Korean Journal of Community Nutrition

Original Articles

[English]
Nutritional Status and Dietary Change after Gastrectomy of Gastric Cancer Patients: Young Ok Park, So Yoon Yoon, Shin Sook Kang, Sang Mi Han, Eun Hee Kang; Korean J Community Nutr 2012;17(1):101-108. Published online February 29, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.1.101

The purpose of this survey is to investigate the nutritional status and dietary intake of gastrectomized cancer patients in Asan Medical Center. The subjects were 98 patients, who underwent a gastrectomy due to gastric cancer and were admitted to the General Surgery Department during March 2007 to December 2007. We examined general characteristics (sex, age, clinicopathological stage, type of operation), anthropometric data (height, weight change), biochemical data (red blood cell RBC, hemoglobin HGB, hematocrit HCT, mean corpuscular volume MCV, total lymphocyte count TLC, albumin, total cholesterol), dietary intake and dietary intake related symptoms. Weight loss of gastrectomized patients was 9.0 +/- 4.3% from preillness weight to visiting out-patient department (OPD) weight. Biochemical data (RBC, HGB, HCT, MCV, TLC, albumin, total cholesterol) significantly deteriorated after gastrectomy. However, outpatient visits were all restored to the normal range. Postoperative energy intake was 785.0 +/- 164.2 kcal, which corresponds to 41.6 +/- 9.6% of daily energy requirement. The cause of poor oral intake is mostly fear, abdominal pain and abdominal discomfort. Therefore, to control pre-or post-operative weight change in the future requires, focusing on the body weight to maintain a normal or usual nutrition by interventions and increased caloric intake during hospitalization for the development of nutrient-dense meals. In addition, as the main reason of the lack of intake of meals after the gastrectomy was fear, the patients should be actively encouraged to consider the importance of eating proper meals.

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Comparison of blood biochemical characteristics and dietary intake by sex in gastric cancer patients over 40 years in Korea based on 7th (2016-2018) Korea National Health and Nutrition Examination Survey: a cross-sectional study
Hyeon-Ju Lee, Sung-Won Oh, Sook-Bae Kim
Korean Journal of Community Nutrition.2023; 28(1): 48. CrossRef
Oral Nutritional Supplements Reduce Body Weight Loss after Gastrectomy in Patients with Gastric Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Mijoo Choi, Jong-Yeup Kim, Hyun-Hi Kang, Eunju Park, Sung Ryul Shim
Nutrients.2023; 15(18): 3924. CrossRef
[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 Journal of Community Nutrition.2022; 27(3): 205. CrossRef
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 Journal of Community Nutrition.2021; 26(4): 280. CrossRef
A Case Study on the Customized Nutrition Intervention for a Patient with Primary Gastrointestinal Non-Hodgkin Lymphoma Underlying Chronic Kidney Disease
Young-Hwa Song, Han-Na Kwon, Jeong-Im Hong, Juyeon Park, Ji-Yeon Kim, Hye-Jin Kim
Clinical Nutrition Research.2020; 9(4): 332. CrossRef
Change in Dietary Intake and Nutritional Status Using Mealworms as Hospital Meal in Postoperative Patie
Seong Hyeon Kim, Jin Young Shon, Jun Sung Park, Jong Won Kim, Jung Hyun Kang, Eun Young Yun, Jae Sam Hwang, Hyung Mi Kim
Journal of the Korean Dietetic Association.2016; 22(4): 292. CrossRef
Development of a Self-Care Performance Scale for Patients with Stomach Cancer after Gastrectomy
Min Kyung Jeon, Geum Ja Park
Asian Oncology Nursing.2016; 16(2): 67. CrossRef
Postoperative Changes in Body Weight, Anxiety, Depression, and Quality of Life after Radical Gastrectomy among Patients with Gastric Cancer
Jin Ha Kim, Ja Yun Choi
Asian Oncology Nursing.2014; 14(3): 139. CrossRef

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[English]
A Study on Nutritional Status after Gastrectomy of Gastric Cancer Patients in Jeonbuk Province: Mi Jin Jeong, Chan Young Kim, Sook Bae Kim; Korean J Community Nutr 2006;11(6):785-792. Published online December 31, 2006

Abstract PDF: The purpose of this study was to investigate the nutritional status before and after gastrectomy of gastric cancer patients in Jeonbuk Province. The subjects were 136 patients with gastrectomy of gastric cancer. We assessed the nutritional status before and after an operation by general characteristics (age, clinicopathological stage, type of operation, method of reconstruction), anthropometric characteristics (height, weight, skeletal muscle mass, body fat mass, body mass index (BMI), percent body fat, arm muscle circumference AMC, arm circumference AC) and biochemical characteristics (hemoglobin Hb, hematocrit Hct, mean corpuscular volume MCV, mean corpuscular hemoglobin MCH, total lymphocyte count TLC, serum albumin, serum transferrin). Mean ages were 60.0 yrs in males and 58.8 yrs in females. Age, clinicopathological stage, types of operation and reconstruction methods were not significantly different between males and females. Weight, skeletal muscle mass, body fat mass, BMI, percent body fat, AMC and AC significantly deteriorated by gastrectomy. There were severe weight losses in males and females after gastrectomy. Hemoglobin, Hct, MCV, MCH, TLC, albumin and transferrin significantly deteriorated by gastrectomy. After gastrectomy, subjects who were assessed as malnounrished in Hb and Hct were increased in male and those who were assessed as malnounrished in Hb were increased in females. These results suggest that a nutrition intervention, specially for energy, protein and iron, is necessary to improve the nutritional status of gastric cancer patients with gastrectomy.

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[English]
Iron Nutritional Status by ALAD Genotype and Intervention Study for Rural Area Residents: Hee Seon Kim, Min Kyung Kim, Sohee Kim, Sung Soo Lee, Byung Kook Lee; Korean J Community Nutr 2006;11(6):771-778. Published online December 31, 2006

Abstract PDF: Previous studies have suggested that delta-aminolevulinic acid dehydratase (ALAD) phenotype differently affect mineral metabolism. The objective of this study was to determine the effectiveness of 6-month iron supplementation as syrup of NaFeEDTA in improvement of iron status according to ALAD genotype. One hundred thirty adult women living in rural areas of Asan were provided NaFeEDTA syrup once a week for 6 months at the dose of 64mg Fe/week. Three hundred control subjects were observed during the study period. Fasting blood was obtained for analyzing hemoglobin (Hb) and zinc protophorphyrin (ZPP) and serum was analyzed for ferritin, iron and total iron capacity (TIBC) levels before and after iron supplementation. Ninety percent of ALAD 1-1 (ALAD1) and 10% of ALAD 1-2 (ALAD2) genotype were observed in the control group. However, in the intervention group, 98% showed ALAD1 while only 2% was ALAD2, which is significantly lower proportions of ALAD2 compared to the control group (p<0.01). The iron status of intervention group significantly improved except for ferritin and TIBC regardless of ALAD genotype, while the control group did not show any changes in iron status except for ZPP. ZPP concentration of the control group significantly increased in both ALAD1 and 2 while the intervention group showed significantly decreased ZPP after supplementation in ALAD1. Iron supplementation in the form of NaFeEDTA seems to be effective in reduction of ZPP levels although ALAD2 did not show significant changes due to the small number. However, it is difficult to make a conclusion from these results, and more specified further investigation is needed with more participants.

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[English]
A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process II: Jung A Park, Jin Sook Yoon; Korean J Community Nutr 2003;8(2):160-170. Published online April 30, 2003

Abstract PDF: Pregnant women in South Korea are a highly risk group for iron deficiency anemia. Previous studies indicated that the 24-hour recall method was insensitive in distinguishing iron deficiency anemic women from normal women. This method is also impractical to when used at community health centers where no public health dietitians are employed. The objective of this study was to develop a convenient tool to evaluate the usual iron (Fe) intake of pregnant women. The study participants were 115 pregnant women (age 23 to 37 years) at gestational stage of 13 to 24 weeks. Anemic subjects were classified on the basis of their serum ferritin < 12.0 microgram/L and hemoglobin < 12.0microgram/dL levels. Food frequency questionnaires with 46, 29, and 15 commonly consumed food items were used to measure the usual intake of iron of the subjects. Hemoglobin and serum ferritin were measured from fasting blood samples. Nutrients intake was assessed on three consecutive days using the 24-hour recall method and the food record method. The iron index score calculated using the food frequency method showed a significantly positive correlation with iron intake for the three days dietary intake. The iron index showed a significantly difference (p < 0.05) between the normal and anemic groups. However, there was no significant difference in the iron intake between the anemic and the normal women as measured by the 24-hour recall and food record method. Our study indicated that the 29-food items questionnaire could be used as a screening tool to identify poor dietary intake of iron.

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[English]
Iron Status and Anemia of Middle School Girls in Ulsan Metropolitan City: Soon Myung Hong, Young Eun Seo, Hye Jin Hwang; Korean J Community Nutr 2003;8(1):26-32. Published online February 28, 2003

Abstract PDF: This study was designed to assess the nutritional iron status and anemia of middle school girls. Three-hundred-fiftythree female subjects in Ulsan metropolitan city were evaluated using a questionnaire, and hematological indices. The average height and weight of the respondents were 157.19 +/- 5.57 cm and 51.06 +/-9.42 kg, respectively. The average Body Mass Index (BMI, Kg/m2) was 20.63 +/-3.23, which was within the normal range. With regard to clinical symptoms, the greatest number of respondents reported that they experienced 'decreased ability to concentrate'. The total caloric intake of each subject was 1743.28 +/- 343.47 kcal (83.01% of the Korean RDA) and the calcium intake was 634.98 +/- 201.43 mg (79.37% of the Korean RDA). The mean daily intake of iron was 14.76 +/- 4.36 mg (92.25% of the Korean RDA) and the heme iron intake was 6.12 +/- 2.30 mg, which was 41.5% of the total iron intake. The average hemoglobin (Hb) concentration of the subjects was 13.24 +/- 1.01 g/dl, and the average hematocrit (Hct) level was 37.79 +/- 4.10%. The transferrin saturation {TS (%)} was 19.41 +/- 9.21%, and the ferritin level was 26.26 +/- 18.60 ng/ml. The iron deficiency anemia among the subjects was estimated at 6.1% by using Hb (< 12 g/dl), 20.5% by using Hct (< 36%), 30.8% by using TS (< 14%), and 23.1% by using ferritin (< 12 ng/ml). The total iron binding capacity (TIBC) showed a negative correlation with the Hb, iron, ferritin and TS. With regard to the correlation between blood biochemistry and clinical symptoms related to anemia, the Hb concentration was negatively correlated with 'pale face' (p < 0.05). In addition, the level of iron was significantly and negatively correlated with 'poor memory' (p < 0.01) and the ferritin concentration was negatively correlated with 'no appetite' (p < 0.05), 'pale face (p < 0.05). These results suggest that the prevalence of iron deficiency among middle school girls is very high; therefore, guidelines on dietary support and nutritional education to improve their dietary iron status should be provided.

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[English]
A Screening Tool for Identifying High-Risk Pregnant Women of Fe Deficiency Anemia : Process I: Jung A Park, Jin Sook Yoon; Korean J Community Nutr 2001;6(5):734-743. Published online December 31, 2001

Abstract PDF: Iron deficiency anemia is a worldwide public health problem relevant to unsound nutritional practice. While the prevalence of iron deficiency anemia is very common among pregnant women, appropriate nutritional service programs to improve the iron status are lacking in Korea. In an attempt to develop a nutritional screening tool to separate the high-risk subjects of iron deficiency, we carried out a nutritional survey for 115 Korean pregnant women whose gestational age ranged from 13 to 24 weeks. Each subject was interviewed with questionnaires for general characteristics and dietary habits. Food intake was measured by 24-hour recap method and 2 day record. Fasting blood was drawn for measuring hemoglobin and serum ferritin. It appeared that half of the pregnant women belonged to the anemia group and had insufficient dietary habits to provide adequate amounts of dietary iron. The first gravida and the working women had better hematological iron indicators than the second or more gravida and the housewives. It also appeared that women who had bigger family size and lower BMI in pre-pregnancy had poorer iron status. Among the food consumption habits, fruit dependent dietary habit was related to poor iron status. Sufficiently consumed green leafy vegetable and appropriate amount of food before morning sickness were positive factors of iron stares. Our results indicated that parity, BMI, current job, family size, food habits including consumption of fruits, green & yellow vegetables, and food habits before the onset of morning sickness are significant factors to contribute the Fe deficiency anemia during pregnancy.

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[English]
Effects of Iron Supplementation on Iron Status of Anomic High School Girls: Soon Myung Hong, Hye Jin Hwang; Korean J Community Nutr 2001;6(5):726-733. Published online December 31, 2001

Abstract PDF: This study was designed to investigate the effect of iron supplementation on the iron nutritional status and anemia of high school girls in Korea. One hundred thirty-five female students residing in Ulian metropolitan city in Korea diagnosed as having anemia or iron deficiency participated in this study. One or two tablets of iron medicine(80-160 mg Fe as ferrous sulfate/day) were administered to all participants for 3 months. Subjects were evaluated with a questionaire, measurement of hematological indices before and after iron supplementation. The average height and weight of respondents were 161.62 +/- 4.68 cm and 53.87 +/- 6.10 kg, respectively. Daily intakes of energy were 1597.8 +/- 302.35 kcal(76.0% RDA). Iron intakes were 13.72 +/- 4.17 mg (76.3% of RDA) and calcium intakes were 580.74 +/- 177.21(72.5% of RDA) before iron supp]ementation. At baseline, 63% of all participants had depleted store(serum ferritin 12 ug/ml and/or transferrin saturation(TS)<14%). After iron supplementation, this proportion declined to 19.3%. 55.6% of subjects had 12 ug/m1 of basal ferritin concentration before iron supplementation, and this proportion declined to 16.3% after iron supplementation. The basal hemoglobin(Hb) concentrations were 12.13 +/- 1.01 g/dl and they increased to 12.79 +/- 0.81 g/dl, which showed significant difference artier iron supplementation(p<0.001). The basal ferritin and TS(%) were 13.24 +/- 11.66 ng/ml, 18.42 +/- 10.12% and they significantly increased to 32.95 +/- 21.14 ng/ml, 33.53 +/- 16.64%, respectively(p<0.001). The basal total iron binding protein(TIBC) were 467.81 +/- 97.24 ug/dl and they significantly decreased to 325.05 +/- 48.89 ug/dl(p<0.001) after iron supplementation. The number of tablets administered was positively correlated with serum iron(t = 0.553, p<0.01), serum ferritin(t = 0.557, p<0.01), TS(%)(t = 0.588, p<0.01) and negatively correlated with TIBC(t= -0.409, p<0.01). The anemia symptoms such as 'Shortening of breath when going upstairs(p<0.01)', 'Tired out easily(p<0.01)', 'Feeling blue(p<0.001)', 'Decreased ability to concentrate(p<0.01)', and 'Poor memory(p<0.001)'improved significantly after iron supplementation. In this study, daily iron supplementations were efficacious in improving the iron status and anemic symptoms of female high school students. Regular check-ups and nutrition education for adolescents are necessary because of their vulnerability to iron deficiency. Further studies are needed to determine the minimum effective dose of iron and to examine the adverse effect of long-term iron supplementation.

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[English]
A Study on Iron Nutritional Status of Girls at Puberty in Kangnung Area: Eun Kyung Kim, Ok Nam Ryu, Ky Wol Park; Korean J Community Nutr 1999;4(2):139-148. Published online June 30, 1999

Abstract PDF: This study was designed to assess the iron nutritional status of girls at puberty in Kangnung area. The subjects consisted of 161 adolescents in sixth-grade in primary school and first-grade in middle school girls. Anthropometric measurements were taken for body weight, height, percentage of body fat, and circumferences of waist and hip. Nutrient intakes were assessed by modified 24-hour recall method. Food models and other measuring tools were also used. Fasting blood samples were obtained and analyzed for hemoglobin(Hb) concentration, hematocrit(Hct), serum iron(FE) and total iron binding capacity(TIBC). Mean values for Hb, Hct, Fe, TIBC, TS and serum ferritin were 13.6+/-0.9g/dl, 39.6+/-3.9%, 91.3+/-36.3 microgram/dl, 327.9+/-45.2 microgram/dl, 28.3+/-11.8% and 37.4+/-24.2ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 4.8% when judged by Hb to 18.4% by serum Fe concentration. The Hb concentration was positively correlated with Hct(r=0.641), serum iron(r=0.266) and transferrin saturation(r=0.237)(p<0.05). On the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.572). Mean daily intake of iron was 14.94mg and heme iron intake was 1.13mg and which was 7.6% of total iron intake. Total absorbable iron calculated by the method of Mosen was 1.38mg and bioavailability of diectary iron was 9.3%. These results suggest that the prevalence of iron deficiency of pubertal girls is very high, therefore the guidelines for diet and social supports, such as, school food service system should be provided to improve their iron status in middle school students.

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Randomized Controlled Trial

[English]
Effect of Vitamin C Supplementation on Iron Status of Adolescent Girls with Low Hemoglobin Levels: Joung Won Lee, Chun Keun Park; Korean J Community Nutr 1997;2(5):687-694. Published online December 31, 1997

Abstract PDF: This study investigated the effects of vitamin C supplementation on the nutritional iron status of 31 adolescent girls, aged 12-15 years, with low hemoglobin levels. They were randomly divided into four groups, and for two groups daily150 mg or 900 mg of L-ascorbic acid(AsA) was given in three equal doses at three meals during 9 weeks. To another group daily 60 mg iron as ferrous sulfate was given in the same way as AsA. The control group was given sugar placebo. Body iron status was monitored through the determination of Hb, Hct, MCHC, and serum ferritin concentrations. Dietary AsA and iron intakes were measured from food consumption surveys performed by 3-day 24-hour recalls. The amount of absorbed iron was estimated from the model of Monsen et al. The average amounts of food iron for four groups were 12.3- 15.0 mg and 11.1 - 18.9 mg at initial and at final period of the supplementation trial, respectively. The tentatively estimated amount of absorbed iron was significantly increased in the 900 mg AsA and iron supplementing groups, but not in the 150 mg AsA and placebo groups. Both Hb and MCHC were improved to above normal levels in all groups except the placebo group. Hct was elevated only in the AsA 900 mg group whose Hct was relatively lower than the other groups. Serum ferritin concentrations of the four groups, which were as low as 8.50 - 14.39ng/mL on average at the intial periods, augmented significantly to 20.18ng/mL and 26.63ng/mL in the 900 mg AsA and iron groups, respectively. Serum ferritin was not elevated in either the AsA 300 mg group or the placebo group. The above data indicated that the daily supplementaion of 150 mg AsA to the meals containing 12-15 mg iron per day promoted Hb levels of adolescent girls with low Hb, and the 900 mg AsA supplementing improved not only Hb level but also body iron store. A supplementation of 60 mg iron per day appeared to be slightly more effective in improving the iron status in comparison to the 900 mg AsA supplement.

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Original Articles

[English]
Nutritional Status of Female Students in the Sixth Grade Attending a Rural Primary School: Hee Kyung Ro; Korean J Community Nutr 1997;2(3):275-280. Published online August 31, 1997

Abstract PDF: This study was conducted to assess the nutritional status of female students in the 6th grade in a rural primary school. The anthropometric data showed their mean height and weight were 149.5+/-6.5 cm and 41.3+/-7.6 kg, respectively, which are slightly higher than those in the Korean Standard Growth data. It was further observed that there was a wide variation in terms of physical growth and development among subjects. The mean hematocrit value was 40.3+/-3.3% and the mean hemoglobin concentration was 12.9+/-1.0gm/dl. It was proven that 22.8% of subjects were anemic based on the WHO standards for hemoglobin level. Twenty four hour dietary recall revealed that their food intakes of subjects was appropriate, compared to the RDA except for Ca. Mean Ca intake among subjects was 381.3 mg which is 47.7% of RDA. Nutrition education from mothers and the school influence nutrient intake significantly. Special nutrition education programs targeting mothers and students should be developed to provide practical assistance such as food choice and the forming of good eating habit.

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[English]
Iron Nutritional Status of Female Students in Kangnung National University: Kyukee Lee, Eunkyung Kim, Mikyung Kim; Korean J Community Nutr 1997;2(1):23-32. Published online February 28, 1997

Abstract PDF: To evaluate iron nutritional status of female college students, fasting blood samples were taken from 76 female students of Kangnung National University. Hemoglobin(Hb), hematocrit(Hct), serum iron(Fe), total iron binding capacity(TIBC) and serum ferritin concentrations were measured and transferrin saturation was calculated. Mean values for Hb, Hct, Fe, TIBC, TS and serum freeitin were 13.64+/-1.42g/dl, 40.99+/-4.31%, 103.0+/-33.3 microgram/dl, 395.3+/-9.07 microgram/dl, 26.58+/-9.07%and 26.76+/-17.5ng/ml, respectively. Prevalence of iron deficiency greatly varied by indices from 6.8% when judged by Hct to 26.0% by serum ferritin concentration. The Hb concentration was positively correlated with hematocrit (r=0.5402), serum iron(r=0.2819) and transferrin saturation(r=0.2777)(p<0.05). on the other hand, serum ferritin concentration showed significantly negative correlation with TIBC(r=-0.3196). Two-day dietary intake records were collected from subjects to estimate mean daily iron intake and bioavailability of dietary iron. Mean daily intake of iron was 13.15 mg and heme iron intake was 0.83 mg which was 6.4% of total iron intake. Total absorbable iron calculated by the method of Monsen was 1.27 mg and bioavailability of dietary iron was 9.6%. In the light of high prevalence of iron deficiency based of serum ferritin concentration and low bioavailability of iron in the diet, guidelines about diet should be made to increase the content and bioavailability of iron in the diet if female college students.

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