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Evaluation of Malnutrition Risk after Liver Transplantation Using the Nutritional Screening Tools.

Hee Sook LIM ; Hyung Chul KIM ; Yoon Hyung PARK ; Soon Kyung KIM

Clinical Nutrition Research.2015;4(4):242-249. doi:10.7762/cnr.2015.4.4.242

Malnutrition is a common problem in patients with end-stage liver disease requiring liver transplantation. The aim of this study was to evaluate nutritional status by using nutritional screening tools [Nutritional Risk Screening (NRS) 2002, Malnutrition Universal Screening Tool (MUST) and Subjective Global Assessment (SGA)] in patients before and after liver transplantation. We analyzed medical record, blood test, nutrient intake and malnutrition rate just before transplantation and at discharge, and at 3, 6, 12 months after transplantation respectively. Initially 33 patients enrolled as study subjects and finally 28 patients completed the study. Nutrients intake such as energy, fiber, calcium, potassium, vitamin C, and folate were insufficient at 12 months after transplantation. The rates of malnutrition before transplantation were very high, reported at 81.8% for the NRS 2002, 87.9% for the MUST, and 84.8% for the SGA. By 12 months after operation, malnutrition rates reported at NRS, MUST and SGA had decreased to 6.1%, 10.7%, and 10.7%, respectively. Sensitivity was 87.1% for the NRS 2002, 82.0% for the MUST, and 92.0% for the SGA. Of these screening tools the SGA was the highest sensitive tool that predict the risk of mortality in malnutrition patients who received transplantation. Further studies on nutritional status of patients and proper tools for nutrition intervention are needed to provide adequate nutritional care for patients.
Ascorbic Acid ; Calcium ; Folic Acid ; Hematologic Tests ; Humans ; Liver Diseases ; Liver Transplantation* ; Liver* ; Malnutrition* ; Mass Screening* ; Medical Records ; Mortality ; Nutritional Status ; Potassium ; Sensitivity and Specificity

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Association Between Usual Vitamin K Intake and Anticoagulation in Patients Under Warfarin Therapy.

Ji Na PARK ; Ji Sun LEE ; Min Young NOH ; Mi Kyung SUNG

Clinical Nutrition Research.2015;4(4):235-241. doi:10.7762/cnr.2015.4.4.235

This study aimed to explore the correlation between usual vitamin K intake and response to anticoagulant therapy among patients under warfarin therapy. We conducted a retrospective survey of patients (n = 50) on continuous warfarin therapy. Clinical information and laboratory parameters were sourced from medical records. Anticoagulant effect was evaluated by using the percent time in therapeutic range (TTR) and the coefficient of variation (CV) of International normalized ratio (INR). Dietary vitamin K intake was assessed using a semi-quantitative food frequency questionnaire that has been developed for the purpose of assessing dietary intake of vitamin K. A total of 50 patients aged between 21 and 87 years were included in the study. The mean vitamin K intake was 262.8 +/- 165.2 microg/day. Study subjects were divided into tertiles according to their usual vitamin K intake. The proportion of men was significantly higher in second and third tertile than first tertile (p = 0.028). The mean percent TTR was 38.4 +/- 28.4% and CV of INR was 31.8 +/- 11.8%. Long-term warfarin therapy group (> or = 3 years) had a higher percentage of TTR as compared to the control group (< 3 years) (p = 0.046). No statistically significant correlation was found between usual vitamin K intake and percent TTR (p > 0.05). In conclusion, no significant association was observed between usual vitamin K intake and anticoagulant effects. Further studies are required to consider inter-individual variability of vitamin K intake. Development of assessment tools to measure inter-individual variability of vitamin K intake might be helpful.
Humans ; International Normalized Ratio ; Male ; Medical Records ; Retrospective Studies ; Vitamin K* ; Vitamins* ; Warfarin*

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Effects of Soy Flour Fortified Bread Consumption on Cardiovascular Risk Factors According to APOE Genotypes in Overweight and Obese Adult Women: A Cross-over Randomized Controlled Clinical Trial.

Elham SHARIFI-ZAHABI ; Mohammad H ENTEZARI ; Mohammad R MARACY

Clinical Nutrition Research.2015;4(4):225-234. doi:10.7762/cnr.2015.4.4.225

Recent studies suggest that inclusion of soy product in the diet may have favorable effects on relief of cardiovascular diseases (CVDs) and risk factors. These effects might be associated with the presence of specific polymorphism in gene. The aim of this study was to examine the effects of consumption of soy flour fortified bread on cardiovascular risk factors in overweight and obese women according to APOE genotype. In a randomized cross-over clinical trial 30 overweight and obese women received a mild weight loss diet and assigned to a regular diet and a soy bread diet, each for 6 weeks and a washout period for 20 days. Subjects in the soy bread diet were asked to replace 120 grams of their daily usual bread intake with equal amount of soy bread. No significant effects of soy bread on serum lipid, systolic blood pressure and anthropometric indices were observed compared to the regular diet (p > 0.05). For diastolic blood pressure (DBP), comparison of mean differences between two groups showed a marginally significant effect of soy bread (p = 0.06). Compared to regular diet, soy bread had a significant effect on DBP in E2 genotype group (epsilon2/epsilon2) (p = 0.03). Having epsilon2 allele may influences responses of CVD risk factor to soy bread consumption. However more nutrigenetic studies are required.
Adult* ; Alleles ; Apolipoproteins E* ; Blood Pressure ; Bread* ; Cardiovascular Diseases ; Diet ; Diet, Reducing ; Female ; Flour* ; Genotype* ; Humans ; Obesity ; Overweight* ; Risk Factors*

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Dietary Patterns and Their Associations with the Diet Quality Index-International (DQI-I) in Korean Women with Gestational Diabetes Mellitus.

Moon Kyung SHIN ; Yoo Sun KIM ; Jung Hyun KIM ; Sung Hoon KIM ; Yuri KIM

Clinical Nutrition Research.2015;4(4):216-224. doi:10.7762/cnr.2015.4.4.216

The aim of this study was to examine dietary pattern, nutritional intake, and diet quality of Korean pregnant women with gestational diabetes mellitus (GDM). Between October 2008 and May 2012, 166 pregnant women diagnosed with GDM completed a questionnaire and dietary intake was assessed using a 3-day food record. Blood pressure, fasting plasma glucose, and glycated hemoglobin (HbA1c) concentrations were measured and oral glucose tolerance test (OGTT) was performed. Two major dietary patterns ("carbohydrate and vegetable" and "western" patterns) were identified through factor analysis. Dietary pattern scores for each dietary pattern were categorized into tertiles. The dietary quality index-international (DQI-I) was used to measure overall diet quality. Subjects with higher carbohydrate and vegetable pattern scores reported less physical activity (p < 0.05) and have higher diastolic blood pressure levels (p = 0.05). After adjusting for age and energy intake, higher carbohydrate and vegetable pattern scores were associated with higher sodium intakes (p = 0.02), but lower intakes of fat (p = 0.002) and other micronutrients. On the other hand, higher western pattern scores were associated with higher fat intake (p = 0.0001), but lower intakes of sodium (p = 0.01) and other micronutrients. Higher scores for both dietary patterns were associated with lower scores in the moderation category of the DQI-I (p < 0.0001). HbA1c and fasting plasma glucose levels were significantly lower among participants with high DQI-I than those with low DQI-I (p < 0.05). The study findings suggest that many Korean women with GDM do not consume nutritionally adequate or balanced diets, regardless of dietary pattern.
Blood Glucose ; Blood Pressure ; Diabetes, Gestational* ; Diet* ; Energy Intake ; Fasting ; Female ; Glucose Tolerance Test ; Hand ; Hemoglobin A, Glycosylated ; Humans ; Micronutrients ; Motor Activity ; Pregnancy ; Pregnant Women ; Sodium ; Vegetables

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Anti-carcinogenic and Anti-bacterial Properties of Selected Spices: Implications in Oral Health.

Anjali GANJRE ; Rahul KATHARIYA ; Neeta BAGUL ; Vivek PAWAR

Clinical Nutrition Research.2015;4(4):209-215. doi:10.7762/cnr.2015.4.4.209

"Let food be thy medicine and medicine be thy food", as said by the father of medicine, Hippocrates in 431 B.C. Nature has provided us with a variety of treatment modalities in the form of food. For the first 5,000 years of civilization, humans relied on herbs and foods for medicine. Only in the past 60 years have we forgotten our medicinal "roots" in favor of patented medicines. While pharmaceutical ingredients have their value, we should not overlook the well-documented, non-toxic and inexpensive healing properties of food. As an individual we consume food several times a day without a complete understanding of its innate qualities. As part of a daily diet, food plays a significant role in helping our bodies function at their best. There are hundreds of extremely nutritious foods, but the items in this article do more than providing healthy nutrients. Many of them consist of ingredients with hidden pharmaceutical qualities ranging from anti-inflammatory to anti-carcinogenic agent. They not only boost our innate immunity but also act as an adjunct to medicines for specific treatment. Prevention and management of symptoms can often be improved significantly through the foods we consume regularly. This paper overviews these beneficial traits of food ingredients, consumed on a daily basis, in various oral diseases.
Diet ; Humans ; Immunity, Innate ; Mouth Neoplasms ; Oral Health* ; Plants, Medicinal ; Spices*

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Nutritional Status and Body Composition in Korean Myopathy Patients.

Soo Yun JANG ; Seong Woong KANG ; Won Ah CHOI ; Jang Woo LEE ; Mi Ri SUH ; Song Mi LEE ; Yoo Kyoung PARK

Clinical Nutrition Research.2016;5(1):43-54. doi:10.7762/cnr.2016.5.1.43

In myopathy patients, fat mass increases as the disease progresses, while lean body mass decreases. The present study aimed to investigate the overall nutritional status of Korean myopathy patients through surveys of diet and dietary habits, bioelectrical impedance analysis (BIA), and biochemistry tests, as well as the examination of related factors, for the purpose of using such findings as a basis for improving the nutritional status in myopathy patients. The energy intake of all participants was found to be insufficient at only 44.5% of Dietary Reference Intakes for Koreans 2010 (KDRIs 2010), whereas protein intake was sufficient at 89.8% of KDRIs 2010. Dietary fiber intake was found to be 58.4% of sufficient dietary fiber intake for adults according to KDRIs 2010. Calcium intake was found to be 55.0% and magnesium was 14.9% of the recommended calcium and magnesium intake for adults according to KDRIs 2010. With respect to quality of life (QOL), overall increase in QOL domain score showed significant positive correlations with vegetable fat intake (p < 0.05), vegetable protein intake (p< 0.05), and dietary fiber intake (p < 0.05). With respect to BIA, the mean phage angle of all participants was found to be 2.49 +/- 0.93degrees, which was below the cutoff value. As a study that examined nutrient analysis and dietary habits of myopathy patients in Korea, the present study is meaningful in providing the basic data for future studies that aim to present dietary guidelines for patients suffering from myopathy.
Adult ; Bacteriophages ; Biochemistry ; Body Composition* ; Calcium ; Diet ; Dietary Fiber ; Electric Impedance ; Energy Intake ; Food Habits ; Humans ; Korea ; Magnesium ; Muscular Diseases* ; Nutrition Policy ; Nutritional Status* ; Quality of Life ; Recommended Dietary Allowances ; Vegetable Proteins ; Vegetables

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Fasting Glucose is a Useful Indicator for Cerebrovascular Risk in Non-Diabetic Koreans: Association With Oxidative Stress and Inflammation.

Jae Hyang LEE ; So Ra YOON ; Ga Yoon NA ; Mira JUN ; Mok Ryeon AHN ; Jae Kwan CHA ; Oh Yoen KIM

Clinical Nutrition Research.2016;5(1):33-42. doi:10.7762/cnr.2016.5.1.33

Diabetes and impaired fasting glucose are associated with incidence of cerebro-/cardio-vascular diseases. This study hypothesized that fasting glycemic status may reflect cerebrovascular risk in non-diabetic Koreans. Fasting glycemic status, lipid profiles, oxidative stress, and inflammation markers were measured in non-diabetic subjects (healthy controls, n = 112 and stroke n = 41). Systolic blood pressure, fasting glucose, glycated hemoglobin (HbA1C), triglycerides, high sensitivity C-reactive protein (hs-CPR), interleukin-6, and tumor necrosis factor-alpha were higher, and high density lipoprotein (HDL)-cholesterols were lower in patients with stroke than healthy controls. Fasting glucose positively correlated with hs-CRP, interleukin-6, tumor necrosis factor-alpha, oxidized low density lipoprotein (LDL) and malondialdehyde. The significances continued or at least turned to a trend after adjustments for confounding factors. Multiple regression analyses revealed that fasting glucose was mainly associated with cerebrovascular risk (beta'-coefficient = 0.284, p < 0.0001) together with age, systolic blood pressure, total cholesterol, hs-CRP, body mass index, dietary poly unsaturated fatty acid/saturated fatty acid (PUFA/SFA), and HbA1C (r2 = 0.634, p = 0.044). The subjects were subdivided by their fasting glucose levels [normal fasting glucose: 70-99 mg/dL, n = 91 [NFG-control] and n = 27 [NFG-stroke]; higher fasting glucose: 100-125 mg/dL, n = 21 [HFG-control] and n = 14 [HFG-stroke]). In both controls and stroke patients, HFG groups show higher triglyceride, total- and LDL-cholesterol and lower HDL-cholesterol than NFG groups. Control-HFG group showed significantly higher levels of oxidative stress and inflammation than control-NFG group. Stroke-HFG group also showed significantly higher inflammatory levels than stroke-NFG group, moreover the highest among the groups. Additionally, stroke-NFG group consumed higher PUFA/SFA than stroke-HFG group. Fasting glucose may be a useful indicator for cerebrovascular risk in non-diabetic individuals which may be mediated by oxidative stress and inflammation status.
Blood Pressure ; Body Mass Index ; C-Reactive Protein ; Cholesterol ; Fasting* ; Glucose* ; Hemoglobin A, Glycosylated ; Humans ; Incidence ; Inflammation* ; Interleukin-6 ; Lipoproteins ; Malondialdehyde ; Oxidative Stress* ; Stroke ; Triglycerides ; Tumor Necrosis Factor-alpha

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Effect of A One-Week Balanced Diet on Expression of Genes Related to Zinc Metabolism and Inflammation in Type 2 Diabetic Patients.

Lucia Leite LAIS ; Sancha Helena DE LIMA VALE ; Camila Alves XAVIER ; Alfredo DE ARAUJO SILVA ; Tolunay Beker AYDEMIR ; Robert J COUSINS

Clinical Nutrition Research.2016;5(1):26-32. doi:10.7762/cnr.2016.5.1.26

To evaluate the effect of diet on metabolic control and zinc metabolism in patients with type 2 diabetes mellitus (T2DM). One-week balanced diet was provided to 10 Brazilians patients with T2DM. Nutritional assessment, laboratorial parameters and expression of zinc transporter and inflammatory genes in peripheral blood mononuclear cells (PBMC) were performed. Healthy non-diabetic subjects of the same demographic were recruited to provide baseline data. Diabetic patients had higher body mass index and greater fasting plasma glucose, plasma tumor necrosis factor alpha (TNFalpha) and plasma interleukin 6 (IL6) levels compared with healthy subjects. In addition, the expression of transporters 4 (ZnT4) mRNA was lower and IL6 mRNA was higher in PBMC of these diabetic patients than in healthy subject. One week after a balanced diet was provided, fasting plasma glucose decreased significantly as did TNFalpha, IL6 and Metallothionein 1 (MT1) mRNAs. No change was observed in zinc transporter expression in PBMC after the dietary intervention. A healthy eating pattern maintained for one week was able to improve metabolic control of diabetic patients by lowering fasting plasma glucose. This metabolic control may be related to down-regulation of zinc-related transcripts from PBMCs, as TNFalpha, IL6 and MT1 mRNA.
Blood Glucose ; Body Mass Index ; Diabetes Mellitus, Type 2 ; Diet* ; Down-Regulation ; Eating ; Fasting ; Humans ; Inflammation* ; Interleukin-6 ; Metabolism* ; Metallothionein ; Nutrigenomics ; Nutrition Assessment ; Plasma ; RNA, Messenger ; Tumor Necrosis Factor-alpha ; Zinc*

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Association of Maternal Diet With Zinc, Copper, and Iron Concentrations in Transitional Human Milk Produced by Korean Mothers.

Yun Kyung CHOI ; Ji Myung KIM ; Ji Eun LEE ; Mi Sook CHO ; Bong Soo KANG ; Hyeon CHOI ; Yuri KIM

Clinical Nutrition Research.2016;5(1):15-25. doi:10.7762/cnr.2016.5.1.15

The aims of this study were to evaluate zinc, copper, and iron concentrations in the transitory milk of Korean lactating mothers and to investigate the relationship between these concentrations and maternal diet. Human milk samples were collected between 5 and 15 days postpartum from 96 healthy, lactating mothers in postpartum care centers in Seoul, Korea. Dietary intake during lactation was determined based on a 3-day dietary record. The mean zinc, copper, and iron concentrations in the human milk samples collected were 3.88 +/- 1.74 mg/L, 0.69 +/- 0.25 mg/L, and 5.85 +/- 8.53 mg/L, respectively. The mothers who consumed alcoholic beverages during pregnancy had tended to have lower concentrations of zinc and copper, as well as significantly lower concentrations of iron, in their milk (p < 0.047). In contrast, the mothers who took daily supplements had much higher iron concentrations in their milk (p = 0.002). Dietary intakes of zinc, copper, and iron during lactation did not affect the concentrations of zinc, copper, and iron in the milk samples analyzed. Intakes of vitamin C, selenium, and iodine were associated with the concentration of copper in the milk samples analyzed, and consumption of food categorized as 'meat and meat products' was positively associated with the concentration of zinc. Consumption of rice was the top contributor to the concentrations of all three minerals. In conclusion, associations between maternal diet and nutrient concentrations in transitory human milk can provide useful information, particularly in regard to infant growth.
Alcoholic Beverages ; Ascorbic Acid ; Copper* ; Diet Records ; Diet* ; Female ; Humans* ; Infant ; Iodine ; Iron* ; Korea ; Lactation ; Meat ; Milk ; Milk, Human* ; Minerals ; Mothers* ; Postnatal Care ; Postpartum Period ; Pregnancy ; Selenium ; Seoul ; Zinc*

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Leukocyte Telomere Length is Associated With Serum Vitamin B12 and Homocysteine Levels in Older Adults With the Presence of Systemic Inflammation.

Chol SHIN ; Inkyung BAIK

Clinical Nutrition Research.2016;5(1):7-14. doi:10.7762/cnr.2016.5.1.7

Folate, vitamin B12, and homocysteine (HCY) are involved in the metabolism of nucleic acid precursors and it has been hypothesized that they also influence telomere length, a biomarker of aging. However, previous studies have reported inconsistent findings, and data for older adults are limited. Our study aimed to evaluate associations between leukocyte telomere length (LTL) and serum folate, vitamin B12, and HCY levels among adults aged 55 years and over. In a cross-sectional study in 798 men and women aged 55-79 years, serum folate, vitamin B12, and HCY levels were measured using chemiluminescent immunometric assays, and relative LTL was assessed using quantitative real-time polymerase chain reaction. To evaluate associations between LTL and serum folate, vitamin B12, and HCY levels, multiple linear regression models were used. In multiple models adjusted for age, sex, serum high sensitive C-reactive protein (hs-CRP) levels, and other potential confounding factors, we found no association between LTL and serum folate, vitamin B12, and HCY levels. However, we did find a significant inverse association between HCY levels and LTL in participants with serum hs-CRP levels of > or = 2 mg/L (p < 0.05). Moreover, there was a trend toward an association between HCY and vitamin B12 levels in these individuals (p = 0.08). In those with serum hs-CRP levels of < 2 mg/L, HCY was inversely associated with vitamin B12 levels (p < 0.001) and had no association with LTL. Our findings suggest that increased serum HCY levels, when combined with the presence of systemic inflammation, may play a role in accelerating biological aging.
Adult* ; Aging ; C-Reactive Protein ; Cross-Sectional Studies ; Female ; Folic Acid ; Homocysteine* ; Humans ; Inflammation* ; Leukocytes* ; Linear Models ; Male ; Metabolism ; Nucleic Acid Precursors ; Real-Time Polymerase Chain Reaction ; Telomere* ; Vitamin B 12* ; Vitamin B Complex ; Vitamins*

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