Annals of Clinical Nutrition and Metabolism

Dysphagia and quality of life: a narrative review: Jung Mi Song; Ann Clin Nutr Metab 2024;16(2):43-48. Published online August 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.2.43

Abstract PDF ePub: Purpose: Dysphagia is a chronic health condition that causes impairment of eating and drinking functions. It occurs in various diseases such as stroke, neurodegenerative disease, brain tumor, and head and neck cancer, and can also occur during the normal aging process.
Current concept: As patients experience symptoms of dysphagia, they no longer feel the pleasure of eating, depression and anxiety increase, and self-esteem decreases. Prolonged loss of appetite can lead to malnutrition, which can lead to death due to serious complications such as aspiration pneumonia and airway obstruction. Dysphagia reduces quality of life by affecting basic activities of daily living, limitations in social life, nutritional deficiencies, and mood disorders.
Conclusion: Accordingly, I plan to conduct a literature review on the quality of life of patients with dysphagia. First, to determine the relationship between quality of life and sociodemographic, physical health, and mental health characteristics of patients with dysphagia. I also aim to review quality of life measurement tools and intervention programs for patients with dysphagia.

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Efficacy of high-protein diet protocol and education after distal gastrectomy for gastric cancer patients to prevent loss of lean body mass in Korea: a non-randomized controlled study: Hee Kyung Yoon, Sun Ae Kim, Ji Yoon Han, Dong Jin Kim; Ann Clin Nutr Metab 2024;16(1):10-19. Published online April 1, 2024; DOI: https://doi.org/10.15747/ACNM.2024.16.1.10

Abstract PDF Supplementary Material ePub: Purpose: We studied whether active education of patients about the importance of a high-protein diet can prevent lean body mass loss after gastrectomy for gastric cancer.
Methods: In the study group, intensive high protein diet education and monitoring was performed immediate post operative, 1, 3, and 6 months after surgery. Study group patients were compared with data from the control group formed using propensity matching with the study group for age, sex, resection extent, and TNM stage. Clinicopathologic factors were compared between the groups, and changes in quality of life (QOL) and lean body mass between preoperative levels and 6 months after surgery were assessed.
Results: Among the 100 patients, 31 patients from each group were matched with propensity matching. The groups had no significant clinicopathologic differences. Although the changes in QOL scale and body composition did not differ statistically between the groups, a favorable trend was observed in the study group. Six months after surgery, the mean change in the QOL scale, which measured physical, role, emotional, cognitive, and social functioning, decreased less than the control group or even increased in the study group. In the body composition analysis, the study group showed greater reductions in weight, body mass index, fat mass, and body fat percentage than the control group, and their lean body mass and skeletal muscle mass decreased less.
Conclusion: A high-protein diet protocol and education might increase patient QOL and prevent a decrease in lean body weight 6 months after distal gastric resection.

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Development of the Korean Version of the Gastrointestinal Quality of Life Index Questionnaire: In Jun Yang, Heung-Kwon Oh, Jeehye Lee, Jung Wook Suh, Hong-min Ahn, Hyeonjeong Park, Hyun Hee Sim, Yong Beom Cho, In Kyu Lee, Seungbum Ryoo, Dong-Won Lee, Duck-Woo Kim, Sung-Bum Kang; Ann Clin Nutr Metab 2022;14(1):32-37. Published online June 1, 2022; DOI: https://doi.org/10.15747/ACNM.2022.14.1.32

Abstract PDF ePub: Purpose: To establish a standardized quality of life measurement that allows global cross-study comparisons, we translated the Gastrointestinal Quality of Life Index (GIQLI) into Korean and linguistically validated the Korean version of the GIQLI (K-GIQLI) in patients who underwent colorectal surgery.
Materials and Methods: A cross-cultural adaptation of the original GIQLI was created based on the established guidelines. Based on participation in a cognitive interview, 20 patients with colorectal cancer were enrolled in the study. To ensure that the Korean version of the questionnaire was understood as intended, the time needed to complete the questionnaire was measured, and three additional items related to comprehension were added.
Results: From May to July 2021, two translators, whose native language was Korean translated the GIQLI items into Korean, and a native English editor who had no knowledge of the original questionnaire translated the items back into English. In the cognitive interview, the median age of the patients was 61.8 (range: 44~82) years, and the median time required to complete the questionnaire was 6.5 (range: 5~10) min. For the language and cultural adaptation process, the participants’ comprehension of the questionnaire was measured on a scale of 1~5, with a mean score of 4 (range: 3~4).
Conclusion: The K-GIQLI was developed and did not exhibit a significant difference from the original English version in terms of social, linguistic, and cultural differences between the Western world and Republic of Korea.

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Longitudinal Change in Health-Related Quality of Life after Total Gastrectomy: Approach Based on the Minimally Important Difference: Sang Chun Park, Oh Jeong, Ji Hoon Kang, Mi Ran Jung; Ann Clin Nutr Metab 2021;13(2):43-51. Published online December 31, 2021; DOI: https://doi.org/10.15747/ACNM.2021.13.2.43

Abstract PDF ePub: Purpose: The post-operative quality of life (QoL) is a significant concern for patients undergoing gastrectomy. Unlike subtotal gastrectomy, the detailed aspects of QoL involving the ability to perform everyday activities that reflect physical, psychological, and social well-being; and satisfaction with levels of functioning and control of the disease after total gastrectomy remain poorly investigated.
Materials and Methods: We enrolled 170 patients who underwent total gastrectomy for gastric carcinoma and completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life questionnaires (QLQ) C30 and STO22 preoperatively and post-operatively at 1, 6, and 12 months. We investigated the QoL change in terms of the minimally important difference (MID), which refers to a score change patients would perceive as clinically important (effect size >0.5).
Results: At 1-month post-surgery, MID in global health, physical, social, role, emotional, and cognitive functions was observed at 44.0%, 68.0%, 42.7%, 38.7%, 32.0%, and 16.0% respectively. Of QLQ-C30 symptoms, MID was frequently observed in appetite (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (74.1%), dysphagia (63.5%), pain (51.8%), and anxiety (50.6%). At 12 months post-surgery, MID in global health, physical, role, cognitive, social, and emotional functions was 32.9%, 58.8%, 42.4%, 40.0%, 36.5%, and 17.6%, respectively. Of QLQ-C30 symptoms, MID was frequently observed in diarrhea (52.9%). Of the QLQ-STO22 symptoms, MID was frequently observed in eating restrictions (63.5%), dysphagia (52.9%), body image (55.3%), pain (55.3%), and anxiety (51.8%). Male sex, comorbidity, D2 lymphadenectomy, and post-operative morbidity were associated with MID in global health at 12 months post-surgery.
Conclusion: This study provides information about the detailed aspects of impairment in various functions and symptoms of QoL after total gastrectomy. This information can be used to develop a tailor-made management plan for QoL.

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Effect of Nutritional Intervention by the Nutrition Support Team on Postnatal Growth in Preterm Infants: So Jin Yoon, Joo Hee Lim, Soon Min Lee, Sun Jung Kim, Sun Kyung Lee, Soo Min Lee; J Clin Nutr 2020;12(2):26-33. Published online December 31, 2020; DOI: https://doi.org/10.15747/jcn.2020.12.2.26

Abstract PDF ePub: Purpose: Nutritional intervention by an interdisciplinary nutrition support team (NST) can potentially improve postnatal growth outcomes in preterm infants. This study aimed to measure the growth impact of a nutritional intervention package performed by an NST in a quality improvement effort in a neonatal intensive care unit (NICU).
Methods: Fifty-two infants born below 2,000 g and admitted to NICU participated in the Quality Improvement (QI) program between March 2016 and February 2017. The nutritional intervention was applied according to newly established nutritional guidelines on parenteral and enteral nutrition, and an NST performed a weekly nutritional assessment. The Z-scores of weight, height, and head circumference were calculated according to the gestational age and sex. The clinical impact on postnatal growth was compared between the QI and pre-QI groups. The pre-QI group included 69 infants admitted in the same NICU between 2014 and 2015.
Results: The time to the initiation of enteral nutrition decreased significantly (P<0.001). Changes in weight (P=0.027), head circumference (P=0.003), Z-scores between birth, and 40 weeks postconceptional age (PCA) were significantly larger in the QI than the pre-QI group. The percentage of infants weighing below the 10th percentile at one month after birth and at 40 weeks PCA was higher in the pre-QI than the QI group.
Conclusion: The implementation of evidence-based best practices for preterm nutrition resulted in significant improvements in the growth outcomes in preterm infants.

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The Present and Future of Nutrition Support Team: Ji-Young Sul, Jeong Goo Kim; Surg Metab Nutr 2019;10(1):1-4. Published online June 30, 2019; DOI: https://doi.org/10.18858/smn.2019.10.1.1

Abstract PDF ePub: Now days, the use of specialized nutrition support has become a standard tool in the care of patients. With the development of specialized nutrition support, an interdisciplinary approach was essential to archive a goal. Fortunately, Nutritional support team (NST) consultation fee has been reimbursed under the national health insurance system since 2014. Overall, it might be true that there has been some progress in the NST’s activities. However, it is still questionable whether there was a positive effect in terms of quality or cost effectiveness compared to quantitative improvements. Before taking into consideration of the future of NST, we are going to look at the status of nutritional support practice and utility of NST in Korea. Upon this background, we hope to make constructive suggestions for a better future of NST.

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Analysis of Compliance with Plan of Nutritional Support Team in Intensive Care Unit: Eunkyoung Kim, Jingyeong Kim, YunJu Park, Soyoung Baek, JinJu Lee, AeHee Lee, Jae Im Lee, Chang Hyeok An, Maru Kim; Surg Metab Nutr 2016;7(2):29-31. Published online December 30, 2016; DOI: https://doi.org/10.18858/smn.2016.7.2.29

Abstract PDF ePub: Purpose:
To improve the nutritional state of patients, cooperation between medical and nutritional support teams is needed. The present study analyzed compliance with the plan of the nutritional support team.
Materials and Methods:
From September 2015 to February 2016, patients undergoing consultation with the nutritional support team at an intensive care unit was enrolled in the study. Their medical records were retrospectively reviewed.
Results:
A total of 123 patients were analyzed. Overall compliance was 56.9% (70/123). Main reason of the non-compliant group was change in patient’s condition (44/53).
Conclusion:
To improve compliance with the medical team, there is a need to assess patients’ condition more rapidly.

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Economic Evaluation of Home Total Parenteral Nutrition: Ja Kyung Min; J Clin Nutr 2016;8(1):19-23. Published online April 30, 2016; DOI: https://doi.org/10.15747/jcn.2016.8.1.19

Abstract PDF ePub: The restricted resources on healthcare highlights the importance of clinical and cost effectiveness. The social and economic costs of chronic diseases are increasing. Home total parenteral nutrition (home TPN) for the patients with intestinal failure is a life-sustaining therapy until intestinal transplantation. An economic evaluation of home TPN has not been conducted in Korea. Three types of economic evaluations for home TPN are cost benefit analysis, cost effectiveness analysis, and cost utility analysis. Korea’s medical market is competitive due to the limited health care resources. A health care delivery system from hospital to home needs to be established under the supervision of professional Nutrition Support Team staff including the systematic policies and social recognition.

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