• Journal of Nutrition and Health
• /
• v.55 no.1
• /
• pp.85-100
• /
• 2022

Purpose: This study is aimed to examine the association between initial enteral nutrition (EN) and the clinical prognosis among patients with severe and multiple traumatic injuries, and to investigate whether this association is modified by the patients' catabolic status. Methods: This was a retrospective study of 302 adult patients with severe and multiple traumatic injuries admitted between January 2017 and September 2020 at Ajou University hospital in Suwon, Korea. The initial nutritional support by EN and parenteral nutrition were monitored up to day 7 after admission. Patients were classified into "No", "Low", and "High" EN groups according to the level of initial EN. Multivariable-adjusted logistic regression and linear regression models were used to estimate the association of the initial EN levels at hospital admission with the risk of mortality, morbidities, and levels of nutrition-associated biochemical markers. Results: High EN support was associated with reduced mortality (odds ratio, 0.07; 95% confidence interval [CI], 0.02, 0.32) and lower levels of C-reactive protein (β, -0.22; 95% CI, -8.66, 1.48), but longer stay in the intensive care unit (β, 0.19; 95% CI, 1.82, 11.32). In analyses stratified by catabolic status, there were fewer incidences of hospital-acquired infections with increasing EN levels in the moderate or higher nitrogen balance group than in the mild nitrogen balance group. Conclusion: Our observation of the inverse association between levels of initial EN administration with mortality risk and inflammatory markers may indicate the possible benefits of active EN administration to the recovery process of severe and multiple trauma patients. Further studies are warranted on whether the catabolic status modifies the association between the initial EN and prognosis.

• Nutritional Sciences
• /
• v.7 no.2
• /
• pp.83-87
• /
• 2004

To investigate the effects of dietary phytate reduction and zinc supplementation on biochemical iron parameters in elderly Korean women consuming inadequate iron, fifteen healthy women aged 64-75 years were recruited for a feeding study. A high-phytate diet (27.8 phytate:zinc molar ratio) was provided for 9 days, followed by a nine-day low-phytate diet(12.3) and a subsequent 28-day period of unregulated meals with zinc supplementation (22 mg/d as zinc gluconate). Serum iron increased significantly with the low-phytate diet (130.4 $\mu g$/L) but returned to the level observed during the high-phytate diet (113.0 $\mu g$ /L) period when subjects were taking zinc supplements (105.8 $\mu g$ /L). However, serum ferritin in the subjects decreased significantly with the low-phytate diet (73.8 $\mu g$ /L) as well as with zinc supplementation (57.2 $\mu g$ /L), compared to levels following consumption of the high-phytate diet (89.6 $\mu g$ /L). Transferrin receptor and transferrin saturation were unchanged with the treatments. In summary, zinc supplementation might result in deteriorated iron status in elderly Korean women who consume inadequate iron, while there was no significant effect from reducing dietary phytate.

• The Korean Journal of Food And Nutrition
• /
• v.32 no.3
• /
• pp.189-201
• /
• 2019

The objective of this study was to investigate the health status and nutritional intake of the old population living in Soonchang, Jeollabuk-do, Korea. 69 subjects aged 65 years and older were recruited in July 2016. The WHR, was significantly higher in elderly male group than elderly female group (p<0.05), but both groups had abdominal obesity (0.85 and over). T-score mean of elderly male and female groups were below $-2.5mg/cm^3$ that they were osteoporotic. In the elderly male group, the higher concentrations of creatinine, homocysteine and uric acid were found to be significantly unfavorable factors (p<0.001, respectively). The blood vitamin $D_3$ levels of elderly male group was significantly higher than that of elderly female group (p<0.05). The physical activity and self-rated health were significantly higher in elderly male group than in elderly female group (p<0.05, p<0.01, respectively). The nutrient intakes of male group were found to be significantly favorable factors than in female group. The score of mini nutrition assessment was significantly lower in elderly female group than in the elderly male group. These results could be useful to plan effective strategies to increase the health-life expectancy and the prevention of disease of Korean elderly people living in rural areas.

• Korean Journal of Community Nutrition
• /
• v.4 no.2
• /
• pp.132-138
• /
• 1999

The purpose of this study was to determine biochemical parameters related to protein and immunity. Subjects were 125 preschool children(M:69, F:56) residing in low income area of Seoul. Mean serum total protein of the children aged 6 was 7.3g/dl which was significantly higher than 6.6g/dl of the group aged 3. The mean serum albumin was 4.7g/dl for 3, 4, 5 age group, and 4.9g/dl for 6 age group and there was no significant difference. Serum retinol binding protein(RBP) is used as a sensitive indicatior of protein, because it tends to fall rapidly in response to protein status and respond to quickly dietary treatment. Mean RBP for each group(3, 4, 5 and 6 age group) were $2.5\mu{g}$/dl, $2.9\mu{g}$/dl, $2.7\mu{g}$/dl, $3.0\mu{g}$/dl. The Proportion of children whose RBP was than $2.6\mu{g}$/dl was 15.9%, 19.2%, 24.3% and 16.7%, respectively. The 24-hour urinary excretion of hydroxyproline was 7.9mg, 14.6mg, 11.7mg and 11.8mg for each group and the mean excretion of all children was 12.2mg/day. Children aged 3 were excreting significantly lower amount of hydroxprolinc per day than the children aged 4. The mean hydroxyproline index were 2.18, 2.39, 2.52, 2.80 for each age group and the mean of a group aged 6 was significantly higher than that of the group aged 3. The proportion of children assessed as malnourished and impaired growth(hydroxyproline index <2.0) was 18.8%, 4.9%, 2.5% and 4.3%, respectively. The nutrients which showed significant relationship with protein and immunity parameters were niacin, vitamin C and calcium. Vitamin C showed significant positive relationship(p<0.05-p<0.01) with serum RBP, total protein and globulin. The triceps skinfold thickness was significantly and positively correlated with serum globulin. Serum IgG showed significant positive relationship with height, weight, girth of chest and midarm circumference(p<0.05-p<0.01).

• Journal of Nutrition and Health
• /
• v.23 no.2
• /
• pp.124-134
• /
• 1990

To investigate nutritional and growth status of premature infants, survey was conducted against 19 premature infants admitted to Nursery of Pediatrics, Young nam University Hospital from Jan. 1984 to July 1988. Variations in feeding patterns as analyzed through the five feeding phases of dextrose, dextrose/hyperal, dextrose/formula, dextrose/hyperal/formula and formula. During 30days from birth, dietary intake, feeding phase, selective anthropometric measurements, biochemical parameters and demograpic information of premature infants were as follows: Distributions of birth weight by gestational age and apgar score showed preamture infants below 1499g were 31 weeks, 4/7(1min/5min) and premature infants from 1500g to 1999g were 33 weeks, 8/9(1min/5min) and premature infants from 2000g to 2500g were 33 weeks, 8/9(1min/5min). Average calorie intakes of premature infants below 1499g, premature infants from 1500g to 1999g and premature infants from 2000g to 2500g were 102.0㎉/kg/day, 119.3㎉/kg/day and 101.7㎉/kg/day. The mean values Na, K, Ca, P for all premature infants remained within the normal level for full term infants throughtout the 25days of this study period. Percentages of inital weight loss showned premature infants below 1499g were 5.4%, premature infants from 1500g to 1999g were 6.4%, premature infants from 2000g to 2500g were 11.4%. Percentages of inital weight loss of the amino acid injection group and the amino acid control group were 9.4% and 9.0%.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.37 no.12
• /
• pp.1599-1608
• /
• 2008

This study aimed to assess the health status based on the anthropometric and biochemical measurements of middle-aged and elderly people living in Andong area. The subjects were 1,384 people (532 males, 852 females) aged 50 years and over (average 62.7 years). The mean anthropometric values for males and females were heights of 163.7 and 151.5 cm; weights 63.6 and 57.3 kg; body mass index (BMI) 23.6 and $24.9kg/m^2$; body fat 21.8 and 31.8%, respectively. Height and weight were lower, however, waist circumference (in female) and BMI were higher than those of the 2001 National Health and Nutrition Survey (NHNS). Obesity incidences of male and female subjects were 28.7% and 47.3% by BMI; 25.8% and 50.8% by % body fat; and 15.6% and 80.9% by waist circumference, respectively. Also, abdominal adiposity was very severe in female subjects of 50s. The mean biochemical measurements of male and female were as follows: systolic and diastolic blood pressure 136.9, 83.8 mmHg and 133.6, 82.5 mmHg; hemoglobin (Hb) 14.3 and 13.0 g/dL; hematocrit (Ht) 44.7 and 39.8%; blood albumin 4.15 and 4.04 g/dL; total-cholesterol 170.0 and 183.1 mg/dL; HDL-cholesterol 43.6 and 42.7 mg/dL; fasting blood glucose 96.7 and 93.0 mg/dL, respectively. Also, the prevalence of biochemically abnormal subjects according to each cut-off point of biochemical measurements were analyzed. The results for male and female were; hypertension 58.0% and 47.2%; iron deficient anemia 19.3% and 20.6% by Hb, 7.2% and 11.9% by Ht; hypoalbuminemia 9.8% and 11.7%; diabetes 12.0% and 10.2%; hypercholesterolemia 19.5% and 30.5%, respectively. From those results we found that hypoalbuminemia, hypertension and hypercholesterolemia were prevalent, and obesity in females of 50s, iron-deficient anemia and diabetes in males of 70 years and over were significant health problems in this area. Therefore, it seems to be necessary to examine their health status periodically and provide the appropriate health and nutrition education program, which includes low sodium intake, balanced diet, exercise and weight control, to prevent the occurrence of chronic diseases.

• Journal of Nutrition and Health
• /
• v.31 no.1
• /
• pp.46-61
• /
• 1998

This study was carried out to evaluate the effects of vitamin D nutritional status on bone mineral density of adults (21-49 years). To attain the aim, we measured bone mineral density (BMD) of the subjects at distal radius by single-photon absorptiometry (SPA). Serum level of 25-hydroxyvitamin D(25-(OH)D) , known to be the best indicator of indicator of vitamin D status in humans was analyzed . The factors affecting this vitamin D level were also investigated in autumn in 122 young adults. Serum level of 25-(OH)D was measured by high pressure liquid chromatography(HPLC) and biochemical variables, general health status, time spent outdoors, and dietary intakes of the subjects. BMD of the male subjects was significantly greater than that of female subjects. Weight, activity and total energy expediture (TEE) showed a positive correlation with distal BMD. The mean level of serum 25-(OH)D was 24.4$\pm$11.0 ng./ml and by sex, 26.0$\pm$6.8ng/ml for males and 23.3$\pm$12.3ng/ml for females , the level was significantly higher in male (p<0.01). there was significant correlation between BMD at distal-radius and s-25(OH)D levels (p<0.001). The serum level fo parathyroid hormone (PTH) showed a negative correlation with BMD(p<0.05), with the more obvious correlation in females. Vitamin D intake was estimated to be 3.75$\pm$2.19ug/day in average. Among the nutrients studied, protein ,fat, calcium , and vitamin D intake were positively correlated with distal BMD. When food frequencies were concerned , milk and dairy products showed a significant positive correlation with the BMD level, and driedfoods, eggs , fats and oils, and cereals also showed a positive correlation. Time spent outdoors was estimated to be about 70 minutes in average and positively correlated with the distal BMD level(p<0.01). During the day, the specific time between 12 :00pm and 2:00pm showed the most significant correlation with BMD (p<0.001). Multiple regression analysis with the variables showed that distal BMD could be fit 31.9% by the time spent outdoors a day, intake of Ca and vitamin D, and TEE. The standardized estimates were 0.344 for vitamin D intake, 0.284 for Ca intake 0.179 for the time spent outdoors a day and 0.273 for TEE. For males, s-25*OH)D level, TEE and time spent outdoors during a day showed a significant correlation. For females, intake of Ca and vitamin D could fit about 27.1% of the distal BMD.

• Journal of the Korean Society of Food Science and Nutrition
• /
• v.40 no.5
• /
• pp.689-695
• /
• 2011

Diabetic patients need nutritional education more than those suffering from other diseases because of the necessity of controlling blood glucose levels with dietary treatment. The purpose of this study was to find out the effectiveness of nutrition education on diabetes control and antioxidant status, both of which are related to diabetic complications. Thirty (15 males and 15 females) type 2 diabetes mellitus patients aged $66.7{\pm}8.8$ years participated in a 4-week nutrition education program. Nutrient intakes, blood glucose level, antioxidant status, and DNA damage were evaluated before, immediately after, and three months after the education program. Changes in those parameters over time were analyzed using repeated-measures analysis of covariance. Over time, HbA1c (p=0.000), plasma total cholesterol (p=0.002), plasma thiobarbituric acid related substances (TBARS; p=0.000), and leukocyte DNA damage (p=0.000) significantly decreased; plasma retinol (p=0.001), plasma tocopherol (p=0.000), erythrocyte catalase (CAT; p=0.000), and erythrocyte glutathione peroxidase (GPx; p=0.000) significantly increased. In an evaluation of nutrient intakes by Dietary Reference Intakes for Koreans (KDRI), energy (p=0.009), phosphorus (p=0.033), sodium (p=0.001), potassium (p=0.019), zinc (p=0.043), riboflavin (p=0.050), folic acid (p=0.048) and vitamin C (p=0.008) intakes had significant positive changes. In a correlation analysis of the biochemical and nutritional changes resulting from the education program, plasma TBARS were negatively correlated with potassium (r=-0.418, p<0.05), iron (r=-0.443, p<0.05), riboflavin (r=-0.432, p<0.05), and folic acid (r=-0.446, p<0.05) intakes, while plasma retinol was positively correlated with energy (r=0.543, p<0.01), protein (r=0.543, p<0.01), phosphorus (r=0.425, p<0.05), iron (r=0.485, p<0.05), zinc (r=0.570, p<0.01) and niacin (r=0.510, p<0.05) intakes. Erythrocyte CAT was positively correlated with folic acid intake (r=0.605, p<0.01). From these results, we suggest that an improvement in nutrition resulting from a diabetic education program for type 2 diabetes patients led to improvement in their antioxidant status, also possibly reducing complications resulting from diabetes.

• Journal of Nutrition and Health
• /
• v.47 no.2
• /
• pp.124-133
• /
• 2014

Purpose: The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospitalized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002. Methods: Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGSGA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hematocrit, and changes in body weight and food intake, were statistically selected as variables for SMST. Results: According to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, ${\kappa}$ = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, ${\kappa}$ = 0.505), respectively, indicating that SMST held high inter-methods reliability. Conclusion: In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

• Journal of Nutrition and Health
• /
• v.51 no.3
• /
• pp.242-253
• /
• 2018

Purpose: The purpose of the study was to identify the nutrition knowledge, dietary attitudes of guardians, and nutritional status of infants and toddlers as well as the relationships between these variables. Methods: The participants were selected among applicants for low-income family financing provided by the government and included 115 infants and toddlers as well as their guardians. Demographic data, nutrition knowledge, dietary attitudes, and nutrition intakes were assessed using a self-administered questionnaire, biochemical examination, and 24 Hour-Recall method. Results: The score for guardians' nutrition knowledge was 12.97 points of a possible 15, and the score for dietary attitudes was 53.38 points of a possible 75. The nutrition knowledge and dietary attitudes showed significant differences by education level (p < 0.05) and family structure (p < 0.05). Energy intakes of subjects aged 6 ~ 24 months and over 25 months were lower than the DRI for Koreans. The intakes of carbohydrates, protein, and fat of subjects aged 6 ~ 24 months and over 25 months showed no significant differences by level of nutrition knowledge or dietary attitudes. The intake of Ca of subjects aged over 12 months showed significant differences by level of nutrition knowledge (p < 0.05). The intakes of Thiamin of subjects aged 6 ~ 11 months and P of subjects aged over 12 months showed significant differences by level of dietary attitudes (p < 0.05). There was a small positive correlation between education level and nutrition knowledge as well as between dietary attitudes. Nutrition knowledge showed a positive correlation with dietary attitudes. There was a positive correlation between nutrition knowledge and Ca, Riboflavin, as well as Vit C levels. Conclusion: Therefore, it is necessary to consider an educational program for increasing the practical application of knowledge to nutrition management for improvement of nutrition intake in infants and toddlers.