• Title/Summary/Keyword: Protein-energy malnutrition

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The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study

  • El Koofy, Nehal Mohamed;Rady, Hanaa Ibrahim;Abdallah, Shrouk Moataz;Bazaraa, Hafez Mahmoud;Rabie, Walaa Ahmed;El-Ayadi, Ahmed Ali
    • Clinical and Experimental Pediatrics
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    • v.62 no.9
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    • pp.344-352
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    • 2019
  • Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to determine the appropriate composition of the nonprotein calories of diet in ventilated patients. Purpose: We aimed to assess the effect of high-fat dietary modification and nutritional status on ventilatory and final outcomes of pediatric intensive care. Methods: Fifty-one ventilated children (1 month to 12 years of age) with pulmonary disease who could be enterally fed, in the Cairo University Pediatric intensive care unit, were divided into 2 groups: group A included 25 patients who received isocaloric high-fat, low-carbohydrate diet; group B included 26 patients who received standard isocaloric diet. Comprehensive nutritional assessment was done for all patients. Results: Group A had a significant reduction in carbon dioxide tension, but no similar reduction in the duration or level of ventilatory support. Assisted minute ventilation was predicted by weight-for-age and caloric intake rather than the type of diet. Poor nutritional status was associated with higher mortality and lower extubation rates. Mild hypertriglyceridemia and some gastrointestinal intolerance were significant in group A, with no impact on the adequacy of energy or protein delivery. Conclusion: The high-fat enteral feeding protocol may contribute to reducing carbon dioxide tension, with mild hypertriglyceridemia and negligible gastrointestinal intolerance as potential adverse effects. Optimization of nutritional status rather than dietary modification may improve ventilatory and survival outcomes in critically ill-ventilated children.

Dietary Intake of the Elderly in Rural and Urban Low Income Areas (농촌(農材)과 도시저소득층(都市低所得層) 노인(老人)의 영양섭취실태(營養攝取實態)에 관(關)한 연구(硏究))

  • Son, Sook-Mee;Mo, Su-Mi
    • Journal of Nutrition and Health
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    • v.12 no.4
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    • pp.1-10
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    • 1979
  • This study was conducted to abbess dietary intake and eating habits of low-income persons aged 60 years or elder. 212 persons were surveyed between July 10 and August 17, 1978 ; 105 from the farming village of Yang-ju, Kyunggi province; and 107 from Karakdong, an area of redevlopment in the suburbs of Seoul. Results were as follows : 1 ) Family environment 84% of elderly persons surveyed, lived with their children; 13.2%, together as a couple; and 1.9%, widowed, lived alone. More than half on the households had an average monthly income of \50,000 to \30,000. The average Engel index was 61.2%. As for pocket money, 56.4% of male subjects had \l,000 to \7,000 per month, whereas 74% of female had less than \1,000. 2) Anthropometric measurements 59.9% of subjects were $70{\sim}90%$ of standard weight, 93% had an arm circumference only $60{\sim}80%$ of the standard. 3) Food and nutrient intake Carbohydrate provided 73.4 to 79.4% of total energy intake, whereas protein and fat accounted for 10.4 to 10.5% and 8.3 to 7.8%, respectively. Those over 65 years of age showed a somewhat greater dependence on carbohydrates for energy, than those under 65. Protein intake was only $42{\sim}52%$ of the recommended allowance. and the proportion of animal protein to total protein was only $2.1{\sim}9.3%$ far below the recommended allowance. Thus the protein nutrition of the subjects was proven to be inadequate qualitatively as well as quantitatively. Intake of energy and of all nutrients except vitamin A and ascorbic acid, were lower than recommended. 4) Correlational assessment The correlation coefficient between poor dental health, clinical sign score, appetite index, dietary balance and nutrient intake, was significant (0<0.01). Poor teeth, illness, and poor appetite were always associated with inadequate intake of energy and nutrients. The results of this survey reveal that many of elderly of the rural and urban poor show evidence of general malnutrition, The authours hope that this study will provide a back. ground and indicate the direction that community health and welfare programs may take to assure proper nutrition for the elderly.

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Analysis on Eating Behavior and Nutritional Status of Nephritic Patients with Mild Kidney Malfunction in Korea (신장염 환자의 식행동 및 영양상태 평가)

  • 김종연;오세영;임천규
    • Journal of Nutrition and Health
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    • v.34 no.7
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    • pp.770-777
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    • 2001
  • This study investigated nutritional status and eating behaviors among 59 nephritic patients with mild kidney malfunction in Korea. Nutritional status was measured by blood analysis and 1-3 day dietary recall and records, and eating behaviors were assessed by a questionnaire. Mean Body Mass Index(BMI) was within the normal range, while 21% and 14% of the patients were underweight and overweight, respectively. They received nutrition information mainly from doctors, nurses and mass media, but rarely from nutrition professionals. A quarter of patients skipped breakfast at least 3 times per 12% of the patients, respectively. Energy intake of 83% of the patients was less than the recommended level. Protein intakes of 56% of them were either under or over the recommended levels. Patients had low vitamin B$_2$ and calcium(<75% of the RDA) and excessive phosphorus(138% RDA) and vitamin C(170% RDA). Major food sources to absolute nutrient intakes were similar to those for the average Koreas, except for milk. Milk intake was low in our patients. Dietary quantity and quality were associated positively with BMI, albumin, and HDL-cholesterol and negatively with triglycerides and BUN. Results of this study indicate low nutritional status of the patients and, in turn a need for conducting nutritional education or counselling at regular at regular basis for the nephritic patients with mild kidney malfunction.

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Status of Early Childhood and Maternal Nutrition in South Korea and North Korea (남북한 영유아 및 가임기 여성의 영양상태 비교)

  • Shim, Jae-Eun;Yoon, Ji-Hyun;Jeong, Seong-Yeon;Park, Mi-Na;Lee, Yeon-Sook
    • Korean Journal of Community Nutrition
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    • v.12 no.2
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    • pp.123-132
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    • 2007
  • The purpose of this study was to compare the nutritional status of children aged 5 or under and women aged 20 to 34 years between the Republic of Korea (South Korea) and the Democratic Peoples' Republic of Korea (DPRK: North Korea). For the source of nutritional status of North Koreans, the DPRK 2004 Nutrition Assessment-Report of Survey Results was used. As the comparable data of South Koreans, the anthropometric data for children and women were obtained from the reports of the Korean Pediatric Society and the Korean Agency for Technology and Standards, respectively. The blood hemoglobin data of South Korean women were obtained from the data file of the 2001 National Health and Nutrition Survey and analyzed. In regard to the North Korea, the Prevalence of underweight (weight for age Z-score < -2.0) in children under 12 months was about $10\sim15%$, and thereafter progressively increased until 30 to 35 months reaching 30%. In South Korea, the prevalence of underweight was less than 3% in most age groups both in boys and girls. In North Korea, the prevalence of stunting (height for age Z-score < -2.0) reached 20% in children under 12 months and increased with age over the level of 50% in children aged 54 to 59 months. In South Korea, the prevalence of stunting was less than 3% in children under 12 months and was less than 10% throughout the age groups. Maternal protein-energy malnutrition and anemia were assessed for the women aged 20 to 34 years using mid-upper arm circumference (< 22.5 cm) and blood hemoglobin level (< 12g/DL), respectively. The prevalence of protein-energy malnutrition was 39.6%, 30.7%, 31.7% in North Korea and 12.5%, 5.0%, 1.5% in South Korea fir the women in $20\sim24,\;25\sim29,\;30\sim34$ years, respectively. The prevalence of anemia in the North Korean women was about $34\sim36%$ while that in the South Korean women was $15\sim18%$. In conclusion, the disparity of nutritional status in early childhood and maternity between South Korea and North Korea is so huge that active and well-planned nutrition support policy and programs for women and children in North Korea is imperative to prepare for the future unified nation.

Effect of Chlorella vulgaris on Immune-enhancement and Cytokine Production in vivo and in vitro

  • An, Hyo-Jin;Rim, Hong-Kun;Lee, Jong-Hyun;Seo, Min-Jun;Hong, Jin-Woo;Kim, Na-Hyung;Myung, Noh-Yil;Moon, Phil-Dong;Choi, In-Young;Na, Ho-Jeong;Kim, Su-Jin;Jeong, Hyun-Ja;Park, Hyeung-Suk;Han, Jae-Gab;Um, Jae-Young;Hong, Seung-Heon;Kim, Hyung-Min
    • Food Science and Biotechnology
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    • v.17 no.5
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    • pp.953-958
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    • 2008
  • The object of this study was to investigate the immune-enhancing effects of Chlorella vulgaris (CV) on a deteriorated immune function by a protein-energy malnutrition (PEM) diet. Unicellular algae, CV were used as a biological response modifier. Male C57BL/6J mice were fed for 15 days with standard diet or a PEM diet, which is associated with decreased host immune defense. After 8 days, mice in the PEM diet group were orally administered by 0.05, 0.1, and 0.15 g/kg body weight of CV or distilled water. Nutritional parameters, and interferon (IFN)-$\gamma$ levels were significantly increased in the blood serum of the CV (0.15 g/kg)-treated group (29.6$\pm$2.8 pg/mL) compared to the non-treated PEM group (4.1$\pm$0.4 pg/mL, p<0.05). In addition, cell proliferation and production of cytokines were investigated via a CV (0.01, 0.1, and 1 mg/mL) treatment using a human T cell line MOLT-4 cell. The CV treatment (1 mg/mL) significantly increased the production of both IFN-$\gamma$ and interleukin (IL)-2 (51.3$\pm$3.4 and 285.9$\pm$18.8 pg/mL, respectively) compared to the control (51.3$\pm$3.4 and 442.6$\pm$14.3 pg/mL, respectively), but did not affect the production of IL-4. These results suggest that CV may be useful in improving the immune function.

The effect of nutritional supply on clinical outcomes and nutritional status in critically ill patients receiving continuous renal replacement therapy (지속적 신대체요법을 받은 중환자에서 영양공급이 임상결과와 영양상태에 미치는 영향)

  • Kim, Ju Yeun;Kim, Ji-Myung;Kim, Yuri
    • Journal of Nutrition and Health
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    • v.48 no.3
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    • pp.211-220
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    • 2015
  • Purpose: This study was designed to investigate whether nutritional supply influences biochemical markers and clinical outcomes in patients who received continuous renal replacement therapy (CRRT) by evaluating adequacy of nutritional supply for patients. Methods: From January 2012 to December 2013, 239 adult patients who received CRRT in the intensive care unit for more than 3 days were included. General information from electronic medical records and nutritional status related biochemical data and clinical outcomes on the first day of CRRT and 2 weeks after CRRT were collected. Results: The rate of delivered energy and protein was 68.06% and 43.13% which was much lower than energy and protein supply based on their requirement. When the patients were divided into two groups according to 70% of energy received rate and 50% of protein received rate, the group with more than 70% of energy received rate showed significant decrease of length of hospital stay (p = 0.007), length of stay in intensive care unit (ICU) (p = 0.008), duration of CRRT (p < 0.001), and APACHE II score (p < 0.001) compared to less than 70% of energy received rate after adjusting for age. In addition, the group with more than 50% of protein received rate showed decreased mortality (p = 0.031), length of hospital stay (p = 0.008), length of ICU stay (p = 0.035), duration of CRRT (p < 0.001), and APACHE II score (p < 0.001) after adjusting for age. We found that the level of hematocrit (p = 0.006) was significantly improved in the group with more than 70% of energy received rate, and the level of TLC (p = 0.049), hematocrit (p = 0.041) was significantly improved in the group with more than 50% of protein received rate. We also found that energy delivery was negatively correlated with length of stay in ICU (p = 0.049) and positively correlated with level of calcium (p = 0.037). In addition, protein delivery was correlated with the levels of serum total protein (p = 0.021), serum albumin (p = 0.048), hematocrit (p = 0.009), and total cholesterol (p = 0.021) when dead patients were included, but was correlated with the levels of hematocrit (p = 0.034) and calcium (p = 0.024) when dead patients were excluded. Conclusion: Proper nutritional delivery may help patients' clinical outcomes for patients receiving CRRT. However, their actual intakes of energy and protein were not adequate for their requirements. Identification of patients with malnutrition is necessary and a multidisciplinary approach for systemic management is also required.

Changes in Nutrient Intake in Patients at Nutritional Risk (영양 불량 입원 환자에서 영양소 섭취 변화 분석)

  • Lee, Ho Sun;Shin, Kyung Hun;Rha, Sun Young;Chung, Moon Jae;Song, Si Young;Song, Seung Eun;Ham, Hye Jin;Kim, Hyung Mi
    • Journal of the Korean Dietetic Association
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    • v.20 no.4
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    • pp.285-295
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    • 2014
  • The purpose of this study was to examine changes in nutrient intake in patients at nutritional risk. We included 106 malnourished patients who were admitted to Severance Hospital from March to September 2014. The average age was $59.0{\pm}11.6$ years old and 59 patients were male (59.7%). The majority of diagnosis was cancer (94.3%). We evaluated patients' nutritional status by scored patient-generated subjective global assessment (PG-SGA), anthropometric measurement (height, weight, body composition by Bioelectrical impedance analysis), hand grip strength, biochemical and dietary assessment. The patients' daily intakes of energy and protein ($1,019.5{\pm}706.4kcal$, $40.4{\pm}27.7g$) during hospitalization were significantly lower than their usual intakes ($1,382.0{\pm}499.8kcal$, $54.4{\pm}25.1g$, P<0.001). Serum levels of albumin, cholesterol, and total lymphocytes were significantly reduced during hospital stay. The negatively influencing factors for reduced dietary intake were anorexia (42.5%), abdominal distention (14.2%), pain (13.2%), and others. The results of this study could be used to establish baseline data for developing new strategies for nutritional intervention in malnourished patients.

A Study on the Provision of TPN for Hospitalized Patients (입원환자의 TPN 공급현황에 대한 연구)

  • Gang, Eun-Hui;Kim, Mi-Gyeong;Gang, Sin-Suk
    • Journal of the Korean Dietetic Association
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    • v.8 no.1
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    • pp.26-32
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    • 2002
  • In Korea, implementation of nutrition support guidelines has been limited due to strict health insurance reimbursement policies as well as the lack of consensus on the best approach to TPN management. We examined the impact of TPN provision to hospitalized patients where NST (nutrition support team ) consultations were not requested by their primary physicians. The study showed the followings : 1. The median dutation of TPN provision was 8 days, but many patients were on TPN for less than 1 week. 2. The intake of energy and protein were less than the patient's requirements 3. Lipid emulsion was not provided to the most TPN patients. In conclusion, the role of NST should be expanded and studies are needed not only on TPN formulations which are suitable to Koreans but also on the cost-effectiveness of NST activities. TPN policies and protocols should be established based on the needs of each hospital.

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Nutritional Assessment of the Oldest-Old Population Aged 85 Over: Based on 2009 Korea National Health and Nutrition Examination Survey

  • Bak, Hoonji;No, Jae-Kyung
    • Culinary science and hospitality research
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    • v.22 no.1
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    • pp.52-60
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    • 2016
  • As Korea is expected to become super high aged society in 2026, nutrition is important elements of health in the elderly and affects their life. In epidemiological surveys, anthropometric and biochemical measurements represent important components of nutritional assessment in elderly. In the present study, we investigated anthropometric index, biochemical markers, and nutrient intake for elderly aged over 85 by using data on 71 elderly (24 men, 47 women) over 85 years which was obtained from Korea National Health and Nutrition Examination Survey in 2009. According to BMI values, the prevalence of underweight and obesity was 9.7% and 34.5% in men, and 7.9% and 26.4% in women. The prevalence of sarcopenia was 70.7% in men and 25.0% in women. However, plasma biochemical data are normal range in the older population. In nutrients intake, daily Intake of energy, protein, dietary fiber, water, thiamin, riboflavin, niacin, calcium, and potassium was inadequate considering the Dietary Reference Intakes for Koreans(KDRIs). In conclusion, elderly need to be educated nutrition and their health dietary life to prevent malnutrition, and standard of nutrition intake should be rearranged in elderly aged 85 over considering their antrhopometric index.

Establishment of a live vaccine strain against fowl typhoid and paratyphoid

  • Cho, Sun-Hee;Ahn, Young-Jin;Kim, Tae-Eun;Kim, Sun-Joong;Huh, Won;Moon, Young-Sik;Lee, Byung-Hyung;Kim, Jae-Hong;Kwon, Hyuk Joon
    • Korean Journal of Veterinary Research
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    • v.55 no.4
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    • pp.241-246
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    • 2015
  • To develop a live vaccine strain against fowl typhoid and paratyphoid caused by Salmonella serovar Gallinarum biovar Gallinarum (Salmonella Gallinarum) and Salmonella serovar Enteritidis (Salmonella Enteritidis), respectively, several nalidixic acid resistant mutants were selected from lipopolysaccharide (LPS) rough strains of Salmonella Gallinarum that escaped from fatal infection of a LPS-binding lytic bacteriophage. A non-virulent and immunogenic vaccine strain of Salmonella Gallinarum, SR2-N6, was established through in vivo pathogenicity and protection efficacy tests. SR2-N6 was highly protective against Salmonella Gallinarum and Salmonella Enteritidis and safer than Salmonella Gallinarum vaccine strain SG 9R in the condition of protein-energy malnutrition. Thus, SR2-N6 may be a safe and efficacious vaccine strain to prevent both fowl typhoid and paratyphoid.