ESTADO NUTRICIONAL DE ALUMNOS UNIVERSITARIOS DE LA PROVINCIA DE MISIONES / NUTRITIONAL STATE OF UNIVERSITY STUDENTS FROM PROVINCE OF MISIONES

las actuales presiones sociales condicionan conductas que conducen a desequilibrios nutricionales.

Evidence-based approaches for establishing the 2015 Dietary Reference Intakes for Koreans

BACKGROUND/OBJECTIVES: The Dietary Reference Intakes for Koreans (KDRIs), a set of reference intake values, have served as a basis for guiding a balanced diet that promotes health and prevents disease in the general Korean population. In the process of developing DRIs, a systematic review has played an important role in helping the DRI committees make evidence-based and transparent decisions for updating the next DRIs. Thus, the 2015 KDRI steering committee applied the systematic review framework to the revision process of the KDRIs. The purpose of this article is to summarize the revision process for the 2015 KDRIs by focusing on the systematic review framework. MATERIALS/METHODS: The methods used to develop the systematic review framework for 2015 KDRIs followed the Agency for Healthcare Research and Quality (AHRQ) and the Tufts Evidence-based Practice Center (EPC). The framework for systematic review of the 2015 KDRIs comprised of the 3 following steps: (1) development of an analytic framework and refinement of key questions and search terms; (2) literature search and data extraction; and, (3) appraisal of the literature and summarizing the results. RESULTS: A total of 203,237 studies were retrieved through the above procedure, with 2,324 of these studies included in the analysis. General information, main results, comments of reviewers, and results of quality assessment were extracted and organized by study design. The average points of quality appraisals were 3.0 (range, 0–5) points for intervention, 6.1 (0–9) points for cohort, 6.0 (3–9) points for nested case-control, 5.4 (1–8) points for case-control, 14.6 (0–22) points for cross-sectional studies, and 7.0 (0–11) points for reviews. CONCLUSIONS: Systematic review helped to establish the 2015 KDRIs as a useful tool for evidence-based approach. Collaborative efforts to improve the framework for systematic review should be continued for future KDRIs.

Study on the Relationship between the Nutrient Intake and Level of Depressive Symptoms: Using the Data from the Korea National Health and Nutrition Examination Survey 2016

The purpose of this study was to examine the relationships between the nutrient intake and level of depressive symptoms. A total of 5,761 subjects with depression were selected for the main data analysis from a Korean National Health and Nutrition Examination Survey, KNHANES (2016), and were divided into low depressed and high depressed groups. The data were analyzed by descriptive analysis, χ2-test, logistic regression, and t-test using SPSS 24.0 statistics. The results revealed significant differences in the prevalence of depression according to sex (P < 0.001), age (P < 0.001), income (P < 0.001), and education (P < 0.001). Regarding the health behavior, higher stress levels (P < 0.001) and smoking habit (P < 0.001) appeared to be strongly associated with high levels of depression. On the other hand, the possibility of experiencing depressive symptoms was lower when the number of walking days per week was more than 3 days (P < 0.05), when the number of working days per week was more than 5 days (P < 0.01), and the rate of aerobic physical activity was higher. Based on the ‘Dietary Reference Intakes for Koreans 2015’, the subjects in the low depression group showed better intake of energy and 22 nutrients than the high depression group.

Nutritional intake analysis of hospital diets in elderly inpatients in Peking Union Medical College Hospi-tal / 中华临床营养杂志

Objective To investigate the nutritional management level of Department of Clinical Nutrition in elderly inpatients through analyzing the actual hospital dietary intakes in elderly inpatients in Peking Union Medical College Hospital from 2013-2015.Methods Using continuous sampling, the nutrients contents and the eating rates of hospital meals ordered by the elderly inpatients on the 1st, 15th, 29th of every month from May 2013 to October 2015 were selected.The intake levels of energy, protein, calcium, vitamin A, vitamin B1 , and vitamin C were calculated and compared with the Chinese dietary reference intakes (DRIs).The nutritional in-take differences between diabetes diet and the basic hospital diet were also compared.Results A total of 90 days of hospital dietary data from 8 402 elderly inpatients were included in the study.The average eating rate was (50.1 ±4.2)%, which was lower than the general eating rate of the hospital [ (59.0 ±4.0)%, P<0.001]. Only protein intake from hospital diet reached the requirement target [male (103.1 ±47.3)%, femal (98.3 ± 33.8)%].Individual compliance rates were 63.2%and 59.8%, respectively, while the other kinds of nutrients were lower.The compliance rates of energy [ (73.3 ±26.3)%vs.(62.1 ±38.2)%, P<0.001] and ma-jor nutrient intake [ protein: ( 119.1 ±41.2 )% vs.( 93.3 ±65.1 )%, P <0.001; calcium: ( 55.5 ± 26.7)% vs.(34.3 ±34.2)%, P <0.001; vitamin A: (75.2 ±48.3)% vs.(57.4 ±97.1)%, P<0.001;vitamin B1:(76.4 ±38.2)%vs.(52.1 ±46.6)%, P<0.001;vitamin C:(92.2 ±51.4)%vs. (49.3 ±55.0)%, P<0.001) in diabetes diet group were significantly higher than those in the basic hospi-tal diet group.Conclusions The nutritional intakes from hospital diets may not meet the nutritional require-ments based on DRIs in elderly inpatients.Medical diet designed by physicians and dietitians should be ex-panded to improve the nutritional management level for these patients.

Trend of dietary nutrient intake among adult females in 9 provinces in China,2000-2011 / 中华流行病学杂志

Objective To investigate trend of dietary nutrient intake among adult females in China. Methods The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey,2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results During the past decade,the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased,while the proportion of females with low carbohydrate(<50%energy)and high fat(>30%energy)intakes increased. Meanwhile,the vitamin and mineral intakes among the females were also unsatisfactory,only small proportion of the females met the requirement for micronutrient intake,and this proportion continued to decline. In 2011,the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%,respectively;the proportion of the females with low carbohydrate and high fat intakes were 40.2%and 63.8%,respectively;the proportion of females who met the requirements for vitamin A, thiamine,riboflavin,niacin,vitamin C and vitamin E intakes were 25.2%,10.7%,6.9%,54.9%,24.3%and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium,iron,zinc and selenium intakes were 3.3%,23.6%,50.9%,75.7%and 13.3%respectively. Conclusion Further nutritional education and intervention is needed to improve nutrition status among Chinese females.

Trend of dietary nutrient intake among adult females in 9 provinces in China,2000-2011 / 中华流行病学杂志

Objective To investigate trend of dietary nutrient intake among adult females in China. Methods The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey,2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results During the past decade,the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased,while the proportion of females with low carbohydrate(<50%energy)and high fat(>30%energy)intakes increased. Meanwhile,the vitamin and mineral intakes among the females were also unsatisfactory,only small proportion of the females met the requirement for micronutrient intake,and this proportion continued to decline. In 2011,the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%,respectively;the proportion of the females with low carbohydrate and high fat intakes were 40.2%and 63.8%,respectively;the proportion of females who met the requirements for vitamin A, thiamine,riboflavin,niacin,vitamin C and vitamin E intakes were 25.2%,10.7%,6.9%,54.9%,24.3%and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium,iron,zinc and selenium intakes were 3.3%,23.6%,50.9%,75.7%and 13.3%respectively. Conclusion Further nutritional education and intervention is needed to improve nutrition status among Chinese females.

Estimation of vitamin K intake in Koreans and determination of the primary vitamin K-containing food sources based on the fifth Korean National Health and Nutrition Examination Survey (2010-2011)

There is little information on dietary vitamin K intake and nutritional status of daily requirements of vitamin K in Korea. The objective of this study was to investigate the vitamin K intake and major food sources of Vitamin K in Koreans. The survey data from the 2010-2011 Korean National Health and Nutrition Examination Survey of 7,792 subjects (aged 19-64 years) were examined. Total vitamin K intake was calculated from 24-hour dietary recall using a vitamin K food database, Computer Aided Nutritional analysis Program and the United States Department of Agriculture database. The geometric mean of vitamin K was estimated as 322.40 +/- 6.33 ug/day for men and 271.20 +/- 4.92 ug/day for women. Daily vitamin K intake increased significantly with age (p for trend < 0.001). The main food source of vitamin K was vegetables (72.84%), including cabbage kimchi (19.26%), spinach (17.38%), sesame leaves (7.11%), radish leaves (6.65%), spring onions (6.28%), and laver (4.82%), followed by seaweed, seasonings, and fat and oils. We observed that the vitamin K intake of Koreans was relatively higher than that reported by other studies in Western countries and differed depending on age.

Current status and trends of both dietary fat and cholesterol intake among Chinese children and adolescents aged 7 to 17 years old in 9 provinces of China, from 1991 to 2009 / 中华流行病学杂志

Objective To study the current status and trends of fat and cholesterol intake among Chinese children and adolescents in 9 provinces from 1991 to 2009,so as to provide evidence on dietary guidance.Methods Data was collected in 1991,1993,1997,2000,2004,2006 and 2009 from the China Health and Nutrition Survey.Sample would include 7-17 years old healthy children and adolescents with a complete 3-day 24-hour-dietary data.Figures on the intake of fat,cholesterol,mean percentage of energy from fat and food source of fat per capita were calculated and compared with the Chinese Dietary Reference Intakes (DRIs).Results Data showed that,in 1991-2009,the dietary fats,mean percentage of energy from total fat and intake of cholesterol had an increasing trend in the population of 9 provinces and were 65.8 g/d,240.0 mg/d and 320％ respectively,in 2009.The percentage of population whose mean energy coming from total fat and reached 57.0％ in 2009.Conclusion The dietary structure of children and adolescents in Chinese 9 provinces had changed significantly.57.0％ of the studied subjects had more than 30％ increase of their fat intake exceeding the Chinese DRIs.It was necessary to provide children and adolescent with basic knowledge on nutrition,in order to properly control the intake of food rich in fat and cholesterol.

Effect of School Lunch Menu Intervention through Calcium Enriched Menus on Nutrient Intakes of High School Girls / 대한지역사회영양학회지

This study was conducted to improve the nutritional status of high school girls via lunch menu intervention. Surveys were carried out twice to evaluate basal status and status after lunch menu intervention. In the first survey nutrient intakes of 24-hour and school lunch were each estimated by 24-hour recall dietary survey and self-recording, respectively. Calcium intake was the lowest among nutrients, and stir-frying was the most preferred cooking method. Five dishes of school lunch menus which were included in the first survey were replaced with recipes containing foods with higher calcium level; anchovy stir-fried with red pepper paste, anchovy stir-fried with almond, pork stir-fried with shredded kelp, crab meat soup, and tteokbokki with cheese. In the second survey calcium intake from school lunch was significantly (p < 0.001) increased from 45.5% to 50.2% of one thirds of recommended intake (RI) after calcium enriched lunch menu intervention. Intakes of vitamin A and E were also significantly increased, whereas those of energy, thiamin, and vitamin C were decreased. Index of nutritional quality values of nutrients of 24-hour intakes (except thiamin, vitamin B6, vitamin C) is increased by intervention; however, those of calcium, folic acid, iron are still very low. Even though this study shows a possibility of improving nutrient intakes of students through school lunch menu intervention, lunch intervention by itself is not enough action to improve nutritional status of micronutrient for adolescents.

Nutritional intake of Korean population before and after adjusting for within-individual variations: 2001 Korean National Health and Nutrition Survey Data

Accurate assessment of nutrient adequacy of a population should be based on usual intake distribution of that population. This study was conducted to adjust usual nutrient intake distributions of a single 24-hour recall in 2001 Korean National Health and Nutrition Surveys (KNHNS) in order to determine the magnitude of limitations inherent to a single 24-hour recall in assessing nutrient intakes of a population. Of 9,960 individuals who provided one 24-hour recall in 2001 KNHNS, 3,976 subjects provided an additional one-day 24-hour recall in 2002 Korean National Nutrition Survey by Season (KNNSS). To adjust for usual intake distribution, we estimated within-individual variations derived from 2001 KNHNS and 2002 KNNSS using the Iowa State University method. Nutritionally at risk population was assessed in reference to the Dietary Reference Intakes for Koreans (KDRIs). The Korean Estimated Average Requirement (Korean EAR) cut-point was applied to estimate the prevalence of inadequate nutrient intakes except for iron intakes, which were assessed using the probability approach. The estimated proportions below Korean EAR for calcium, riboflavin, and iron were 73%, 41%, and 24% from usual intake distribution and 70%, 51%, and 39% from one-day intake distribution, respectively. The estimated proportion of sodium intakes over the Intake Goal of 2,000 mg/day was 100% of the population after adjustment. The energy proportion from protein was within Korean Acceptable Macronutrient Distribution Ranges (Korean AMDR), whereas that of carbohydrate was higher than the upper limit and that of fat was below the lower limit in the subjects aged 30 years or older. According to these results, the prevalence of nutritional inadequacy and excess intake is over-estimated in Korea unless usual intake distributions are adjusted for one-day intakes of most nutrients.

Macro and micro minerals: are frozen fruits a good source?

Fruits are rich in minerals, which are essential for a wide variety of metabolic and physiologic processes in the human body. The use of frozen fruits has greatly spread in the last years not only in the preparation of juices, but also as raw material for yogurts, candies, cookies, cakes, ice creams, and children's food. However, up to now there is no data about the mineral profile of frozen fruits. This is the first database to quantify the levels of minerals in 23 samples of frozen fruits, including the most used around the world and some native fruits from the Amazon rainforest in Brazil. Considering the Dietary Reference Intakes, 100g of frozen fruits can provide 0.2 to 2.8 percent of macro and 2.5 to 100 percent of microminerals for adults (31-50 years old). Although geographical differences should be considered, these data can help to plan diets and to develop population interventions aiming to prevent chronic diseases.

As frutas são ricas em minerais, sendo estes essenciais para uma grande variedade de processos metabólicos e fisiológicos no corpo humano. A utilização de frutas congeladas tem se ampliado nos últimos anos, não só na preparação de sucos, mas também como matéria-prima para iogurtes, doces, biscoitos, bolos, sorvetes e alimentos infantis. No entanto, até o momento não há dados sobre o perfil mineral de frutas congeladas. Este trabalho é o primeiro banco de dados para quantificar os níveis de minerais em 23 amostras de frutas congeladas, bastante consumidas em todo o mundo e de algumas frutas nativas da floresta amazônica, Brasil. Considerando-se as Referências de Ingestão Diárias, 100g de frutas congeladas podem fornecer 0,2-2,8 por cento de macro e de 2,5 a 100 por cento dos mi-crominerais para adultos (31-50 anos). Embora as diferenças geográficas devam ser consideradas, estes dados ajudam para o plano de dietas e desenvolvimento de intervenções junto à população co o objetivo de prevenir doenças crônicas.

The Assessment for Nutrient Intakes of Korean Patients with Heart Failure

The prevalence of heart failure (HF) is increasing globally and growing evidence has shown that dietary factors play an important role in preventing and improving prognosis of HF. However, little data on nutrient intake in Korean HF patients which are available to develop dietary guidelines for HF. The aims of this study were to estimate nutrient intake in 78 HF patients and evaluate whether the estimated nutrient intake is appropriate compared to dietary reference intake for Koreans. Data are presented as the ratio of actual intake and estimated average requirement (EAR) for each nutrient. The result showed that the average nutrient intakes including total energy and protein met EAR in total patients. However, the deficiencies in mineral and vitamin intakes were found. Moreover, the proportion of subjects with lower intake than EAR was substantial. The results showed that the proportion of male HF patients with inferior intakes to EAR in calcium, potassium (compared to adequate intake: AI), folate and vitamin B12 were 38%, 79%, 38%, and 65%, respectively. Also, the proportion of female HF patients with inferior intakes to EAR in calcium, potassium (compared to AI), folate and vitamin B12 were 35%, 88%, 38% and 40%, respectively. In particular, the elderly with HF (> or = 70 yrs, n = 28) showed more serious deficiencies in calcium, potassium (compared to AI), folate and vitamin B12. In summary, the intakes of potassium, calcium, folate, and vitamin B12 were not sufficient to meet EAR in HF patients. Furthermore, the proportions of subjects with lower intake than EAR in these nutrients were substantial, raising the possibility that these micronutrients may be involved in the pathogenesis of HF. Practical dietary guideline for HF patients is needed to improve prognosis of HF.

Urgent need to increase current dietary reference intakes of vitamin D / 中华临床营养杂志

level and recommended nutrient intake)in China has been out-of-date.Therefore,it has became an urgent problem for Chinese Nutrition Society to re-evaluate the DRIs of vitamin D and make corresponding modifications.

Nutrient Intake Determined by School Lunch Plate Waste and by self-reported Food Consumption of Selected High School Students in Seoul

The Purposes of this study were to assess high school students' nutrient consumption at the ordinary time and to analyze nutrient contents and nutrition consumption of lunch. The questionnaires for self-reported food consumption were distributed to 210 students enrolled in a boy's high school and a girl's high school located in Seoul area. A final response rate was 87.1%, excluding responses that had significant missing data. Data of self-reported food consumption and BMI(Body Mass Index) were analyzed with descriptive analysis and t-test using SPSS Win(ver. 12.0). To measure the serving size and the waste amount, data were collected for three meals in a three day period at each school. A weighed plate method was employed to measure plate wastes and consumption of the menus served. Nutrient analyses for the served and consumed menus were performed using CAN-PRO. The result of nutrient intake determined by self-reported food consumption demonstrated 74.2% of boys and 70.0% of the girls did not meet EAR(Estimated Average Requirement) for calcium. In addition, the data collection showed that 60.2% boys and 26.7% girls did not consume EAR for Vitamin B1. Nutrient analyses of the served and consumed menus at school lunch were compared with 1/3 of the Dietary Reference Intakes(DRIs) for this age group. The served menus did not meet 1/3 of the Recommended Intake(RI) for calcium, iron, and vitamin B2. In contrast, the menu provided to students exceeded almost five times(490%) more than the sodium needed for 1/3 of the Adequate Intake(AI). Considering the amount of the students' plate waste, intake of vitamin A and vitamin C were below 1/3 of the RI, and calcium, iron, and vitamin B2 intake were also reduced. Students' sodium consumption still exceeded 1/3 of the AI at 340.0%.

Establishing new principles for nutrient reference values (NRVs) for food labeling purposes

Many countries such as The Republic of Korea have established their own nutritional standards, collectively termed Nutrient Reference Values(NRVs), and they vary due to the science which was reviewed, the purposes for which they are developed, and issues related to nutrition and food policy in the country. The current effort by the Codex Alimentarius Committee on Nutrition and Foods for Special Dietary Uses (CNFSDU) to update the NRVs that were established following the Helsinki Consultation in 1988 represents an opportunity to develop a set of reference values reflecting current scientific information to be used or adapted by many countries. This paper will focus on possible approaches to selecting or developing reference values which would serve the intended purpose for nutrition labeling to the greatest extent possible. Within the United States, the Food and Drug Administration (U.S. FDA) is currently reviewing regulations on nutrition labeling to better address current health issues, and is expected to enter into a process in the next few months to begin to explore how best to update nutrient Daily Values (DVs), most of which are still based on the Recommended Dietary Allowances (RDAs) of the Food and Nutrition Board, U.S. National Academy of Sciences, last reviewed and revised in 1968. In this presentation, I review the current purposes in the U.S. for nutrition labeling as identified in the 1938 Food, Drug, and Cosmetic Act as amended, the scientific basis for current nutrition labeling regulations in the United States, and the recommendations made by the recent Committee on Use of Dietary Reference Intakes in Nutrition Labeling of the Institute of Medicine (2003) regarding how to use the DRIs in developing new DVs to be used on the label in the United States and Canada. Based on these reviews, I then provide examples of the issues that arise in comparing one approach to another. Much of the discussion focuses on the appropriate role of nutrient labeling within the Nutrition Facts panel, one of the three major public nutrition education tools in the United States (along with MyPyramid and Dietary Guidelines for Americans).