• Journal of Community Nutrition
• /
• v.2 no.1
• /
• pp.36-49
• /
• 2000

Evaluation of nutritional status is an essential element in providing appropriate intervention strategies to achieve the highest level of health, Nutritional assessment of the older population is complicated by many factors which do not significantly affect the nutritional status in young adults, therefore, it should be considered in two ways; community-dwelling elders group and hospitalized or institutionalized elderly group. To sort out the individuals with nutritional problems in a community efficiently, nutrition screening tools must be simple, relatively inexpensive, and applicable to a large number of subjects. Combination of tools and indicators such as 24-hour food recall, body weight and height, and questionnaires on eating practices, and the presence of chronic diseases is practically applicable as basic tools of nutritional screening of older age group. However, the lack of validated screening techniques remains a barrier in improving nutrition. Validation is only limited to energy, BMI, protein intake of the older populations living in western countries. Further refinement of nutritional assessment tools is demanded to figure out whether those are practically applicable to community-living older adults in Asian Society. A careful and systematic evaluation of nutritional assessment tools should be carried out prior to implementation of stepwise nutrition service to the heterogeneous older population. For an in-depth nutritional assessment at the individual level, we need to extend research efforts to clarify the requirements of nutrients due to aging and diseases. More cost-effective method that will allow rapid analysis of survey results are needed so that information can be readily available to policymakers.

• Journal of Neurocritical Care
• /
• v.11 no.2
• /
• pp.71-80
• /
• 2018

Nutritional assessment and support are often overlooked in the critically ill due to other urgent priorities. Unlike oxygenation, organ dysfunction, infection, or consciousness, there is no consensus of indicators. Making it difficult to evaluate the effectiveness of an intervention. Nevertheless, appropriate nutritional support in the critically ill has been associated with less morbidity and lower mortality. But, nutritional support has been considered an adjunct, for body weight maintenance and to help patients during the inflammatory phase of illness. Thus, it has been assigned a lower priority, compared to mechanical ventilation or hemodynamic stability. Recent findings have shown that nutritional support may prevent cellular injury due to oxidative stress and help strengthen the immune response. Large-scale randomized trials and clinical guidelines have shown a shift from nutritional support to nutritional therapy, with an emphasis on the importance of protein, minerals, vitamins, and trace elements. Nutrition is also important in neurocritically ill patients. Since there are few studies or recommendations with regard to the neurocritical population, the general recommendations for nutritional support should be applied.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.22 no.4
• /
• pp.387-397
• /
• 2015

Purpose: This study aimed to evaluate nutritional status and fatigue, and to identify the relationship between nutritional status and fatigue in gynecological cancer patients receiving chemotherapy. Methods: Participants were 106 outpatients who had uterine, ovary, or breast cancer and a descriptive cross-sectional design was used. Nutritional indicators including biochemical and anthropometric measures, the Subjective Global Assessment (SGA) scale, and the Piper's Revised Fatigue Scale were completed. Results: About thirty-nine percent of the patients were malnourished based on the SGA. Serum hemoglobin and total lymphocyte levels were less than the normal ranges, although anthropometrics were normal. The women experienced moderate fatigue with a mean score of $5.84{\pm}2.00$. Nutritional status was significantly different by age, education, employment status, and monthly income. The women also had different nutritional status and fatigue depending on the type of cancer and chemotherapy. Fatigue was significantly related to SGA scores, serum hemoglobin, triceps skinfold thickness and mid-arm muscle circumference. Conclusion: The results of this study highlight an urgent need to provide adequate nutritional support and fatigue management with individualized strategies for gynecological cancer patients on chemotherapy.

• Journal of the Korean Dietetic Association
• /
• v.21 no.1
• /
• pp.11-24
• /
• 2015

This study investigated the general status of tube feeding for intensive care unit (ICU) inpatients and evaluated the consequent nutritional status of patients. This study was approved by the Institutional Review Board (IRB) of a general hospital located in Daegu metropolitan city. The subjects of this study were 80 adult patients who had been admitted to the ICU of a hospital, received fed tube feeding, and then been discharged. The differences in nutrition screening indicators, including percentage ideal body weight (PIBW), serum albumin, hemoglobin, total lymphocyte count, and total cholesterol, before and after tube feeding according to body mass index (BMI) or nutrient feeding levels were investigated. The ratios of actually provided amounts to calorie and protein requirements of patients were $72.8{\pm}15.8%$ and $72.6{\pm}19.8%$, respectively. The change in PIBW before and after tube feeding was significantly different among the BMI groups (P<0.01). The change in hemoglobin concentration before and after tube feeding was also significantly different among the BMI groups (P<0.01). When subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided calories to required calories, there was no significant difference in nutrition screening indicators before and after tube feeding. When the subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided protein to required protein, serum albumin concentration showed a significant difference among the groups before and after tube feeding (P<0.05). Therefore, an intensive nutrition intervention program would be needed for the nutritional improvement of ICU inpatients receiving tube feeding.

• Nutrition Research and Practice
• /
• v.2 no.2
• /
• pp.93-99
• /
• 2008

A community-based longitudinal study was conducted in the Manya Krobo District of the Eastern Region of Ghana with the objective of assessing how caregiving practices influence nutritional status of young children in Ghana. The study subjects were one hundred mothers with infants between the ages of 6 and 12 months. Each child was visited at home monthly for a period of six months. On each visit, information was collected on caregiver household and personal hygiene, child's immunization status, child's dietary diversity, caregiver responsiveness during feeding, caregiver hygienic practices related to feeding and child's weight and length. At the end of the study, summary scores were generated for each variable and quality of care practice determined based on their distribution. Classification of child nutritional status was based on z-scores for both weight-for-age and length-for-age. The results revealed that caregivers who exhibited better quality of care practice had well-nourished children. Such caregivers were more likely to practice good household and personal hygiene than those of poorly nourished children (97.1% vs 31.8%, p<0.001). They were also more likely to complete their children's immunization schedules (88.2% vs 62.2%, p<0.001), provide good quality diets from highly diversified sources (79% vs 23%, p<0.001), exhibit high responsiveness during feeding (100% vs 22.7%, p<0.001) and feed under hygienic conditions (100% vs 22.7%, p<0.001). Based on the findings it was concluded that good caregiving practices are associated with improved child nutritional status.

• Journal of the Korean Dietetic Association
• /
• v.16 no.2
• /
• pp.122-132
• /
• 2010

Elderly people comprise an increasing proportion of the population, and nutritional impairments may contribute to health problems among this group. This study was conducted to evaluate the nutritional status by Mini-Nutritional Assessment (MNA) and to identify relationships among anthropometric measurements, biochemical indicators, bone Mineral Density (BMD) and MNA results among older adults (${\geq}$65 yrs, n=98, 66.7${\pm}$2.5 yrs; M=52, F=46, BMI 24.5${\pm}$2.8 $kg/m^2$) at a Health Care Center. A dietitian administered MNA and collected anthropometric measurements (weight, height, waist circumference), biochemical indicators (albumin, hemoglobin, hematocrit, TLC, glucose, lipids) and the BMD (spine, femur, F=46). Subjects were grouped into a normal nutrition group (0~2 risk factors of malnutrition) and a high risk of malnutrition group (>=3 risk factors of malnutrition) based on their risk factor status for malnutrition. The risk factors for malnutrition include age ${\geq}$65 years, PIBW <90%, albumin <3.5 g/dl, TLC <1,500%, Hgb <14 g/dl (men), Hgb <10 g/dl (women), loss of appetite and weight loss 1~3 kg/last 3 months. In addition, subjects were grouped into a normal, osteopenia and osteoporosis group by BMD. We found that 12% of the subjects were at risk of malnutrition (MNA score, 21.4${\pm}$2.1) and that 88% were well nourished (27.3${\pm}$1.5) according to the MNA. Full-MNA scores were positively and significantly (p<0.05) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), albumin and hemoglobin, respectively. The full-MNA score of the high risk of malnutrition group (23.0${\pm}$3.8) was lower than that of the normal nutrition group (27.0${\pm}$2.1) (p<0.05). In addition, the Full-MNA score was negatively associated with the risk factor of malnutrition (r=－0.35, p=0.0004). We found that 39.1% of the subjects had osteoporosis, 45.7% had osteopenia and 15.2% were normal according to their BMD. The MNA score of osteoporosis group (24.58${\pm}$3.3) was lower than that of the normal (27.4${\pm}$1.1) and osteopenia group (26.9${\pm}$1.5) (p<0.05). These results suggested that MNA can be useful as a nutritional screening tool of older adults in Health Care Centers.

• Journal of Gastric Cancer
• /
• v.22 no.1
• /
• pp.56-66
• /
• 2022

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.

• Journal of Nutrition and Health
• /
• v.31 no.8
• /
• pp.1338-1346
• /
• 1998

North Korea has been experiencing a serious food shortage. However, the extent and magnitude of malnutrition and health problems are virturally unknown because a nationwide food and nutritional survey has never been conducted. To get a better udnerstanding of the situation., an exhaustive literature search on the health and nutritiona conditions of North Koreans was performed. We also obtained anthropometric data on 274 North Korean Defectors who are recently resettlers in the South. Some(137) measurements were taken at the time of entry to the South, and the remaining data was from the health and nutrition mail survey conducted by us on North Korean refugeee re-settlers. Health and inutritional status of North Koreans was found to be less than desirable as shown in high infant mortality rates, high mortality and morbidity rates of malnutriton-related infectious deseases, and smaller body sizes. Striking differences were noted in all of the above health and nutrition indicators between north and South Koreans. Considering the fact that North and South Koreans are homogeneous in their genetic back-ground, ours study results clearly demonstrate that the health and nutrition of North Koreas has deteriorated with the dhronic food shortage, which might have sorsened with a recent food crissi. The smaller and thinner adult stature proevailing in North Korea could play a significant negative role in the country's economy, since lower lean body mass has been associated with reduced work productivity that could hinder economic growth and development.

• The Korean Journal of Community Living Science
• /
• v.28 no.1
• /
• pp.5-16
• /
• 2017

This study was conducted to compare the nutritional status, nutrient intakes, and chronic disease risks of Chinese elderly people. MNA (Mini Nutritional Assessment) developed for elderly people was used to determine their nutritional status. In this study, participants consisted of 148 urban residents aged 65 years and over residing in three cities in Shandong Province, China. Participants were 67 (45.3%) men and 81 (54.7%) women, and average age was 72.8 years. According to MNA score, 77.7% of participants were 'well nourished', 22.3% were 'at risk of malnutrition', and 2% were 'malnourished'. Nutritional status was divided into two groups by MNA score as 'well nourished' and 'malnourished', which was formed with the combination of 'at risk of malnutrition' and 'malnourished'. Compared with the well nourished group, the malnourished group was older, and physical status indicators such as weight, BMI (Body Mass Index), and calf circumference of the malnourished group were much smaller. The malnourished group had higher prevalence rates of heart disease and stomach disorders while the well nourished group had a higher rate of hypertension. There was no significant difference between the malnourished group and well nourished group in nutritional intake below Chinese DRIs (Dietary Reference Intakes) among elder males. A higher proportion of elder females showed insufficient intakes of energy, protein, vitamin A, vitamin E, and zinc in the malnourished group compared to the well nourished group. The INQ (Index of Nutrition Quality) of calcium, magnesium, zinc, iodine, and most vitamins was less than 1 in both the malnourished and well nourished groups.

• Korean Journal of Community Nutrition
• /
• v.21 no.4
• /
• pp.354-365
• /
• 2016

Objectives: Studies that reported the association between diet quality/nutritional intake status and mortality have rarely used long-term follow-up data in Asian countries, including Korea. This study investigated the association between the risk of mortality (all-cause and cause-specific) and the diet quality/nutritional intake status using follow-up 12-year mortality data from a nationally representative sample of South Koreans. Methods: 8,941 individuals who participated in 1998 and 2001 Korea Health and Nutrition Examination Surveys were linked to mortality data from death certificates. Of those individuals, 1,083 (12.1%) had died as of December, 2012. Cox proportional hazard models were used to estimate the relative risks of mortality according to the level of diet quality and intakes of major nutrients. Indicators for diet quality index and nutritional intake status were assessed using MAR (mean adequacy ratio) and energy and protein intake level compared with the 2010 Korean DRI. Results: Higher diet quality/nutritional intake status were associated with lower mortality; the mortality risk (95% confidence interval) from all-cause of lowest MAR group vs highest was 1.66 (1.27 to 2.18) among ${\geq}30$ year old, and 1.98 (1.36 to 2.86) among 30~64 year old individuals. Those with below 75% of energy and protein intake of Korean DRI had higher mortality risks of all-cause mortality compared to the reference group. Diet quality/nutritional intake status was inversely associated with mortality from cardiovascular diseases and cancer. Conclusions: Poor Diet quality/nutritional intake status were associated with a higher risk of mortality from all-cause and mortality from cardiovascular diseases and cancer among South Korean adults.