어린이 성인병과 영양관리

위경애 대한영양사회 1994 國民營養 Vol.156 No.-

페닐케톤뇨증(Phenylketouria, PKU)과 단풍당뇨증(Maple Syurp Urine Disease, MSUD)

위경애 대한영양사회 1996 國民營養 Vol.179 No.-

표준체중 및 총열량 계산과 3대 영양소 배분 -바른 혈당관리는 당질$\cdot$단백질$\cdot$지방의 3대 영양소를 균형있게 배분 섭취 필요

위경애 사단법인 한국당뇨협회 1995 당뇨 Vol.69 No.-

대사증후군 환자 및 위험군의 식사 내 총 항산화능과 산화스트레스 및 대사 지표의 연관성

함동우(Ham, Dongwoo),전신영(Jun, Shinyoung),강민지(Kang, Minji),신상아(Shin, Sangah),위경애(Wie, Gyung-Ah),백현욱(Baik, Hyun Wook),정효지(Joung, Hyojee) 한국영양학회 2017 Journal of Nutrition and Health Vol.50 No.3

본 연구에서는 수도권에 위치한 일개 종합병원의 건강검진 수검자 중 대사증후군 위험요인을 두 가지 이상 보유한 346명을 대상으로 건강검진과 설문조사 자료, 한국인 상용식품의 총 항산화능 데이터베이스와 연계한 식사 자료를 분석하여 성별에 따라 대사증후군 환자 및 위험군의 식사 내 총 항산화능과 그에 따른 산화스트레스 및 대사 지표의 특성을 파악하였다. 대상자들의 식사 내 평균 총 항산화능은 여성이 196.4 mg VCE/d/1,000 kcal, 남성이 132.0mg VCE/d/1,000 kcal로 남성은 총 항산화능 수준이 높을수록 GGT로 추정한 산화스트레스 수준과 수축기·이완기혈압, 혈중 중성지질 농도의 이상자 비율이 유의하게 낮았던 반면 여성은 그렇지 않았다. 또한 남성은 플라바논, 안토시아니딘을 비롯한 플라보노이드의 섭취밀도가 GGT와, α-카로틴, β-카로틴, 루테인/제아잔틴을 비롯한 카로티노이드의 섭취밀도가 d-ROMs과 유의한 음의 상관관계를 보인 반면 여성에서는 α-토코페롤과 γ-토코페롤만이 BAP와 양의 상관관계를 보였다. 식사 내 총 항산화능 수준에 따른 높은 산화스트레스 수준과 대사 지표 이상자의 유병률 차이는 남녀 모두 유의하지 않았다. 추후 식사 내 총 항산화능과 대사증후군을 비롯한 만성질환의 관련성을 규명하기 위하여 대규모의 표본으로 전향적 연구를 진행할 필요가 있을 것이라 사료된다. Purpose: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. Methods: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual"s TAC. Results: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of γ-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of α-tocopherol (p < 0.05) and γ-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. Conclusion: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.

자유연제 2 : 위절제 환자의 초기 영양상태 개선 활동에 관한 연구

조영아,위경애,김형숙,배재문,신동옥 한국정맥경장영양학회 2004 한국정맥경장영양학회 학술대회집 Vol.2004 No.-

2012년 제11회 KSPEN 학술대회 : 3-4 ; 암환자에서 암종별, 치료법별 영양상태와 임상경과 및 삶의 질과의 관계 분석

고윤희,박상재,조영아,위경애,이나래,김지연,이승덕,이종목 한국정맥경장영양학회 2012 한국정맥경장영양학회 학술대회집 Vol.2012 No.-

암환자의 경우 영양불량 위험이 높아 입원환자의 20∼50%는 입원 당시 영양상태가 불량하고 입원기간 동안더욱 심해지며 이는 사망률, 합병증 발생률과 재원일수의 증가, 삶의 질 감소와 관련이 있는 것으로 알려져 있다. 본 연구에서는 암환자의 영양상태를 암종별, 치료법별로 파악하고 영양상태와 임상경과 및 삶의 질과의 관계를 분석하고자 한다. 2011년 3월부터 2012년 4월까지 국립암센터에 입원한 1588명의 암환자를 대상으로 전향적으로 연구하였다. 영양상태는 Patient Generated-Subjective Global Assessment (PG-SGA)를 통해 영양양호군(Well-nourished, StageA), 영양불량군(Malnourished, StageB+C)으로 평가하였다. 임상경과는 연령, 성별, 재원기간, 진단명, 치료방법, 합병증 등을 조사하였고 삶의 질은 Korean version EORTC QLQ-C30을 자가설문방법으로 평가하였다. 자료는 SAS9.1통계프로그램으로 분석하였다(p<0.05). 조사대상자는 폐암 386명(24.3%), 위암 368명(23.2%), 대장암 358명(22.5%), 간암 320명(20.25%), 췌담도계암105명(6.6%), 식도암 51명(3.2%)으로 구성되었다. 전체대상자의 30.5%가 영양불량군으로 나타났으며, 암종별 영양불량군의 비율은 식도암이 52.9%로 가장 높았고, 췌담도암 47.6%, 폐암 42.8%, 위암 29.1%, 간암 24.7%, 대장암 15.9%순으로 유의한 차이를 보였다(p<0.0001). 치료법에 따른 영양상태는 대증치료군이 68.6%로 영양불량군비율이 가장 높았고, 항암치료군 35.2%, 수술치료군 12.3%순으로 유의한 차이를 나타냈다(p<0.0001). 수술치료군 771명 중 췌담도계암, 식도암 환자의 영양불량률(36.5%, 36.4%)이 다른 암에 비해 유의하게 높았다. 또한 수술 환자에서 영양불량군이 진행된 병기(Stage 3/4)가 유의하게 많았고(p<0.0001), 합병증 발생률이 많은 경향이 있었으나 통계적으로 유의하지 않았다(p=0.146). 재원기간은 영양양호군(9.1±6.9일)이 영양불량군(13.4±13.0일)보다 유의적으로 짧았고(p<0.0001), 전반적인 삶의 질 평가에서 영양양호군(65.1점)이 영양불량군(36.5점)보다 유의적으로 높게 나타났다(p<0.0001). 본 연구 결과 식도암, 췌담도계암, 폐암 환자에서 다른 암에 비해 영양상태가 불량하였으며 대증치료군 및 항암치료군에서 수술치료군에 비해 불량한 영양상태를 보였다. 또한 영양불량군에서 합병증 발생률이 증가하는 경향을 보이며 재원일수의 증가와 삶의 질이 유의적으로 감소함을 알 수 있었다. 영양불량률이 높았던 암종과 치료군에서는 특히 입원환자의 영양적 위험을 조기에 파악하여 영양상태를 개선시키는 중재활동이 필요할 것으로 사료된다.

암 환자의 임상영양치료를 위한 임상영양사의 직무분석과 직무표준 개발

최수경 ( Soo Kyong Choi ),위경애 ( Gyung Ah Wie ),이송미 ( Song Mi Lee ),김은미 ( Eun Mi Kim ),박미선 ( Mi Sun Park ),손정민 ( Cheong Min Sohn ),우미혜 ( Mi Hye Woo ),주달래 ( Dal Lae Ju ),차진아 ( Jin A Cha ),서정숙 ( Jung Sook S 대한영양사협회 2015 대한영양사협회 학술지 Vol.21 No.2

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 monitoringㆍevaluation. 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.

한국 성인의 대사증후군 예방을 위한 건강한식 교육프로그램 개발

강민지(Kang, Minji),백희영(Paik, Hee Young),위경애(Wie, Gyung-Ah),정효지(Joung, Hyojee) 한국영양학회 2012 Journal of Nutrition and Health Vol.45 No.6

Metabolic syndrome is a cluster of metabolic risk factors associated with increased risk of cardiovascular diseases. Recently, the prevalence of metabolic syndrome has increased in Korea. The aim of this study was to develop a Healthy Han-sik Nutrition Education Program (HHNEP) based on commonly recognized Korean foods in order to decrease metabolic syndrome risks. The target population of the HHNEP is adults with metabolic risk factors. The initial version of the HHNEP was developed based on a review of literature and various dietary guidelines by expert committees as well as the results of a survey on the perception of common Korean dishes and foods as Han-sik. The focus group discussion conducted of nine participants from the target population. After minor modification, the final version was developed. The contents included five sections: 1) aims, 2) introduction of Korean Food Guidance System, 3) cholesterol contents in food, 4) menu planning method using Han-sik, and 5) examples of daily Han-sik menu. The Han-sik list was selected based on the results from a Han-sik perception answered by 35 Korean adults aged 30-60 years using 517 frequently consumed Korean foods from the fourth Korea National Health and Nutrition Examination Survey. The nutrition education program was developed based on scientific evidence for the prevention of metabolic syndrome and focuses on tailoring education to an individual’s dietary problems. Educational method was developed by a group of expert committees based in planned behavior theory and related research results. The education method consisted of assessment of current diet, four face-to-face nutrition education sessions over 8 weeks, and evaluation after 8 and 16 weeks. Initial version of nutrition education materials and methods was tested for feasibility by a select group of nine Korean healthy adults. Successful implementation of the program would include application by nutritional professionals at the health promotion center of the hospitals, public health center, and work sites. Intervention studies are needed to evaluate the feasibility and effectiveness of this program before large-scale applications.

당뇨병 환자의 임상영양치료를 위한 임상영양사의 직무표준 개발

권수진 ( Su Jin Gwon ),우미혜 ( Mi Hye Woo ),주달래 ( Dal Lae Ju ),김은미 ( Eun Mi Kim ),박미선 ( Mi Sun Park ),손정민 ( Cheong Min Sohn ),위경애 ( Gyung Ah Wie ),이송미 ( Song Mi Lee ),차진아 ( Jin A Cha ),서정숙 ( Jung Sook Seo 대한영양사협회 2015 대한영양사협회 학술지 Vol.21 No.1

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus- specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoringㆍevaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoringㆍevaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

유전성 과당 불내증 1례

강은경,양혜란,서정기,정주영,고재성,하일수,송정한,위경애,신윤숙 대한소아청소년과학회 2002 Clinical and Experimental Pediatrics (CEP) Vol.45 No.1

Hereditary fructose intolerance(HFI) is an autosomal recessive disease caused by catalytic deficiency of aldolase B in which affected homozygotes develop hypoglycemia and abdominal symptoms after taking foods containing fructose. Chronic exposure to fructose may lead to progressive hepatic injury, renal injury, growth retardation, and ultimately to liver and kidney failure. Herein, we report a case of HFI with presentation of episodic vomiting, diarrhea, cold sweating, abnormal liver function and failure to thrive after 12 months of her age. She developed an aversion to fruits and sweet-tasting foods. When she was admitted to hospital at the age of 30 months, hepatomegaly, and dysfunction of proximal renal tubule with renal tubular acidosis were noted. We confirmed the diagnosis via enzyme assay on biopsied liver and intestine. A fructose restrictied diet was recommended. The patient has been symptom free with normal liver functions since then. 이유 시작 후 반복되는 구토, 설사, 저혈당 증상, 간 효소 치의 증가가 있어왔으며 간종대, 성장부전, 신장기능 이상소견을 보이면서, 단것을 싫어하는 경향이 있는 환아에서 효소 활성도 검사로 진단된 유전성 과당 불내증 1례를 경험하였기에 보고하는 바이다.