Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients , few valid screening instruments fur Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than $18.5kg/m^2$, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.
This nutritional survey was conducted from February 8 to March 10, 1994, in order to investigate the nutritional knowledge, food habits, nutritional attitude, food preferences and nutrient intakes of urban middle-aged women living in Daegu and Pohang district. The subjects of this survey were 164 urban middle-aged women living in Daegu and Pohang Area. The completely answered questionnaires were analyzed for nutritional knowledge, food habits, nutritional attitude, food preference and nutrient intakes of urban middle-aged women. The results obtained are summarized as follows: The subjects had a high level of perceived knowledge (82.9%), that is the knowledge that each subject believed she had, but the accuracy of the knowledge was only 66.1%. The average nutrition knowledge score was 8.26 out of possible 15 points, and food habit score was 5.50 out of 10 points. Most of the subjects belonged to 'Fair' or 'Good' food habit group, which is considered to be relatively good. With increasing age, the percentage of perceived knowledge, accuracy, and nutrition knowledge score were getting lower. But food habit score and nutritional attitude score were getting higher at 40's women than 30's women. The correlation between nutritional knowledge score and food habit score was low (r=0.0748). The correlation between nutritional attitude score and food habit score was low, too (r=-0.0653). Food preferences for kimchi, potato, cooked rice, beef, noodle, cabbage and milk were high. Average calorie and protein intake of the subjects were $1967.4{\pm}27.8\;Kcal$, $75.8{\pm}1.4\;g$ respectively. Carbohydrate, protein and fat ratio on energy composition was 63.3%:15.5%:21.2%.
In recent years, the number and proportion of Korean elderly have grown rapidly, and elderly individuals show a disproportionate risk for poor nutritional status. The purpose of this study was to examine the relationship of sociodemographic background to nutrient intake of persons 65 years of age or older, living in 15 cities in Korea. Data on 1973 subjects (603 males, 1370 females), who participated in the Korean Elderly Nutrition Survey (2000), were analyzed. Their mean age was 72.3 years and their mean body mass index (BMI) was 24.2 kg/$m^2$. Basic sociodemographic data were obtained through personal interviews. The 98-item semi-food frequency questionnaire, developed and previously validated for Korean middle-aged and elderly subjects, was administered. “Percentage of subjects who consumed under 75% Korean RDA,” “number of nutrients consumed below 75% Korean RDA,” “mean nutrient adequacy ratio,” and “nutrient density” were used to determine nutritional status. Male elderly had better nutritional quality than female elderly. Nutritional quality decreased with age, especially in older elderly (over 75). Elderly who were underweight (BMI 〈 20 kg/$m^2$) showed poorer nutritional quality than those who were normal weight (BMI 20∼25 kg/$m^2$) and overweight (BMI $\geq$ 25 kg/$m^2$). Elderly who lived alone had significantly poorer nutritional quality than those who lived with a spouse, and/or with children. Lower education level and economic dependence also showed lower nutritional quality. A stepwise multiple regression analysis was performed to examine the effects of specific sociodemographic factors on nutritional quality. For number of nutrients under 75% RDA as a dependent variable, education level explained 4.8% of the variance, followed by living status, age, body mass index, gender, and living expense support (Model $R^2$ = 0.091). For mean nutrient adequacy ratio as a dependent variable, model $R^2$ was 0.098. Therefore, sociodemographic variables such as gender, age, body mass index, living status, educational level, and economic status influenced elderly nutrition status. These results indicate that an elderly nutrition intervention should focus on subjects who are poorly educated, living alone, age 75 or older, and/or underweight.
Objectives: This study examined the characteristics and nutritional risk of the elderly who receive home delivery services. We then analyzed the effects of the characteristics of the elderly who receive the home-delivery meal service on their nutritional risk. Methods: A total of 220 respondents who receive home-delivery meal service in Seoul participated in the survey. The survey consisted of the characteristics of the elderly (health status, tooth condition, physical activity, social participation activity, depression and relationship with neighbors), nutritional risk assessment and other general matters. The data was analyzed by using the SPSS program. Cross-tabulation analysis, t-test, correlation analysis and regression analysis were all conducted. Results: 47.0% of the subjects were under 80 years old and 53.0% were over 80 years old, The nutritional risk score, as evaluated by a Nutrition Screening Initiative (NSI) checklist was 10.7 points, and the high nutrition risk group was 91.5% of the subjects. The subjective self-health status score was 2.24 points (out of a total of 5 points) and the tooth status score was 3.30 points. The physical activity level was 2.17 points for the under 80 years old group and 1.76 points for the over 80 years old, and there was a significant difference according to age (p<0.01), The higher the health status, tooth condition, physical activity and social participation activity level, the lower was the nutritional risk. Further, the higher the degree of depression, the higher was the nutritional risk. Conclusions: For the healthy life of the elderly in the community, various welfare policies should be planned to increase social participation as well as to promote physical health and reduce depression.
Lee, Seon Hye;Lee, Haejung;Hyun, Sookyung;Lee, Mi Soon;Kim, Do Hyung;Kim, Yeong Dae
Journal of Korean Biological Nursing Science
/
v.23
no.1
/
pp.11-21
/
2021
Purpose: The aim of this study was to examine the nutritional intake status of the lung cancer patients who underwent pulmonary resection and to analyze the relationship between the status of the nutritional intake and the occurrence of postoperative pulmonary complications. Methods: This study was a secondary analysis to determine whether the changes in the nutritional intake after surgery were related to pulmonary complications. Data of a total of 89 patients were included in the analysis and the nutritional intake status was confirmed using a 24-hour dietary recall method. The data were analyzed by descriptive statistics, chi-square or Fisher's exact test, and ANOVA using the SPSS WIN 26.0 program and word clouds were generated using the R software program. Results: Overall, a decrease in the postoperative nutritional intake was observed in the patients who underwent pulmonary resection, except for the intake of fat. The pulmonary complications were identified to be associated with BMI and the presence of comorbidity. Twenty-three out of 74 patients with vitamin E levels below the Estimated Average Requirements developed pulmonary complications after surgery. Conclusion: Lung cancer patients who underwent pulmonary resection generally have difficulty in acquiring appropriate nutritional intake and need balanced nutritional management. Future investigations on the impact of increased vitamin E intake on postoperative pulmonary complications may provide better insight into the relationship between vitamin E intake and pulmonary complication among patients who underwent pulmonary resection.
Objectives: This study evaluated nutritional quality of convenience store meal boxes according to store company and meal price. Methods: In May 2020, 71 meal boxes from five major convenience store companies were collected. Respective weights of all dishes and food ingredients included in each meal box were measured with a digital scale. Information on nutritional contents was collected from nutrition fact panels on packages. Food group patterns, dietary diversity scores (DDS), and dietary variety scores (DVS) were analyzed. Nutritional contents, i.e., amounts of energy, protein, and sodium, and percentages of energy from carbohydrate, sugar, fat, and saturated fat were compared with respective standards based on the 2020 Dietary Reference Intakes for Koreans. Comparison was made among five companies (Company A, B, C, D, E) and three price groups (≦ 4,200 won, ≧ 4,300 and ≦ 4,500 won, ≧ 4,600 won). Multiple regression analyses were conducted to examine the difference of nutritional contents according to company and price, respectively while holding the other variable constant. Results: DDS, but not DVS, significantly differed among companies. The percentages of meal boxes meeting the nutritional standards of sodium significantly differed among companies; the percentage was highest in companies B (75.0%) and C (73.3%). "Company" was associated with amount of energy, protein, and sodium, and percentage of energy from saturated fat. "Price" was associated with the amount of energy and percentage of energy from carbohydrate. The average number of satisfied standards was highest in companies B (5.0) and C (4.0). About two-thirds of the meal boxes provided less amount of energy than the standard; the percentage of such meal boxes was highest in meal boxes with price of 4,200 won or lower. Conclusions: There were significant differences in the nutritional quality of meal boxes according to "company". Meanwhile, higher-priced meal boxes did not necessarily ensure better nutritional quality.
Purpose: Nutritional problems after gastrectomy affect continuation of postoperative chemotherapy. There have been no studies limited to total gastrectomy, which is particularly prone to nutritional problems. In this study, we aimed to investigate the factors that predict the continuation of postoperative chemotherapy. Materials and Methods: We included 101 patients who underwent curative total gastrectomy and postoperative chemotherapy at Hiroshima Memorial Hospital. The effects of 37 factors, including perioperative inflammatory, nutritional, and tumor status, on the persistence of postoperative chemotherapy were analyzed. Results: In univariate analysis of preoperative factors, age, carbohydrate antigen 19-9, platelet-to-neutrophil ratio, Onodera's prognostic nutritional index (PNI), controlling nutritional status score, and nutritional risk screening (NRS-2002) score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of preoperative factors, age (≥74 years) was an independent factor for a shorter duration of postoperative chemotherapy (hazard ratio [HR], 5.24; 95% confidence interval [CI], 2.19-12.96; P<0.01). In univariate analysis of factors before postoperative chemotherapy, intraoperative blood loss, perioperative weight loss rate, postoperative performance status, PNI, albumin-to-bilirubin index, and NRS-2002 score were significantly associated with the duration of postoperative chemotherapy. In multivariate analysis of factors before postoperative therapy, age (≥74 years) (HR, 5.75; 95% CI, 1.90-19.49; P<0.01) and PNI (<39) (HR, 3.29; 95% CI, 1.26-8.56; P=0.02) were independent factors for a shorter duration of postoperative chemotherapy. Conclusions: Age and PNI are useful predictors of postoperative chemotherapy intolerance after total gastrectomy and may determine the treatment strategy and timing of chemotherapy initiation.
The purpose of this study was to determine the basic materials needed for nutrition and health programs for aged people. In order to set up these programs, the nutritional habit, nutritional knowledge and functional health status (mobility, functional assessment, and falls efficacy) of the aged were measured, and their relationships were determined. Data was collected on 57 aged individuals that participated in the 'Exercise Program for the Aged' conducted by the National Health Insurance Corporation. These 57 subjects were interviewed and tested by direct measurement prior to conducting the program. The data was analyzed using the SPSS 13.0 Package. According to the results, the nutritional habit ranged from 24-50 out of 50, and the average was 37.2, which was above the middle level. The average nutritional knowledge was of 4.02 out of 5, which was considered reasonably high. Especially, more than half of these subjects were uneducated, but they had a high interest in nutrition. The average mobility was determined to be 9.2 seconds and the falls efficacy was 64.2 out of 100. In addition, subjects answered that they had a fear of falling due to low confidence, which indicates that safety education for the prevention of falls should be provided to aged individuals in the future. The results showed that notable counter-relations between nutritional habit and functional health status existed.
Purpose: Approximately 30% of children with chronic liver disease (CLD) are malnourished. However, proper assessment of their nutritional status is difficult. The subjective global nutritional assessment (SGNA) is a comprehensive approach that uses nutrition-focused history and examination, followed by grading of malnourishment. We aimed to study the prevalence of malnutrition in children with CLD using the SGNA tool. Methods: This cross-sectional observational study included patients aged <18 years with CLD. Nutritional assessments were recorded using SGNA tool. Conventional anthropometric measurements were performed and corroborated with nutritional status using SGNA tool. Results: A total of 85 children with CLD and mean age of 62 months were enrolled in this study. The prevalence of malnourished children according to SGNA was 34%; 22% were moderately malnourished and 12% were severely malnourished. We found statistically significant differences in anthropometric parameters among the three groups. A moderate degree of agreement was found between SGNA and weight-for-age (W/A) (p=0.020), mid-upper arm circumference (MUAC) (p<0.001), and triceps skin-fold thickness (TSF)-for-age (p=0.029). Furthermore, a fair degree of agreement was found between height-for-age (H/A) (p=0.001) and weight-for-height (W/H) (p<0.001). The sensitivity of W/A for detecting malnutrition was 93%, H/A was 90%, MUAC was 86%, and TSF was 88%. The sensitivity was much lower for W/H and body mass index for age (55% for both). Conclusion: In our study, more than one-third of children with CLD were malnourished. Nutritional assessment using SGNA is a reliable method for evaluating nutritional status and is significantly correlated with common anthropometric measurements.
BACKGROUND/OBJECTIVES: Maintaining total muscle mass in the older adults with swallowing difficulty (dysphagia) is important for preserving swallowing function. Increasing protein intake can help sustain lean body mass in the older adults. The aim of this study was to evaluate the effect of various high-protein texture-modified foods (HPTMFs) on muscle mass and perform dietary assessment in ≥ 65-yrs-old patients with dysphagia. SUBJECTS/METHODS: Participants (n = 10) received the newly developed HPTMFs (average 595.23 ± 66.75 kcal/day of energy, 54.22 ± 6.32 g/day of protein) for 10 days. Relative handgrip strength (RHS), mid-upper arm circumference (MUAC), body composition, mini nutritional assessment (MNA), mini dietary assessment (MDA), and Euro Quality-of-Life questionnaire 5-dimensional classification (EQ-5D) were assessed. RESULTS: After 10 days, an increase in MUAC (26.36 ± 2.35 cm to 28.50 ± 3.17 cm, P = 0.013) and RHS (0.38 ± 0.24 kg/kg body weight to 0.42 ± 0.22 kg/kg body weight, P = 0.046) was observed. Although MNA, MDA, EQ-5D, subjective health status, muscle mass, and calf circumference showed a tendency to increase after intervention, no significant differences were found. CONCLUSIONS: These results suggest that the HPTMFs can be used for improving the nutritional and health status in patients with dysphagia.
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