Korean Journal of Community Nutrition

Research Articles

[Korean]
Process evaluation of a mobile healthcare program among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement: Imhuei Son, Jiyoun Hong, Young Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun; Korean J Community Nutr 2023;28(6):466-479. Published online December 31, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.6.466

Abstract PDF: Objectives
A mobile health intervention program was provided for employees with overweight and obesity for 12 weeks, and a process evaluation was completed at the end of the program. We investigated participant engagement based on app usage data, and whether engagement was associated with the degree of satisfaction with the program.
Methods
The program involved the use of a dietary coaching app and a wearable device for monitoring physical activity and body composition. A total of 235 employees participated in the program. App usage data were collected from a mobile platform, and a questionnaire survey on process evaluation and needs assessment was conducted during the post-test.
Results
The engagement level of the participants decreased over time. Participants in their 40s, high school graduates or lower education, and manufacturing workers showed higher engagement than other age groups, college graduates, and office workers, respectively. The overall satisfaction score was 3.6 out of 5. When participants were categorized into three groups according to their engagement level, the upper group was more satisfied than the lower group. A total of 71.5% of participants answered that they wanted to rejoin or recommend the program, and 71.9% answered that the program was helpful in improving their dietary habits. The most helpful components in the program were diet records and a 1:1 chat with the dietary coach from the dietary coaching app. The barriers to improving dietary habits included company dinners, special occasions, lack of time, and eating out. The workplace dietary management programs were recognized as necessary with a need score of 3.9 out of 5.
Conclusions
Participants were generally satisfied with the mobile health intervention program, particularly highly engaged participants. Feedback from a dietary coach was an important factor in increasing satisfaction.

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[English]
Effectiveness of a mobile health intervention on weight loss and dietary behavior changes among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement: Imhuei Son, Jiyoun Hong, Young-Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun; Korean J Community Nutr 2023;28(2):141-159. Published online April 30, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.2.141

Objectives
This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness.
Methods
The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention.
Results
After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior.
Conclusions
The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.

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Improving the nutrition quotient and dietary self-efficacy through personalized goal setting and smartphone-based nutrition counseling among adults in their 20s and 30s
Dahyeon Kim, Dawon Park, Young-Hee Han, Taisun Hyun
Journal of Nutrition and Health.2023; 56(4): 419. CrossRef
Process evaluation of a mobile healthcare program among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement
Imhuei Son, Jiyoun Hong, Young Hee Han, Bo Jeong Gong, Meng Yuan Zhang, Woori Na, Cheongmin Sohn, Taisun Hyun
Korean Journal of Community Nutrition.2023; 28(6): 466. CrossRef
Systematic Review on the Study of the Childhood and Adolescent Obesity in Korea: Dietary Risk Factors
Eun Jeong Heo, Jae Eun Shim, Eun Young Yoon
Korean Journal of Community Nutrition.2017; 22(3): 191. CrossRef

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[Korean]
Association between Sarcopenia and Energy and Protein Intakes in Community-dwelling Elderly: Woori Na, Dayoung Oh, Seohyeon Hwang, Bonghee Chung, Cheongmin Sohn; Korean J Community Nutr 2022;27(4):286-295. Published online August 31, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.4.286

Abstract PDF

Objectives
Sarcopenia is one of the most representative factors of senescence, and nutritional status is known to affect sarcopenia. This study was performed to analyze the relationships between energy and protein intake and sarcopenia.
Methods
The study subjects were 3,236 individuals aged ≥ 65 that participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 ~ 2011. General characteristics and anthropometric and 24-hour dietary recall data were analyzed. Sarcopenia was diagnosed using a formula based on appendicular skeletal muscle mass (ASM) and body weight. Logistic regression was performed to determine relationships between sarcopenia risk and energy and protein intakes.
Results
For energy intake, the odds ratio (OR) of sarcopenia in women was significantly higher those with the lowest intake [OR = 1.680, 95% confidence interval (CI) = 1.213-2.326] than those with the highest intake (P for trend = 0.001). Regarding protein intake per kg of body weight, the odds ratio of sarcopenia was significantly higher for those that consumed < 0.8 g/kg of protein daily than those that consumed > 1.2g/kg for men (OR = 2.459, 95% CI = 1.481-4.085) and women (OR = 2.178, 95% CI = 1.423-3.334).
Conclusions
This study shows a link between sarcopenia and energy and protein intake levels and suggests that energy and protein consumption be promoted among older adults to prevent sarcopenia.

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Muscle Mass Changes After Daily Consumption of Protein Mix Supplemented With Vitamin D in Adults Over 50 Years of Age: Subgroup Analysis According to the Serum 25(OH)D Levels of a Randomized Controlled Trial
Yeji Kang, Namhee Kim, Yunhwan Lee, Xiangxue An, Yoon-Sok Chung, Yoo Kyoung Park
Clinical Nutrition Research.2023; 12(3): 184. CrossRef

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Original Articles

[English]
Sarcopenia and Sarcopenic Obesity and Their Association with Cardiovascular Disease Risk in Postmenopausal Women: Results for the 2008-2011 Korea National Health and Nutrition Examination Survey: Misung Kim, Cheongmin Sohn; Korean J Community Nutr 2016;21(4):378-385. Published online August 31, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.4.378

Abstract PDF PubReader

OBJECTIVES
This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women.
METHODS
We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass.
RESULTS
The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher (3.82 Â± 0.22%) than the normal group (2.73 Â± 0.09%) and sarcopenia group (3.17 Â± 0.22%) (p < 0.000). The odd ratios (ORs) for the â‰¥7.5% 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy).
CONCLUSIONS
Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

Citations

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The Impact of Possible Sarcopenia and Obesity on the Risk of Falls in Hospitalized Older Patients
Kahyun Kim, Dukyoo Jung
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 18. CrossRef
Association of Sarcopenia with Heart Rate Variability
Jeong-Min Ji, Hyun-Min Koh, Ji-Yong Jang, Jin-Sook Moon, Hye-Rang Bak, Hye-Jin Jang, An-Na Lee, Nak-Gyeong Ko
Korean Journal of Family Practice.2022; 12(5): 311. CrossRef
Risk Factors for Sarcopenia, Sarcopenic Obesity, and Sarcopenia Without Obesity in Older Adults
Seo-hyun Kim, Chung-hwi Yi, Jin-seok Lim
Physical Therapy Korea.2021; 28(3): 177. CrossRef
Association among the Prevalence of Sarcopenia without Obesity, Nonsarcopenic Obesity, Sarcopenic Obesity, and Metabolic Syndrome in Cancer Survivors: Based on Korea National Health and Nutrition Examination Survey
Yoon J Park, Young M Lee
Asia-Pacific Journal of Oncology Nursing.2021; 8(6): 679. CrossRef

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[English]
Relationship between Bone Mineral Density and Bone Metabolic Biochemical Markers and Diet Quality Index-International(DQI-I) in Postmenopausal Obese Women: Yeonah Jeong, Misung Kim, Saeron Shin, Ahreum Han, Geomsuk Seo, Cheongmin Sohn; Korean J Community Nutr 2016;21(3):284-292. Published online June 30, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.3.284

Abstract PDF PubReader: OBJECTIVES
This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density.
METHODS
The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than 25 kg/m2 and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed.
RESULTS
Normal weight women were 56.03 Â± 3.76 years old and obese women were 58.09 Â± 5.13 years old and there was no significant difference in age between the two groups. The T-score of bone mineral density was 0.03 Â± 1.06 in normal weight women and -0.60 Â± 1.47 in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women (6.09 Â± 3.37 ng/mL) compared to obese women in (9.01 Â± 4.99 ng/mL) (p<0.05). The total score of diet quality index-international was 70.41Â±9.34 in normal weight women and 64.93 Â± 7.82 in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (Î²=-0.048, p<0.05), triglyceride (Î²=-0.005, p<0.05) and HDL-cholesterol (Î²=0.034, p<0.01), moderation of DQI-I (Î²=-0.231, p<0.05) affected T-score significantly.
CONCLUSIONS
The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.

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[English]
Association of Plasma Osteoprotegerin with Adiponectin and Difference according to Obesity in Men with Metabolic Syndrome: Woori Na, Cheongmin Sohn; Korean J Community Nutr 2011;16(6):762-770. Published online December 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.6.762

Abstract PDF PubReader: Osteoprotegerin (OPG) plays a core role in bone reformation by antagonizing the effect of receptor activator of nuclear factor kappa-B ligand (RANKL), and mediates vascular calcification in cardiovascular disease patients. Thus, we aimed to examine the relationship between serum OPG levels and cardiovascular factors and inflammatory markers in metabolic syndrome patients (MS). This cross-sectional study included 96 men who visited the diet clinic between May and July 2011. Patients were classified into 2 groups based on NCEP-ATP guidelines: normal and with MS (n = 50 and 46, respectively). Physical measurements, biochemical assay were measured. Serum OPG and IL-6, diponectin and hs-CRP were assessed. MS were aged 50.02 +/- 10.85 years, and normal patients 52.07 +/- 9.56 years, with no significant differences. Significant differences were not observed in BMI between the 2 groups. Moreover, significant differences were not observed in serum OPG, however, the serum OPG level (4.41 +/- 1.86 pmol/L) differed significantly between an overweight MS (BMI > 25) and normal patients. OPG was correlated to age (r = 0.410, p = 0.000), HDL-cholesterol (r = 0.209, p = 0.015), and log adiponectin (r = 0.175, p = 0.042). Multiple regression analyses using the enter method showed that age (beta = 0.412, p = 0.000) and BMI (beta = 0.265, p = 0.000) considerably affected OPG. In conclusion, out study showed that serum OPG levels are correlated with cardiovascular risk factors, such as BMI, HDL-cholesterol and adiponectin in MS and adiponectin, suggesting that serum OPG has potential as a cardiovascular disease indicator and predictor.

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[English]
Relationship between Nutrients Intakes, Dietary Quality, and Serum Concentrations of Inflammatory Markers in Metabolic Syndrome Patients: Misung Kim, Juyoung Kim, Wookyung Bae, Sohye Kim, Yesong Lee, Woori Na, Cheongmin Sohn; Korean J Community Nutr 2011;16(1):51-61. Published online February 28, 2011; DOI: https://doi.org/10.5720/KJCN.2011.16.1.51

Abstract PDF PubReader

Elevated serum concentration of inflammation markers is known as an independent risk factor of metabolic syndrome (MS) and dietary intake is an important factor to control MS. The purpose of this study was to investigated the hypothesis that inflammatory indices are associated with dietary intake and diet quality index-international (DQI-I) in subjects with MS. A cross-sectional study was conducted on 156 men and 73 postmenopausal women with MS, defined by three or more risk factors of the modified Adult Treatment Panel III criteria. Serum levels of high sensitive C-reactive protein (hs-CRP), adiponectin were examined and nutrients intake and DQI-I were assessed using a semi-quantitative food frequency questionnaire. The total DQI-I score was significantly higher in female subjects (65.87 +/- 9.86) than in male subjects (62.60 +/- 8.95). There was a positive association between hs-CRP and polyunsaturated fatty acid intake (p < 0.05) and a negative association between adiponectin and lipid (p < 0.05), total sugar (p < 0.01), and total fatty acids (p < 0.05). When the subjects were divided into 5 groups by quintile according to serum adiponectin and hs-CRP level, there was no association between DQI-I score and hs-CRP levels. Moderation score of DQI-I was significantly higher in highest quintile group than the lower quintile groups. Therefore, our results provide some evidence that dietary intake and diet quality are associated with inflammation markers and dietary modification might be a predictor to decrease risk for metabolic syndrome complications. However further research is needed to develop the dietary quality index reflecting the inflammatory change by considering the dietary habit and pattern of Koreans.

Citations

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Exploring metabolic syndrome and dietary quality in Iranian adults: a cross-sectional study
Zahra Namkhah, Kiyavash Irankhah, Sina Sarviha, Seyyed Reza Sobhani
BMC Nutrition.2024;[Epub] CrossRef
A Comparisons of Nutritional Intake and Diet Quality Index-International in Gynecological Cancer Survivors and Normal Women: Using the Korea National Health and Nutrition Examination Survey 2013~2016
Bo-Young Seo, Eun-Sil Her
Korean Journal of Community Nutrition.2020; 25(5): 406. CrossRef
Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults
Saerom Shin, Seungmin Lee
Korean Journal of Community Nutrition.2020; 25(1): 61. CrossRef
Development of a food-based index of dietary inflammatory potential for Koreans and its relationship with metabolic syndrome
Woori Na, Tae Yang Yu, Cheongmin Sohn
Nutrition Research and Practice.2019; 13(2): 150. CrossRef
Association between Total Diet Quality and Metabolic Syndrome Incidence Risk in a Prospective Cohort of Korean Adults
Saerom Shin, Seungmin Lee
Clinical Nutrition Research.2019; 8(1): 46. CrossRef
Effects of food items and related nutrients on metabolic syndrome using Bayesian multilevel modelling using the Tehran Lipid and Glucose Study (TLGS): a cohort study
Zahra Cheraghi, Saharnaz Nedjat, Parvin Mirmiran, Nazanin Moslehi, Nasrin Mansournia, Mahyar Etminan, Mohammad Ali Mansournia, Lawrence C McCandless
BMJ Open.2018; 8(12): e020642. CrossRef
Development and Validation of Korean Inflammtory Index(K-DII) for Metabolic Disease Patients: by Using the Health Examinee Cohort (2012-2014)
Woori Na, Misung Kim, Susan Park, Minhyung Lee, Cheongmin Sohn
Korean Journal of Human Ecology.2017; 26(4): 369. CrossRef
Amelioration of metabolic disturbances and adipokine dysregulation by mugwort (Artemisia princeps P.) extract in high-fat diet-induced obese rats
Yun-Hye Kim, Chung-Mu Park, Gun-Ae Yoon
Journal of Nutrition and Health.2016; 49(6): 411. CrossRef
Development of dietary pattern evaluation tool for adults and correlation with Dietary Quality Index
Yeo Do Lee, Kyung Won Kim, Kyung-Suk Choi, Misung Kim, Yeo Jin Cho, Cheongmin Sohn
Nutrition Research and Practice.2016; 10(3): 305. CrossRef
Analysis of Dietary Inflammatory Index of Metabolic Syndrome in Korean : Data from the Health Examinee Cohort (2012-2014)
Mi-Sung Kim, Cheong-Min Sohn
Korean Journal of Human Ecology.2016; 25(6): 823. CrossRef
A study on dietary habits, nutrient intakes and dietary quality in adults of a health screening and promotion center according to non-alcoholic fatty liver disease
Ji Ho Chang, Hye Seung Lee, Eun Hee Kang
Journal of Nutrition and Health.2014; 47(5): 330. CrossRef
Correlation between vitamin D and cardiovascular disease predictors in overweight and obese Koreans
Misung Kim, Woori Na, Cheongmin Sohn
Journal of Clinical Biochemistry and Nutrition.2013; : 167. CrossRef
Comparison of health outcomes according to intervention compliance in male Korean workers with metabolic syndrome
Kyung-Hui Nam, Ji-Yeon Kang, Yeon-Ju Lee, Sook-Hee Sung, Youn-Koun Chang, Ji-Young Lee, Ill-Keun Park, Tae-In Choi
Korean Journal of Nutrition.2013; 46(2): 156. CrossRef
Effect of the Telephone-Delivered Nutrition Education on Dietary Intake and Biochemical Parameters in Subjects with Metabolic Syndrome
Juyoung Kim, Wookyung Bea, Kiheon Lee, Jongsoo Han, Sohye Kim, Misung Kim, Woori Na, Cheongmin Sohn
Clinical Nutrition Research.2013; 2(2): 115. CrossRef
Evaluation of nutrient intake and diet quality of gastric cancer patients in Korea
Heesook Lim, Gyuseok Cho, Soonkyung Kim
Nutrition Research and Practice.2012; 6(3): 213. CrossRef
The framingham risk score, diet, and inflammatory markers in Korean men with metabolic syndrome
Cheongmin Sohn, Juyong Kim, Wookyung Bae
Nutrition Research and Practice.2012; 6(3): 246. CrossRef
The Effects of 12-Weeks Intensive Intervention Program on Cardiovascular Risk Factors, Adipocytokines and Nutrients Intakes in Industrial Male Workers
Kieun Moon, Ill Keun Park, Yeon Sang Jo, Yun Kyun Chang, Yun Mi Paek, Tae In Choi
The Korean Journal of Nutrition.2011; 44(4): 292. CrossRef

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[English]
Comparative Study on Nutrients Intake, Physical Activities and Bone Mineral Density of Specialized Game High School Students according to Obesity Level: Yun Kyoung Oh, Cheongmin Sohn; Korean J Community Nutr 2010;15(3):393-402. Published online June 30, 2010

Abstract PDF: The purpose of this study was performed to evaluate the prevalence of overweight and to compare the dietary behaviors, nutrient intake and physical activities of specialized game high school students. Total of 163 subjects participated and their weight, height, waist circumference, hip circumference and bone status by a quantitative ultrasound method were measured. The subjects were surveyed by a self-administered questionnaire about general characteristics, dietary behaviors and physical activities. Nutrient intakes of the subjects were assessed by semi-quantitative food frequency questionnaire. The subjects were divided into four groups on their obesity level by BMI. The prevalence of underweight, normal, overweight and obese group was 6%, 58%, 16%, and 20% respectively. BMI was negatively correlated with bone mineral density (p < 0.01) and positively correlated with WHR (p < 0.01). The dietary guideline compliance score for "Enjoy Korean rice food style" was 2.63, followed by "Prepare food sanitarily" 2.48, "Do not skip breakfast" 2.29, "Eat a variety of vegetables, fruits, dairy products daily" 2.25, "Drink water instead of beverage" 2.10, "Choose less fried foods" 2.09 and "Maintain healthy weight" 1.91. The exercise frequency of walking was not significantly different between groups; however, heavy exercise frequency was significantly lower in underweight group than the other groups (p < 0.05). The energy intake was 2153 kcal, which was 81.2% of the Estimate Energy Requirement, and the intake of calcium and vitamin B2 was 66.7% and 77.8% of KDRIs. Particularly, the intake of iron, vitamin A and vitamin C was about 59.4%, 52.2% and 55.4% of KDRIs and INQ was 0.71, 0.63 and 0.65 respectively, and intake of folic acid fell behind 39.1% of KDRIs and INQ was 0.46. Our study suggests that the systematic and continuous nutrition education will have to be provided at schools to improve dietary and health behaviors and prevent chronic metabolic disease for students of specialized game high school.

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[English]
Development of Nutrition Screening Index for Hospitalized Patients: Suan Kim, Soyeon Kim, Cheongmin Sohn; Korean J Community Nutr 2006;11(6):779-784. Published online December 31, 2006

Abstract PDF: Several studies about hospital malnutrition have been reported that about more than 40% of hospitalized patients are having nutritional risk factors and hospital malnutrition presents a high prevalence. People in a more severe nutritional status ended up with a longer length of hospital stay and higher hospital cost. Nutrition screening tools identify individuals who are malnourished or at risk of becoming malnourished and who may benefit from nutritional support. For the early detection and treatment of malnourished hospital patients, few valid screening instruments for Koreans exist. Therefore, the aim of this study was to develop a simple, reliable and valid malnutrition screening tool that could be used at hospital admission to identify adult patients at risk of malnutrition using medical electrical record data. Two hundred and one patients of the university affiliated medical center were assessed on nutritional status and classified as well nourished, moderately or severely malnourished by a Patient-Generated subjective global assessment (PG-SGA) being chosen as the 'gold standard' for defining malnutrition. The combination of nutrition screening questions with the highest sensitivity and specificity at prediction PG-SGA was termed the nutrition screening index (NSI). Odd ratio, and binary logistic regression were used to predict the best nutritional status predictors. Based on regression coefficient score, albumin less than 3.5 g/dl, body mass index (BMI) less than 18.5 kg/m2, total lymphocyte count less than 900 and age over 65 were determined as the best set of NSI. By using best nutritional predictors receiver operating characteristic curve with the area under the curve, sensitivity and 1-specificity were analyzed to determine the best optimal cut-off point to decide normal or abnormal in nutritional status. Therefore simple and beneficial NSI was developed for identifying patients with severe malnutrition. Using NSI, nutritional information of the severe malnutrition patient should be shared with physicians and they should be cared for by clinical dietitians to improve their nutritional status.

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[English]
Comparison of Nutritional Status and Inflammational Markers in DM and nonDM Hemodialysis Patients: Suan Kim, Cheongmin Sohn, Dong Wan Chae; Korean J Community Nutr 2005;10(5):693-699. Published online October 31, 2005

Abstract PDF: Protein-calorie malnutrition is common in maintenance dialysis patients. Indeed, diabetic patients with chronic renal failure are considered to be at increased risk of malnutrition. The aim of this study was to compare the nutritional status and markers of inflammation of hemodialysis patients with and without type 2 diabetes. We compared nutritional parameters and C-reactive protein (CRP) as a marker of inflammation in 30 type 2 diabetic patients and age-matched 30 non-diabetic patients with hemodialysis. Serum albumin was significantly lower in patients with type 2 diabetes (3.45 +/- 0.43 g/dL) than in non-diabetic patients (3.64 +/- 0.36 g/dL) (p < 0.05). In contrast, the concentration of serum CRP was significantly higher in type 2 diabetes (1.42 +/- 1.8 mg/dL) (p < 0.05). There were significant negative-relationships between serum albumin and CRP level in both diabetic (r = -0.553, p < 0.01) and non-diabetic (r = -0.579, p < 0.01) patients. In diabetic patients, serum albumin level was significantly correlated with hemoglobin (r = 0.488, p < 0.01) and hematocrit (r = 0.386, p < 0.01). Diabetic patients as compared to non-diabetic patients showed a significant (p < 0.01) increased serum triglyceride (TG) (153.1 +/- 80.1 mg/dL vs 101.6 +/- 62.4 mg/dL) and decreased serum HDL cholesterol (36.89 +/- 13.48mg/dL vs 47.00 +/- 14.02 mg/dL, P < 0.05). There were significant correlations in the intake of calorie and serum albumin levels in both diabetic (r = 0.438, p < 0.05) and non-diabetic (r = 0.527, p < 0.05) patients. Serum CRP level was negatively correlated with calorie (r = -0.468, p < 0.05), protein (r = -0.520, p < 0.01) and fat intakes (r = -0.403, p < 0.05) in diabetic patients and calorie (r = -0.534, p < 0.05) and protein intakes (r = -0.559, p < 0.05) in non-diabetic patients. The prevalence of protein malnutrition and the risk factors of cardiovascular disease were significantly higher in type 2 diabetic patients than in non-diabetic hemodialysis patients. Thus, we can suggest that the higher comorbidity and mortality rate in diabetic hemodialysis patients are partially explained by malnutrition and inflammation.

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