• Title/Summary/Keyword: protein-calorie malnutrition

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A Survey of Nutritional-Immunologic Interactions in the Children Under 6 Years Old in the Suburbs of Seoul (6세미만 도시 주변거주 어린이의 면역능력에 따르는 영양상태 판정에 관한 연구)

  • Lee, In-Sil;Kim, Yun-Chung;Kim, Wha-Young;Kim, Sook-He;Hong, Young-Ja
    • Journal of Nutrition and Health
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    • v.16 no.3
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    • pp.193-199
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    • 1983
  • Clinical and epidemiologic data point to a causal interrelationship between nutritional deficiency and infectious illness. Both are major contributors to childhood morbidity and mortality, particulary in underprivileged population groups. Protein-calorie malnutrition depress a variety of immune funtions. Delayed hypersensitivity and number of T-lymphocytes are consistently reduced. The interrelationship between nutritional status and immune response was studied in 80 children aged under 6 years. According to the anthropometric assessment based on weight for height for age, 36 children were classified as normal, 22 as morderate malnutrition, and 22 as severe malnutrition. The following determinations were made : hemeglobin, hematocrit, serum albumin, immunoglobulin G, complement 3, and WBC levels. Results indicate that levels of Hb, Hct, serum albumin, and C3 concentration were decreased in moderate and severe malnutrition children. However, levels of IgG and WBC were not affected by the nutritional status. It is suggested that nutritional status has more profound effects on complement system than humoral immunity.

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A Survey of Nutrition and Blood Pictures of Senior High School Girls in a Korean Rural Area (일부(一部) 농촌지역(農村地域) 여고생(女高生)의 영양실태(營養實態)및 혈액상(血液像)에 관(關)한 연구(硏究))

  • Kim, Chong-Mi;Chung, Kook-Rye
    • Journal of Nutrition and Health
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    • v.18 no.1
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    • pp.5-13
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    • 1985
  • The purpose of this study was to provide the proper nutritional management, and help to improve the health of girl students in a rural area. The nutritional survey, and blood sampling was conducted for five days, from April 26 to 30, 1983. The subjects of this survey were 110 students of girl's high school in Cheongyang area. The results were summerized as follows; 1) The daily food intake was 842.3g and that of animal foods was 34.4g. The average intake of calorie, protein, Ca, Fe, thiamin, riboflavin and niacin except Vit. A and Vit. C was below the RDA. Total calorie intake was l,802kcal. The ratio of carbohydrate, protein and fat was 81:11:8. 2) The extent of malnutrition was explained in terms of the amount of calorie, protein, Ca, Fe, and Vit. C. The predicted percentage of deficiency was 47.3% in calorie, 46.4% in protein, 61.8% in Ca, 48.2% in Fe, and 15.5% in Vit C of total subjects. 3) The mean values of Hgb, Hct and MCHC were 13.15g/dl, 39.57% and 33.2%, thus, the anemic prevalences were 10.9%, 2% and 78.2% respectively. The mean values of SI.TIBCand TS were $109.86{\mu}g$/61, $317.11{\mu}g/dl$ and 34.59%. 4) The correlation between the economic levels and nutrients intake was significant. Correlation between weight and nutrients intake was also significant but nutrients intake was not significantly correlated to blood contents.

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Effect of Nutritional Support on Underweight Patients (저체중 환자를 대상으로한 영양보충 효과에 관한 연구)

  • 백인경
    • Journal of Nutrition and Health
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    • v.24 no.6
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    • pp.496-505
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    • 1991
  • Underweight patients were studied with respect to changes in their nutritional status before and after administration of nutritional beverage. Patients with renal hepatic or endocrine disease gastrectomy malabsorption and weight gain over past 6 months were excluded. Ten patients were participated as controls and were allowed to eat ad libitu, Twenty patients were served as case and were administered in addition to their usual diet 400ml of nutritio-nal beverage(Greenbia) high in calorie and protein for 8 weeks. In the beginning of the study most underweight patients showed depressed nutritional status in terms of calorie intake quality of protein intake and the levels of visceral protein status and serum micronut-rients. The controls consumed less amounts of calories proteins vitamins and minerals while those given the nutritional beverage exceeded their estimated energy requirement(105%) and consumed a mean of 96g protein per day. Those given nutritional beverage for 8 weeks showed significant increase in body weight(3%) hemoglobin(3.2%) hematocrit(5.4%) serum transferrin(19.4%) iron(30.1%) and zinc(20.9%) In the controls however significant improvement was not observed in any parameters compared with initial values. significant improvement was not observed in any parameters compared with initial values. This study suggests that patients with underweight can show mild nutritional deprivation nutritional support can improve their unbalanced status and prevent severe malnutrition.

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Assessment of Malnutrition of Dialysis Patients and Comparison of Nutritional Parameters of CAPD and Hemodialysis Patients

  • Wi, Jin Woo;Kim, Nam-Ho
    • Biomedical Science Letters
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    • v.23 no.3
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    • pp.185-193
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    • 2017
  • Malnutrition is common and the major risk factor of mortality of end stage renal disease (ESRD) patients. The aim of this study is to assess nutritional status of malnutrition patients on dialysis by various methods and compare nutritional parameters of continuous ambulatory peritoneal dialysis (CAPD) patients with hemodialysis patients. 137 patients on dialysis from April 2009 to July 2013 were enrolled. Nutritional parameters of 66 CAPD and 71 hemodialysis patients were investigated by anthropometry, biochemical study, diet analysis and questionnaires. Malnutrition patients were selected by body mass index (BMI), serum albumin and pre-albumin based on International Society of Renal Nutrition and Metabolism (ISRNM) diagnostic criteria for protein-energy wasting and compared with non-malnutrition patients. In comparison of CAPD and hemodialysis patients, most anthropometric values showed no significant difference except total body water (TBW). TBW was lower in CAPD patients (P=0.024). Although serum albumin was slightly higher in hemodialysis patients (P=0.047), pre-albumin were significantly higher in CAPD patients (P=0.000). Serum blood urea nitrogen (BUN) was higher in hemodialysis patients (P=0.000). In diet analysis, Total calorie (P=0.000) and total cholesterol (P=0.012) intakes were higher in CAPD patients. Mean subjective global assessment (SGA) grade was higher in CAPD patients (P=0.003). Several nutritional parameters of CAPD patients were better than hemodialysis patients implying more intensive therapeutic approach may be needed for hemodialysis patients. We have to understand multiple factors contributing malnutrition of ESRD patients and individualized therapeutic approach is needed.

A Study of Nutritional Improvement in the Patients with Neurologic Disorders by Changing Enteral Feeding Methods (경장영양 공급방식 변경에 따른 신경계질환자의 영양개선 효과 연구)

  • Kim, Hui-Jeong;Gang, Eun-Hui;Lee, Jong-Ho;Kim, O-Yeon
    • Journal of the Korean Dietetic Association
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    • v.10 no.4
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    • pp.442-451
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    • 2004
  • Protein-calories malnutrition is common among patients in the hospital. In particular, elderly patients with neurologic disorders has more risk of nutritional deficiency due to swallowing difficulty. Enteral tube feeding is more economical, physiological and immunological than parenteral nutrition for patients who have adequate gastrointestinal function. This study was conducted patients with neurologic disorders who received enteral nutrition at Asan Medical Center from February 1 to October 10, 2002. The control group (48 patients) were given traditional feeding methods 4 times a day while the treatment group (45 patients) were given improved feeding methods 3 times a day. We assessed nutritional status of patients and compared to both groups. We investigated body weight, serum albumin, hemoglobin, total lymphocyte count by means of nutrition markers. The objectives of this study is to reduce the time needed for nutritional requirement of patients without an increase in gastrointestinal intolerances. The results of this study are as follows: 1. Nutritional status of many patients in both groups were either malnourished or at risk for malnutrition. 2. The time to arrive to the nutritional requirements were 6.21 $\pm$ 0.35 days for the control group and 4.24 $\pm$ 0.52 days for the treatment group. The treatment group showed a significantly shorter amount of time. 3. The changes of the nutritional marker in the control group showed a significant drop in body weight, serum albumin and serum hemoglobin while the treatment group experienced a significant increase in body weight, serum albumin and total lymphocyte count. 4. Feeding intolerane such as diarrhea, high residual volume, ileus, nausea and vomiting were investigated. Diarrhea found in 25.1% (12 patients) of the control group and 22.2% (10 patients) of the treatment group and these findings are not significant.

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Association of the Nutritional Status and Essential Amino Acids Intake in Hemodialysis Patients (혈액투석환자에서 영양상태와 필수아미노산 섭취의 관련성 연구)

  • Kim, Hye-Jin;Kim, Su-An;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.39 no.7
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    • pp.617-623
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    • 2006
  • The mortality and morbidity rate of hemodialysis patients (HD) remain high. Among many factors, protein and calorie malnutrition has been shown to be a major risk factor for increased mortality in the HD patients population. Malnutrition can be caused by insufficient amino acid intake, nutrient losses in dialysate, oxidant stress and muscle catabolism. In this study, we evaluated the association of markers of nutritional status and essential amino acids intake in HD patients. We investigated nutritional status of 41 HD patients (mean age: $64.2\;{\pm}\;11.5\;y$, men: 24, women: 27) by measuring anthropometric, biochemical parameters and food intakes by using 24 hr recall methods. Subject's total energy intake and total protein intake were $1,648.0\;{\pm}\;397.31\;kcal/day,\;79.2\;{\pm}\;27.2\;g/day$:, respectively. The animal protein intake was $42.7\;{\pm}\;22.1\;g/day$, essential amino acids intake was $23.4\;{\pm}\;9.92\;g/day$, and the ratio of essential amino acids to total protein intake was $29.6\;{\pm}\;5.42%$. There were significantly positive correlation between muscle mass and lean body mass with serum creatinine level (r=0.435, p<0.01; r=0.435, p<0,01). There were also significant positive correlation in muscle mass and lean body mass with pre hemodialysis blood urea nitrogen (preHD BUN) (r=0.329, p<0.05; r=0.329, p<0.05). There were no significant correlation in total energy intake and total protein intake per kg ideal body weight (IBW) to muscle mass and lean body mass. However, there were significantly positive correlation between the ratio of essential amino acids and muscle mass and lean body mass (r=0.368, p<0.05; r=0.405, p<0.01). And serum hematocrit concentration was positively correlated with the ratio of essential amino acids (r=0.032, p<0.05). The results of this study indicate that strong associations exist in essential amino acid intakes with malnutrition than total protein intakes in HD patient. In conclusion, specialized nutrition education should be necessary to efficiently improve the quality of protein intakes.

A Case of Intestinal Tuberculosis with Protein-calorie Malnutrition (단백질-칼로리 영양 실조를 동반한 장결핵 1례)

  • Song, Joon Sup;Park, Ji He;Chung, So Chung;Kim, Kyo Sun
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.222-228
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    • 2001
  • The frequency and severity of intestinal tuberculosis are decreased due to socioeconomic development, pasteurization of milk and more effective anti-tuberculous chemotherapy. But in recent year, HIV-infected patients are known to be at high risk of developing tuberculosis. The pathogenesis of intestinal tuberculosis is dependent on a immune state and nutritional status of the patient, the tuberculosis amount of sputum and tuberculosis toxicity. The diagnosis of intestinal tuberculosis is usually difficult because of non-specific clinical features and radiological signs. Chronic diarrhea in intestinal tuberculosis is able to produce a malnutrition, marasmus, kwashiorkor or the combined form. The treatment is anti-tuberculous chemotherapy for 12~24 months, but operation should be considered to intestinal perforation, obstruction, fistula formation and massive bleeding. The study about kwashiorkor in intestinal tuberculosis is rare in recent years, we should remind that tuberculosis is still prevalent disease in Korea. We report a ten year-old boy with ileocecal tuberculosis who presented with kwashiorkor, severe malnutrition with review of literature.

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Assessment of Nutritional Status in Elderly Dialysis Patients (노인 투석환자의 영양상태 평가)

  • 노유자;하혜정;고혜영;박옥순
    • Journal of Korean Academy of Nursing
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    • v.26 no.2
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    • pp.304-319
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    • 1996
  • It is important to evaluate nutritional status of elderly patients receiving dialysis, since wasting and malnutrition are their common problems. This study aims at assessing their nutritional status by the type and duration of dialysis. The nutritional status such as somatic fat and protein storage was evaluated with anthropometric measure including weight/height ratio, triceps skinfold thickness and midarm muscle circumference. It was also measured with albumin, transferrin, C3 and IGF-1 and calorie and protein intakes. The general clinical condition of patients was evaluated with the severity of uremia and metabolic acidosis. which were measured through the levels of serum urea, creatinine and bicarbonateion. The data were analyzed by using t-test, ANOVA, Wilcoxon-rank sums test, Scheffe test, Kruskal-Wallis test and Pearson correlation coefficients. The results are following : 1. There was no significant difference in the calorie and protein intakes by the type and duration of dialysis received. 2. As for the anthropometric measures, no significant difference was found by the type of dialysis in body mass index triceps skinfold thickness and midarm muscle circumference. Yet these anthropometric measures differed significantly by the duration of dialysis in those elderly patients receiving hemodialysis(HD group), but this finding was not found in those receiving continuous ambulatory peritoneal dialysis(CAPD). 3. Regarding the indicators of uremia and metabolic acidosis, blood urea nitrogen(BUN) and creatinine were lower in the CAPD group than in the HD group, whereas bicarbonate ion was higher in the CAPD group than in the HD group, with no statistical significance. In the HD group, creatinine increased significantly with the increase of the duration of dialysis. 4. Serum trasferrin and C3 were significantly higher in the CAPD group than in the HD group. However. each of biochemical indices did not show statistical significance by the duration of dialysis in both HD and CAPD groups. 5. Anthropometric measures were significantly associated with dietary intake. Significant correlations were observed between biocarbonate ion, BUN and creatinine. In addition, the correlations between serum protein and albumin and between transferrin and C3 were statistically significant. Yet, IGF-1 revealed no significant correlation with other nutritional indices. The above findings indicate that there were no difference in nutritional status measured with protein and calorie intakes between the type and duration of dialysis, but CAPD seems to benefit correcting uremia and metabolic acidosis than HD. Studies of dietary management for dialysis patients need to be pursued in order to improved the quality of aged patients receiving dialysis.

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A Study on the Nutritional Assessment of Early Childhood Using Mid-Upper-Arm Circumference (상박위(上膊圍)에 의(依)한 성장기(成長期) 아동(兒童)에 영양상태(營養狀態)의 판정(判定)에 관(關)한 연구(硏究))

  • Tchai, B.S.;Nam, Y.K.;Chung, Y.J.
    • Journal of Nutrition and Health
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    • v.8 no.4
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    • pp.9-14
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    • 1975
  • Growth retardation and a variable degree of body disproportion are recognized features of malnutrition, and mild and moderate protein-calorie malnutrition(PCM). Among the various body measurements suggested to assess the prevalence of all grades of PCM as judged by growth retardation and by body disproportion, the 'mid-upper-arm circumference'-abbreviated to 'arm-circumference' has been suggested as a potential useful simple field index for the assessment of PCM showing that the measurement would give composite information simultaneously on three important effects on PCM-deficit in the muscle protein reservoirs, availability of calorie stores in the form of subcutaneous fat, and growth failure. And this is selected because of its easy accessibility, and less involvement with clinical edema. This study is conducted to make a comparison between the percentage of Korean weight for age standards and the percentage of mid-upper-arm circumference for age standards of 175 preschool children aged $3{\sim}72$ months who are selected among the low-income residents in Seoul. In this study, a comparison is made between the results obtained by expressing the observed weight of the child as a percentage of Korean standard, referred to as 'weight-for-age' and the observed arm-circumference expressed as a percentage of the age-specific arm standard of Jelliffe, referred to as 'arm-for-age'. All the measurements were taken following the techniques described by Jelliffe. The left mid upper arm was measured using a glass-fibre tape and the Fairbanks Morse beam balance was used for weighing. 80% level of weight for age Korean standard and 85% level of arm for are Jelliffe standard were used as an upper borderline limit for PCM. Comparing the 80% weight-for-age and the 85% arm-for-age standard as an upper limit for PCM, for children aged $3{\sim}72$ months, results in 84.6% agreement with the sensitivity of 86.4% and its specificity of 83.5%. If arm circumference alone had been measured and judgement made on this basis, then only 5.1% of the children would have been 'wrongly' classified. And there is a moderately close correlation between arm circumference and weight for age as the data in Table 4 shows. The problem therefore lies in the standard for arm circumference in normal children and in determining what is the lower limit of normal. Once this is clearly difined, one can rely more confidently on arm circumference measurements alone for the nutritional assessment of early childhood.

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