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Early Postoperative 24-Hour Continuous Jejunostomy Feeding in Esophagectomy Patients.

Jeong Hyun LIM ; Dal Lae JU ; Yoohwa HWANG ; Chang Hyun KANG

Clinical Nutrition Research.2014;3(1):69-73. doi:10.7762/cnr.2014.3.1.69

Esophagectomy can result in various postoperative nutrition-related complications that may impair the nutritional status of the patient. In our institution, we usually initiate 16-hour continuous jejunostomy feeding using an enteral feeding pump on postoperative day 2 as a routine protocol after esophagectomy. The target calorie intake was achieved in 6-7 days with this protocol, which is longer than that required with other recently reported feeding protocols. Accordingly, early jejunostomy feeding protocol, which starts on postoperative day 1 and continues for 24 hours was attempted. In the present report, we described 3 cases of early 24-hour continuous jejunostomy feeding after esophagectomy. The use of this new protocol reduced the duration required to achieve the target calorie intake as less than 5 days without any enteral feeding-related complications.
Enteral Nutrition ; Esophagectomy* ; Humans ; Jejunostomy* ; Nutritional Status

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Nutritional Intervention for a Patient with Diabetic Nephropathy.

Hee Young KIM

Clinical Nutrition Research.2014;3(1):64-68. doi:10.7762/cnr.2014.3.1.64

In recent years, several studies have reported that the prevalence of diabetes mellitus is increasing every year, and also the acute and chronic complications accompanying this disease are increasing. Diabetic nephropathy is one of chronic complications of diabetes mellitus, and food intake which is burden to kidney function should be limited. At the same time, diet restriction could deteriorate quality of life of patient with diabetic nephropathy. According to the results of previous studies, the aggressive management is important for delaying of the progression to diabetic nephropathy. Also, the implementation of a personalized diet customized to individuals is an effective tool for preservation of kidney function. This is a case report of a patient with diabetic nephropathy who was introduced to a proper diet through nutrition education to prevent malnutrition, uremia and to maintain blood glucose levels.
Blood Glucose ; Diabetes Complications ; Diabetes Mellitus ; Diabetic Nephropathies* ; Diet ; Eating ; Education ; Humans ; Kidney ; Malnutrition ; Prevalence ; Quality of Life ; Uremia

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Comparison of Nutrient Intake and Diet Quality Between Hyperuricemia Subjects and Controls in Korea.

Kyoung A RYU ; Hyun Hee KANG ; So Young KIM ; Min Kyong YOO ; Jeong Seon KIM ; Chan Haw LEE ; Gyung Ah WIE

Clinical Nutrition Research.2014;3(1):56-63. doi:10.7762/cnr.2014.3.1.56

Hyperuricemia is associated with metabolic syndrome as well as gout, and the prevalence of hyperuricemia is increasing in Korea. This study aimed to compare the nutrient intake and diet quality between hyperuricemia subjects and controls. Of the 28,589 people who participated in a health examination between 2008 and 2011, 9,010 subjects were selected whose 3-day food records were available. Clinical and laboratory data were collected from electronic medical records. Diet quality was evaluated using the food habit score (FHS), nutrient adequacy ratio (NAR), and mean adequacy ratio (MAR). The prevalence of hyperuricemia was 13.8% (27.1%, men; 5.2%, women). Body mass index, waist circumference, triglycerides, total cholesterol, and low-density lipoprotein cholesterol were significantly higher (p < 0.0001), while high-density cholesterol (p < 0.001) was significantly lower in the hyperuricemia subjects than in the controls. The hyperuricemia subjects had a lower intake of vitamin A (p < 0.004), vitamin C, folate, fiber, and calcium than the controls (p < 0.0001). Intake of vegetables and dairy products was significantly lower, whereas alcohol intake was significantly higher in the hyperuricemia subjects than in the controls ( p < 0.0001). The FHS (p < 0.0001), MAR (p < 0.0001), and NARs for vitamin A (p = 0.01), vitamin B2, vitamin C, folate, and calcium (p < 0.0001) were significantly lower in the hyperuricemia subjects than in the controls. In conclusion, the hyperuricemia subjects reported poorer diet quality than the controls, including higher alcohol intake and lower vegetable and dairy product intake.
Ascorbic Acid ; Body Mass Index ; Calcium ; Cholesterol ; Dairy Products ; Diet Records ; Diet* ; Electronic Health Records ; Folic Acid ; Food Habits ; Gout ; Humans ; Hyperuricemia* ; Korea* ; Lipoproteins ; Male ; Nutritive Value ; Prevalence ; Riboflavin ; Triglycerides ; Uric Acid ; Vegetables ; Vitamin A ; Waist Circumference

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The Palatability of Cereal Based Nutritional Supplements in Cancer Patients.

Hyun Wook BAIK ; Mi Kyung SUNG ; Yu Sun LEE ; Min Kyung SONG ; Yun Jung BAE

Clinical Nutrition Research.2014;3(1):48-55. doi:10.7762/cnr.2014.3.1.48

Recently, it is reported that intervention of oral nutritional supplement improves the nutritional status of cancer patients, and the effectiveness is affected by the sensory preference of cancer patients on the oral nutritional supplement. However, the variety of oral nutritional supplement is extremely limited and the number of patient's benefits from using the products are restricted mostly due to sensory dislikes. The objective of this study was to provide sensory preference score of trial manufactured products with different accessory ingredients to maximize the use of oral nutritional supplements. Cancer patients (n = 30) and age, sex-matched healthy volunteers (n = 30) participated in the sensory assessments (taste, flavor, viscosity, color and overall preference) of three types of oral supplements (cereal base, cereal base+herb and cereal base+fruit) and a control supplement product with scorched cereal flavor, a top seller in current Korean market. Results indicate that the cancer patients' overall preference was significantly higher for the control supplement, and fruit added supplement was preferred over plain cereal and herb added products, although the difference was insignificant. However, there was no significant preference difference for the supplements among the control group for all sensory factors. These results suggest that cancer patients are more sensitive to sensory preferences compared to the control group, and the patients prefer the flavor of cooked cereal which is a staple food in Korea.
Edible Grain* ; Fruit ; Healthy Volunteers ; Humans ; Korea ; Nutritional Status ; Viscosity

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Effect of 8-Week Nutrition Counseling to Increase Phytochemical Rich Fruit and Vegetable Consumption in Korean Breast Cancer Patients: A Randomized Controlled Trial.

Sang Woon CHO ; Jin Hee KIM ; Seung Min LEE ; Song Mi LEE ; Eun Jung CHOI ; Joon JEONG ; Yoo Kyoung PARK

Clinical Nutrition Research.2014;3(1):39-47. doi:10.7762/cnr.2014.3.1.39

High fruit and vegetable consumption is associated with a lower risk of breast cancer. The incidence of breast cancer is continuously increasing in Korea, but only a few studies on nutrition intervention in breast cancer patients has been reported. The aim of this study was to investigate whether an 8-week nutrition intervention based on dietary counseling can promote fruit and vegetable consumption, increase serum antioxidant nutrient levels, and improve quality of life in Korean breast cancer patients. Sixty-one breast cancer patients received either standard care (n = 31) or nutrition counseling (n = 30). The standard care group was given brochures recommending phytochemical rich diet. The intervention group was provided with two nutrition counseling sessions and one cooking class session, thereby encouraged subjects to eat at least 10 or more servings of fruits and vegetables per day. After 8-week intervention, waist circumference in the intervention group was significantly decreased (p < 0.001) even though no difference was reported for body mass index. Energy intake (p = 0.007), fiber (p < 0.001), and antioxidant nutrient (vitamin A, C, E, and beta-carotene, p < 0.001, respectively) intakes were significantly increased. Serum antioxidant level was also increased significantly, i.e., vitamin A (p = 0.048); vitamin E (p = 0.004). Total vegetable intake (excluding kimchi intake) in the intervention group was increased from 425 g to 761 g (p < 0.001), fruit consumption was also increased from 232 g to 334 g (p < 0.001), while standard care group did not show any significant change. Our study showed that nutrition counseling and providing cooking tips helped to encourage the patient to consume and maintain more fruit and vegetable intakes.
Antioxidants ; beta Carotene ; Body Mass Index ; Breast Neoplasms* ; Breast* ; Cooking ; Counseling* ; Diet ; Energy Intake ; Fruit* ; Humans ; Incidence ; Korea ; Pamphlets ; Quality of Life ; Vegetables* ; Vitamin A ; Vitamin E ; Vitamins ; Waist Circumference

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Relationship of Delayed Parenteral Nutrition Protocol with the Clinical Outcomes in a Medical Intensive Care Unit.

Hosun LEE ; Kyung Soo CHUNG ; Moo Suk PARK ; Sungwon NA ; Young Sam KIM

Clinical Nutrition Research.2014;3(1):33-38. doi:10.7762/cnr.2014.3.1.33

Although parenteral nutrition (PN) is an important treatment for patients who are unable to tolerate enteral nutrition (EN), recent international guidelines recommended that PN should be reserved and initiated only after 7 days in well-nourished patients. This retrospective study was conducted to analyze the effect on clinical outcomes of a PN protocol with PN starting 4 days after admission to the intensive care unit (ICU). Eighty-one patients who were admitted from January to March of 2012 were included in the pre-protocol group, and 74 patients who were admitted from April to June of 2012 were included in the post-protocol group. There were no significant differences between the two groups when the age, gender, and admission Acute Physiology and Chronic Health Evaluation (APACHE) II scores were compared. Significantly fewer patients in the post-protocol group were provided PN (58.1% vs. 81.3%, p = 0.002), which was initiated significantly later than in the pre-protocol group (2.7 +/- 2.2 days vs. 1.9 +/- 2.0 days, p = 0.046). Five patients (6.2%) in the pre-protocol group acquired central line-associated bloodstream infection (CLA-BSI) in the ICU, yet none of the patients in the post-protocol group developed CLA-BSI (p = 0.03). The duration of antibiotic therapy and ICU stay were significantly shorter in the post-protocol group than in the pre-protocol group. By delaying initiation of PN, short-term clinical outcomes including incidence of CLA-BSI, antibiotic use, and ICU stay might be improved. Further research should be conducted to investigate the long-term effects of the decreased nutrient intake resulting from delayed PN.
APACHE ; Catheter-Related Infections ; Enteral Nutrition ; Humans ; Incidence ; Intensive Care Units* ; Critical Care* ; Parenteral Nutrition* ; Retrospective Studies

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Six-month Outcomes of Mobile Phone Application-based Self-management in a Patient with Type 2 Diabetes.

Mi Kyeong HONG ; Young Yun CHO ; Mi Yong RHA ; Jae Hyeon KIM ; Moon Kyu LEE

Clinical Nutrition Research.2015;4(3):201-207. doi:10.7762/cnr.2015.4.3.201

We report the case in order to examine the effect of a mobile application program ("Diabetes & Nutrition") developed in 2011-2012 for self-management in patients with type 2 diabetes and to recommend important considerations when the mobile application program is developed. A 46-year-old man was newly diagnosed with type 2 diabetes in 2013 and had no complications. The height of the patient was 168 cm and the body weight was 75.6 kg. Nutrition education was conducted according to a medical prescription, and follow-up nutrition education was conducted after 3 and 6 months. After nutrition education, the patient was engaged in self-management using "Diabetes & Nutrition" program during 3 months. At 3 months, the body weight had decreased by 4.4 kg (from 75.6 to 71.2 kg), waist circumference by 5 cm (from 88 to 83 cm) and HbA1c level from 7.9% to 6.1%. Also at 3 months, the medication was reduced from from the dose of 850 mg to the dose of 500 mg metformin per twice a day. Since then, the patient did not continue to use the "Diabetes & Nutrition" because the level of blood glucose had stabilized, and the patient felt inconvenient and annoying to use the program. At 6 months, no significant change in the body weight and body composition was observed in comparison with those at 3 months. The present case demonstrates that the early use of "Diabetes & Nutrition" could be helpful for self-management of glycemic control in patients with type 2 diabetes. Developing self-management mobile application programs in the future will require strategies of how to promote continuous use of application program and self-management of type 2 diabetes.
Blood Glucose ; Body Composition ; Body Weight ; Cellular Phone* ; Diabetes Mellitus, Type 2 ; Education ; Follow-Up Studies ; Humans ; Metformin ; Middle Aged ; Mobile Applications ; Nutrition Therapy ; Prescriptions ; Self Care* ; Waist Circumference

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Eating Habits and Food Preferences of Elementary School Students in Urban and Suburban Areas of Daejeon.

Eun Suk PARK ; Je Hyuk LEE ; Myung Hee KIM

Clinical Nutrition Research.2015;4(3):190-200. doi:10.7762/cnr.2015.4.3.190

This study investigated the dietary habits and food preferences of elementary school students. The survey was conducted by means of a questionnaire distributed to 4th and 5th grade elementary school students (400 boys and 400 girls) in urban and suburban areas of Daejeon. The results of this study were as follows: male students in urban areas ate breakfast, unbalanced diets, and dairy products more frequently than male students in suburban areas (p < 0.05). Female students in urban areas ate dairy products (p < 0.01) and fruits (p < 0.001) more frequently than female students in suburban areas. Students had the high preferences for boiled rice and noodles with black bean sauce, beef rib soup, steamed beef rib, steamed egg, beef boiled in soy sauce, egg roll, bulgogi, pork cutlet, deep-fried pork covered with sweet and sour starchy sauce, and honeyed juice mixed with fruit as a punch. All students preferred kimchi, although students in the suburban areas preferred kimchi-fried rice (p < 0.05), and those in the urban areas preferred bean-paste soup (p < 0.01). Students in suburban areas showed a greater preference for seasoned bean sprouts and Altari kimchi. All of the students preferred fruits, rice cake made with glutinous rice, and pizza among other foods. Overall, there were distinct differences in the eating habits and food preferences of elementary school students according to the place of residence.
Breakfast ; Dairy Products ; Diet ; Eating* ; Female ; Food Habits ; Food Preferences* ; Fruit ; Humans ; Male ; Ovum ; Ribs ; Seasons ; Soy Foods ; Steam

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Dietary Very Long Chain Saturated Fatty Acids and Metabolic Factors: Findings from the Korea National Health and Nutrition Examination Survey 2013.

Youn Sue LEE ; Yoonsu CHO ; Min Jeong SHIN

Clinical Nutrition Research.2015;4(3):182-189. doi:10.7762/cnr.2015.4.3.182

The present study was aim to evaluate the association between very long chain saturated fatty acids (VLSFAs) and metabolic syndrome (MetS) in Korean population. The study population were recruited from the Korea National Health and Nutrition Examination Survey VI (2013). Using the cross-sectional study design, socio-demographic factors, medical history, and clinical measurements were investigated according to quartiles of VLSFAs intake. The associations between each and sum of VLSFAs intake and MetS were assessed by logistic regression. The result indicated that higher intake of VLSFAs was significantly associated with favorable metabolic status, including lower levels of circulating triglyceride (TG) (p < 0.05). Additionally, subjects with higher intake of arachidic acid and total VLSFAs were negatively associated with MetS risk compared to subjects with lower intake of those fatty acids (p < 0.05). In conclusion, dietary VLSFAs intake was associated with metabolic risk factors and lower risk of MetS in Korean population.
Cross-Sectional Studies ; Fatty Acids* ; Korea* ; Logistic Models ; Nutrition Surveys* ; Risk Factors ; Triglycerides

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Comparative Study of Serum Leptin and Insulin Resistance Levels Between Korean Postmenopausal Vegetarian and Non-vegetarian Women.

Mi Hyun KIM ; Yun Jung BAE

Clinical Nutrition Research.2015;4(3):175-181. doi:10.7762/cnr.2015.4.3.175

The present study was conducted to compare serum leptin and insulin resistance levels between Korean postmenopausal long-term semi-vegetarians and non-vegetarians. Subjects of this study belonged to either a group of postmenopausal vegetarian women (n = 54), who maintained a semi-vegetarian diet for over 20 years or a group of non-vegetarian controls. Anthropometric characteristics, serum leptin, serum glucose, serum insulin, insulin resistance (HOMA-IR; Homeostasis Model Assessment of Insulin Resistance), and nutrient intake were compared between the two groups. The vegetarians showed significantly lower body weight (p < 0.01), body mass index (p < 0.001), percentage (%) of body fat (p < 0.001), and serum levels of leptin (p < 0.05), glucose (p < 0.001), and insulin (p < 0.01), than the non-vegetarians. The HOMA-IR of the vegetarians was significantly lower than that of the non-vegetarians (p < 0.01) after adjustment for the % of body fat. A long-term vegetarian diet might be related to lower insulin resistance independent of the % of body fat in postmenopausal women.
Adipose Tissue ; Blood Glucose ; Body Mass Index ; Body Weight ; Diet ; Diet, Vegetarian ; Female ; Glucose ; Homeostasis ; Humans ; Insulin Resistance* ; Insulin* ; Leptin*

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