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Low-FODMAP Formula Improves Diarrhea and Nutritional Status in Patients Receiving Enteral Nutrition
( So Ra Yoon ),( Jong Hwa Lee ),( Jae Hyang Lee ),( Ga Yoon Na ),( Seung Hye Kim ),( Kyun Hee Lee ),( Yoon Bok Lee ),( Gu Hun Jung ),( Oh Yoen Kim ) 한국정맥경장영양학회 2015 한국정맥경장영양학회 학술대회집 Vol.2015 No.-
Background & Aims: Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) are poorly absorbed, short-chain carbohydrates that play an important role in inducing functional gut symptoms. A low-FODMAP diet improves abdominal symptoms in patients with inflammatory bowel disease and irritable bowel syndrome. However, there is no clinical intervention study for the effect of FODMAP content on gastrointestinal intolerance (GI) and nutritional status in patients receiving enteral nutrition (EN). Therefore, we investigated the effect of EN formulas containing different FODMAP contents on GI and nutritional status in patients receiving EN through the randomized, multicenter, double-blind, 14-day clinical trial. Methods: Eligible hospitalized patients receiving EN (n=95) from 10 hospitals in Busan and its environs were randomly assigned to three groups; 84 patients completed the trial (low-FODMAP EN, n=30; moderate-FODMAP EN, n=28; high-FODMAP EN, n=26). Anthropometric and biochemical parameters were measured; stool assessment was performed using the King’s Stool Chart and clinical definitions. Results: Baseline values were not significantly different among the three groups. After the 14-day intervention, diarrhea was significantly improved in the low-FODMAP group (73.3%) than in the moderate- (33.3%) and high-FODMAP (30.8%) groups (P=0.046). King’s Stool scores were significantly reduced in the low-FODMAP group compared with the other two groups (P<0.05). BMI increased significantly in the low- and high-FODMAP groups over the course of the intervention (P<0.05 for both), and showed a trend toward increasing in the moderate-FODMAP group (P<0.10). Serum prealbumin increased significantly in all groups by day-14; by day-3, it had increased to the levels at day-14 in the low-FODMAP group. At day-14, serum transferrin had increased significantly in the moderate-FODMAP group. When subjects were classified by condition (unimproved, no-symptom, diarrhea-improved, and constipation-improved), BMI increased significantly in all groups except the unimproved. Prealbumin levels significantly increased in the diarrhea-improved group at day-3 and day-14, and in the constipation-improved group at day-14. Transferrin levels significantly increased in the diarrhea-improved group at day-14. Conclusion: Low-FODMAP EN may improve diarrhea, leading to improved nutritional status and facilitating prompt recovery from illness.
( Mi-hyang Lee ),( Nayeon Kwon ),( So Ra Yoon ),( Oh Yoen Kim ) 한국임상영양학회 2016 Clinical Nutrition Research Vol.5 No.3
We hypothesized that lower proportion of serum phospholipid docosahexaenoic acid (DHA) is inversely associated with increased cardiovascular risk and vascular function in metabolically healthy men. To elucidate it, we first compared serum phospholipid free fatty acid (FA) compositions and cardiovascular risk parameters between healthy men (n = 499) and male patients with coronary artery disease (CAD, n = 111) (30-69 years) without metabolic syndrome, and then further-analyzed the association of serum phospholipid DHA composition with arterial stiffness expressed by brachial-ankle pulse wave velocity (ba- PWV) in metabolically healthy men. Basic parameters, lipid profiles, fasting glycemic status, adiponectin, high sensitivity C-reactive protein (hs-CRP) and LDL particle size, and serum phospholipid FA compositions were significantly different between the two subject groups. Serum phospholipid DHA was highly correlated with most of long-chain FAs. Metabolically healthy men were subdivided into tertile groups according to serum phospholipid DHA proportion: lower (< 2.061%), middle (2.061%-3.235%) and higher (> 3.235%). Fasting glucose, insulin resistance, hs-CRP and ba-PWVs were significantly higher and adiponectin and LDL particle size were significantly lower in the lower-DHA group than the higher- DHA group after adjusted for confounding factors. In metabolically healthy men, multiple stepwise regression analysis revealed that serum phospholipid DHA mainly contributed to arterial stiffness (β′-coefficients = -0.127, p = 0.006) together with age, systolic blood pressure, triglyceride (r = 0.548, p = 0.023). Lower proportion of serum phospholipid DHA was associated with increased cardiovascular risk and arterial stiffness in metabolically healthy men. It suggests that maintaining higher proportion of serum phospholipid DHA may be beneficial for reducing cardiovascular risk including arterial stiffness in metabolically healthy men.
( Jae Hyang Lee ),( So Ra Yoon ),( Ga Yoon Na ),( Mira Jun ),( Mok Ryeon Ahn ),( Jae Kwan Cha ),( Oh Yoen Kim ) 한국임상영양학회 2016 Clinical Nutrition Research Vol.5 No.1
Diabetes and impaired fasting glucose are associated with incidence of cerebro-/cardio-vascular diseases. This study hypothesized that fasting glycemic status may reflect cerebrovascular risk in non-diabetic Koreans. Fasting glycemic status, lipid profiles, oxidative stress, and inflammation markers were measured in non-diabetic subjects (healthy controls, n = 112 and stroke n = 41). Systolic blood pressure, fasting glucose, glycated hemoglobin (HbA1C), triglycerides, high sensitivity C-reactive protein (hs-CPR), interleukin-6, and tumor necrosis factor-alpha were higher, and high density lipoprotein (HDL)-cholesterols were lower in patients with stroke than healthy controls. Fasting glucose positively correlated with hs-CRP, interleukin-6, tumor necrosis factor-alpha, oxidizedlow density lipoprotein (LDL) and malondialdehyde. The significances continued or at least turned to a trend after adjustments for confounding factors. Multiple regression analyses revealed that fasting glucose was mainly associated with cerebrovascular risk (ß``-coefficient = 0.284, p < 0.0001) together with age, systolic blood pressure, total cholesterol, hs-CRP, body mass index, dietary poly unsaturated fatty acid/saturated fatty acid (PUFA/SFA), and HbA1C (r2 = 0.634, p = 0.044). The subjects were subdivided by their fasting glucose levels [normal fasting glucose: 70-99 mg/dL, n = 91 [NFG-control] and n = 27 [NFG-stroke]; higher fasting glucose: 100-125 mg/dL, n = 21 [HFG-control] and n = 14 [HFG-stroke]). In both controls and stroke patients, HFG groups show higher triglyceride, total- and LDL-cholesterol and lower HDL-cholesterol than NFG groups. Control-HFG group showed significantly higher levels of oxidative stress and inflammation than control NFG group. Stroke-HFG group also showed significantly higher inflammatory levels than stroke-NFG group, moreover the highest among the groups. Additionally, stroke-NFG group consumed higher PUFA/SFA than stroke-HFG group. Fasting glucose may be a useful indicator for cerebrovascular risk in non-diabetic individuals which may be mediated by oxidative stress and inflammation status.
( So Ra Yoon ),( Jae Hyang Lee ),( Ga Yoon Na ),( Yu Jeong Seo ),( Seong Ho Han ),( Min-jeong Shin ),( Oh Yoen Kim ) 한국임상영양학회 2015 Clinical Nutrition Research Vol.4 No.2
This study aimed to investigate if glycated hemoglobin (HgbA1C) as compared to fasting blood glucose is better for reflecting cardiometabolic risk in non-diabetic Korean women. Fasting glucose, HgbA1C and lipid profiles were measured in non-diabetic women without disease (n = 91). The relationships of fasting glucose or HgbA1C with anthropometric parameters, lipid profiles, and liver and kidney functions were analyzed. Both fasting glucose and HgbA1C were negatively correlated with HDL-cholesterol (r = -0.287, p = 0.006; r = -0.261, p = 0.012), and positively correlated with age (r = 0.202, p = 0.008; r = 0.221, p = 0.035), waist circumference (r = 0.296, p = 0.005; r = 0.304, p = 0.004), diastolic blood pressure (DBP) (r = 0.206, p = 0.050; r = 0.225, p = 0.032), aspartate transaminase (AST) (r = 0.237, p = 0.024; r = 0.368, p < 0.0001), alanine transaminase (ALT) (r = 0.296, p = 0.004; r = 0.356, p = 0.001), lipid profiles including triglyceride (r = 0.372, p < 0.001; r = 0.208, p = 0.008), LDL-cholesterol (r = 0.315, p = 0.002; r = 0.373, p < 0.0001) and total cholesterol (r = 0.310, p = 0.003; r = 0.284, p = 0.006). When adjusted for age and body mass index, significant relationships of DBP (r = 0.190, p = 0.049), AST (r = 0.262, p = 0.018), ALT (r = 0.277, p = 0.012), and HDL-cholesterol (r = -0.202, p = 0.049) with HgbA1C were still retained, but those with fasting glucose disappeared. In addition, the adjusted relationships of LDL-cholesterol and total cholesterol with HgbA1C were much greater than those with fasting glucose. These results suggest that glycated hemoglobin may be a better predictor than fasting glucose for cardiometabolic risk in non-diabetic Korean women.
( Juhyun An ),( So Ra Yoon ),( Jae Hyang Lee ),( Hyunyoung Kim ),( Oh Yoen Kim ) 한국임상영양학회 2019 Clinical Nutrition Research Vol.8 No.3
We investigated weight loss effect of personalized diet education in overweight/obese Korean adults. Overweight/obese Korean adults (body mass index [BMI] ≥ 23 kg/m<sup>2</sup> or waist circumference [WC] ≥ 90 cm for men, ≥ 85 cm for women) were recruited, and 40 participants who completed the 10-week intervention were finally included in the analyses. At first visit, study participants (small group with individual counseling) were educated for optimal diet by clinical dietitian, and checked for their compliance through telephone/text message every 1-2 week during the intervention. Anthropometric and biochemical parameters and dietary intake were investigated. Body weight, BMI, WC, and body fat mass were significantly reduced in whole participants. Hemoglobin A1c, insulin, and low-density lipoprotein cholesterol were also significantly decreased after the intervention. Total energy intake (EI) during the intervention was not significantly decreased compared to the baseline value, but the proportions of energy derived from macronutrients were within the ranges recommended by 2015 Dietary Reference Intake for Koreans. Based on actual EI, participants were classified into high-adherence (HA) (prescribed EI ± 25%, n = 29), low-adherence I (LA-I) (< 75% of prescribed EI, n = 7), and low-adherence II (LA-II) group ( > 125% of prescribed EI, n = 4). Only HA group showed significant improvements in anthropometric parameters, glycemic control and lipid profile. Interestingly, LA-I group showed significant increases in glucose, insulin, C-peptide and insulin resistance. In conclusion, a shift from overweight/obesity to healthy weight can be accomplished by high adherence to personalized diet modification, not by EI reduction.
김동욱(Dong-Ook Kim),이기연(Ki-Yoen Lee),김향곤(Hyang-Kon Kim),고원식(Won-Sik Ko),정영식(Young-Sik Chung) 대한전기학회 2009 대한전기학회 학술대회 논문집 Vol.2009 No.10
전기화재에 대한 규명방법은 추정에 의하거나 화재현장에서 수집한 전기기기나 전선용혼을 육안관찰에 의해 전기화재를 판정하는 등 감식기준이 모호하여 원인을 규명하는데 미흡한 점이 많으며 이로 인해 전기화재 점유율은 전기사용량 증가율보다 높은 증가율을 보이고 있다. 이에 전기화재 점유율이 외국에 비해 높은 원인을 분석한 결과 전기적 원인에 의한 전기화재 추정사례가 많아 단락이나 과전류, 외부화염 등에 의한 금속 조직변화 고찰에 의한 화재원인 감정방법을 정립하여 정확한 원인규명을 기하도록 하고 전기화재 원인별 실증에 의한 원인규명 후 재발방지 대책수립에 활용하는데 연구목적이 있다.