• Animal Bioscience
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• v.35 no.7
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• pp.1010-1020
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• 2022

Objective: The experiment was conducted to evaluate the effects of maternal undernutrition during late pregnancy on the expressions of genes involved in growth and development in ovine fetal perirenal brown adipose tissue (BAT). Methods: Eighteen ewes with singleton fetuses were allocated to three groups at day 90 of pregnancy: restricted group 1 (RG1, 0.33 MJ metabolisable energy [ME]/kg body weight [BW]^0.75/d, n = 6), restricted group 2 (RG2, 0.18 MJ ME/kg BW^0.75/d, n = 6), and a control group (CG, ad libitum, 0.67 MJ ME/kg BW^0.75/d, n = 6). The fetuses were removed at day 140 of pregnancy. All data were analyzed by using the analysis of variance procedure. Results: The perirenal fat weight (p = 0.0077) and perirenal fat growth rate (p = 0.0074) were reduced in RG2 compared to CG. In fetal perirenal BAT, the protein level of uncoupling protein 1 (UCP1) (p = 0.0001) was lower in RG1 and RG2 compared with CG and UCP1 mRNA expression (p = 0.0265) was decreased in RG2. The protein level of myogenic factor 5 (Myf5) was also decreased in RG2 (p = 0.0001). In addition, mRNA expressions of CyclinA (p = 0.0109), CyclinB (p = 0.0019), CyclinD (p = 0.0015), cyclin-dependent kinase 1 (CDK1) (p = 0.0001), E2F transcription factor 1 (E2F1) (p = 0.0323), E2F4 (p = 0.0101), and E2F5 (p = 0.0018) were lower in RG1 and RG2. There were decreased protein expression of peroxisome proliferator-activated receptor-γ (PPARγ) (p = 0.0043) and mRNA expression of CCAAT/enhancer-binding protein-α (C/EBPα) (p = 0.0307) in RG2 and decreased PPARγ mRNA expression (p = 0.0008) and C/EBPα protein expression (p = 0.0015) in both RG2 and RG1. Furthermore, mRNA expression of bone morphogenetic protein 4 (BMP4) (p = 0.0083) and BMP7 (p = 0.0330) decreased in RG2 and peroxisome proliferator-activated receptor co-activator-1α (PGC-1α) reduced in RG2 and RG1. Conclusion: Our observations support that repression of regulatory factors promoting differentiation and development results in the inhibition of BAT maturation in fetal perirenal fat during late pregnancy with maternal undernutrition.

• Journal of Korean Academy of Nursing
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• v.44 no.3
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• pp.280-293
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• 2014

Purpose: The study was done to develop an evidence-based enteral nutrition (EN) protocol for effective nutritional support for dysphagia in patients with acute stroke, and to evaluate effects of this protocol on clinical outcomes. Methods: A methodological study was used to develop the EN protocol and a quasi-experimental study to verify the effectiveness of the protocol. The preliminary EN protocol was drawn by selecting recommendations from previous well-designed EN guidelines, and then developing additional recommendations based on high-quality evidence. Content validation was assessed by an expert group, and clinical applicability by care providers and patients. The scale-level content validity index of the final EN protocol was 0.99. Assessment was done of differences in percentage of caloric goals achieved and presence of undernutrition, aspiration pneumonia, and gastrointestinal (GI) complications after application of the EN protocol. Results: In the EN protocol group, the percentage of caloric goals achieved ($R^2=.24$, p=.001) and the reduction of GI complications (p=.045) were significantly improved, but the presence of undernutrition (p=.296) and aspiration pneumonia (p=.601) did not differ from the usual care group. Conclusion: Results indicate that the new EN protocol for dysphagia in patients with acute stroke significantly increased their nutritional intake and reduced GI complications.

• Perspectives in Nursing Science
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• v.2 no.1
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• pp.19-36
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• 2005

Muscle atrophy is defined as a decrease in muscle mass, cross-sectional area, and myofibrillar protein content. Causes inducing muscle atrophy may be inactivity, denervation, undernutrition and steroid. Inactivity may decrease protein synthesis and increase protein breakdown of skeletal muscle. The muscle atrophy due to inactivity was induced by bed rest, hindlimb suspension, cast, total hip replacement arthroplasty, anterior cruciate ligament reconstruction. Denervated atrophy may be induced by the loss of innervation from lower motor neuron. The atrophy was apparent in the lower limb of hemiplegic patients following ischemic stroke and in the hindlimb of ischemic stroke rats. Protein breakdown of skeletal muscle in the undernourished state results in muscle atrophy. The atrophy due to undernutrition was evident in cancer and leukemia patients and in the undernourished rats. Steroids have been used to treat allergies, inflammatory diseases, autoimmune diseases and to inhibit immune function following transplantation. Steroids may induce muscle atrophy by protein breakdown of skeletal muscle. Muscle Physiology Laboratoryat College of Nursing, Seoul National University proved that dexamethasone may induce hindlimb muscle atrophy in rats and exercise and DHEA may attenuate hindlimb muscle atrophy induced by the steroid in rats. Nurses working with patients undergoing steroid treatment need to be cognizant of steroid induced muscle atrophy. They need to assess whether muscle atrophy is being occurred during and after the steroid treatment. Moreover, they need to apply exercise and DHEA to the patients undergoing steroid treatment in order to attenuate the steroid induced muscle atrophy.

• Korean Journal of Agricultural Science
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• v.43 no.1
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• pp.72-79
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• 2016

It has long been known that nutritional and environmental influences during the early developmental period affect the biological mechanisms which determine animal metabolism. This phenomenon, termed 'metabolic imprinting', can cause subtle but long-lasting responses to prenatal and postnatal nutrition and even be passed onto the next generation. A large amount of research data shows that nutrient availability, in terms of quantity as well as quality, during the early developing stages can decrease the number of newborn piglets and their body weight and increase their susceptibility to death before weaning. However, investigation of potential mechanisms of 'the metabolic imprinting' effect have been scant. Therefore, it remains unknown which factors are responsible for embryonic and early postnatal nutrition and which factors are major determinants of body weight and number of new born piglets. Intrauterine undernutrition, for example, was studied using a rat model providing dams 50% restricted nutrients during pregnancy and the results showed significant decreases in birth weight of newborns. This response may be a characteristic of a subset of modulations in embryonic development which is caused by the metabolic imprinting. Underlying mechanisms of intrauterine undernutrition and growth retardation can be explained in part by epigenetics. Epigenetics modulate animal phenotypes without changes in DNA sequences. Epigenetic modifications include DNA methylation, chromatin modification and small non-coding RNA-associated gene silencing. Precise mechanisms must be identified at the morphologic, cellular, and molecular levels by using interdisciplinary nutrigenomics approaches to increase pig production. Experimental approaches for explaining these potential mechanisms will be discussed in this review.

• Korean Journal of Community Nutrition
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• v.10 no.5
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• pp.645-653
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• 2005

The prevalence of undernutrition in hospital populations is known to be high. The presence of malnutrition is associated with depression, infections, sarcopaenia, falls, fractures, reduced autonomy and increased mortality. This study specifically examined the prevalence of malnutrition in patients aged 65 or older at the time of admission as determined by the Mini Nutritional Assessment (MNA) which has been a frequently used nutritional risk screening tools in detecting undernutrition in old people. This study was done for one hundred eight hospitalized geriatric patients in Seoul National University Bundang Hospital, Seoul, Korea. On admission baseline history, anthropometrics measurements, laboratory data and nutritional status by MNA were assessed. Length of hospital stay was obtained by reviewing medical charts. We used one-way analysis of variance to compare the differences in variables. Spearman's rank correlation coefficients were calculated for associations between MNA and variables. On admission, $22.3\%$ of patients were malnourished and $40.7\%$ were at risk of malnutrition according to the MNA. Percent of ideal body weight, anthropometrics data, albumin, and hemoglobin were lower in the malnourished patients (p<0.05). The malnourished patients stayed in the hospital 7.3 days longer, as compared with well nourished patients (p<0.05). Percent of ideal body weight, albumin, hemoglobin and total cholesterol were correlated inversely with nutritional status according to MNA (p<0.05). MNA can be used for nutritional assessment in Korean old people, because MNA significantly correlated with other nutritional assessment parameters, such as, anthropometric and laboratory data in hospitalized geriatric patients. The high prevalence of malnutrition in the elderly was observed and the presence of malnutrition on admission predicted a significant increase in the length of hospital stay in this study. Therefore further studies are needed to determine whether nutritional interventions in old people with low MNA scores can improve clinical outcomes during the hospital course.

• Clinical and Experimental Pediatrics
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• v.61 no.8
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• pp.231-238
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• 2018

Purpose: Wasting and underweight are the 2 main indicators of children's undernutrition. We aimed to estimate the prevalence of undernutrition at the national level in Iran. Methods: We performed a search for original articles published in international and Iranian databases including MEDLINE, Web of Science, Google Scholar, Scopus, CINHAL (Cumulative Index to Nursing and Allied Health Literature), Scientific Information Database, Irandoc, Iranmedex, and Magiran during January 1989-August 2017. Seven keywords, in English and Persian, including malnutrition, protein energy malnutrition, growth disorders, underweight wasting, weight loss, children below 5 years old, and children, were used to search the databases. Results: Finally, 17 articles were included in the meta-analysis, based on which the prevalence of underweight and wasting in Iranian children were estimated to be 11% and 5%, respectively. The prevalence rates of underweight among children in the central, western, southern, and northern parts of Iran and at the national level were 24%, 5%, 20%, 17%, and 6%, respectively. The prevalence rates of wasting in the central, western, southern, and northern parts of Iran and at the national level were 9%, 4%, 11%, 5%, and 4%, respectively. Conclusion: Although the prevalence of underweight and wasting in Iran was low, some parts of the country showed high prevalence. The main reason behind this difference in the prevalence of malnutrition may be due to the level of development in different regions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.19 no.4
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• pp.269-275
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• 2016

Purpose: Undernutrition during hospitalization increases the risk of nosocomial infection and lengthens the disease courses. The aim of this study was to evaluate the risk factors of weight loss during hospitalization in children. Methods: All the patients who were admitted in general wards between April and May 2014 were enrolled. Patients aged >18 years and discharged within 2 days were excluded. Weight loss during hospitalization was defined as a decrease in body weight of >2% in 8 hospital days or on the day of discharge. Patients who lost body weight during hospitalization were compared with patients who maintained their body weights. Significant parameters were evaluated by using the multivariate logistic regression analysis. Results: We enrolled 602 patients, of whom 149 (24.8%) lost >2% of their body weight. Complaint of pain (p=0.004), admission to the surgical department (p=0.001), undergoing surgery (p=0.044), undergoing abdominal surgery (p=0.034), and nil per os (NPO) durations (p=0.003) were related to weight loss during hospitalization. The patients who had high weight-for-age tended to lose more body weight (p=0.001). Admission to the surgical department (odds ratio [OR], 1.668; 95% confidence interval [CI], 1.054-2.637; p=0.029) and long NPO durations (OR, 1.496; 95% CI, 1.102-2.031; p=0.010) were independent risk factors of weight loss during hospitalization. The patients with high weight-for-age tended to lose more weight during hospitalization (OR, 1.188; 95% CI, 1.029-1.371; p=0.019). Conclusion: Greater care in terms of nutrition should be taken for patients who are admitted in the surgical department and have prolonged duration of nothing by mouth.

• Korean Journal of Human Ecology
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• v.16 no.1
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• pp.193-204
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• 2007

This research has done for 67 undernutrition people of the aged men and women that are practiced follow-up nutrition intervention programs for 9weeks. The result of health related status, eating habit, food attitude and food intake for 2days is as following. 37.3% of objected old people are drinking, 20.9% of those are smoking and 29.9% of those are exercising. 55.2% of objected old people of the second intervention program about self-rated health say good. Sleeping hours of 25.4% of objected old people is from 6 to 8 hours. Meal amount and appetite above 98% of objected old people, compared to those of before sixty age, are decreasing and similar. 67.8% or 70.1% of the objected old people, compared to those of before sixty age, say same in sweet and salt taste. More significantly increased food group in after intervention than before intervention is vegetables and animal foods. There is no difference between management group and comparison group by ANCOVA analysis. DDS and DVS in management group are no significant differences between before intervention and after intervention.

• Nutrition Research and Practice
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• v.13 no.3
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• pp.222-229
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• 2019

BACKGROUND/OBJECTIVES: Aging is an imperative problem for many countries in this century, and presents several challenges for the maintenance of good nutritional status. This study aims to assess the impact of socio-demographic factors, lifestyle and health status on the nutritional status among the elderly in Taiwan. SUBJECTS/METHODS: A cross-sectional study was carried out in Taiwan. Data were obtained from the Mei Jau Health Management Institution, which is a private health evaluation provider with multiple health screening centers in Taiwan and Asia. This study included 7947 adults aged 65 years or above. The data were extracted between 2001 to 2010. Nutritional status was assessed using anthropometric data, biochemical data and dietary intake information. RESULTS: Among the 7947 participants with mean age of 70.1 (SD = 4.5) years, 20.2%, 6.6%, 10.5% and 52.5% experienced underweight, protein malnutrition, anemia and inadequate dietary intake in the past month, respectively. Age was negatively correlated with body weight (r = -0.19, P = 0.02), body mass index (r = -0.41, P < 0.001), albumin level (r = -0.93, P < 0.001) and hemoglobin level (r = -0.30, P = 0.008). Age above 70 years, gender, unmarried status, retirement, lack of education, low family income, smoking, alcohol drinking, sleep duration of 6-8 hours, vegetarian diet, multiple medications, comorbidity and dysphagia were positively associated with malnutrition in older adults. CONCLUSIONS: Underweight and inadequate dietary intake are prevalent among the elderly in Taiwan. Vegetarian diet, multiple medications, comorbidity, dysphagia and lifestyle factors such as smoking, alcohol drinking and sleep duration of 6-8 hours are risk factors for undernutrition in older adults.

• Nutrition Research and Practice
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• v.16 no.5
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• pp.658-672
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• 2022

BACKGROUND/OBJECTIVES: Although children of ethnic minority groups are experiencing a transition from a predominance of undernutrition to overnutrition, there is little evidence of a dual-malnutrition burden. Therefore, this study examined the double burden of malnutrition among school-aged ethnic minority children living in mountainous areas and its association with their diets. SUBJECTS/METHODS: A cross-sectional study was conducted from September 2019 to March 2020 in 3 mountainous areas of Northern Vietnam among 1,556 ethnic minority school-aged children. The prevalence of under-nutrition (stunting and thinness) and over-nutrition (overweight and obesity) were measured using the WHO 2006 child growth standards (height-for-age and BMI-for-age Z-score). Nutritional practices were evaluated by the frequency of food consumption based on a 4-level scale. RESULTS: The percentage of children with stunting and thinness were 14.0% and 5.4%, respectively, while the figure for overweight/obesity was 9.4%. The factors positively associated with stunting were living in a family with more than 2 children or being Muong/other ethnicities compared to the Tay ethnicity. Children who consumed fish/shrimps/crabs or milk weekly/daily were less likely to be undernourished compared to those who never consumed these foods. By contrast, children who never consumed foods rich in vitamin A precursors and vitamin A and fruit or consumed daily snacks/junk food were more likely to be overweight/obese. CONCLUSIONS: Undernutrition remains a common issue among school-aged children and adolescents of ethnic minority groups, while over-nutrition exists simultaneously. Public health nutrition programs promoting adequate diets and positive lifestyle changes related to nutrition are essential to tackle the double burden of malnutrition among ethnic minority children.