• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.167-175
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• 2018

Sarcopenia, a common clinical syndrome in older adults, is defined as decreased muscle mass, strength, and physical performance. Since sarcopenia is associated with the incidence of functional decline, falls, and even mortality in older adults, researchers and health care providers have been keen to accumulate clinical evidence to advocate the screening and prevention of sarcopenia progression in older adults. The factors that may accelerate the loss of muscle mass and function include chronic diseases, inactivity, and deficiency in appropriate nutritional support. Among these, nutritional support is considered an initial step to delay the progression of muscle wasting and improve physical performance in community-dwelling older adults. However, a nationwide study suggested that most Korean older adults do not consume sufficient dietary protein to maintain their muscle mass. Furthermore, considering age-associated anabolic resistance to dietary protein, higher protein intake should be emphasized in older adults than in younger people. To develop a dietary protein recommendation for older adults in Korea, we reviewed the relevant literature, including interventional studies from Korea. From these, we recommend that older adults consume at least 1.2 g of protein per kg of body weight per day (g/kg/day) to delay the progression of muscle wasting. The amount we recommend (1.2 g/kg/day) is 31.4% higher than the previously suggested recommended daily allowance (i.e., 0.91 g/kg/day) for the general population of Korea. Also, evidence to date suggests that the combination of exercise and nutritional support may enhance the beneficial effects of protein intake in older adults in Korea. We found that the current studies are insufficient to build population-based guidelines for older adults, and we call for further researches in Korea.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.17-21
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• 2011

Purpose: Percutaneous endoscopic gastrostomy (PEG) can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6) months. Results: Mean patient age was 9.4 (4.5) years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD). The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87%) had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

• Journal of Korean Academy of Nursing
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• v.39 no.4
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• pp.508-517
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• 2009

Purpose: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. Methods: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. Results: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. Conclusion: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.

• Journal of Korean Traditional Oncology
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• v.24 no.2
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• pp.1-11
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• 2019

Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

• Journal of Korean Academy of Nursing
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• v.45 no.6
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• pp.812-822
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• 2015

Purpose: The purpose of this study was to examine the effect of lifestyle intervention on the development of fatigue, nutritional status and quality of life of patients with gynecologic cancer. Methods: A nonequivalent control group quasi-experimental design was used. Participants were 49 patients with gynecologic cancer. They were assigned to the experiment group (n=24) or the control group (n=25). The lifestyle intervention for this study consisted of physical activity, nutritional education, telephone call counseling, health counseling, monitoring for lifestyle, and affective support based on Cox's Interaction Model of Client Health Behavior and was implemented for six weeks. Results: Significant group differences were found for fatigue (p =.037), nutritional status (p =.034) and social/family well-being (p =.035) in these patients with gynecologic cancer. Conclusion: Results indicate that this lifestyle intervention is effective in lessening fatigue, and improving nutritional status and social/family well-being. Therefore, nurses in hospitals should develop strategies to expand and provide lifestyle interventions for patients with cancer.

• Journal of Animal Science and Technology
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• v.57 no.12
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• pp.46.1-46.19
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• 2015

Background: This study examined whether activation of innate immunity and alterations of carbohydrate and lipid metabolism precede development of subclinical mastitis (SCM). Methods: Blood samples were collected from the coccygeal vein from 100 Holstein dairy cows at -8, -4, disease diagnosis week, and +4 weeks postpartum. Six healthy cows (controls - CON) and six cows that showed clinical signs of SCM were selected for serum analyses. All serum samples were analyzed for acute phase proteins (APP) haptoglobin (Hp) and serum amyloid A (SAA); proinflammatory cytokines including interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF) and serum lactate, BHBA, and NEFA concentration. Data of DMI, milk production, and milk composition were recorded and analyzed. Results: The results showed that cows with SCM had greater concentrations of SAA, TNF (P < 0.01), and lactate before expected day of parturition (P < 0.05) compared to CON cows. Cows with SCM showed greater concentrations of lactate starting at -8 weeks (P < 0.05) and TNF starting at -4 weeks prior to the expected day of parturition (P < 0.01). Interestingly, at -4 weeks, concentrations of IL-1 and Hp were lower in cows with SCM compared to healthy cows (P < 0.01) followed by an increase during the week of disease diagnosis (P < 0.05). Subclinical mastitis was associated with lower DMI, at -4 weeks before calving, milk production (P < 0.05) and increased somatic cell counts (SCC) (P < 0.01). Conclusions: Results of this study suggest that SCM is preceded by activated innate immunity and altered carbohydrate metabolism in transition dairy cows. Moreover the results support the idea that Hp, lactate, and SAA, at -8 weeks, and TNF and IL-1 at -4 weeks can be used as early indicators to screen cows during dry off for disease state.

• Journal of the Korean Dietetic Association
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• v.17 no.4
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• pp.416-428
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• 2011

This study was carried out to investigate the effects of breakfast service on nutritional status, hematological status, and attentiveness of children in low-income families. The subjects were 19 boys and 13 girls between 7 and 11 years old. The subjects were divided into a control group and a breakfast service (BS) group, in which 12 boys and 5 girls received breakfast from February 1 to December 31, 2010. The results can be summarized as follows: intakes of energy, protein, carbohydrate, calcium, iron, zinc, vitamin A, vitamin $B_2$, niacin, and vitamin C in the BS group were significantly higher than those in the control group. In the BS group, the intakes of calcium, folic acid, and vitamin C were lower than 75% of recommended intake levels. There were no significant differences in the total blood protein level and total cholesterol level between the BS group and control group. A blood albumin level was significantly higher in the BS group than in the control group. Systolic blood pressure was higher in the BS group than in the control group, whereas the diastolic blood pressure showed no significant difference between the groups. A dietary attitude score increased according to breakfast service and nutritional education. No significant differences were found in the capacity value and continuity value between the two groups, but the control value was significantly higher in the BS group than in the control group. Therefore, to sustain the effect of breakfast service and improve nutritional status for children skipping breakfast in low-income families, nutrition intervention services, as well as legal and financial support by the government should be provided.

• Nutrition Research and Practice
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• v.4 no.5
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• pp.393-399
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• 2010

Enteral nutritional support has been used via tube feeding for dysphagic stroke patients. We performed long and short term trials to evaluate the effects of commercial enteral nutritional supports on nutrition and health in stroke patients (mRS = 3~5) and quality of life in their caregivers. For a long term study, we recruited chronic (${\geq}$ 1 yrs) stroke patients (n = 6) and administered them 6 cans/day (1,200 kcal) of the commercial enteral formula N for 6 months according to IRB-approved protocol. We collected peripheral blood at 0, 2, 4 and 6 months. For a short term study, we recruited acute (${\leq}$ 3 months) stroke patients (n = 12) and randomly administered them two different commercial enteral formulas, N or J, for 2 weeks. We collected their blood at 0, 4, 7 and 14 day of the administration. Blood samples were analyzed to quantify 19 health and nutritional biomarkers and an oxidative stress biomarker, malondialdehyde (MDA). In order to evaluate quality of life, we also obtained the sense of competence questionnaire (SCQ) from all caregivers at 'before' and 'after trials'. As results, the enteral formula, N, improved hemoglobin and hematocrit levels in the long term trial and maintained most of biomarkers within normal ranges. The SCQ levels of caregivers were improved in the long term treatment (P < 0.05). In a case of the short term study, both of enteral formulas were helpful to maintain nutritional status of the patients. In addition, MDA levels were decreased in the acute patients following formula consumption (0.05 < P < 0.1). Most of health and nutrition outcomes were not different, even though there is a big difference in price of the two products. Thus, we evaluate the formula N has equal nutritional efficacy compared to the formula J. In addition, long term use of enteral formula N can be useful to health and nutrition of stroke patients, and the quality of life for their caregivers.

• Journal of the Korean Dietetic Association
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• v.14 no.4
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• pp.337-350
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• 2008

The principal objective of this study was to assess the nutritional status and dietary quality in low-income elderly individuals residing at home (LH) or in health care facilities (LHCF) with dietitian. This study was conducted via anthropometric measurements, questionnaire interviews, and dietary surveys using a 24 hr recall method with 120 low-income elderly individuals (LHCF=46, LH=74). The average ages of the LH and LHCF group were 76.3 years and 78.6 years, respectively. The LH group evidenced a significantly higher frequency of skipping meals than the LHCF group. The average energy intakes of the LHCF and LH group were 1921.0 kcal and 1443.9 kcal, with a significant difference (p<0.001). Most of the nutrient intake and intake rates for recommended intake were significantly higher among the LHCF group as compared with the LH group. The LHCF group showed significantly higher values for the nutrient adequacy ratio (NAR), the mean adequacy ratio (MAR), nutrient density (ND), and the index of nutritional quality (INQ) by dietary qualitative estimation than in the LH group. The Korean diet diversity scores (KDDS) were 3.66 for LH group and 4.93 for the LHCF group, thus were significantly higher in the LHCF group than in the LH group. The results of the present study demonstrate that the LH group appeared to experience more dietary problems than the LHCF group. It was suggested that nutritional education is needed for low-income elderly individuals living at home, in order for them to learn proper dietary management. This can be achieved via educational programs in social welfare institutions, incentives toward employment as a dietitian, and implementation of community-based support.

• Research in Community and Public Health Nursing
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• v.16 no.1
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• pp.23-31
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• 2005

Purpose: this study was to compare the health service need according to residence characteristics. Method: The subjects consisted of 194 elderly people classified into two groups of living in community and living in institution. Data was collected from January to March, 2004 by a structured questionnaire that included general characteristics. health related variables, MMSE-K, nutritional status, pain, depression and ADL scale. The collected data was analyzed by the SPSS program including descriptive analysis, $X^2$ test, t-test and Pearsons Correlation Coefficient. Result In general characteristics, there were differences in religions and spouses and all the group of people were aged. In health related variables according to residential characteristics. cognitive level (MMSE-K) of the elderly living in institutions was lower than that of the elderly living in community and the group of living in institutions showed more than 'moderate level' of subjective and relative health perception and their ADL was confirmed to be more dependent. But there was no significant difference among depression, BMI, nutritional status, number of present disease and pain according to residence characteristics. It was identified that pain had) positive correlation with nutritional status. ADL, and the number of present disease, and ADL showed negative correlation with cognitive level. Subjective and relative health perception had positive correlation with depression and negative correlation with nutritional status. In conclusion. the need of the health service of the elderly identified according to residential characteristics showed differences only in cognition and ADL. The elderly living in institutions showed relatively poor results. Conclusion: The concern of nutritional status is necessary to increase health status for the elderly, especially more concern and support is necessary for the elderly living in community.