Korean Journal of Community Nutrition

[Korean]
Comparison of blood biochemical characteristics and dietary intake by sex in gastric cancer patients over 40 years in Korea based on 7^th (2016-2018) Korea National Health and Nutrition Examination Survey: a cross-sectional study: Hyeon-Ju Lee, Sung-Won Oh, Sook-Bae Kim; Korean J Community Nutr 2023;28(1):48-60. Published online February 28, 2023; DOI: https://doi.org/10.5720/kjcn.2023.28.1.48

Abstract PDF: Objectives
The purpose of this study was to compare the sex-associated differences in the dietary intake of gastric cancer patients in Korea.
Methods
Data from the Korea National Health and Nutrition Examination Survey (KNHANES) the 7 th (2016-2018) were analyzed in the present study. The subjects included 122 gastric cancer patients aged over 40 years (75 male, 47 female). General characteristics (age, marital status, household income, education, food security, comorbidities, alcohol drinking, and smoking), anthropometric characteristics (height, weight, body mass index, and blood pressure), blood biochemical characteristics [fasting plasma glucose (FPG), blood urea nitrogen (BUN), creatinine, triglyceride, total cholesterol, and HDL-cholesterol)], and quantity and quality of dietary intake were compared between male and female participants.
Results
Males had higher rates of having a spouse, prevalence of hypertension, alcohol drinking, and smoking than females. The proportion of males with a normal range of FPG, BUN, and HDL-cholesterol was lower than that in females. The total cholesterol levels above the normal range were higher in females than in males. We also found that females had a higher percentage of intakes below the estimated energy requirement (EER) and intakes below the estimated average requirement (EAR) for carbohydrates, niacin, phosphorus, and iron than males. The index of nutritional quality (INQ) for phosphorus and folate, nutrient adequacy ratio (NAR) for vitamin C, thiamine, niacin, folate, calcium, and phosphorus, and the mean adequacy ratio (MAR) were lower in females than males.
Conclusions
In Korean gastric cancer patients, management of comorbidities such as diabetes and hypertriglyceridemia, lowering FPG, and raising HDL-cholesterol level management is required for males, whereas management of lowering total cholesterol and raising hematocrit is required for females. The quantitative and qualitative nutritional intakes were poor in gastric cancer patients, especially in females, who had a lower nutritional intake than males. We suggest that nutritional interventions are needed to improve the overall nutritional intake in both male and female gastric cancer patients. In particular, we propose that support is urgently needed for females whose nutritional intake is lower than that of males. In addition, family, social, and national support for nutritional management of female gastric cancer patients is highly necessary.

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[Korean]
[Republished study] Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery: A Comparative Study of Five Nutritional Screening Tools: Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee; Korean J Community Nutr 2022;27(3):205-222. Published online June 30, 2022; DOI: https://doi.org/10.5720/kjcn.2022.27.3.205

Objectives
This study examined the characteristics of patients according to nutritional status assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools.
Methods
A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 were included. The patients were categorized into malnutrition and normal status according to five nutritional screening tools one month after surgery. The Spearman partial correlation, Cohen’s Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each two screening tools were calculated.
Results
Malnutrition was observed in 86.24% of patients based on the PG-SGA and 85.82% based on the NUTRISCORE. When NRI or CONUT were applied, the proportions of malnutrition were < 30%. Patients with malnutrition had lower intakes of energy and protein than normal patients when assessed using the PG-SGA, NUTRISCORE, or NRI. Lower levels of albumin, hemoglobin, total lymphocyte count, and total cholesterol and longer postoperative hospital stays were observed among patients with malnutrition compared to normal patients when NRI, PNI, or CONUT were applied. Relatively high agreement for NUTRISCORE relative to PG-SGA was found; the sensitivity was 90.86%, and the AUC was 0.78. When NRI, PNI, and CONUT were compared, the sensitivities were 23.72% for PNI relative to NRI, 44.53% for CONUT relative to NRI, and 90.91% for CONUT relative to PNI. The AUCs were 0.95 for NRI relative to PNI and 0.91 for CONUT relative to PNI.
Conclusions
NUTRISCORE had a high sensitivity compared to PG-SGA, and CONUT had a high sensitivity compared to PNI. NRI had a high specificity compared to PNI. This relatively high sensitivity and specificity resulted in 77.00% agreement between PNI and CONUT and 77.94% agreement between NRI and PNI. Further cohort studies will be needed to determine if the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

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Report on the Current Trend of Commercial Enteral/Parenteral Nutrition in Outpatient
Hyun Ji Lee, Hyo Jung Park, Seon Young Chung, Myung Sook Min, Ok Soon Jeong, Ja Kyung Min
Journal of Korean Society of Health-System Pharmacists.2023; 40(2): 211. CrossRef

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[Korean]
Assessing Nutritional Status in Outpatients after Gastric Cancer Surgery : A Comparative Study of Five Nutritional Screening Tools: Jae Won Cho, Jiyoung Youn, Min-Gew Choi, Mi Young Rha, Jung Eun Lee; Korean J Community Nutr 2021;26(4):280-295. Published online August 31, 2021; DOI: https://doi.org/10.5720/kjcn.2021.26.4.280

Abstract PDF

Objectives
This study aimed to examine the characteristics of patients according to their nutritional status as assessed by five nutritional screening tools: Patient-Generated Subjective Global Assessment (PG-SGA), NUTRISCORE, Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) and to compare the agreement, sensitivity, and specificity of these tools. Methods: A total of 952 gastric cancer patients who underwent gastrectomy and chemotherapy from January 2009 to December 2012 at the Samsung Medical Center were included. We categorized patients into malnourished and normal according to the five nutritional screening tools 1 month after surgery and compared their characteristics. We also calculated the Spearman partial correlation, Cohen’s Kappa coefficient, the area under the curve (AUC), sensitivity, and specificity of each pair of screening tools. Results: We observed 86.24% malnutrition based on the PG-SGA and 85.82% based on the NUTRISCORE among gastric cancer patients in our study. When we applied NRI or CONUT, however, the malnutrition levels were less than 30%. Patients with malnutrition as assessed by the PG-SGA, NUTRISCORE, or NRI had lower intakes of energy and protein compared to normal patients. When NRI, PNI, or CONUT were used to identify malnutrition, lower levels of albumin, hemoglobin, total lymphocyte count, total cholesterol, and longer postoperative hospital stays were observed among patients with malnutrition compared to those without malnutrition. We found relatively high agreement between PG-SGA and NUTRISCORE; sensitivity was 90.86% and AUC was 0.78. When we compared NRI and PNI, sensitivity was 99.64% and AUC was 0.97. AUC ranged from 0.50 to 0.67 for comparisons between CONUT and each of the other nutritional screening tools. Conclusions: Our study suggests that PG-SGA and NRI have a relatively high agreement with the NUTRISCORE and PNI, respectively. Further cohort studies are needed to examine whether the nutritional status assessed by PG-SGA, NUTRISCORE, NRI, PNI, and CONUT predicts the gastric cancer prognosis.

Citations

Citations to this article as recorded by

Effects of Continuous Nutrition Care on Nutritional Status and Dietary Habits of Patients With Colorectal Cancer Receiving Adjuvant Chemotherapy After Surgery
Jina Son, Ha I Kang, Eun young Jung, Hae won Ryu, Kyung-Ha Lee
Clinical Nutrition Research.2023; 12(2): 99. CrossRef

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[English]
Effect of Nutrition Education on the Eating Habits and Quality of Life of Gastric Cancer Outpatients Undergoing Gastrectomy: YoonHee Jung, Joomin Lee; Korean J Community Nutr 2018;23(2):162-173. Published online April 30, 2018; DOI: https://doi.org/10.5720/kjcn.2018.23.2.162

Abstract PDF PubReader: OBJECTIVES
This study examined the effects of nutrition education on the nutritional status, including eating habits and quality of life in gastric cancer patients undergoing a gastrectomy.
METHODS
Thirty one out-gastric resection patients at C University Hospital in Gwangju, Korea were enrolled in this study. The patients received an individualized nutritional counseling session, and the effects were assessed before and after a 3-month nutrition education intervention. Nutrition education for gastric cancer outpatients included the dietary guidelines (e.g., food intake), the level of nutrient intake, and nutrition support.
RESULTS
The patients had significantly improved serum albumin and hematocrit levels after nutrition education. Of the dietary habits, the meal time and amount of food compared to the first education were increased significantly. Of the changes in the food intake frequency, fish and meat, and vegetables and fruits intake were increased, but not at a statistically significant level. The score of eating habits related to the gastrectomy was improved significantly after nutrition education from 31.7 to 34.5. The composite scores for the quality of life were also improved significantly after the nutrition education program.
CONCLUSIONS
The nutrition education for gastric cancer outpatients may be crucial and efficient for improving their lifestyle.

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