were collected using a questionnaire containing questions on socio-demographic characteristics. health behavior and disease. dietary pattern. Nutritional Screening Initiative. Geriatric Depression Scale and Barthel Index for ADL. Collected data were analyzed through descriptive statistics. $X^2-test$ and multiple regression analysis using SPSS. Results: Of the subjects, 63% had high nutritional risk, 21.3% moderate nutritional risk, and 15.7% good nutritional risk. NSI score was significantly different according to economic status, subjective health condition, medication, dental health, depression. regularity of diet and meal with family. Multiple regression analysis revealed that depression, subjective health condition, dental health and regularity of diet and meal with family explain 38.1% of nutritional risk. Conclusion: It is necessary to evaluate nutrition status and to control nutritional risk factors such as depression, dental health, regularity of diet and meal with family for improving the health of the low-income elderly.
Recently, the number of patients who received Bone Marrow Transplantation(BMT) has been increased dramatically and the diseases for which BMT if efficacious are increasing. Adequate nutritional card for BMT patients is crucial for the success of BMT because nutritional deficiency could provoke deteriorative effects. However, little is known about nutritional status among BMT patients in Korea. This study was conducted to assess oral and parenteral intake of BMT patients and compare the change of nutritional status before and after BMT. Twenty-two BMT patients who were admitted to the Severance hospital from December in 1995 to September in 1997 participated in the study. Total calorie requirements were calculated for each patients individually and nutritional support for each patients consisted of oral and parenteral feeding. To assess oral intake of BMT patients, each patients recorded the amount of food they have eaten from 6 days before BMT to 28 days after BMT. The medical records of each patients were used to assess parenteral intake. To compare the nutritional status before and after BMT, the results of anthropometric and biochemical test from 14 days before BMT to 28 days after BMT were used. At the time of admission, the patients were in allowable nutritional status and their total calorie intake was 93% of total calorie requirement. When the preparative regimen for BMT was started, the patients' oral intake was dramatically decreased below 400kcal/day. Even though their oral intake was increased after BMT, their oral intake at the 4th week after BMT was only 752kcal/d, which is only 35.8% of total calorie requirement. The patients' mean oral intake during BMT period (from 6 days before BMT to 28 days after BMT) was only 439kcal/d. Although Total Parenteral Nutrition(TPN) was added when the preparative regimen was started, the patients' mean total caloric intake during BMT period was 111% of basal energy expenditure and 83% of total calorie requirement. The mean total protein intake was only 58% of total protein requirement. In the comparison of nutritional status between pretransplant phase and posttransplant phase in BMT patients, their body weight and serum albumin level were significantly decreased(p<0.001). These results show inadequacies in nutritional intake among BMT patients, and indicate the need of TPN during BMT period.
Kim, Ji-Yeong;Park, Mi-Seon;Lee, Yeong-Hui;Jo, Sam-Je;Yang, Han-Gwang
Journal of the Korean Dietetic Association
/
v.7
no.1
/
pp.72-79
/
2001
The purpose of this study is to investigate the dietary intakes and nutritional status in total gastrectomized patients. We assessed the nutritional status by dietary intake, anthropometric data and biochemical data. And we also checked the subjective postprandial symptoms and gastrofiberscopy to detect the reflux esophagitis in 22 patients who were free of tumors for more than 1 year after total gastrectomy by the three different reconstruction methods(Loop esophagojejunostomy with A-loop tie/ Roux-en-Y esophagojejunostomy/Roux-en-Y esophagojejunostomy with Paulino pouch). Any patients were not in malnutrition status in respect to biochemical data. By assessing the dietary intake, the average daily calorie intake was 1848.2$\pm$440.2kcal, it was 105.9$\pm$23.8% of energy requirement. But there was weight loss in 21 patients of 22 patients after operation and the weight loss was 12.8% of preoperative weight(61.0$\pm$7.9 vs. 53.5$\pm$6.7kg, preoperatively vs. at the time of study). This may suggest that continuous nutritional care is necessary after total gastrectomy to promote sufficient calorie intake, keeping good nutritional state. There were no significant differences between the methods of reconstruction and dietary intakes or nutritional status. Endoscopic esophagitis was more frequently found in patients of loop esophagojejunostomy than any other reconstruction methods(p<0.001), but it didn't show any effect on the dietary intakes.
Journal of the Korean Society of Food Science and Nutrition
/
v.28
no.3
/
pp.722-731
/
1999
The purpose of this study is to analyze the factors associated with health and diet by nutritional status. The subjects were the children aged 2 to 6. Physicians and nurses measured children's anthropometries and examined their blood and urine. Interviewers questioned children's food habits to their mothers. 24 hour recall was done for children with their mother. The nutritional status was classified to 'underweight', 'normal weight' and 'overweight' by weight for height(median±1 S.D.) of the reference population. The number of subjects in each group(under, normal, over) was 25, 130 and 49. Factors including anthropometry and hemoglobin concentration were not significantly dif ferent by the nutritional status. The birth weight of children was correlated positively to mothers' BMI. Z scores of weight for height were related to the birth weight positively by the analysis of variance. The children of the underweight group used nutritional supplements more frequently than those of normal and overweight group. The nutrient intakes of normal weight group were higher than those of low and overweight group. Particularly, the intakes of energy, carbohydrate and calcium were significantly high among the groups. In terms of number of foods, food groups and dishes consumed per day, the children of the normal weight group ate more diversely than other groups but the differences were not significant. In conclusion, the children of normal weight group had similar characteristics with other groups but had more desirable dietary intakes than other groups in this study. Because the diet of children may be different by the nutritional status, nutrition education for children should be conducted according to the characteristics of each group's diet.
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