Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one(26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.
Antineoplastic Combined Chemotherapy Protocols ; Cooking ; Counseling ; Cytarabine ; Diet ; Eating ; Etoposide ; Food Services ; Hospitals, General ; Humans ; Inpatients ; Length of Stay ; Malnutrition ; Meals ; Methotrexate ; Quality Improvement ; Seasons ; Weights and Measures

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.
Aged ; Cholesterol ; Depression ; Humans ; Ideal Body Weight ; Korea ; Length of Stay ; Malnutrition ; Mass Screening ; Mortality ; Nutrition Assessment* ; Nutritional Status* ; Prevalence ; Seoul

This study was performed to improve the hospital food service in quality and customer satisfaction by using 6-sigma strategy which was processed by DMAIC methods. The research procedure was as follows; analyzing the main causes of customer dissatisfaction of food service by using numerical method, and then finding out the standardized problem solving methods, and finally reforming food service process. The effectiveness of 6-sigma activity was measured by 'food service quality index', 'customer satisfaction index' and 'total food service satisfaction index'. Food service quality index was calculated by adding grade of soup temperature, food service, delivery time, and setting accuracy. Statistical data analyses were completed by using the Minitab Ver. 14. By performing 6 sigma activity, food service quality index was increased from 67 to 79 points (p<0.05) and customer satisfaction index also rise from 73 to 79points (p<0.05). Satisfaction of meals' taste, diverse menu, food setting accuracy, remove of food service, overall food service were significantly improved(p<0.05). The results of capability analysis in food service quality index, customer satisfaction index, and total food service satisfaction index were improved 2.11sigma to 2.49sigma , 1.88sigma to 2.43sigma, and 2.04sigma to 2.47sigma respectively (p<0.05). Therefore this study showed that subjective food service improving process could be measured by objective numerical value which might be used for financial value in hospital management.
Data Interpretation, Statistical ; Food Service, Hospital* ; Food Services ; Problem Solving

In Korea, there are many kinds of functional foods to manage diabetes, however, they have not been evaluated or investigated systematically. The purpose of this study was to investigate the status of recognition and intake of functional foods among diabetic patients. The study subjects were 307 patients(male 135, female 172), who diagnosed with type 2 diabetes at Seoul National University of Bundang Hospital. Questionnaire survey was done from July to October, 2004 for the characteristics of patients and factors related to the use of functional foods. The mean age of the subjects was 64+/-10.2 years, and the mean duration of disease was 9.5+/-8.90 years. Approximately 49.8% of the subjects had experience to use functional foods at least once in past. Total number of functional foods used were 56 types. Red ginseng was used most frequently(27.9%), then followed by Silkworm powder(13.6%), Vitamin supplements(10.4%), Mulberry tree(7.1%), Cordyceps sinensis(6.8%) and Ginseng(4.2%). Functional foods were introduced by their friends.relatives(38.4%), family(29.1%), internet(13.9%), and the mass media(10.6%). Among respondents, 94.7% took functional foods with conventional diet therapies(diet, exercise and medication). The purpose of functional food use was to control blood glucose level(49.0%), to relieve fatigue and improve stamina(19.9%), to treat and prevent a disease(17.2%) and to help blood circulation(7.9%). Upon the question of further recommendation of functional foods to others, 74.8% of the subjects answered negative response. However, 12.6% of the subjects showed the further intention of using new product. Therefore, to guide the appropriate use of functional foods for diabetic patients, diabetic educator should provide the knowledge of the efficacy of functional foods and the desirable guidelines.
Blood Glucose ; Bombyx ; Cordyceps ; Surveys and Questionnaires ; Diabetes Mellitus ; Diet ; Fatigue ; Female ; Functional Food* ; Humans ; Intention ; Korea ; Morus ; Panax ; Seoul ; Vitamins

The purpose of this study was to assess the diet diversity, food habit and nutrient intake of obese adults who were visiting the health promotion center. This study was accomplished with the 138 obese adults (men = 103, women = 35) aged over 20 years old whose BMI were above 25 kg/m2. Nutrient adequacy ratio (NAR), the number of foods (Dietary Variety Score, DVS), and food group consumed (Dietary Diversity Score, DDS) by using the data from the three days record were analyzed and the food habit and lifestyle were assessed by self reporting questionnaire. The average energy intake of men was 2150.2 kcal which was significantly higher than that of women (p < 0.05). The intake ratio of carbohydrate, protein and fat over total energy was 54.8% : 19.3% : 25.8% in men, 59.5% : 17.8% : 22.6% in women, respectively. Frequency of the breakfast in a week above 4, 2~3 time and under one time was 75.7%, 10.7% and 9.7% in men, 77.1%, 5.7% and 14.3% in women respectively. Frequency of eating between meals in a day under one time was 73.8% in men, 57.1% in women (p < 0.05). The average DDS and DVS was 3.63 +/-0.07 and 14.10 +/-3.45, respectively which was significantly correlated with MAR (r = 0.40 in DDS, r = 0.64 in DVS, p < 0.01). The most frequent style of food pattern was DMGFV = 01101 in 35% of men, and DMGFV = 01111 in 37.1% of women. Our results show that dietary diversity and variety are useful parameters for evaluating nutrient intakes in obese adults. These findings suggest that nutritional education based on obese persons' eating behavior and eating diversity may be required to increase educational efficiency of weight control programs.
Adult* ; Breakfast ; Diet ; Eating ; Education ; Energy Intake ; Feeding Behavior ; Female ; Food Habits ; Health Promotion ; Humans ; Life Style ; Male ; Meals ; Obesity ; Self Report ; Young Adult

OBJECTIVES: This study was conducted to investigate the status and need for nutrition and dietary life education among nutrition teachers at schools. These characteristics were analyzed if they were different between elementary schools and middle-high schools. METHODS: Subjects were 151 nutrition teachers from 70 elementary schools, 41 middle schools and 40 high schools in 17 cities nationwide selected by two-stage stratified cluster sampling process. Survey questionnaires included the items on general characteristics, status and need assessment for nutrition and dietary life education. Chi-square test or t-test was used for data analysis by school groups. RESULTS: Nutrition education was implemented at 65.7% of elementary schools and 51.9% of middle-high schools. Nutrition education was mainly performed in 'discretionary activities·extracurricular activities' at elementary school and through 'newsletters, school homepage, foodservice bulletin board' at middle-high school (p<0.001). The most needed topic for nutrition education in nutrition teachers was 'healthy dietary habits and table manners' and this was not significantly different by school groups. Responses on adequate frequency (p<0.01), methods used for nutrition education (p<001), materials for nutrition education (p<0.001), information sources for nutrition education (p<0.001) were significantly different by school groups. Major tasks for activating nutrition education included 'securing the time for implementing nutrition education by reducing work loads' and 'developing standardized nutrition education materials' in schools. CONCLUSIONS: Nutrition education at schools might be activated by improving working conditions of nutrition teachers and developing the practical programs that reflect the needs of nutrition teachers.
Adolescent ; Child ; Education* ; Food Habits ; Humans ; Needs Assessment ; Statistics as Topic

BACKGROUND: Conventional diagnostic methods of pulmonary tuberculosis, such as acid-fast bacilli staining and culture of sputum, have the disadvantages of low sensitivity and long incubation period, respectively. The diagnosis of extrapulmonary tuberculosis needs invasive procedures. We investigated the value of PCR-based detection of Mycobacterium tuberculosis from peripheral blood mononuclear cells for diagnosis of pulmonary or extrapulmonary tuberculosis. METHODS: The peripheral blood mononuclear cells were collected from 23 patients with pulmonary tuber-culosis( n=10) and extrapulmonary tuberculosis(n=13), in-cluding miliary tuberculosis(n=5), and 10 healthy indi-viduals as negative controls. A pair of primers was used to produce a 314 bp amplification product from the insertion element IS6110, which is specific for M. tuberculosis. PCR products were detected by agarose gel electrophoresis and southern hybridization using a IS6110 specific oligoprobe. RESULTS: Eight out of ten with pulmonary tuberculo-sis and 9 out of 13 patients with extrapulmonary tuber-culosis showed positive results, yielding 73.9%(17/23) positivity on PCR assay. All five patients with miliary tuberculosis were positive. None of the healthy indivi-duals showed positive results. CONCLUSION: The PCR assay for M. tuberculosis from peripheral blood seems to be useful for diagnosis of tuberculosis, especially miliary tuberculosis. Further studies about the value of the PCR assay in monitoring treatment response are needed.
Diagnosis ; Electrophoresis, Agar Gel ; Humans ; Mycobacterium tuberculosis* ; Mycobacterium* ; Polymerase Chain Reaction* ; Sputum ; Tuberculosis* ; Tuberculosis, Miliary ; Tuberculosis, Pulmonary

There is little information on dietary vitamin K intake and nutritional status of daily requirements of vitamin K in Korea. The objective of this study was to investigate the vitamin K intake and major food sources of Vitamin K in Koreans. The survey data from the 2010-2011 Korean National Health and Nutrition Examination Survey of 7,792 subjects (aged 19-64 years) were examined. Total vitamin K intake was calculated from 24-hour dietary recall using a vitamin K food database, Computer Aided Nutritional analysis Program and the United States Department of Agriculture database. The geometric mean of vitamin K was estimated as 322.40 +/- 6.33 ug/day for men and 271.20 +/- 4.92 ug/day for women. Daily vitamin K intake increased significantly with age (p for trend < 0.001). The main food source of vitamin K was vegetables (72.84%), including cabbage kimchi (19.26%), spinach (17.38%), sesame leaves (7.11%), radish leaves (6.65%), spring onions (6.28%), and laver (4.82%), followed by seaweed, seasonings, and fat and oils. We observed that the vitamin K intake of Koreans was relatively higher than that reported by other studies in Western countries and differed depending on age.
Brassica ; Female ; Humans ; Korea ; Male ; Nutrition Surveys* ; Nutritional Status ; Oils ; Onions ; Raphanus ; Seasons ; Seaweed ; Sesamum ; Spinacia oleracea ; United States Department of Agriculture ; Vegetables ; Vitamin K 1 ; Vitamin K* ; Vitamins*

The purpose of the study was to examine the current status of nutritional management at elderly nursing homes. A survey was performed of 83 nursing homes from January 5, 2011 to January 21, 2011 via mail. A total of 34 nursing homes responded to the survey and 149 elderly subjects were analyzed according to the presence of a dietitian. Among the 34 nursing homes, 70.6% had a dietitian on duty. All of the facilities with a dietitian had the dietitian making the meal plan, whereas 70% of the facilities without dietitian served meals planned by a non-professional person. Overall, however, a low proportion of nursing homes implemented dietetic treatments for residents with diseases. For the nutritional assessment of these residents, a mini nutritional assessment (MNA) was performed. MNA scores were significantly associated with body mass index (BMI), mid-arm circumference (MAC), calf circumference (CC), ingestion problems, and weight loss during the last 3 months (P<0.001). Among the elderly studied, 5.4% were malnourished, and 36.9% were at risk for malnutrition by MNA score. The results of this survey show that the current management of nutrition at nursing homes is insufficient because the elderly who needed dietetic treatment did not receive proper care. Dietetic management is the most important service in all nursing homes. Therefore, to improve the nutritional status of elderly residents in nursing homes, systematic nutrition management by nutrition experts should be implemented.
Aged* ; Body Mass Index ; Eating ; Humans ; Insurance, Long-Term Care ; Malnutrition ; Meals ; Nursing Homes* ; Nursing* ; Nutrition Assessment ; Nutritional Status ; Postal Service ; Weight Loss

Obesity not only reduces bone mineral density but also increases inflammatory markers. Therefore, we examined the change in inflammatory markers and morphological microstructure of the bones using a mouse model fed a high-fat diet. C57BL/6J 4-week-old male mice were divided into a control group (n = 6) and a experimental group (n = 6); the control group was provided with 10% Kcal fat diet, and the high-fat diet group was provided with 45% Kcal fat diet for 12 weeks using the free provision method. Blood was analyzed for inflammatory markers, and micro-computed tomography was used to measure the morphological microstructure of the femoral bone. The weight increases in the control group and high-fat diet group were 5.85 +/- 1.84 g and 16.06 +/- 5.64 g, respectively (p < 0.01), glucose was 115.00 +/- 16.88 mg/dL and 188.33 +/- 13.29 mg/dL (p < 0.01), and triglycerides were 65.00 +/- 6.19 mg/dL and 103.33 +/- 8.02 mg/dL (p < 0.05) respectively. Leptin and interleukin (IL)-6 were significantly higher in the high-fat diet group than that in the control group (p < 0.01). As a result of a biochemical index analysis of bone metabolism, osteocalcin tended to be lower in the high-fat diet group, whereas CTx was significantly higher in the high-fat diet group compared to that in the control group (p < 0.01). The thickness of the bony trabecula was significantly narrower in the high-fat diet group than that in the control group (p < 0.05), and the gap in the bony trabecula was significantly wider in the high-fat diet group than that in the control group (p < 0.05). IL-6 and the gap in the bone trabecula, which was a morphological microstructure of the bones, showed a positive correlation (p < 0.05). Taken together, inducing obesity through a high-fat diet in mice during the growth phase caused a change in bone microstructure and was correlated with the inflammation index. Accordingly, restriction of excessive fat intake may be needed to suppress the inflammatory reactions and promote normal bone formation.
Animals ; Bone Density ; Diet ; Diet, High-Fat ; Glucose ; Humans ; Inflammation ; Interleukin-6 ; Interleukins ; Leptin ; Male ; Mice ; Obesity ; Osteocalcin ; Osteogenesis ; Triglycerides