Medical nutrition therapy of coronavirus disease 2019 inpatients based on the tenth edition of the National Diagnosis and Treatment Protocol / 中华临床营养杂志

Most hospitalized patients infected with coronavirus disease 2019 (COVID-19) are in severe or critical condition, and malnutrition is a key factor contributing to adverse outcomes. The basic principles of medical nutrition therapy have been determined in the recently released tenth edition of the National Diagnosis and Treatment Protocol. The principles have promoted nutritional risk assessment, emphasized the preferred method of enteral nutrition, and recommended the daily intake of calories at 25 to 30 kcal/kg and protein at > 1.2g/kg. Parenteral nutrition should be also added when necessary. Based on the above principles, Beijing Hospital has refined the medical nutrition therapy measures to facilitate the implementation in clinical practice, in order to improve healthcare quality and decrease the mortality in COVID-19 patients.

Medical nutrition therapy in the context of value-based healthcare / 中华临床营养杂志

The purpose of value-based healthcare is to effectively control medical costs on the basis of comprehensively improved healthcare quality, which is the key focus of medical system reform in China. Improving information system framework, establishing scientific evaluation methods and transforming medical insurance payment methods are the impetus for value-based healthcare practice in China. "Screening, assessment and intervention" is the critical step in standardized medical nutrition management. In line with the connotation of value-based healthcare, nutritional risk screening aims to improve clinical outcomes. The diagnosis of malnutrition per the Global Leadership Initiative on Malnutrition (GLIM) criteria enables the inclusion into Diagnosis Related Groups (DRGs). Oral nutritional supplement is the preferred medical nutrition treatment for patients at nutritional risk or with malnutrition and insufficient food intake. Standardized application can reduce weight loss, improve clinical outcomes, save medical costs and improve the health and survival of malnourished elderly patients at a lower cost, exemplifying the value-based healthcare model.

Health values of cassava compared to wheat and yam in relation to diabetes and dyslipidaemia management

The objective of the study was to evaluate how diabetes and dyslipidaemia can be managed by increasing the consumption of root and tuber crops such as cassava and yam. Journal literatures based on research reports as well as institutional publications and databases on nutritional values of various foods were reviewed. Critical reviews were also performed to synthesize a comparison between the various foods, especially in terms of their fibre values. The critical review shows that guidelines devoted six pages to protein-energy malnutrition and another seven pages on micronutrients. However, there is no mention of the dietary fibre values of the staple root and tuber food crops. From the narrative review, previous report showed that carbohydrate or fibre and fat or fibre ratios are negligible in the raw products, but highest in wheat flour and higher in yam relative to cassava flour. A further comparative review in terms of proximate analysis of the foods elaborates that unprocessed wheat is high in crude protein, carbohydrate and fibre. Thus, the extent or nature of processing is a key factor. Whether wheat has better health value over root and tuber crops has neither being expatiated, nor cassava and yam acknowledged as having any medical value relative to wheat. Since fat is pro-obesity and pro-diabetic while fibre is anti-dyslipidaemic; the foods based on processed wheat flour may possess the least pharmacological values relative to the indigenous carbohydrate food crops. This report provides indication of medical nutrition therapy potentials of indigenous carbohydrate food crops in Delta state of Nigeria

Indigenously Prepared Ready-to-use Therapeutic Food (RUTF) in Children with Severe Acute Malnutrition

Objective: To compare efficacy of indigenous Ready-to-useTherapeutic Food (Medical Nutrition Therapy) with StandardNutrition Therapy in children with Severe acute malnutrition.Design: Two facility-based and two community-based models:(i) Open prospective randomized controlled trial comparingIndigenous Ready-to-use Therapeutic Food (Medical NutritionTherapy) with Standard Nutrition Therapy; (ii) Only IndigenousReady-to-use Therapeutic Food (Medical Nutrition Therapy); (iii)Doorstep Child Care Centre; and (iv) Community-basedManagement of Acute Malnutrition.Setting: (i) Urban Health Center, Dharavi, Mumbai; (ii) Two daycare centers of Non-governmental Organization SNEHA –Mumbai; (iii) Urban slums, M East and L Ward, MumbaiParticipants: 1105 children aged 6-60 months in community orhospital inpatient/ outpatient department diagnosed as SevereAcute Malnutrition by WHO definition.Intervention: All subjects received either Indigenous Ready-to-use Therapeutic Food (Medical Nutrition Therapy) or StandardNutrition Therapy (protein calorie rich diet) for eight weeks andfollowed up for next four months.Main outcome measures: Mean rate of weight gain (g/kg/day), target weight, change in nutritional status.Results: Rate of weight gain was higher (P<0.05) at 2 weeks onindigenous Ready-to-use Therapeutic Food (Medical NutritionTherapy) (5.63 g/kg/day) as compared to Standard NutritionTherapy (3.43 g/kg/day). 61.2% subjects achieved target weightcompared to 47.7% controls. At 8 weeks, 82.8% subjectsrecovered from Severe Acute Malnutrition compared to 19.3%controls (P<0.005). The results obtained in community werecomparable to facility-based indigenous Ready-to-useTherapeutic Food (Medical Nutrition Therapy). The morbidity wasless in study group at follow-up.Conclusions: Indigenous Ready-to-use Therapeutic Food(Medical Nutrition Therapy) appeared to be superior to StandardNutrition Therapy in promoting weight gain in children with SevereAcute Malnutrition.Keywords:Medical Nutrition Therapy, Micronutrients, Nutritionalrehabilitation, Protein energy malnutrition. Ready-to-use-food

Current Status and Effects of Dining with Diabetes in Korea and Abroad / 임상당뇨병

Education about self-management is critical for improving the lifestyles of diabetic patients. Medical nutritional therapy is especially important to keep blood glucose levels in the normal range. Several studies report that education involving cooperation with patients to actually improve lifestyle habits, as opposed to lecture-based education, was more effective in controlling blood glucose level as well as improving eating behavior. This review examines the current status and the effects of medical nutritional therapy and practical training in Korea and abroad. The findings of this review suggest that practical education involving hands-on training should be used as an essential treatment method of diabetic patients.

Progression on the medical nutrition therapy of type 2 diabetes mellitus / 中国糖尿病杂志

Medical nutrition therapy (MNT)is the basic and long-term treatment of diabetes patients. At present,the dietary structure of type 2 diabetes mellitus(T2DM)patients in China has yet to be further improved. This article focused on the effect,dietary structure,food selection and guarantee of compliance of MNT in T2DM.We recommended that the dietary pattern should be designed based on the traditional dietary habits around the country,combined with people living and working reality. The rational utilization of network platform can improve the efficiency and compliance of nutrition education.

In-depth Medical Nutrition Therapy for a Woman with Diabetes: From Pregnancy to Delivery

Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process.

Nutrition management after metabolic surgery / 中国糖尿病杂志

[Summary] Nowadays ,obesity and diabetes mellitus have become an important worldwide public health problem. Bariatric surgery is an effective treatment method of morbid obesity and type 2 diabetes mellitus (T2DM ). Although nutrition‐related complications after surgery is relatively common ,these complications can be detected and prevented. The key is to establish a routine perioperative prophylaxis and postoperative long‐term monitoring system. Routine metabolic and nutritional monitoring is recommended after all bariatric surgical procedures ,which can help patients maintain long‐term weight loss ,timely detect and treat surgery‐related complications and improve clinical outcomes. In the present mini review ,the perioperative and postoperative nutrition management was introduced.

Medical Nutrition Therapy based on Nutrition Intervention for a Patient with Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is a major cause of disability, and according to statistics from the World Health Organization, COPD is the fourth leading cause of death overall in the face of decades, and expected to be increased. In 2005, the reported prevalence of COPD in Korea was 17.2% of adults over the age of 45. Malnutrition is a common problem in papatients with COPD. And several nutritional intervention studies showed a significant improvement in physical and functional outcomes. According to the results of previous studies, the nutritional support is important. This is a case report of a patient with COPD who was introduced to a proper diet through nutrition education based on the medical nutrition therapy protocol for COPD.

Medical nutrition therapy for diabetes: a revisit / 中华内分泌代谢杂志

Nutritional therapy constitutes the basis for the integrated treatment of diabetes.It is essential for diabetic dietary management to be an individualized and balanced diet pattern based on total calorie control Carbohydrates is the main dietary ingredient to affect postprandial blood glucose levels.Dietary structure,way of eating,and physical exercise all contribute to the control of postprandial blood glucose levels.

Diet Therapy in Patients of Diabetic Nephropathy / 임상당뇨병

Diabetes Mellitus is a chronic disease with a rising prevalence worldwide. Diet therapy for type 2 Diabetes Mellitus (T2DM) recommends a balanced diet, while that for diabetic nephropathy differs in every stage of kidney disease because of some foods' potential to affect kidney damage. Medical nutrition therapy for early diabetic nephropathy (once microalbuminuria is detected) is focused on controlling weight and blood sugar, and reducing sodium intake. Medical nutrition therapy in late diabetic nephropathy (after proteinuria is detected) is focused on controlling weight and blood sugar, reducing sodium intake, and also focuses on protein restriction to address decreasing proteinuria. It is important to closely follow therapeutic diet guidelines established through individualized medical nutrition therapy by a registered dietitian, as dietetic therapy for diabetic nephropathy differs according to kidney function and individual health.

Medical Nutrition Therapy Administered by a Dietitian Yields Favourable Diabetes Outcomes in Individual with Type 2 Diabetes Mellitus

Aim: This prospective, single-group, pre-post design trial was conducted to evaluate the effect of individualised Medical Nutrition Therapy intervention administered by a dietitian in individuals with type 2 diabetes mellitus on glycaemic control, metabolic parameters and dietary intake. Methods: Subjects (n=104; age=56.4 +9.9 years; 37% male; years of diagnosis = 6.3 +4.9 years) treated with diet and on a stabile dose of oral anti-diabetic agents were given dietary advice by a dietitian for a 12 week period. Individualised dietary advice was based on Malaysian Medical Nutrition Therapy for adults with type 2 diabetes mellitus. The primary outcome measure was glycaemic control (fructosamine and HbA1c level) and the secondary outcome included measures of anthropometry, blood pressure, lipid profile, insulin levels dietary intake and knowledge on nutrition. Results: At week 12, 100 subjects completed the study with a dropout rate of 3.8%. The post-Medical Nutrition Therapy results showed a significant reduction of fructosamine (311.5 +50 to 297 +44 umol/L; p9.3% at baseline. Waist circumference (90.7 +10.2 to 89.1 +9.8 cm, p<0.05), HDL-cholesterol (1.1 +0.3 to 1.2 +0.3 mmol/L, p<0.05), dietary intake and nutrition knowledge score (42 +19 vs. 75 +17%; p< 0.001) were significantly improved from the baseline. Conclusions: Individualised Medical Nutrition Therapy administered by a dietitian resulted in favourable diabetes outcomes, which were more apparent for individuals with higher than optimal HbA1c levels at the start of the study.

Evaluation of Nutrient Intake in Early Post Kidney Transplant Recipients

The purpose of our study was to evaluate the dietary intake of kidney transplant recipients (KTRs) and assess oral intake related nutrition problems. Fifty patients who had undergone kidney transplantation were included: 24 males, 26 females. The mean age was 46.8 +/- 11.2 years, height was 161.3 +/- 8.3 cm, and body weight was 60.5 +/- 8.7 kg. We conducted nutrition education based on the diet guideline for KTRs (energy 32 kcal/kg of ideal body weight [IBW], protein 1.3 g/kg of IBW) and neutropenic diet guideline before discharge. Dietary intake of the patients at 1 month after transplantation was investigated by 3-day food records. Body weight and laboratory values for nutritional status and graft function were also collected. Body weight was significantly decreased from admission to discharge. Body weight from discharge to 1 month and 3 months after transplantation was increased but was not significant. Biochemical measurements were generally improved but the number of patients with hypophosphatemia increased. The daily dietary intake of energy and protein was adequate (33.1 kcal/kg, 1.5 g/kg, respectively). However, the dietary intake of calcium, folate, and vitamin C did not meet the Korean Recommended Nutrient Intake of vitamins and minerals (86.8%, 62.4%, and 88.0%, respectively). Patients with low intake of calcium, folate, and vitamin C presented low intake in milk and dairy products, vegetables, and fruits, and these foods were related to restricted food items in neutropenic diet. More attention should be paid on improving quality of diet, and reconsideration of present neutropenic diet guideline is necessary. These results can be used to establish evidence-based medical nutrition therapy guideline for KTRs.

Medical nutrition therapy by evidence-based clinical pathway to improve outcome of gluten enteropathy: a case report / 中华临床营养杂志

Celiac disease (CD) is a chronic autoimmune gastrointestinal disorder induced by ingestion of gluten-containing foods.In the past CD was thought prevalent only in Western countries,whereas it has been found common throughout the world and increasing numbers of Chinese patients has been reported recently.However,there are still many deficiencies in management of patients with CD in China and either the diagnosis or the treatment of CD is lacking evidence-based clinical pathway.We report a case of a young woman with CD presenting with chronic diarrhea,abdominal distention,and weight loss,whose outcome was improved by following evidence-based guidelines of medical nutrition therapy.Diagnosis and treatment of the patient was analyzed with review of foreign and domestic literature to provide readers reference of the standardized nutritional intervention of CD.

Medical-Nutrition-Therapy for Obese Patients with Type 2 Diabetes Mellitus Undergoing Metabolic Surgery

Currently, metabolic surgery (Laparoscopic Roux-en-Y gastric bypass, LRYGB) has an important role and should be recommended as an intervention in the management of obese patients with type 2 diabetes mellitus (T2DM). A successful outcome of surgery requires medical nutrition therapy. Therefore, we performed a retrospective study on 25 patients with T2DM who underwent LRYGB at Yeouido St. Mary's Hospital from October 2008 to May 2010. The patients were followed up for an average of 6 months after surgery (range: 2~19 months). Diabetes was resolved in 80% of the patients. Percentage of excess weight loss was (%EWL) was 56.2%. After surgery, fasting blood sugar (FBS) and HbA1c were significantly reduced (123 mg/dl, A1c 6.7%, P<0.001) and triglyceride was also significantly reduced to 107.6 mg/dl (P<0.05). As diets of the patients progressed from liquid to soft to regular diet, energy, carbohydrates, and fat intakes increased significantly (P<0.001). But protein intake did not change significantly. Nutrient intake of the patients after the surgery was significantly lower than the recommended diet for the non-surgery group. Patients experienced side-effects related to the diets after surgery, including hair-loss (76%), smelly gas (52%), vomiting (48%), etc. A significantly positive correlation was observed between vomiting and FBS (P<0.001). There was a significant relationship between side effects and the amount of nutrient intakes. Therefore, guide patients to a diet progression with treatment to minimize side effects, especially vomiting. And monitor their dietary life to be healthy and not to regain weight until remission of T2DM.

The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE)(n = 35), and the other receiving intensive nutritional education (IE)(n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p < 0.05) and systolic blood pressure (p < 0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p < 0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p < 0.05). Mean time taken for a dietitian to educate the subject was 67.9 +/- 9.3 min/person for BE group, while 96.4 +/- 12.2 min/person for IE group. Mean number of educational materials was 1.9 +/- 0.7/person for BE group and 2.5 +/- 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA1c, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

Effects of Medical Nutrition Therapy on Food Habits and Serum Lipid Levels of Hypercholesterolemic Patients

Hypercholesterolemia has been regarded as a major risk factor of coronary heart disease(CHD). CHD is increasing in recent years among Koreans due to westernization of lifestyle and dietary behaviors. In the United States, implementation of the National Cholesterol Education Program(NCEP) had resulted 40% decline in mortality from CHD. This study was designed to evaluate the effect of medical nutrition therapy on serum lipid levels and discuss the effective nutrition education contents. Thirty outpatients(Male 40%, female 60%) with hypercholesterolemia were educated by medical nutrition therapy(MNT) protocol. At first visit and after three months of MNT, we assessed serum lipid profile, body weight and surveyed general characteristics, lifestyle and food habits through questionnaire. After 12 weeks of MNT, there were significant reductions in serum cholesterol and low-density lipoprotein cholesterol(LDL-C). Foods habits and lifestyle were changed to the desirable patterns. These results indicate that lipid profile is improved by changes of dietary behaviors and lifestyle. Especially in case of obesity, cholesterol lowering effect of MNT was more powerful. Consequently, MNT is effective on reduction of serum lipids by behavior change in hypercholesterolemic patients.

Effects of Medical Nutrition Therapy on Changes of Anthropometric Measurements, Dietary Pattern and Blood Parameters in Over Weight or Obese Women

The purpose of this study was to investigate the effect of medical nutrition therapy (MNT) on anthropometric measurements, quality of diets, and blood parameters through the weight loss program in over weight and obese women. The subjects (n = 76, age 31.1 +/- 8.4 y, weight 70.3 +/- 7.9 kg, BMI 27.2 +/- 2.4 kg/m2) without medical disease were treated with MNT 5 times for 12 weeks by dietitian. Anthropometric measurements included height, weight, fat mass, lean body mass, triceps and thigh skin-fold thickness, mid-arm, waist, hip and thigh circumference. Dietary assessments were accomplished using 3-days food records, diet quality index (DQI), and dietary pattern. The dietary pattern was assessed by daily energy intakes from breakfast, lunch, dinner, and snacks of calorie density, and numbers of eating. Blood levels of leptin, lipid profiles (total lipids, total cholesterol, LDL-cholesterol, HDL-cholesterol), and insulin were analyzed. Anthropometric measurements decreased significantly after MNT (p < 0.001). Waist circumference was reduced most rapidly and tricep skin-fold thickness was reduced most effectively after 12 weeks of MNT. Daily energy intake, calorie density and numbers of eating incidence decreased significantly (1796.4 +/- 395.5 vs 1402.9 +/- 217.8 kcal/day, 162.3 +/- 56.5 vs 113.4 +/- 30.1, 5.0 +/- 1.4 vs 3.8 +/- 0.4, respectively, p < 0.05). The daily energy intake from breakfast and snacks significantly decreased (p < 0.001). Calories from snack, calorie density of snack and numbers of snacking also decreased (p < 0.05). The mean scores of DQI significantly increased (7.6 +/- 2.1 vs 6.5 +/- 1.6, p < 0.05). The plasma levels of total lipid, triglyceride (TG), total cholesterol, LDL-cholesterol and leptin decreased significantly after MNT (489.8 +/- 100.4 vs 447.0 +/- 87.3 mg/dL, 187.7 +/- 34.0 vs 175.9 +/- 31.5 mg/dL, 115.2 +/- 29.2 vs 109.2 +/- 26.7 mg/dL, 15.7 +/- 7.6 vs 12.4+/- 5.9 ng/mL, respectively, p < 0.05). These results indicate that MNT efficiently reduced the body weight through the changes in dietary intake, dietary patterns and dietary quality. MNT also changed body composition and reduced the levels of plasma lipid, cholesterol and leptin.

Evaluation of Cost-Effectiveness of Medical Nutrition Therapy: Meta-Analysis

OBJECTIVES: A meta-analysis of the literatures was conducted to evaluate the cost-effectiveness of medical nutrition therapy by dietitians. METHODS: The 30 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and the PQD database until May, 2002 and a review of reference lists. The main search terms were "dietitian", "dietary intervention", "nutrition intervention", "cost", "cost-effectiveness" and "cost-benefit analysis". The subgroup analysis was performed by publication year, study design, intervention provider, type of patient (in/out-patient) and type of cost (total cost/direct cost). Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. RESULTS: The 30 studies were identified using the electric database search and bibliographies. The 17 trials were eligible for inclusion criteria, then the systematic review and a meta-analysis were conducted on effectiveness and cost-effectiveness of medical nutrition therapy. The quality of the studies was evaluated using the quality assessment tool for observational studies. The quality score was 0.515+/-0.121 (range : 0.279-0.711, median : 0.466). The meta-analysis of 17 studies based on the random effect model showed that medical nutrition therapy was highly effective in treating the diseases (effect size 0.3092 : 95% confidence interval 0.2282-0.3303). The vote-counting method, one of meta-analysis methods, was applied to evaluate the cost-effectiveness of medical nutrition therapy conducted by dietitians. Two criteria (method 1, method 2) for voting were used. The calculated p-values for method 1 (more conservative method) and method 2 (less conservative method) were 0.1250 and 0.0106, respectively. Medical nutrition therapy by dietitians was significantly cost-effective in the method 2. CONCLUSION: This meta-analysis showed that the effectiveness of medical nutrition therapy was statistically significant in treating disease (effect size 0.3092), and that the cost-effectiveness of medical nutrition therapy was statistically significant in the method 2 (less conservative method) of vote counting.

The clinical and cost effectiveness of medical nutrition therapy in persons with hypercholesterolemia

Although medical nutrition therapy (MNT) is considered as a cornerstone of medical treatment for hypercholesterolemia, few studies have evaluated medical and economical outcome of MNT. This study was conducted to identify whether MNT administered by registered dieticians could lead to a beneficial clinical and cost outcome in persons with hypercholesterolemia. A prospective clinical trial was carried out at outpatient clinics, which involved an initial visit with a dietitian followed by another visit at first 4 weeks during the 6 weeks study periods. Thirty-nine subjects took part in a 6 weeks nutrition intervention program. Clinical and economical outcomes were compared before and after MNT. Medical nutrition therapy lowered total serum cholesterol level 6.1% (P<0.05), low-density lipoprotein cholesterol (LDL-C) 9.4% (P<0.05) and high-density lipoprotein cholesterol (HDL-C) 3.0% (P<0.05). The cost-effective ratio was 1,520 won/cholesterol mg/dl and 1,441 won/LDL-cholesterol mg/dl, respectively. After dietitian's intervention, lipid drug eligibility was obviated in 16 of 39(41%) subjects. The cost savings from the avoidance of lipid medications was 151,107 won per patient annually. In conclusion, it is suggested that provision of systemic intensive nutritional care for persons with hypercholesterolemia has significant effects on serum cholesterol reduction and clinical cost savings.