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.
Children with autism spectrum disorder (ASD) often present with selective eating behaviors and dietary imbalances, which contribute to nutritional deficiencies that can adversely impact growth and development. Despite increasing awareness of the role of nutrition in ASD management, existing nutritional interventions frequently fail to accommodate the unique dietary needs of this population. This study aimed to develop tailored nutritional counseling materials for ASD children by adapting the food exchange list framework originally designed for individuals with diabetes. A comprehensive food database was constructed using data from the Korean Diabetes Association, the Korea Rural Development Administration, and related resources, specifically addressing the dietary habits and nutritional deficiencies observed in ASD children. Representative foods were selected, standardized for exchange units, and visually documented through photographs to enhance usability. These elements were integrated into a practical, visually engaging educational brochure, which includes detailed food exchange unit tables, photographic representations of portion sizes, and portion standards to guide caregivers in meal planning. The materials focus on enhancing dietary diversity, correcting common nutrient deficiencies, and fostering balanced eating habits. However, limitations exist in adapting a diabetes-centric framework, which may not fully capture the unique dietary preferences and challenges of ASD children. Nevertheless, the developed materials provide a valuable resource for nutritional education and intervention, supporting the health and development of ASD children. Further research is required to refine these materials and evaluate their effectiveness across diverse settings and populations.
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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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.
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.
Protein intake has been identified as a key modifiable factor in preventing and managing sarcopenia, a common age-related condition characterized by the loss of muscle mass, strength, and function. This scoping review aimed to summarize the available literature on the association between protein intake and sarcopenia-related outcomes among Korean older adults and identify current research trends and gaps in this field. The review followed the 5-step methodological framework developed by Arksey and O’Malley for scoping reviews and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist to ensure a comprehensive search strategy. Protein intake was assessed using various methods, including grams per day, grams per kilogram of body weight per day, and intake quartiles. Sarcopenia-related outcomes were categorized into 3 domains as follows: muscle mass, strength, and physical performance. Although most intervention studies demonstrated improvements in muscle mass following protein supplementation, findings on muscle strength and physical function were inconsistent. Cross-sectional studies generally reported better sarcopenia-related outcomes with higher protein intake, particularly when the intake was expressed relative to body weight or analyzed according to quartiles. However, heterogeneity in protein intake assessments and variations in sarcopenia definitions could have contributed to the inconsistent findings across studies. This review highlights the need for applying standardized approaches for protein intake measurement and sarcopenia diagnosis. Future studies should consider the quantity, quality, and timing of protein intake while also focusing on the implementation of integrated, multidisciplinary intervention strategies to promote healthy aging among Korean older adults.
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.
The relationship between vitamin D status and visceral adiposity among older adults remains unclear. This study aimed to investigate the association between serum vitamin D levels and visceral adipose tissue (VAT) among older Iranian adults. This cross-sectional study included older adults aged ≥ 60 years from the Amirkola Health and Aging Project. Serum 25-hydroxyvitamin D levels were measured by enzyme-linked immunosorbent assay. VAT was assessed using dual-energy X-ray absorptiometry. Furthermore, the relationship between vitamin D and VAT was examined through multiple linear regression analysis, adjusting for potential confounders. Of the 600 participants, 345 (57.5%) were males and 255 (42.5%) were females. Their mean age was 68.90 ± 6.97 years, and the mean vitamin D level was 60.50 ± 39.45 ng/mL. Serum vitamin D levels showed a weak negative association with VAT mass (β = −0.062, p = 0.012). In both sexes, VAT mass predictors followed a similar pattern. Body mass index (BMI; β = 0.811, p < 0.001) was identified as a strong predictor, while diabetes status exhibited a positive association with VAT mass (β = 0.078, p = 0.002). Serum vitamin D levels appear to have a weak inverse relationship with visceral adiposity in older Iranian adults. BMI was the most robust predictor of VAT. Further longitudinal research is needed to clarify the causal relationship between vitamin D status and visceral adiposity among older adults.
The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a brain-focused dietary pattern designed to prevent cognitive decline in older adults. This systematic review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aimed to examine the association between the MIND diet and cognitive function in older adults. Relevant studies published between 2015 and 2024 were identified through comprehensive searches of PubMed and the Cochrane Library using keywords including “MIND diet,” “cognitive performance,” and “older adults.” From a total of 138 records screened, 11 studies met the inclusion criteria after excluding reviews, meta-analyses, editorials, and those incorporating other lifestyle interventions such as physical activity or education. These studies included 7 prospective cohort studies, 2 cross-sectional studies, 1 randomized controlled trial (RCT), and 1 case-control study, comprising a total of 17,201 participants aged 57–91 years. Across studies, at least 57% of participants were women, and in the 5 studies reporting race, more than 75% were White. Dietary intake and MIND adherence were assessed primarily via food frequency questionnaires, while cognitive outcomes were evaluated using validated instruments including the Montreal Cognitive Assessment, global cognition scores, Consortium to Establish a Registry for Alzheimer’s Disease tests, and magnetic resonance imaging. Six cohort and two cross-sectional studies reported significant associations between higher MIND adherence and better cognitive outcomes. One cohort study and the single RCT showed no effect. Excluding 2 studies with short durations (≤ 3 years), the remaining nine studies suggest consistent cognitive benefits of MIND adherence. Future studies should include systematic reviews and large-scale RCTs focusing on Asian populations.
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