• Journal of Nutrition and Health
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• v.18 no.4
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• pp.318-327
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• 1985

This study was designed to investigate the effect of early protein undernutrition of rats on later susceptibility to lead poisoning. Weanling rats, weighing about 55 grams, were malnourished by feeding low protein diets ( 12% and 5% casein diet ) during the four weeks of protein deprivation period. For the following 5 weeks, the malnourished rats were fed with 25% casein diet as rehabilitation diet. After the rehabilitation period, all rats were fed with 25% casein diet and the drinking water containing 2000ppm-Pb during the four weeks. The results obtained were as follows ; 1 ) Feed intake, body weight gain and food efficiency ratio were reduced in all rats exposed to lead, especially in rats fed with 5% casein diet during the four weeks of weanling period. 2 ) Enlargement of kidney and spleen were observed in all rats exposed to lead and were more remarkable in rats fed with 5% casein diet. 3 ) In rats exposed to lead, activity of serum glutamic oxaloacetic transaminase ( S- GOT ) was significantly increased by increasing the degree of early protein deprivation, whereas hematocrit value was significantly decreased. Activity of serum glutamic pyruvic transaminase ( S- GPT ) was shown a tendency to increase by increasing the degree of early protein deprivation, but the difference was not significant. 4) In rats exposed to lead, the amount of lead accumulation in kidney was increased by increasing the degree of early protein deprivation. The significant increase was shown in rats fed with 5% casein diet during the four weeks of weanling period. The results of the experiment suggest that early protein undernutrition, even after some period of rehabilitation, may enhance the later susceptibility to lead poisoning.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• 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.

• Journal of Nutrition and Health
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• v.35 no.5
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• pp.512-523
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• 2002

The objective of this study was to investigate the nutritional status, biochemical parameters, lipid and electrolytes concentrations of the enteral nutrition patients according to the duration of enteral nutrition. Eighteen neurosurgery patients in the intensive care unit (ICU) at K University Hospital were subjected in this study. The duration of enteral nutrition was classified into under or over six month of period. Anthropometric, biochemical, clinical, and dietary assessments were performed. Patients' intakes of energy and protein were insufficient, from 82% to 95% of their requirements. Mid-arm muscle circumference (MAMC) and mid-am muscle area (MAMA) were significantly lower in patients over six months of enteral nutrition than those in patients under six months. The subjects were malnourished as indicated by nutrition-related parameters such as hemoglobin, albumin, total lymphocyte count (TLC), tricep skinfold thickness (TSF), mid-arm circumference (MAC), MAMC, and MAMA. Serum chloride level of the patients eve, six months of enteral nutrition was lower (94.7 $\pm$ 3.4 mmo1/1) significantly as compared to that of patients (99.3 $\pm$ 3.5 mmol/ 1) under six months. Urinary sodium and chloride levels were lower in the longer time of enteral nutrition patients than those of shorter period of enteral nutrition patients (p < .05). While serum phospholipid level was higher in the patients over six months of enteral nutrition, other blood biochemical parameters and electrolyte concentrations did not show any differences with the duration of enteral nutrition. Neurosurgery patients in the ICU undergoing long-term enteral nutrition tube-feeding were malnourished and had a variety of metabolic complications. The duration of enteral nutrition could affect the patients' nutritional status, biochemical parameters, and electrolytes balance. The patients who require nutritional support over an extended time need the continuous follow-up care and monitoring by the nutrition support team for laboratory, clinical, and nutritional assessments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.2
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• pp.171-180
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• 2019

Purpose: Malnutrition may influence neurocognitive development in children by directly affecting the brain structural development, or indirectly by affecting the children's cognition experience. Malnutrition alters the cell numbers, cell migration, synaptogenesis, and neurotransmission due to inadequate availability of necessary micronutrients to support cell growth. We aimed to analyze neurocognitive development in infants with malnutrition and its association with long chain polyunsaturated fatty acids (LC-PUFA), micronutrients levels and magnetic resonance spectroscopy (MRS) findings. Methods: The study included two groups; group 1, infants with malnutrition (n=24), group 2; healthy infants (n=21). Peripheral blood was obtained from the participants for studying micronutrients and LC-PUFA levels. The neurocognitive development was analyzed by the use of an Ankara Developmental Screening Inventory test. MRS were performed on all infants. Results: All parameters of neurocognitive development and serum calcium ($9.6{\pm}0.9mg/dL$ vs. $10.4{\pm}0.3mg/dL$, p<0.05) and magnesium ($2.02{\pm}0.27mg/dL$ vs. $2.2{\pm}0.14mg/dL$, p<0.05) levels were noted as being low in infants with marked malnutrition. No difference was found in LC-PUFA levels between healthy and malnourished infants. Thalamic choline/creatine levels were significantly high in infants with malnutrition ($1.33{\pm}0.22$ vs. $1.18{\pm}0.22$, p<0.05). Total neurocognitive development in infants was positively correlated with serum calcium levels (p<0.05, r=0.381). Conclusion: Calcium supplementation may improve neurocognitive development in malnourished infants.

• Nutrition Research and Practice
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• v.13 no.3
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• pp.247-255
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• 2019

BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

• Journal of Nutrition and Health
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• v.43 no.1
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• pp.26-33
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• 2010

This study was performed to investigate the changes of oral diet intake during the admission period and identify the factors related with nutritional status in discharging of leukemia patients. This is a retrospective cross sectional study on 46 leukemia patients receiving chemotherapy at the Catholic University of Korea Seoul St. Mary's Hospital from July to September 2009. The patients' charts were surveyed on the general characteristics and factors relating chemotherapy. The calorie count method was used to investigate diet intake during admission period. Multivariate logistic regression analysis was used to identify possible confounding factors. A p < 0.05 was considered statistically significant. The mean age was $42.8\;{\pm}\;14.6$ years and the average length of stay was $30.4\;{\pm}\;7.0$ days. The incidence of malnourished patients was 60.9% in discharging. There was a significant difference in chemotherapy sessions and chemotherapy period between well-nourished and malnourished patients. The average energy intake was 1,525.9 kcal in well-nourished patients and 1,143 kcal in malnourished patients, which was significant different. From repeated measures ANOVA test, the changes of oral intake during admission period were significant by groups. In addition, there were significant differences in oral intake according to each period between well-nourished and malnourished patients. In multivariate logistic regression analysis, both the ratio of total oral energy intake to recommended energy intake and chemotherapy sessions were significantly associated with nutritional status in discharging. The results of this study could be used to establish a protocol of nutritional management for leukemia patients receiving chemotherapy.

• Journal of Nutrition and Health
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• v.50 no.6
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• pp.595-602
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• 2017

Purpose: Malnutrition is a major concern in patients with gynecologic cancer receiving chemotherapy. The aim of this study was to evaluate the prognostic significance of malnutrition in patients with gynecologic cancer undergoing chemotherapy. Methods: A prospective, observational study was conducted on a total of 99 subjects who were treated at a tertiary hospital in Korea. Data regarding demographic, clinical, nutritional, and psychological characteristics at baseline and survival were obtained. Results: Performance status, nutritional status, depression, and annual income were significantly different between survivors and non-survivors. Multivariate Cox modeling after adjusting for other factors showed that a malnourished status in patients with gynecologic cancer undergoing chemotherapy was a significant and independent negative influencing factor for survival. Conclusion: These findings provide evidence that adequate nutritional assessment and intervention may assist in improving survival in patients with gynecologic cancer undergoing chemotherapy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.93-97
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• 2009

Worldwide, diarrhea remains one of the most common illnesses among children. Oral rehydration therapy (ORT) is the cornerstone of diarrhea treatment. Yet, the rates at which ORT is used are still disappointingly low. Additional treatment interventions include antimotility drugs, antisecretary drugs, adsorbents, probiotics, antibiotics, oral immunoglobulin, micronutrient supplementation. Drugs are generally not necessary. However, selected probiotics may reduce the duration and intensity of diarrhea. Zinc is beneficial especially to malnourished children with diarrhea. Antibiotic treatment is effective mainly in shigella and cholera infection. Other drugs may be effective but require further investigations.

• Journal of the Korean Home Economics Association
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• v.20 no.1
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• pp.57-64
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• 1982

This study was designed to observe the effect of two levels of dietary protein intake on the development and growth of rats from fetus to adult. The pregnant rats were fed either 20% casein diet or 7% casein diet. After weaning or two weeks postweaning, some of the pups from malnourished mothers were rehabilitated by feeding 20% casein diet. The results were. 1. On the 14th day of gestation, no differences were found in weight and total body fat or protein between fetuses from dams fed 7% casein diet and those from those from 20% casein diet. 2. The birth weight of the pups from 7% casein diet group were significantly lower than those from 20% casein diet group. 3. After rehabilitation, the total body fat and protein of low protein group were not different from those of control group when they were compared at the same body weights regardless the age of rats or the duration on the low protein diet. 4. The nitrogen retention of low protein group, after rehabilitation, was higher than that of control group when they were compared at the same body weight.