• Title/Summary/Keyword: clinical nutrition management

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Dietary Habits and Factors Associated with Depression in Yangpyeong-gun Elderly (양평군 노인에서 우울 지수, 영양불량과 식생활 실천 요인)

  • Hee Jung Park;Jae Young Lee;Wookyoun Cho
    • Journal of the Korean Society of Food Culture
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    • v.38 no.6
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    • pp.381-391
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    • 2023
  • This study was conducted to analyze relationships between depression indices, mini nutritional assessment scores, and nutritional quotients among 80 elderly in Yangpyeong-gun and to identify factors that help prevent depression and malnutrition. Nutrition assessment scores were low in the high-risk group (PHQ-9 score ≥10), and nutritional quotient scores were lower in the high-risk group than in the normal group (PHQ-9 score ≤4). Interestingly, the consumption frequencies of fruits, eggs, and nuts were low in the high-risk group, and subjective health awareness, dental condition, and sleep were poorer. The total PHQ-9 score was correlated with malnutrition, body mass index, calf circumference, weight change, independent daily living, reduced meal amount, water intake, and the need for help when eating. Analysis of correlations between items of the PHQ-9 and nutritional status evaluation indices showed that a self-perceived feeling of depression, low energy, difficulty controlling sleep or appetite, negative thoughts (e.g., failure, disappointment), and difficulty concentrating were negatively correlated with total nutritional status scores. These results show that attention is required when food or water intake decreases and that deviation from normal sleep and appetite cycles flags the need to prepare guidelines to prevent depression.

Review on Weight Loss Interventions that Can Prevent Muscle Mass Loss in Sarcopenic Obesity (근감소성 비만에 대하여 근육량을 보존할 수 있는 체중 감량 중재에 대한 고찰)

  • Min-jeong Park;Young-Woo Lim;Eunjoo Kim
    • The Journal of Korean Medicine
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    • v.45 no.1
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    • pp.80-99
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    • 2024
  • Objectives: The objective of this study was to review clinical studies conducted over the last ten years that investigated weight or fat loss interventions that can preserve muscle or fat-free mass in Sarcopenic obesity Methods: PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Research Information Sharing Service (RISS) and Korea Studies Information Service (KISS) were searched for Randomized clinical trials that had investigated all-type of interventions on the management of sarcopenic obesity from October 2013 to September 2023. Results: A total of 14 studies met all the inclusion criteria. Interventions that increase muscle mass while reducing body fat at the same time included resistance training (including using elastic bands) and whole-body electromyostimulation(WB-EMS) in exercise intervention and Hypocaloric high-protein diet in nutritional intervention, exercise and nutritional combined intervention, and combination intervention of electrical acupuncture and amino acid supplementation. Among them, the most positive method of changing the body composition in sarcopenic obesity was the electric acupuncture and amino acid supplements. Conclusion: Varying diagnostic criteria and management interventions for sarcopenic obesity in the included studies made it hard to maintain homogeneity across the studies. Well-defined criteria for diagnostic sarcopenic obesity should be considered. In addition, since all of the interventions examined did not show sufficient clinical effectiveness, follow-up studies are needed to confirm effective interventions for sarcopenic obesity patients in the future.

Factors Affecting Patient Experience with Outpatient Care (외래 환자경험에 영향을 주는 요인)

  • Kim, Kyoung-Hoon
    • Health Policy and Management
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    • v.31 no.2
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    • pp.207-216
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    • 2021
  • Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data. Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience. Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience. Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.

The Effect of Nutrition Education on Weight Control in Male Workers by the Community Health Center (보건소에서 실시한 직장인 비만 영양교육의 효과)

  • Kim, Tae-Yon;Suh, Myung-Ok
    • Journal of the Korean Dietetic Association
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    • v.14 no.4
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    • pp.351-360
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    • 2008
  • The principal objective of this study was to determine the importance of obesity management nutrition programs for obese male workers after performing a 10-week nutrition program and to compare changes in the obesity index, health behavior, meal intake, and blood constituents. The study subjects included 44 individuals, all without chronic disease. After the program, the weight, body mass index (BMI), body fat percentage, and waist-hip ratio (WHR) of the subjects dropped. Dietary life behavior scores increased. In particular, more than 30% increases were detected in self-control of surfeit, control of eating speed, temperance, and regular exercise items. Total caloric intake and average drinking intake dropped. Though insignificant, systolic pressure, total cholesterol, LDL-cholesterol, and sGPT all dropped as compared to the levels measured prior to the program. Fasting blood sucrose, triglyceride, $\gamma$-GTP, and atherogenic index dropped significantly. HDL-cholesterol, though insignificant, increased. As the result of examining correlations between the subjects' health life behavior, caloric intake, and improvement in obesity, we noted a significant correlation between self-control of surfeit and temperance in the health life behavior item, along with significant correlations among total calorie intake, surfeit percentage, and daily average drinking intake. These results demonstrated that nutrition program for obese workers performed at the Community Health Center had the effect of reducing obesity, improving health behavior, and improving clinical levels. Thus, it is advisable that obesity management programs be achieved, linking the center of local societies' health promotion projects, community health centers, and workplaces, and various programs should be developed to maintain and continue changes in workers' behaviors, such that the positive effects of improvement in obesity could be maintained, even after the program.

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How to Improve Eating Behaviour during Early Childhood

  • Green, Robin John;Samy, Gamal;Miqdady, Mohamad Saleh;Salah, Mohamed;Sleiman, Rola;Abdelrahman, Hatim Mohamed Ahmed;Al Haddad, Fatima;Reda, Mona M.;Lewis, Humphrey;Ekanem, Emmanuel E.;Vandenplas, Yvan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.1
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    • pp.1-9
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    • 2015
  • Eating behaviour disorder during early childhood is a common pediatric problem. Many terminologies have been used interchangeably to describe this condition, hindering implementation of therapy and confusing a common problem. The definition suggests an eating behaviour which has consequences for family harmony and growth. The recent Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition does not cover the entire spectrum seen by pediatricians. Publications are substantive but level of evidence is most of the time low. This purpose of this review is to clarify terminology of eating behaviour problems during early childhood; including benign picky eating, limited diets, sensory food aversion, selective eating, food avoidance emotional disorder, pervasive refusal syndrome, tactile defensiveness, functional dysphagia, neophobia and toddler anorexia. This tool is proposed only to ease the clinical management for child care providers. Diagnostic criteria are set and management tools are suggested. The role of dietary counselling and, where necessary, behavioural therapy is clarified. It is hoped that the condition will make its way into mainstream pediatrics to allow these children, and their families, to receive the help they deserve.

The Role of Milk Products in Metabolic Health and Weight Management

  • Zemel, Michael B.
    • Journal of Dairy Science and Biotechnology
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    • v.28 no.1
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    • pp.17-28
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    • 2010
  • A substantial body of evidence has emerged over the last decade in support of the novel concept that dietary calcium and dairy foods play an important role in regulating energy metabolism and thereby promote healthy weight management and reduce obesity risk. This concept has been demonstrated in experimental animals studies, cross-sectional and prospective population studies and a number of randomized clinical trials. Notably, the effects of dairy foods in weight management are more consistent than the effects of supplemental calcium across clinical trials, and calcium per se is responsible for approximately 40-50% of the effects of dairy. The calcium component is only effective in individuals with chronically low calcium intake, as it serves to prevent the endocrine response to low calcium diets which otherwise favors adipocyte energy storage; calcium also serves to promote energy loss via formation of calcium soaps in the gastrointestinal tract and thereby reduce fat absorption. The calcium-independent anti-obesity bioactivity of dairy resides primarily in whey. The key components identified to date are leucine and bioactive peptides resulting from whey protein digestion. The high concentration of leucine in whey stimulates a repartitioning of dietary energy from adipose tissue to skeletal muscle where it provides the energy required for leucine-stimulated protein synthesis, resulting in increased loss of adipose tissue and preservation of skeletal muscle mass during weight loss. Finally, dairy rich diets suppress the oxidative and inflammatory responses to obesity and thereby attenuate the diabetes and cardiovascular disease risk associated with obesity.

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Development and validation of a nutrition literacy assessment tool for young adults (젊은 성인의 영양정보이해력 평가도구 개발 및 타당성 검증)

  • Ahn, Seokyoung;Kim, Bogyeong;Um, Mihyang;Park, Yookyung;Kye, Seunghee
    • Journal of Nutrition and Health
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    • v.53 no.2
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    • pp.175-189
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    • 2020
  • Purpose: This study was conducted to develop, validate, and assess the reliability of a questionnaire for nutritional literacy among young Korean adults. Methods: The draft questionnaire contained 65 items in 7 domains (i.e., dietary guideline, nutrition and health, nutrients, 5 food groups [food bicycle], nutrition labeling, portion size, and nutrition management for disease prevention). The authors developed a draft questionnaire based on a literature review. After multiple drafts, 52 items were retained and 13 were eliminated in the 7 domains according to professional advice from 5 nutrition experts. A panel of experts (n = 20) comprised of clinical dietitians and nutrition professors completed the content validity assessment, including quantitative and qualitative feedback. As the results, all items of the portion size were eliminated from the questionnaire. A sample of 211 young adults completed the test-retest reliability assessment. Test-retest reliability was evaluated using intra-class correlation coefficient (ICC) and inter-item reliability by Cronbach α coefficient. Results: The final questionnaire contained 30 items with 5 questions each on the dietary guideline, nutrition and health, nutrients, 5 food groups (food bicycle), nutrition labeling, and nutrition management for disease prevention. The Lawshe content validity ratio for domains ranged from 0.60 to 1.00. The ICC scores for questions ranged from 0.64 to 0.86. Cronbach's α for domains ranged from 0.83 to 0.90 and for the overall questionnaire was 0.87. Conclusion: The questionnaire showed strong content validity, test-retest reliability, and high inter-item reliability, indicating that it is a useful tool for assessing nutritional literacy of young adults.

Validation of soy isoflavone intake and its health effects: a review of the development of exposure biomarkers

  • Jang, Hwan-Hee;Lee, Young-Min;Choe, Jeong-Sook;Kwon, Oran
    • Nutrition Research and Practice
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    • v.15 no.1
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    • pp.1-11
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    • 2021
  • BACKGROUND/OBJECTIVES: It is difficult to consistently demonstrate the health effects of soy isoflavones owing to the multitude of factors contributing to their bioavailability. To accurately verify these health effects, dietary isoflavone intake should be measured using a biologically active dose rather than an intake dose. This concept has been expanded to the development of new exposure biomarkers in nutrition research. This review aims to provide an overview of the development of exposure biomarkers and suggest a novel research strategy for identifying the health effects of soy isoflavone intake. MATERIALS/METHODS: We cover recent studies on the health effects of soy isoflavones focusing on isoflavone metabolites as exposure biomarkers. RESULTS: Compared to non-fermented soy foods, fermented soy foods cause an increased concentration of isoflavones in the biofluid immediately following ingestion. The correlation between exposure biomarkers in blood and urine and the food frequency questionnaire was slightly lower than that of corresponding 24-h dietary recalls. Urinary and blood isoflavone levels did not show a consistent association with chronic disease and cancer risk. CONCLUSION: It is crucial to understand the variable bioavailabilities of soy isoflavones, which may affect evaluations of soy isoflavone intake in health and disease. Further studies on the development of valid exposure biomarkers are needed to thoroughly investigate the health effects of isoflavone.

Clostridioides difficile Infection in a Japanese Tertiary Children's Hospital

  • Meguro, Mariko;Nambu, Ryusuke;Hara, Tomoko;Ebana, Ryo;Yoshida, Masashi;Yamamoto, Saki;Mori, Koki;Iwama, Itaru
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.5
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    • pp.387-395
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    • 2022
  • Purpose: Toxins produced by Clostridioides difficile infection (CDI) can cause enteritis and diarrhea. Although the number of pediatric CDI cases is increasing, the clinical management of pediatric CDI, including patient characteristics and prognosis, remains unclear. This study aimed to elucidate the background and clinical course of patients with CDI and evaluate the reliability of diagnostic tests in a tertiary pediatric hospital in Japan. Methods: We retrospectively analyzed the clinical data of children diagnosed with CDI between 2011 and 2021 at the Saitama Children's Medical Center in Saitama, Japan. Results: During the study period, 1,252 C. difficile antigen/toxin tests were performed, and 37 patients were diagnosed with CDI. The main underlying diseases among the patients were hematological and malignant disorders and gastrointestinal diseases, including inflammatory bowel disease (IBD) (59.4%). Two patients (5.4%) had an unremarkable medical history. Among the 37 patients, 27 (73.0%) were immunocompromised, 25 (67.6%) had a history of antibiotic use within the past two months, and 6 (16.2%) were negative on the initial test but were positive on the second test. Finally, 28 patients (75.7%) required primary antibiotic therapy only, and two patients with IBD required additional antibiotic therapy as secondary treatment. Conclusion: The number of pediatric patients with CDI is increasing. Both a comprehensive interview, including underlying diseases and history of antibiotic use, and an understanding of the features of clinical examinations should be emphasized to appropriately diagnose and treat CDI.

Research for Developing Medical Nutrition Therapy on Korean Medicine : Literature Study and a Survey (한의학적 임상영양치료법 개발을 위한 연구)

  • Han, Eun Kyung;Hwang, Sang Moon;Seo, Soo Youn;Jung, Yun Im;Bae, Go Eun;Kim, Byung Joo;Lee, Sang Jae;Chae, Han;Kwon, Young Kyu
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.4
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    • pp.350-361
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    • 2013
  • aksun(藥饍), or 'Traditional oriental medicine nutrition therapy', is expected to be an effective nutritional intervention for the patients suffering from chronic diseases. However, there are no systemized protocol that utilize Yaksun as an effective nutrition therapy for Asian patients even though they are accustomed to traditional oriental diet. We investigated the possibility of using Yaksun for developing an effective Medical Nutrition Therapy for Asian patients and proposed factors that have to be considered. Articles published between 1995-2012 about MNT (Medical Nutrition Therapy) and Yaksun were reviewed. Male and female patients of two Korean Medicine Hospitals (n=93) and one Korean Medicine Clinic (n=20) answered a questionnaire asking about their thoughts on the effectiveness of nutritional intervention for their disease management and about their expectations toward Medical Nutrition Therapy on Korean Medicine. 92.9% of the patients have perceived that nutritional intervention is important in disease management. 79.6% of the patients have positively responded that they are willing to use the Medical Nutrition Therapy on Korean Medicine as a clinical nutrition therapy if developed. Female patients, aged in their forties and fifties, educated equivalent to high school graduates and more, and who visited Korean medicine clinic were most interested in the Medical Nutritional Therapy on Korean Medicine. The factors considered in developing the protocol are 1. effectiveness 2. safety 3. expense, in order of importance. Nutritional intervention protocol using Yacksun is necessary for the patients. Medical Nutrition Therapy on Korean Medicine is in need of development. Accumulated case-control studies, cost effectiveness studies, and studies about programming and systemizing the protocol are needed.