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Ketogenic Diet for Children with Epilepsy: A Practical Meal Plan in a Hospital.

Eunjoo LEE ; Hoon Chul KANG ; Heung Dong KIM

Clinical Nutrition Research.2016;5(1):60-63. doi:10.7762/cnr.2016.5.1.60

A ketogenic diet (KD) is a dietary approach to treat intractable epilepsy. The KD begins with hospitalization and the child and their parents can adapt to the KD for 1-2 weeks. Recently, various type of dietary intervention such as the modified Atkins diet (MAD) and the low glycemic index treatment (LGIT) have been performed. Since 2010, we carried out the KD, MAD, and LGIT for total of 802 patients; 489 patients (61%) for the KD, 147 patients (18.3%) with the MAD, and 166 patients (20.7%) for the LGIT. In this report, application of these dietary practices in Severance Hospital is shared.
Child* ; Diet, Carbohydrate-Restricted ; Epilepsy* ; Glycemic Index ; Hospitalization ; Humans ; Ketogenic Diet* ; Meals* ; Parents

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Effect of Salivary Reaction Time on Flow Properties of Commercial Food Thickeners Used for Dysphagic Patients.

Hwa Young LEE ; Seung Ro YOON ; Whachun YOO ; Byoungseung YOO

Clinical Nutrition Research.2016;5(1):55-59. doi:10.7762/cnr.2016.5.1.55

The effect of human saliva on the flow properties of pudding-like thickened water prepared with commercial food thickeners was investigated, and their viscosity differences were also compared as a function of salivary reaction time (0-60 min after the addition of saliva). Food thickeners used in this study were starch-based (SB), gum-containing starch-based (GSB), and gumbased (GB) commercial thickeners marketed in Korea. GB showed no significant reduction in viscosity upon contact with human saliva during the salivary reaction. In contrast, SB almost completely lost its viscosity shortly after the addition of saliva, and GSB significantly reduced its viscosity after 20 min of reaction time but retained its viscosity. The results of this study indicate that GB can enhance the swallowing safety of dysphagic patients by retaining a stable viscosity level without the reduction of viscosity during consumption of thickened fluids, whereas SB may increase the possibility of aspiration owing to a rapid decrease of viscosity upon contact with human saliva.
Deglutition ; Humans ; Korea ; Reaction Time* ; Saliva ; Viscosity ; Water

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Preoperative Oral Carbohydrate Loading in Pancreaticoduodenectomy.

Kum Hee SON ; So Young KIM ; Yeong Ah CHO ; Gyung Ah WIE ; Sung Sik HAN ; Sang Jae PARK

Clinical Nutrition Research.2016;5(3):213-218. doi:10.7762/cnr.2016.5.3.213

Overnight fasting before elective surgery has been the routine to reduce the risk of pulmonary aspiration. Recently, several international guidelines for preoperative fasting recommend to intake carbohydrate-containing fluids up to 2 to 3 hours before the induction of anesthesia to improve postoperative recovery. Based on the recommendations, we developed a "preoperative carbohydrate diet" provided for the preoperative patients. The purpose of this case report is to share our experience of applying preoperative carbohydrate loading prior to surgery.
Anesthesia ; Fasting ; Humans ; Insulin Resistance ; Pancreaticoduodenectomy*

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Association of Serum Apolipoprotein B with the Increased Risk of Diabetes in Korean Men.

Hyo Hee LIM ; Oh Yoen KIM

Clinical Nutrition Research.2016;5(3):204-212. doi:10.7762/cnr.2016.5.3.204

This study aimed to investigate the association of Apolipoprotein B (ApoB) with the risk of diabetes in Koreans. Korean men (n = 790, 40-79 years) who had been never diagnosed for diabetes before participating were enrolled. Subjects were categorized into normal fasting glucose (NFG, n = 519), impaired fasting glucose (IFG, n = 188) and newly-onset diabetes (n = 83) according to fasting glucose levels. Age was not significantly different among the subgroups. Mean values of BMI, waist circumference, Blood pressure(BP), triglyceride, non-HDL cholesterol were significantly higher in IFG or newly-onset diabetic subjects compared to NFG subjects. The levels of glucose, insulin, free fatty acid, insulin resistance and ApoB were highest in diabetic patients and lowest in NFG subjects. According to ApoB level, subjects were divided into two groups (high-ApoB group: ≥ 87.0 mg/dL vs. low-ApoB group: < 87.0 mg/dL). The risk of diabetes was higher in the high-ApoB group than the low-ApoB group [OR₀: 2.392, (95% CI: 1.470-3.893), P₀< 0.001]. This association was maintained after adjusted for age and BMI [OR₁: 2.228, (95% CI: 1.362-3.646), P₁ = 0.001] and further adjustment for blood pressure, triglyceride, HDL-cholesterol, LDL-cholesterol, non-HDL-cholesterol, ApoA1 and adiponectin [OR₂: 1.984, (95% CI: 1.001-4.064), P₂ = 0.049]. The association was much greater in subjects with metabolic syndrome (MetS) [OR₁: 2.805 (95% CI: 1.137-5.737), P₁ = 0.005] than in those without [OR₁: 1.917 (95% CI: 0.989-3.718), P₁ = 0.054]. After 3-month, further investigation was randomly performed in subjects with NFG or IFG who agreed to reinvestigation. Multiple stepwise regression analysis revealed that net change of ApoB levels was a main contributor to the net change of glucose levels (standardized b-coefficient: 0.315, p = 0.002). In conclusion, ApoB levels are closely associated with the increased risk of diabetes in Korean men.
Adiponectin ; Apolipoproteins B ; Apolipoproteins* ; Blood Pressure ; Cholesterol ; Fasting ; Glucose ; Humans ; Insulin ; Insulin Resistance ; Male ; Triglycerides ; Waist Circumference

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Serum Phospholipid Docosahexaenoic Acid Is Inversely Associated with Arterial Stiffness in Metabolically Healthy Men.

Mi Hyang LEE ; Nayeon KWON ; So Ra YOON ; Oh Yoen KIM

Clinical Nutrition Research.2016;5(3):190-203. doi:10.7762/cnr.2016.5.3.190

We hypothesized that lower proportion of serum phospholipid docosahexaenoic acid (DHA) is inversely associated with increased cardiovascular risk and vascular function in metabolically healthy men. To elucidate it, we first compared serum phospholipid free fatty acid (FA) compositions and cardiovascular risk parameters between healthy men (n = 499) and male patients with coronary artery disease (CAD, n = 111) (30-69 years) without metabolic syndrome, and then further-analyzed the association of serum phospholipid DHA composition with arterial stiffness expressed by brachial-ankle pulse wave velocity (ba-PWV) in metabolically healthy men. Basic parameters, lipid profiles, fasting glycemic status, adiponectin, high sensitivity C-reactive protein (hs-CRP) and LDL particle size, and serum phospholipid FA compositions were significantly different between the two subject groups. Serum phospholipid DHA was highly correlated with most of long-chain FAs. Metabolically healthy men were subdivided into tertile groups according to serum phospholipid DHA proportion: lower (< 2.061%), middle (2.061%-3.235%) and higher (> 3.235%). Fasting glucose, insulin resistance, hs-CRP and ba-PWVs were significantly higher and adiponectin and LDL particle size were significantly lower in the lower-DHA group than the higher-DHA group after adjusted for confounding factors. In metabolically healthy men, multiple stepwise regression analysis revealed that serum phospholipid DHA mainly contributed to arterial stiffness (β'-coefficients = -0.127, p = 0.006) together with age, systolic blood pressure, triglyceride (r = 0.548, p = 0.023). Lower proportion of serum phospholipid DHA was associated with increased cardiovascular risk and arterial stiffness in metabolically healthy men. It suggests that maintaining higher proportion of serum phospholipid DHA may be beneficial for reducing cardiovascular risk including arterial stiffness in metabolically healthy men.
Adiponectin ; Blood Pressure ; C-Reactive Protein ; Coronary Artery Disease ; Fasting ; Glucose ; Humans ; Insulin Resistance ; Male ; Particle Size ; Pulse Wave Analysis ; Triglycerides ; Vascular Stiffness*

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The Association between Coffee Consumption and Bone Status in Young Adult Males according to Calcium Intake Level.

Mi Kyeong CHOI ; Mi Hyun KIM

Clinical Nutrition Research.2016;5(3):180-189. doi:10.7762/cnr.2016.5.3.180

The purpose of this study was to investigate the association between coffee consumption and bone status (bone mineral density and bone metabolism-related markers) according to calcium intake level in Korean young adult males. Healthy and nonsmoking males (19-26 years, n = 330) participated in this study. Anthropometric measurements, dietary habits, and nutrient intakes were surveyed. Bone status of the calcaneus was measured by using quantitative ultrasound (QUS). Bone metabolism-related markers including serum total alkaline phosphatase activity (TALP), N-mid osteocalcin (OC), and type 1 collagen C-terminal telopeptide (1CTP) were analyzed. The subjects were divided into two groups based on daily calcium intake level: a calcium-sufficient group (calcium intake ≥ 75% RI, n = 171) and a calcium-deficient group (calcium intake < 75% RI, n = 159). Each group was then further divided into three subgroups based on daily average coffee consumption: no-coffee, less than one serving of coffee per day, and one or more servings of coffee per day. There were no significant differences in height, body weight, body mass index, energy intake, or calcium intake among the three coffee consumption subgroups. QUS parameters and serum 1CTP, TALP, and OC were not significantly different among either the two calcium-intake groups or the three coffee consumption subgroups. Our results may show that current coffee consumption level in Korean young men is not significantly associated with their bone status and metabolism according to the calcium intake level.
Alkaline Phosphatase ; Body Height ; Body Weight ; Calcaneus ; Calcium* ; Coffee* ; Collagen Type I ; Energy Intake ; Food Habits ; Humans ; Male* ; Metabolism ; Miners ; Multiple Endocrine Neoplasia Type 1 ; Osteocalcin ; Ultrasonography ; Young Adult*

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Application of Iron Oxide as a pH-dependent Indicator for Improving the Nutritional Quality.

Xiangpeng MENG ; Jina RYU ; Bumsik KIM ; Sanghoon KO

Clinical Nutrition Research.2016;5(3):172-179. doi:10.7762/cnr.2016.5.3.172

Acid food indicators can be used as pH indicators for evaluating the quality and freshness of fermented products during the full course of distribution. Iron oxide particles are hardly suspended in water, but partially or completely agglomerated. The agglomeration degree of the iron oxide particles depends on the pH. The pH-dependent particle agglomeration or dispersion can be useful for monitoring the acidity of food. The zeta potential of iron oxide showed a decreasing trend as the pH increased from 2 to 8, while the point of zero charge (PZC) was observed around at pH 6.0-7.0. These results suggested that the size of the iron oxide particles was affected by the change in pH levels. As a result, the particle sizes of iron oxide were smaller at lower pH than at neutral pH. In addition, agglomeration of the iron oxide particles increased as the pH increased from 2 to 7. In the time-dependent aggregation test, the average particle size was 730.4 nm and 1,340.3 nm at pH 2 and 7, respectively. These properties of iron oxide particles can be used to develop an ideal acid indicator for food pH and to monitor food quality, besides a colorant or nutrient for nutrition enhancement and sensory promotion in food industry.
Food Industry ; Food Quality ; Hydrogen-Ion Concentration ; Iron* ; Nutritive Value* ; Particle Size ; Water

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Differences of Socio-psychology, Eating Behavior, Diet Quality and Quality of Life in South Korean Women according to Their Weight Status.

Jieun KIM ; Ryowon CHOUE ; Hyunjung LIM

Clinical Nutrition Research.2016;5(3):161-171. doi:10.7762/cnr.2016.5.3.161

We aimed at assessing psychological variables and eating behaviors on quality of diet and life in South Korean women according to their weight status. Socio-psychology, eating behavior, quality of diet and quality of life data were assessed in 114 women (mean age: 34.5 ± 8.09 years). NEO Personality Inventory (NEO-PI-RS) and coping styles questionnaire were used to assess socio-psychology variables, and eating behavior was assessed using the Eating Attitudes Test-26 (EAT-26), Dutch Eating Behavior Questionnaire (DEBQ), and General Food Craving Questionnaire Test (G-FCQ-T). Quality of diet was analyzed by Diet Quality Index-international (DQI-I), and obesity-related quality of life was evaluated using the Korean Obesity-related Quality of life Scale (KOQOL). Significant differences were in the psychological variables and eating behaviors in the obese group than the normal and overweight groups (p < 0.05). The overall score of DQI-I was significantly lower in the obese group than that of their counterparts (p < 0.05). BMI was positively correlated with neuroticism, emotional eating, and obesity-related quality of life, and negatively correlated with diet quality. Neuroticism was positively correlated with emotional eating and food craving. Emotional eating was positively correlated with obesity-related quality of life. In conclusion, women with a higher BMI had significantly more problematic eating behaviors, poor diet quality and quality of life.
Craving ; Diet* ; Eating* ; Feeding Behavior* ; Female ; Humans ; Obesity ; Overweight ; Personality Inventory ; Quality of Life*

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Validity and Reliability of a Self-administered Food Frequency Questionnaire to Assess Vitamin K Intake in Korean Adults.

Eunsu KIM ; Misung KIM ; Cheongmin SOHN

Clinical Nutrition Research.2016;5(3):153-160. doi:10.7762/cnr.2016.5.3.153

This study was conducted to validate a food frequency questionnaire (FFQ) to assess vitamin K intake in clinical and research settings based on data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). We collected a subset of data on informative food items using the 24-hour recall method from adults aged 19 to 64 years from KNHANES V. The cumulative percent contribution and cumulative multiple regression coefficients for vitamin K intake from each food were computed. Twenty-five foods items were selected for the FFQ to assess vitamin K intake. The FFQ was validated against intakes derived from a 5-day food record (5DR) (n = 48). To assess the reliability of the FFQ, participants completed the self-administered FFQ (FFQ1) and a second FFQ (FFQ2) after a 6-month period (n = 54). Data were analyzed using Pearson's correlation coefficients, the cross-classification method, and Bland-Altman plots. Mean intakes were similar for vitamin K between the FFQ and dietary records, with significant correlations observed (r = 0.652), and cross-classification analyses demonstrated no major misclassification of participants into intake quartiles. Bland-Altman plots showed no serious systematic bias between the administrations of the two dietary assessment methods over the range of mean intakes. FFQ reliability was high, with a Pearson's correlation coefficient of 0.560. This pilot study shows promising validation and reliability evidence for the use of this FFQ, which is focused on vitamin K intake in adults, as an efficient screening tool in clinical and research settings.
Adult* ; Bias (Epidemiology) ; Diet Records ; Humans ; Korea ; Mass Screening ; Methods ; Nutrition Surveys ; Pilot Projects ; Reproducibility of Results* ; Vitamin K* ; Vitamins*

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Nutritional Factors Affecting Mental Health.

So Young LIM ; Eun Jin KIM ; Arang KIM ; Hee Jae LEE ; Hyun Jin CHOI ; Soo Jin YANG

Clinical Nutrition Research.2016;5(3):143-152. doi:10.7762/cnr.2016.5.3.143

Dietary intake and nutritional status of individuals are important factors affecting mental health and the development of psychiatric disorders. Majority of scientific evidence relating to mental health focuses on depression, cognitive function, and dementia, and limited evidence is available about other psychiatric disorders including schizophrenia. As life span of human being is increasing, the more the prevalence of mental disorders is, the more attention rises. Lists of suggested nutritional components that may be beneficial for mental health are omega-3 fatty acids, phospholipids, cholesterol, niacin, folate, vitamin B6, and vitamin B12. Saturated fat and simple sugar are considered detrimental to cognitive function. Evidence on the effect of cholesterol is conflicting; however, in general, blood cholesterol levels are negatively associated with the risk of depression. Collectively, the aims of this review are to introduce known nutritional factors for mental health, and to discuss recent issues of the nutritional impact on cognitive function and healthy brain aging.
Aging ; Brain ; Cholesterol ; Cognition ; Dementia ; Depression ; Fatty Acids, Omega-3 ; Folic Acid ; Humans ; Mental Disorders ; Mental Health* ; Niacin ; Nutritional Status ; Phospholipids ; Prevalence ; Schizophrenia ; Vitamin B 12 ; Vitamin B 6

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