Effect of Nutrition Counseling by Nutrition Care Process on Diet Therapy Practice and Glycemic Control in Type 2 Diabetic Patients / 대한지역사회영양학회지

Objectives@#This study examined the effects of nutrition counseling by the nutrition care process (NCP) on diet therapy practice and glycemic control in patients with type 2 diabetes mellitus. @*Methods@#The survey was conducted on 49 patients whose hemoglobin A1c (HbA1c) level ranged from 6.5% to below 10% among patients aged 30∼60s with type 2 diabetes mellitus. Nutrition counseling by the NCP process was carried out twice: first nutrition counseling and follow up counseling. The questionnaires were composed of 54 questions in five fields (general characteristics, health-related behaviors, diet therapyrelated items, dietary life, diet therapy-related knowledge, diet therapy-related barriers). Nutrition intervention in nutrition counseling was performed based on the individualized diagnosis of NCP. @*Results@#All the subjects practiced self-monitoring of their blood glucose levels, regular exercise, and diet therapy after NCP-based nutrition counseling. Diet therapy-related knowledge and practice by the subjects were improved after nutrition counseling. While the intake of boiled white rice decreased, the intake of boiled brown rice and barley rice in the subjects increased significantly. After nutrition counseling, the weight and HbA1c of the subjects decreased. @*Conclusions@#These results suggest that personalized nutrition counseling by NCP process is effective for diet therapy compliance and glycemic control of type 2 diabetic patients.

Evaluation of the Nutrition Status and Metabolic Syndrome Prevalence of the Members according to the Number of Household Members based on the Korea National Health and Nutrition Examination Survey (2013–2014) / 대한지역사회영양학회지

OBJECTIVES: This study evaluated the nutritional status and prevalence of metabolic syndrome of the people who participated in the KNHANES according to the number of household members. They were assessed by using information from the 2013~2014 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 6,088 persons aged 19 years and over participated in 2013~2014 KNHANES, and they were classified into three groups according to the number of household members (single-person, two-person, three-person & over). The dietary behavior, nutritional status, health-related factors and the prevalence of metabolic syndrome of the subjects were investigated with using information from the survey questionnaires of KNHANES. The nutrient intake data of the subjects were obtained by the 24-hour recall method and this was analyzed for evaluating the nutrition adequacy ratio and the index of nutritional quality. The prevalence of metabolic syndrome among the subjects, and according to the study groups, was estimated using the blood and physical measurement data of the subjects. RESULTS: As for EQ-5D index available for all the health states generated by the EQ-5D descriptive system, the single-person household member was the lowest among all the household types. The index of nutrition quality for protein, crude fiber, calcium, phosphorus, potassium, riboflavin and vitamin C in the single-person household was lower than that of the two-person or the three-person and over households (p<0.001). The mean adequacy ratio of single-person households was significantly decreased compared with that of the other types of households (p<0.001). The prevalence of metabolic syndrome was higher in the single-person households than that in the multiple-person households (p<0.001). CONCLUSIONS: These results showed that dietary behaviors, nutrition status and health status might be influenced by the number of household members. The results from this study would be useful for improving Korean people's dietary life and health status by implementing evidence-based, specialized intervention for the members of diverse types of households.

Development of Job Standards of Clinical Dietitian for the Clinical Nutrition Therapy to Cancer Patients in Hospitals

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring.evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

Calcium and Milk Intake of Elementary School Students from School Foodservices: Focus on the Gyeongsangbukdo Province

The calcium intake of elementary school students residing in Gyeongsangbukdo province from their school foodservice and milk program was evaluated. A total of 252 subjects (50.4% boys and 49.6% girls) were examined. A significant percentage of the total subjects (32.9%) reported skipping breakfast once or more per week, with the major reasons for skipping breakfast being a lack of time and appetite. A majority of the total subjects (78.2%) participated in the school milk program. The type of milk consumed by the subjects was mainly white milk, with a milk intake mostly between one and two cups. Participants in the school milk program consumed over the recommended nutrient intake (RNI) of calcium, but non-participants consumed only 48.1% of the RNI (P<0.001). The calcium intake rate according to food cooking methods, from highest to lowest was in the order bap, twigim, jeon, jjim, and gui. Although the food intake rate of guk was low, the calcium intake rate by RNI was the highest for guk. On the other hand, the food intake rate of bap and kimchi was high, but their calcium intake rate by RNI was relatively low. These results show that non-participants in the school milk program are significantly deficient in calcium. Therefore, to improve the calcium nutrition for children, school lunch menus containing high calcium need to be developed and children should be encouraged to enter a school milk program.

Development of Job Description of Clinical Dietitians in Hospitals by the DACUM Method

The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring.evaluation, consultation.cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

Lycopene supplementation suppresses oxidative stress induced by a high fat diet in gerbils

The effect of lycopene supplementation on the antioxidant system was investigated by analyzing lipid peroxide levels, glutathione contents, and antioxidant enzyme activities in Mongolian gerbils fed a high fat diet. Gerbils were fed on each experimental diet for 6 weeks; normal diet (NC), normal diet with 0.05% lycopene (NL), high fat diet (HF), and a high fat diet with 0.05% lycopene (HFL). Dietary supplementation of lycopene increased hepatic lycopene level in gerbils fed a normal or high fat diet (P < 0.05). Liver and erythrocyte concentrations of lipid peroxide increased in gerbils fed a high fat diet, whereas lycopene supplementation decreased liver and erythrocyte concentrations of lipid peroxide (P < 0.05). Hepatic total glutathione content was higher in the NL group than that in the NC group (P < 0.05). Total antioxidant status in plasma increased following lycopene supplementation compared with that of the non-lycopene supplemented groups (P < 0.05). Hepatic catalase activity increased following dietary lycopene supplementation (P < 0.05). Superoxide dismutase activity in liver remained unchanged with lycopene supplementation, but erythrocyte superoxide dismutase activity increased in NL group compared with NC group (P < 0.05). Glutathione-S-transferase activity increased in the NL group compared to NC group (P < 0.05). Liver and erythrocyte glutathione peroxidase activity increased significantly in the NL group compared to that in the HF group (P < 0.05). Liver glutathione reductase activity was higher in the NL group than that in the NC group (P < 0.05). These results suggest that lycopene supplementation may be efficient for preventing chronic diseases induced by oxidative stress related to high fat diet.

Suppression of oxidative stress by grape seed supplementation in rats

Polyphenol-rich grape seeds have a beneficial effect on human health. The present study was performed to investigate the effects of grape seeds on antioxidant activities in rats. Male Sprague-Dawley rats were randomly divided into a control diet group (C), a high-fat diet group (HF), a 5% grape seed-supplemented control diet group (G), and a 5% grape seed-supplemented high-fat diet group (HG). Dietary supplementation with grape seeds reduced serum concentrations of lipid peroxides compared with those in the C and HF groups. The hepatic level of lipid peroxides decreased significantly in the grape seed groups compared with that in the C and HF groups. Superoxide dismutase activity in the G group increased significantly compared with that in the C group. Catalase activity tended to be higher by feeding grape seeds. The grape seed diet increased glutathione peroxidase activity in the C group. Glutathione-S-transferase activity increased significantly in the G group compared with that in the C group. Hepatic content of total glutathione increased significantly in the HG group but decreased significantly in the HF group. The ratio of reduced glutathione and oxidized glutathione increased by feeding the grape seed diet. Total vitamin A concentration was significantly higher in HG group than in other groups. Liver tocopherol content of the G and HG groups was significantly higher than that of the control groups. These results suggest that dietary supplementation with grape seeds is beneficial for suppressing lipid peroxidation in high fat-fed rats.

Obesity Index and Related Factors among Elementary School Students Visiting Pediatric Department of General Hospital

The present study was conducted to investigate dietary habits and biochemical indices according to the obesity index of elementary school students visiting a hospital for diagnosis. The subjects of this study were 150 elementary school students and their mothers. The overweight rates of child subjects were 37.5% for males and 40.9% for females, whereas the rates of underweight children were 35.0% for males and 14.5% for females. Children's obesity index significantly decreased with an increase in the average monthly income of children's families. Children's obesity index, mothers's weights, BMI, and percent ideal body weight were all positively correlated. Blood biochemical values in children (hemoglobin, hematocrit, albumin, globulin, glucose, total cholesterol, and triglyceride levels) and their obesity index also showed positive correlation. For the underweight group, the frequency of iron-deficiency anemia was significantly high, whereas for the overweight group, the frequency of dyslipidemia was high. There was a significant increase in children's obesity index and a decrease in frequency of regular exercise with time spent on the TV/computer. The normal weight group recorded the highest total scores for mothers' nutritional knowledge, whereas the overweight group recorded the lowest total scores. Therefore, to maintain healthy weight in children, nutritional education programs for mothers and children should be developed.

Anti-obesity effect of resveratrol-amplified grape skin extracts on 3T3-L1 adipocytes differentiation

Resveratrol (3,4,5-trihydroxy-trans-stilbene), a phytoalexin found in grape skin, grape products, and peanuts as well as red wine, has been reported to have various biological and pharmacological properties. The purpose of this study was to investigate the anti-obesity effect of resveratrol-amplified grape skin extracts on adipocytes. The anti-obesity effects of grape skin extracts were investigated by measuring proliferation and differentiation in 3T3-L1 cells. The effect of grape skin ethanol extracts on cell proliferation was detected by the MTS assay. The morphological changes and degree of adipogenesis of preadipocyte 3T3-L1 cells were measured by Oil Red-O staining assay. Treatment with extracts of resveratrol-amplified grape skin decreased lipid accumulation and glycerol-3-phosphate dehydrogenase activity without affecting 3T3-L1 cell viability. Grape skin extract treatment resulted in significantly attenuated expression of key adipogenic transcription factors, including peroxisome proliferator-activated receptor, CCAAT/enhancer-binding proteins, and their target genes (FAS, aP2, SCD-1, and LPL). These results indicate that resveratrol-amplified grape skin extracts may be useful for preventing obesity by regulating lipid metabolism.

Effect of Dietary Grape Pomace on Lipid Oxidation and Related Enzyme Activities in Rats Fed High Fat Diet

The present study was conducted to investigate the effect of dietary supplementation of grape pomace on lipid peroxidation and related enzyme activities of rats fed high fat diet. Male Sprague-Dawley rats weighing about 90 g were assigned to 4 experimental groups of 8 rats on the basis of their body weight. The high fat diet contained additional 15% lard to AIN 93-based diet. Rats were fed experimental diets containing 5% grape pomace for 4 weeks. Dietary supplementation of grape pomace reduced serum concentration of lipid peroxide in rats fed high fat diet. Hepatic concentration of lipid peroxide tended to be lower by feeding grape pomace. Hepatic total glutathione content and GSH/GSSG ratio were increased by grape pomace feeding in normal or high fat diet groups. Hepatic superoxide dismutase activity of grape pomace group with high fat diet was induced significantly compared with high fat diet group without grape pomace. Hepatic catalase activity of high fat fed rats was induced by feeding grape pomace. Grape pomace diet increased glutathione-S-transferase and glutathione peroxidase activities in rat liver fed high fat. Hepatic glucose-6-phosphatase activity was not affected by dietary supplementation of grape pomace in rats fed high fat. These results suggest that dietary supplementation of grape pomace may alleviate lipid peroxidation through antioxidant effect in rats fed high fat.

The Differences of Biochemical Status and Dietary Habits according to the Obesity Degree among Obese Elementary School Students in the Gyungbuk Area / 대한지역사회영양학회지

The prevalence of obesity in children has steadily risen during recent years in developed countries. Child obesity has become a major concern to health providers since it has grown to epidemic proportions over the past few decades. This study was conducted to investigate the biochemical status, dietary habits and life styles according to the obesity degree among obese children residing in the Gyungbuk area. The subjects were 148 elementary school students (boy 103, girl 45) and classified as mildly obese (n = 56), moderately obese (n = 61) and severely obese (n = 31) by the obesity index. The average body weight and height increased significantly according to the obesity degree (P <0.05, P <0.001). Serum cholesterol concentration came under the normal level in all groups. Serum AST activity increased according to the obesity degree but it was not significant. Serum ALT activity increased according to the obesity degree (P <0.05). Dietary habit score was lower significantly according to the obesity degree (P <0.01). Life style of the subjects was significantly different for the level of 'healthy state (P <0.05)', 'body perception (P <0.01)', 'watching TV and video (P <0.05)', 'normal sleeping hour (P <0.05)' and 'degree of stress (P <0.05)' according to the obesity degree. A positive relationship between obesity index and blood pressure, ALT has been shown in the subjects. Obesity index and dietary habit scores were negatively associated. Therefore, these results suggest that a practical nutrition-exercise education program for the prevention of child obesity should be provided to elementary school children.

Development of Program Based on the Website for Individual Meal Planning / 대한지역사회영양학회지

The purpose of this study was to develop the website-based program for individual meal planning. The program consisted of the basic information of clients, dietary habits, analysis of nutrient intakes and menu planning. The first part of the program consisted of general information such as general characteristics and anthropometric data of clients. The second part was designed to investigate the dietary habits, food intake frequency, nutrition knowledge, and drinking and smoking habits of the clients. The third part consisted of analysis of nutrient intakes including three major nutrients, calorie intake by foods and alcohol, and ratio of individual fatty acid intake. Nutrient intakes was evaluated by comparing with dietary reference intakes. In the final part, the program included the menu planning by using standard recipe. This system was also designed to insert, remove or change the food items or amount according to the user need. It is expected that the development of a meal planning system based on the internet can facilitate the professional dietary counseling, and thus help to improve the health of people.

Grape skin improves antioxidant capacity in rats fed a high fat diet

This study was conducted to investigate the effect of dietary grape skin on lipid peroxidation and antioxidant defense system in rats fed high fat diet. The Sprague-Dawley rats were fed either control (5% fat) diet or high fat (25% fat) diet which was based on AIN-93 diet for 2 weeks, and then they were grouped as control group (C), control + 5% grape skin group (CS), high-fat group (HF), high fat + 5% grape skin group (HFS) with 10 rats each and fed corresponding diets for 4 weeks. The hepatic thiobarbituric acid reacting substances (TBARS) were increased in high fat group as compared with control group, but reduced by grape skin. The serum total antioxidant status, and activities of hepatic catalase and superoxide dismutase, xanthine oxidase and glucose-6-phosphatase were increased by supplementation of grape skin. Glutathione peroxidase activity was significantly higher in CS group than in C group. Grape skin feeding tended to increase the concentration of total glutathione, especially in control group. The ratio of reduced glutathione to oxidized glutathione was lower in high fat groups than in control groups. The ratio was increased by dietary supplementation of grape skin in control group. These results suggest that dietary supplementation of grape skin would be effective on protection of oxidative damage by lipid peroxidation through improvement of antioxidant defense system in rats fed high fat diet as well as rats with low fat diet.