This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.
Recent research reported health risks associate with high carbohydrates diets. Objectives of this study were to evaluate in a cross-sectional study if high carbohydrate diet is associated with coronary heart disease(CHD) risk factors: examined blood concnetration of triglyceride(TG), total cholesterol, high density lipoprotein cholesterol(HDL-C), plasma glucose, systolic blood pressure(BP), body mas index(BMI), wasit-hip ratio(WHR) and waist-stature ratio(WSR). Using the most recent US National Health and Nutrition Examination Survey(IIINHANES III) data, the nationally representative US population (3772 men, 4095 women of 25-64 years of age) was divided into low vs. high carbohydrate diet groups(below 40% vs. above 60% energy intake from cab carbohydrates) and compared by the CHD risk factors. Triglyceride was higher(p<0.001) in the high carbohydrate group, whereas high density-lipoprotein cholesterol(HDL-C)was lower(p<0.01) in the high carbohydrate diet group. In plasma glucose, there was no significant differences between high carbohydrate diet and low carbohydrate diet. In adiposity(BMI, WHR and WSR), it also showed no significant differences, After adjustment for age, ethnicity, alcohol and smoking in upper 60%-carbohydrate diet, Odds Ratio of TG and HDL-C were 1.42 and 1.23 in men and 1.22 and 1.17 in women. 50-60% carbohydrate diet was associated with decreased risk of CHD. Dietary guidelines for Koreans recommend 60-70% of total energy from carbohydrate, as Koreans traditionally consumed high carbohydrate diets. In a cross-sectional population of adults, diets containing 55-60% energy from carbohydrate were suggested as a dietary guideline of carbohydrate intake for Koreans. (Korean J Nutrition 33(8) : 873-881, 2000)
The known risk factors for atherosclerosis include plasma low density lipoproteins (LDL)or Cholesterol, low PUFA in the diet, hypertension, and high Na intake, obesity, diabetes, lack of exercise, cigarette smoking, sugar, low fiber and nicotinic acid in the diet, sources of Protein foods, and Psychological factors. Among various dietary factors, fat is known as the most serious causative agent for atherosclerosis. The genetic factor is a18o known as an important one but is out of scope in this paper. Since atherosclerosis is a progressive disease which may develop for many years before showing any definitive symptoms, it is very important to develop preventive programs especially in the country like Korea that is not quite overdevelopted as some western countries. In this paper all the factors mentioned above were reviewed and the dietary suggestion were made on the basis of the content of polyunsaturated and saturated fat in the diet to prevent or/and to cure this disease. Most of the available data on diet therapy with emphasis. on P/S ratio were tabulated together. after tile patient's habitual dietary intake is analized the guidelines of personalized fat-controlled diet can be recommended. It is of utmost importance to develop Korean diets for beth prevention and cure of atherosclerosis emphasizing individual eating habit in the near future which can be more Practicaly used both at home and in the hospital.
To evaluate iron nutritional status of female college students, fasting blood samples were taken from 76 female students of Kangnung National University. Hemoglobin(Hb), hematocrit(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin concentrations were measured and transferrin saturation was calculated. Mean values for Hb, Hct, Fe, TIBC, TS and serum freeitin were 13.64$\pm$1.42g/dl, 40.99$\pm$4.31%, 103.0$\pm$33.3$\mu\textrm{g}$/이, 395.3$\pm$9.07$\mu\textrm{g}$/dl, 26.58$\pm$9.07$\%$and 26.76$\pm$17.5ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 6.8% when judged by Hct to 26.0$\%$ by serum ferritin concentration. The Hb concentration was positively correlated with hematocrit (r=0.5402), serum iron(r=0.2819) and transferrin saturation(r=0.2777)(p<0.05). on the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.3196). Two-day dietary intake records were collected from subjects to estimate mean daily iron intake and bioavailability of dietary iron. Mean daily intake of iron was 13.15mg and heme iron intake was 0.83mg which was 6.4% of total iron intake. Total absorbable iron calculated by the method of Monsen was 1.27mg and bioavailability of dietary iron was 9.6%. In the light of high prevalence of iron deficiency based of serum ferritin concentration and low bioavailability of iron in the diet, guidelines about diet should be made to increase the content and bioavailability of iron in the diet if female college students.
This study was conducted to investigate the anthropometric data, serum profiles, nutrient intakes and diet quality of men in their 30s. The subjects were divided into a married group and an unmarried group. For the study, we obtained data for analysis from the combined 2008~2015 Korean National Health and Nutrition Examination Survey (KNHANES). Mean height and weight of study population were 173.5 cm, and 74.0 kg in the married group and 173.1 cm, and 73.6 kg in the unmarried group, respectively. Systolic blood pressure in the unmarried group was significantly higher than that of the married group (P<0.001), while circulating vitamin D levels in the married group were significantly higher than those of the unmarried group (P<0.001). The proportion of obesity in the two groups was 42.41% and 38.40%, respectively. In the unmarried group, prevalence of depression was significantly higher than that those of the married group. Intakes of energy, water, protein, fat, carbohydrate and calcium in the married group were significantly higher than those of the unmarried group. In both groups, water and fiber intakes were low and sodium intakes were extremely high based on the KDRIs (Dietary Reference Intakes for Koreans). The mean adequacy ratio (MAR) of the married group was higher than that of the unmarried group. The index of nutritional quality (INQ) in the married group was also higher than that of the unmarried group. Therefore, we propose development of dietary guidelines and education programs for improvement of food and nutrient intakes, nutrition balance and dietary quality of unmarried men in their 30s.
The purpose of this study were to assess iron status and obesity in 82 middle aged women living in Kangnung area. Anthropometric measurements were taken for body weight, height, percentage of body fat and circumferences of waist and hip. Venous blood samples were drawn from subjects for measurement of hemoglobin(Hb), hematocrit(Hct), serum iron(Fe), total iron binding capacity(TIBC), transferrin saturation(TS) and serum ferritin. Dietary intakes of iron(heme iron and nonheme iron), the amounts of MPF(meat, poultry and fish) and ascorbic acid were assessed by modified 24-hr recall method. The results obtained are summarized as follows : Postmenopausal women had more body fat than premenopausal women. That is, postmenopausal women tend to be obeser than premenopausal women. There was no difference in Hb, Hct, Fe, TIBC and TS between pre- and postmenopausal women. But the serum ferritin concentration of postmenopausal women(83.7$\pm$42.1ng/ml) was significantly (p<0.05) higher than premenopausal women(56.4$\pm$41.0ng/ml). Prevalences of iron deficiency (20%, 20.0% and 17.1% respectively) of postmenopausal women. The mean daily intakes of total iron in pre- and postmenopausal women were 17.5$\pm$9.3mg and 15.6$\pm$6.9mg, respectively. Bioavailabilities of dietary iron were 6.5% and 4.5% in pre- and post-groups. These results indicate that individual dietary guidelines should be used to educate middle-aged women different in status of menopause. For example, premenopausal women should increase nutritional iron status and postmenopausal women should try to prevent obesity.
This study was conducted to provide guideline data for future instructional materials and practice guidelines on reforming the dietary life of military personnel in terms of lowering sodium intake. A total of 264 persons were surveyed to obtain basic data on sodium intake and understanding of sodium. The study also examined the practice that is carried forward in this endeavor. The subjects liked 'kimchi' and 'rice with topping', and these could be the reason for higher salt intake. Career soldiers scored higher in terms of nutrition knowledge than enlisted soldiers (p<0.01). Nutrition education concerning sodium intake was statistically insignificant between the two, whereas career soldiers showed a higher experience rate at these nutrition educational events. Career soldiers also had with higher sodium intake than enlisted soldiers, and this difference was statistically significant (p<0.01). In terms of practice, officers were more likely to experience difficulty in putting the theory of less sodium into practice than their enlisted soldiers counterparts (p<0.05), and the main reason behind this difficulty was that they did not feel the need to lower their sodium intake. Soldiers should be well educated about sodium and healthy diet during their service. Education should focus on lowering sodium intake and changing their attitudes and awareness of this issue in order to elicit behavioral changes.
Purpose: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). Methods: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. Results: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. Conclusion: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.
Seoyeon Park;Yeonhee Shin;Seoyeon Lee;Heejung Park
대한지역사회영양학회지
/
제28권4호
/
pp.269-281
/
2023
Objectives: This study aimed to examine the frequency of convenience food consumption at convenience stores (CVS) and the CVS usage patterns of middle and high school students as well as to understand students' attitude toward sodium and sugar reduction. Methods: We used an online questionnaire for data collection. The questionnaire comprised five distinct categories: general characteristics, CVS usage, frequency of consumption according to convenience food menus at CVS, attitude toward sodium and sugar reduction, and adherence to dietary guidelines. Results: A total of 75 students from Seoul (14 middle school students and 61 high school students) participated in the study. Most respondents visit CVS 3-5 times a week. CVS are predominantly used during weekdays, mostly during lunch, and dinner. The students mostly checked the caloric content and expiration date as food labeling information. The participants were aware of the need to reduce their sugar and sodium intake. Among frequent CVS convenience food consumers, there was an increased consideration of the need to reduce their sugar and sodium consumption, despite their actual selection of foods with high sugar and sodium content. Additionally, they did not check the sugar and sodium levels indicated in food labeling. Further, the dietary action guide from the Ministry of Health and Welfare were poorly followed by most students. Conclusions: There is a need for nutrition education specifically addressing the sugar and sodium content of the convenience foods predominantly consumed by students. Additionally, educating students with frequent convenience food consumption to actively check the sugar and sodium information on food labels could help promote healthier food choices.
BACKGROUND/OBJECTIVES: In the United States, one in every 5 children is obese with greater likelihood in low-income households. The coronavirus disease 2019 (COVID-19) pandemic may have accelerated disparities in child obesity risk factors, such as poor dietary intake and increased sedentary behaviors, among low-income families because of financial difficulties, social isolation and other struggles. This study reveals insights into nutrition and health challenges among low-income families of young children in West Texas to better understand needs and develop interventions. SUBJECTS/METHODS: In-depth individual interviews were performed via Zoom among 11 families of children under the age of 3. A semi-structured interview guide was developed to explore 3 areas: changes in (1) dietary intake and (2) sedentary behaviors and (3) families' preferences regarding a parent nutrition education program. Each interview was audiorecorded, transcribed, and coded using MaxQDA software. RESULTS: Eating together as a family become challenging because of irregular work schedules during the COVID-19 pandemic. Most parents stated that their children's dietary habits shifted with an increased consumption of processed foods. Many parents are unable to afford healthful foods and have utilized food and nutrition assistance programs to help feed their families. All families reported that their children's screen time substantially increased compared to the pre-pandemic times. Moreover, the majority of parents did not associate child screen time with an obesity risk, so this area could be of particular interest for future interventions. Meal preparation ideas, remote modality, and early timing were identified as key intervention strategies. CONCLUSIONS: Online nutrition interventions that emphasize the guidelines for child screen time and regular meal routines will be effective and promising tools to reach low-income parents for early childhood health promotion and obesity prevention.
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