Pressure injuries are common complications in patients with limited mobility, particularly those who are bedridden. These wounds not only cause pain and reduce quality of life but also lead to prolonged hospitalization, increased risk of infection, and higher healthcare costs. Among the various contributing factors, malnutrition plays a crucial role by impairing collagen synthesis, weakening immune function, and delaying tissue repair. Adequate nutritional support—particularly sufficient protein and energy intake—is therefore an essential component of comprehensive pressure injury management. We present the case of a paraplegic patient who developed a vulvar pressure injury. A structured, stepwise nutritional intervention was implemented, including adjustment of meal composition based on appetite, supplementation with high-protein oral nutritional supplements, vitamins and minerals, and the use of probiotics to manage diarrhea. As a result, the patient’s daily protein intake increased from less than 10 g to 80–90 g, accompanied by progressive wound improvement. Serial clinical assessments showed reduced slough, increased granulation tissue formation, and epithelialization. This case highlights the vital role of individualized nutritional management within a multidisciplinary approach to pressure injury care. Stepwise nutritional intervention, tailored to the patient’s tolerance and clinical status, contributed significantly to wound healing. Nutritional optimization should be considered an integral component of effective pressure injury treatment strategies.
Cataracts are a major cause of visual impairment worldwide, particularly among older adults, with an increasing prevalence due to population aging. Surgery is the primary treatment; however, preventive strategies are crucial for reducing the disease burden. This study aimed to investigate dietary and health-related factors associated with cataract occurrence and develop a predictive model using machine learning. Data were derived from the Korea National Health and Nutrition Examination Survey 2015–2017. The study included 190 women aged 60–79 years: 124 with cataracts and 66 controls. Analyzed variables included sociodemographic, behavioral, chronic disease, and dietary intake factors. After data preprocessing, 4 machine learning algorithms: support vector machine (SVM), random forest (RF), eXtreme gradient boosting, and multilayer perceptron were used. Model performance was evaluated using accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUROC) and precision-recall curves. Among the tested models, the SVM achieved the best performance under stratified 10-fold cross-validation, with 71% accuracy, 86% precision, 73% recall, 79% F1-score, 65% AUROC, and 81% AUPRC. According to our findings, the odds of having cataracts can be effectively predicted using dietary and health data without relying on specialized ophthalmic equipment. The proposed model demonstrates the potential of machine learning-based tools for early identification and prevention of cataracts. Future studies with larger and more diverse samples, as well as integrating additional data sources such as genomics and lifestyle factors, are warranted to refine predictive accuracy and enhance personalized nutrition-based interventions.
This study provides the first national update on phase angle (PhA) as a biomarker of body composition, nutritional status, and health outcomes in Korean adults. Using data from 5,035 adults aged 20–80 years from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), we analyzed age-related variations in PhA, body composition, metabolic diseases, and nutrient intake. The mean PhA declined from 5.57° in participants aged 20–39 to 4.23° in those aged 80+, corresponding with decreases in height and weight. Individuals with higher PhA exhibited significantly greater lean body mass and lower body fat; for example, among those aged 20–39, the high PhA group showed 56.02 kg of lean mass versus 40.71 kg in the low group (p < 0.001) and total body water of 41.07 L versus 29.84 L (p < 0.001). Regarding metabolic diseases, 35.2% of the high PhA group aged 20–39 had grade 1 obesity compared with 17.4% in the low group, with similar associations observed for diabetes and hypertension across age groups. Nutritional intake was also higher in the high PhA group, with mean energy intake of 2,180.84 versus 1,710.16 kcal (p < 0.001). Overall, PhA was positively associated with favorable body composition, nutritional intake, and metabolic profiles across all age groups, suggesting its potential as a comprehensive biomarker for assessing physiological health and guiding nutritional interventions in the Korean population.
Adequate nutrition reportedly can help reduce the degree of muscle loss and improve muscle quality in hospitalized patients recovering from trauma. This study investigated the association between nutritional intake and changes in muscle quality and quantity in these patients. The handgrip strength (HGS) and body composition of 52 patients admitted to the trauma ward were measured at 1-week intervals. According to their dietary intake, they were categorized into the hypocaloric nutrition group (HNG; < 70% of recommended caloric intake) and the isocaloric nutrition group (ING; ≥ 70% of recommended caloric intake). Within one week, body mass index (24.3 ± 4.4 kg/m2 vs. 23.4 ± 4.5 kg/m2), body fat percentage (24.1% ± 9.8% vs. 17.2% ± 9.2%), and skeletal muscle mass (28.6 ± 4.9 kg vs. 27.5 ± 4.3 kg) significantly decreased in the ING compared with those in the HNG. Although the skeletal muscle mass decreased, the ING’s left HGS significantly increased (26.6 ± 9.6 kg vs. 28.5 ± 10.1 kg). The ING also consumed a significantly greater amount of protein (beyond the recommended amount) than the HNG (72.6 ± 43.2 → 100.8 ± 27.0% vs. 58.6 ± 25.9 → 49.5 ± 20.1%; p = 0.039). In bioelectrical impedance vector analysis, the vectors of the ING shifted more within the normal range of the 75% tolerance ellipse than those of the HNG (23% vs. 10%). These results suggest that, although the muscle mass quantitatively decreased during trauma recovery, adequate nutritional support helps preserve muscle quality.
This study evaluated the effects of replacing skipped meals with oral nutritional supplements (ONS) on the nutritional status and functional health of older adults. A total of 29 participants aged ≥ 65 years who regularly skipped at least one meal per day were included in this single-arm study. For 8 weeks, participants consumed two packs of ONS daily (150 mL each, providing 400 kcal and 18 g of protein) as a substitute for skipped meals. Nutritional status, nutrient intake, body composition, and physical function were assessed before and after the intervention. The Nutrition Quotient for the Elderly score significantly increased from 58.97 to 63.62 (p = 0.014). Total nutrient intake, including ONS, significantly improved compared with baseline (p < 0.01). Body weight and body mass index increased significantly from 58.87 to 59.47 kg (p = 0.028) and from 23.9 to 24.18 kg/m2 (p = 0.016), respectively. Calf circumference decreased significantly from 34.1 to 33.39 cm (p = 0.010). Physical function, assessed using the Short Physical Performance Battery, showed significant improvement (p = 0.003). In conclusion, replacing skipped meals with ONS may enhance nutritional status and support functional health in older adults.
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Cataracts are a major cause of vision impairment in older adults and pose a growing concern in aging societies. This study examined the association between dietary macronutrient intake and the odds of having cataracts among 1,619 Korean adults aged ≥ 60 years using data from the 2015–2017 Korea National Health and Nutrition Examination Survey. Cataracts were present in 51.8% of participants. Dietary intake was assessed via 24-hour recall and macronutrient intake was categorized by quartiles and energy ratios. After adjusting for covariates, individuals in the highest quartile of carbohydrate-to-energy intake (> 80%) had 41% higher odds of having cataracts (odds ratio [OR], 1.41; 95% confidence interval [CI], 0.99–2.01), with a significant trend (p for trend = 0.022). In contrast, the highest quartile of protein intake (Q3: 12%–15% energy) was associated with significantly lower odds of having cataracts in women (OR, 0.59; 95% CI, 0.40–0.88). Likewise, fat intake exceeding 18% of total energy was associated with reduced odds of having cataracts (OR, 0.69; 95% CI, 0.49–0.97). Saturated and monounsaturated fat intake also showed inverse associations with the odds of having cataracts. These results suggest that excessive carbohydrate intake, particularly when replacing fats and proteins, may increase the odds of having cataracts in older adults, especially among women. Dietary adjustments aimed at reducing the proportion of carbohydrates and increasing high-quality protein and fat intake may help prevent cataracts in aging populations. Further longitudinal studies are needed to clarify causal relationships and to inform nutritional guideline development.
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Chronic obstructive pulmonary disease (COPD) is a major respiratory disorder characterized by irreversible airflow limitation. The role of diet in the prevention and management of COPD is receiving increasing attention. This study aimed to examine the association between the composite intake of vegetables, fruits, meat, and fish and pulmonary function as well as COPD prevalence in a representative sample of Korean adults aged ≥ 40 years using data from the 7th Korea National Health and Nutrition Examination Survey. Higher vegetable intake was associated with significantly better pulmonary function parameters, including forced vital capacity (p < 0.001), forced vital capacity percent predicted (p = 0.050), forced expiratory volume (FEV) in 1 second (FEV1; p < 0.001), FEV1 percent predicted (p = 0.038), FEV in 6 seconds (p < 0.001), and peak expiratory flow (p < 0.001). Furthermore, individuals with a high combined intake of vegetables, fruits, meat, and fish demonstrated a 0.261-fold lower COPD prevalence than those without such intake (p = 0.039). The dietary inflammatory index (DII) was significantly lower among participants without COPD than among those with COPD (mean DII = −3.6947, p = 0.002), indicating that a diet rich in anti-inflammatory nutrients can help reduce COPD risk. These findings suggest that vegetable consumption supports improved respiratory function, and a composite dietary pattern incorporating various food groups may help reduce the prevalence of COPD in the adult population.
Neurocritically ill patients often encounter challenges in maintaining adequate enteral nutrition (EN) owing to metabolic disturbances associated with increased intracranial pressure, trauma, seizures, and targeted temperature management. This case report highlights the critical role of the nutrition support team (NST) in overcoming these barriers and optimizing EN delivery in a patient with traumatic brain injury (TBI). A 59-year-old man was admitted to the neuro-intensive care unit following TBI. EN was initiated early in accordance with clinical guidelines. By the time of transfer to the general ward, 82.4% of the estimated energy requirement and 102.8% of the protein requirement were met. Despite this, the patient experienced 19.4% weight loss, likely due to underestimation of hypermetabolic demands and delays in EN advancement caused by fluctuating clinical conditions. NST adjusted the nutrition strategy by incorporating high-protein formulas, parenteral nutrition supplementation, and gastrointestinal management. This case report demonstrates the importance of individualized, multidisciplinary nutritional interventions in improving clinical outcomes for neurocritically ill patients.
Malnutrition is prevalent among older patients, leading to increased morbidity, prolonged hospitalization, and diminished quality of life. The Comprehensive Geriatric Assessment (CGA) facilitates the evaluation of multifaceted health issues, enabling individualized nutritional interventions. This case report describes nutritional management guided by CGA in a 75-year-old female hospitalized for severe hypernatremia with significant malnutrition and high-risk for refeeding syndrome. Upon admission, CGA identified multiple comorbidities, cognitive impairment, and complete dependence on caregivers for daily activities. Due to persistent refusal of oral intake, enteral nutrition (EN) was cautiously initiated at 25% of the target energy requirement, with close monitoring of electrolyte levels. Despite an initial decrease in phosphorus levels suggestive of refeeding syndrome, gradual advancement of nutritional support successfully stabilized her clinical condition. Following discharge, structured caregiver education was provided to support EN at home; however, suboptimal intake persisted due to gastrointestinal intolerance, resulting in weight loss. Post-discharge follow-ups identified feeding rate-related symptoms, necessitating formula adjustments and caregiver re-education. This case emphasizes the critical role of CGA in early malnutrition detection, individualized nutritional intervention, prevention of refeeding syndrome, and the importance of continuous post-discharge monitoring and caregiver education. Although the findings are limited by the single-case design, proactive CGA-based nutritional interventions remain crucial for optimizing clinical outcomes in older patients hospitalized due to acute medical problems. Further research involving larger samples and prolonged follow-up periods is required to validate the long-term benefits of CGA-based nutritional intervention.
This review offers a comprehensive analysis of food for special medical purposes (FSMPs)—specially formulated foods designed to support the dietary management of individuals with specific medical conditions. The regulatory frameworks governing FSMP differ significantly across key regions, including the European Union, North America (with a focus on the United States), and Asia (primarily China and India). FSMP is critical in addressing malnutrition, metabolic disorders (including inborn errors of metabolism), and chronic diseases, such as cancer, diabetes, and neurological conditions. Recent advancements, such as the application of three-dimensional printing technology and the growing emphasis on personalized nutrition, are poised to revolutionize the FSMP industry. The global market for FSMP is experiencing rapid growth, particularly in China, driven by factors like aging populations and the increasing prevalence of chronic diseases. Future trends suggest a shift toward more personalized, technologically advanced FSMP formulations. However, challenges such as high costs, limited accessibility, unclear regulations, and poor palatability must be addressed to maximize the potential of FSMP in enhancing patient care.
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The primary aim of this study was to evaluate the value of predictive equation (PE) standard care compared with indirect calorimetry (IC)-based nutrition therapy. The secondary aim was to compare the results among 3 groups to assess the accuracy of IC and PE. This was a single-center, retrospective study of patients admitted to the neurosurgery (NS) intensive care unit (ICU), from January 2019, to August 2020. Anthropometric, biochemical, clinical, and dietary data were collected from NS ICU admission to discharge. If patients had an IC: PE ratio of 90%–110%, they were classified into the optimal estimation group (OEG); if the ratio was < 90%, they were classified into the underestimation group (UG); and if the ratio was > 110%, they were classified into the overestimation group (OG). There were no significant differences in anthropometric, biochemical, clinical data and nutrition assessment between baseline and discharge from the NS ICU. The OEG showed a larger cumulative caloric deficit rate compared to UG and OG, though this difference was not statistically significant. There was a negative association between calf circumference (CC) and length of stay (LOS). Repeated measures of CC showed a significant difference according to LOS and groups (p < 0.001). Anthropometric, biochemical, clinical, and dietary data of 77 NS patients were analyzed to determine the effectiveness of concordance between IC and PE. The UG and OG showed a significant decrease in CC during hospitalization, but CC in the OEG was maintained or increased from 4 weeks onward.
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Nutrition fact labels (NFLs) are a simple way to help people improve their nutritional intake by making healthier food choices. This study aimed to evaluate NFL use and eating habit changes among quarantined and hospitalized coronavirus disease 2019 (COVID-19) patients during the pandemic. This cross-sectional study used data from the 2019 and 2020 Korean Community Health Surveys (KCHSs). Data were collected from 229,099 subjects in 2019 and 229,269 subjects in 2020. In the 2020 KCHS, data from 1,073 COVID-19 patients were included. NFL use was divided into 4 categories based on a questionnaire: affect, read, aware, and never heard. Among COVID-19 patients, 32.15% reported that they had not heard of NFLs (never heard group) compared to 44.36% of the healthy population (p < 0.001). A total of 35.1% of COVID-19 patients who reported daily life change scores of 20 or less were in the affect group compared to 23.8% of healthy subjects. In the affect group, the proportion of respondents who reported increased consumption of delivered food was 38.7% in the COVID-19 group, which was 17.1% higher than that in the never heard group (Cramér’s V = 0.257; p < 0.001). Respondents with increased consumption of fast food/soda showed a higher ratio of having never heard of NFLs among healthy subjects (28.5%) than among COVID-19 patients (22.5%; p = 0.043). Confirmed COVID-19 infections and more unfavorable daily life changes due to COVID-19 led to increased nutritional information seeking and NFL use.
Nutrition fact labels (NFLs) have advantages because they are an intuitive tool that provides unified information regulated by the government and does not require any devices or special skills. During pandemic, with increased interest in information about healthy food choices and optimum nutrition, frequent exposure to NFLs on pre-packaged foods and dietary supplements may have helped consumers become aware of and/or use NFLs. We aimed to evaluate NFL usage changes from the pre- and early to the late pandemic years in the Korean adult population, using data from the Korean Community Health Survey (3-year total respondents n = 687,610) conducted from 2019 to 2021. NFL awareness, effect, and utilization ratios in each subgroup (sex, age, diabetes mellitus/hypertension, subjective health status, and physical activity) were analyzed for the 3 years by the cross-tabulation test of weighted complex sample analysis. Despite the declining awareness of NFLs in the Korean population, the proportion of individuals who were affected by the NFL content in the entire population and the utilization ratio among those who were aware of NFLs increased continuously during the early and late pandemic periods. Thus, Nutrition experts and policy-makers need to increase efforts to maintain interest in NFLs that emerged during the pandemic. NFLs, a conventional but well-regulated and effective tool, may have enabled the Korean population to make healthy food choices during the pandemic.
This study compared the effects of 12 weeks of intensive nutrition education (IE) using the 5A's behavioral change model and basic nutrition education (BE) on nutritional knowledge and nutrient intake among Korean adolescent athletes. This study included elite adolescent athletes (IE group: n = 65, BE group: n = 65) at a physical education high school in Seoul. In this prospective, randomized, controlled trial, the athletes' body composition, nutritional knowledge, nutrient intake, and self-management practices were evaluated at the beginning and end of the intervention. Both groups had increased levels of nutrition knowledge between pre- and post-test, but the change in total score for nutrition knowledge was significantly higher in the IE group than in the BE group (p < 0.001). Energy intake post-test increased significantly in the IE group (from 2,185 to 2,651 kcal/day, p < 0.001) but not in the BE group. The intake of carbohydrates, protein, and fat also increased significantly in the IE group (carbohydrates: from 298 to 352 g/day, protein: from 86 to 106 g/day, fat: from 71 to 88 g/day, all p < 0.001), but the change in the BE group was not significant. Additionally, the IE group showed a significant overall increase in vitamins and minerals compared to the BE group at post-test. Adolescent athletes in the IE group showed improved nutritional knowledge and intake compared to those in the BE group 12 weeks after the intervention.
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