ABSTRACT
In the era of the fourth industrial revolution technology, the inclusion of personalized nutrition for healthcare (PNH), when establishing a healthcare platform to prevent chronic diseases such as obesity, diabetes, cerebrovascular and cardiovascular disease, pulmonary disease, and inflammatory diseases, enhances the national competitiveness of global healthcare markets. Furthermore, since the government experienced COVID-19 and the population dead cross in 2020, as well as numerous health problems due to an increasing super-aged Korean society, there is an urgent need to secure, develop, and utilize PNH-related technologies. Three conditions are essential for the development of PNH technologies. These include the establishment of causality between obesity genome (genotype) and prevalence (phenotype) in Koreans, validation of clinical intervention research, and securing PNH-utilization technology (i.e., algorithm development, artificial intelligence-based platform, direct-to-customer [DTC]-based PNH, etc.). Therefore, a national control tower is required to establish appropriate PNH infrastructure (basic and clinical research, cultivation of PNH-related experts, etc.). The post-corona era will be aggressive in sharing data knowledge and developing related technologies, and Korea needs to actively participate in the large-scale global healthcare markets. This review provides the importance of scientific evidence based on a huge dataset, which is the primary prerequisite for the DTC obesity gene-based PNH technologies to be competitive in the healthcare market. Furthermore, based on comparing domestic and internationally approved DTC obese genes and the current status of Korean obesity genome-based PNH research, we intend to provide a direction to PNH planners (individuals and industries) for establishing scientific PNH guidelines for the prevention of obesity. © 2022 The Korean Nutrition Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Introduction: Older adults living in residential care are at increased risk for dehydration due to factors at the resident, staff, and home level. Prior research indicates that social drinking opportunities may influence fluid intake. The COVID-19 pandemic has highlighted the relevance of social interactions to hydration. Restrictions intended to limit the spread of the virus have led to increased resident isolation, which may have increased the risk for dehydration. To date, there is limited examination for the potential effects of decreased socialization of residents on their hydration. Objective: To identify the potential impact of restrictions on socialization arising from COVID-19 on hydration. Methods: Experts (researchers n = 18, providers n = 9) participated in a knowledge exchange meeting to provide their insights into the potential impact of COVID-19 restrictions in residential care on social interactions and hydration. Zoom technology with audio recording was used;meeting notes and audio recordings were transcribed for qualitative content analysis. The majority were from Canada (78%), and although multiple disciplines were represented, the two most common groups were dietitians (44.4%) and nursing (18.5%). Results: Participants shared that restrictions related to COVID-19 infection control procedures have reduced resident access to social programs and activities, volunteer/family visiting, and affected staff roles and activities, which resulted in fewer care touch points with residents during the day. Specifically, pandemic procedures caused compressed staff schedules--a barrier to resident-centred care practices-- leading to less frequent beverage offerings, reminders, and inquiries regarding drink preferences. Physical distancing in the home environment has decreased opportunities for communal dining and social events, which would normally encourage fluid intake in non-outbreak situations. Rules around physical distancing decreased family visitations, further reducing opportunities for social drinking or the consumption of special drinks brought in by family. Conclusions: COVID-19 restrictions have brought changes to the frequency of care touch points and opportunities for residents to socially engage, resulting in decreased opportunities for drink offers from staff and social drinking. Significance: Incorporating opportunities for socialization and social interactions in hydration interventions can promote fluid intake in LTC residents. Funded by: University of Waterloo International Research Development Program, with matching funds from Adelphi University (A. Namasivayam-MacDonald), and University of California at Los Angeles (J. Mentes).
ABSTRACT
Introduction: Older adults residing in residential care are at an increased risk for dehydration due to physiological changes related to aging (changes to body composition, decreased thirst sensation and kidney function), disease condition (medication use), and increased dependence on others (functional ability, access to fluid). A variety of hydration techniques are used in residential care, but there is no consensus on how to maintain hydration. Infection control measures aimed at limiting the spread of COVID-19 in residential care amplified the need for creative ways to ensure that residents are consuming adequate food and fluids. Effective practices that are also feasible during infectious outbreaks are needed. Objectives: To examine the perspectives of experts and providers in residential care on challenges and potential strategies to improve hydration practices during COVID-19. Methods: Twenty-seven research/academic experts (67%) and providers (33%) in residential care from Canada (78%) and outside of Canada (22% UK, US, & Germany) participated in an audio- recorded three-hour virtual discussion about hydration practices before and during COVID-19. The participants were from a variety of disciplines: nutrition (45%);nursing (19%);speech-language pathology (11%);administration (11%);food service (7%);and other (7%). Qualitative content analysis was conducted. Results: COVID-19 hydration-related challenges and potential solutions to mitigate them were identified and categorized into three levels: resident (e.g., reduced access to beverages due to COVID-19 restrictions, apathy);staff (e.g., limited staff, decreased beverage offerings, new staff and role changes, changes in hydration assessment);and home-related (e.g., changes in beverage availability, drinking cups, routines for social events/volunteer assistance and physical distancing in dining areas). Some potential strategies to mitigate the problems included: trolley beverage service between meals;physically distanced interactions;offerings of fluids at every contact by all staff;and, physically distanced events that encourage fluid intake. Conclusions: COVID-19 has impacted hydration practices in residential care at the resident, staff, and home levels. Significance: Creative strategies involving an interdisciplinary team approach are needed to change hydration practices during a pandemic to ensure resident fluid needs are being met in residential care. Funded by: University of Waterloo International Research Development Program, with matching funds from Adelphi University (startup funds for ANM), and University of California at Los Angeles (JM).