Development of supplemental nutrition care program for women, infants and children in Korea: NutriPlus+

Onto the world-fastest ageing of society, the world-lowest fertility rate prompted a development of various policies and programs for a betterment of the population in Korea. Since the vulnerability of young children of low socio-economic class to malnutrition was clearly shown at the in-depth analysis of the 2001 Korea National Health and Nutrition Examination Survey data, an effort to devise supplemental nutrition care program for pregnant/breastfeeding women, infants and preschool children was initiated. The program was designed to offer nutrition education tailored to fit the needs of the participants and special supplementary foods, using USDA WIC program as a benchmark. Based on the dietary intake of those age groups, target nutrients were selected and their major food sources were searched through nutrient content of foods and dietary pattern analysis. As a result, we developed 6 kinds of food packages using combinations of 11 different food items. The amount of each item in a food package was determined to supplement the intake deficit in target nutrients. Nutrition education in NutriPlus+ aims to improve the nutrition knowledge, attitude, and dietary behaviors of the participants, and is provided through group lessons, individual counseling sessions and home visits. Breastfeeding is promoted with top priority in education for the health of both mother and baby. The eligibility guidelines were set for residency, household income, age, pregnancy/breastfeeding and nutritional risk such as anemia, stunting, underweight, and/or inadequate nutrient intake. Income eligibility was defined as household income less than 200 percent of the Korean poverty guidelines. A pilot study to examine the feasibility of program implementation was run in 3 public health centers in 2005 and expanded to 15 and 20 in the following 2 years. The result of 3-year pilot study will be reported separately along with the ultimate nationwide implementation of the NutriPlus+ in 2008

The effect of a nutritional education program on the nutritional status of elderly patients in a long-term care hospital in Jeollanamdo province: health behavior, dietary behavior, nutrition risk level and nutrient intake

This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P < 0.001) and of depression (P < 0.001) improved significantly and that dietary behavior scores also improved significantly (P < 0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P < 0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals

Cost-Benefit Analysis of Haemophilus Influenzae Type B Immunization in Korea

An economic evaluation of Haemophilus influenzae type b (Hib) immunization was conducted to examine whether Hib immunization should be included in the Korea's national immunization program. The costs and benefits included direct and indirect values and an estimation of the economic efficiency. We determined that a universal Hib immunization program in Korea would prevent 17 deaths and 280 invasive Hib cases. When we assumed the one Hib immunization cost as 26,000 won, the national Hib immunization would cost 34.6 billion won. Costs for various Hib diseases were estimated at 26.8 billion won (11.8 billion won from direct costs and 14.9 billion won from indirect costs). A benefit-cost ratio of 0.77 showed that the economic efficiency of the integration of Hib immunization in Korea is low because of the low incidence rate of Hib disease and high price of vaccine. However, if the Hib immunization cost decrease to less than 20,000 won, a benefit-cost ratio increase to 1.0 and above, integrating Hib immunization into the national immunization program with economic efficiency can be considered

Anthropometric indices and selected nutrient intakes of young children in Kwangju, Korea

The assessment of children's nutritional intakes is important because any nutritional inadequacies or toxicities may have adverse consequences. Studies on the nutritional intakes of Korean children are limited. The aims of this study were to determine anthropometric indices, estimate selected nutrient intakes of young Korean children, and compare these intakes with current Dietary Reference Intakes for Koreans. This study included 136 healthy children (65 boys, 71 girls), 2-6 y old, living in Kwangju, Korea. Weights and heights were measured. Three consecutive 24-h food recalls were obtained. According to International Obesity TaskForce BMI cutoffs, 8% were overweight and 2% were obese. The energy intakes of 40% were < Korean Estimated Energy Requirements, while all subjects consumed ≥ Korean Estimated Average Requirement (EAR) for protein. The majority of the children consumed > Korean EAR for iron, zinc, vitamin B1, vitamin B2, vitamin B6, and niacin. Vitamin E intakes of 65% of the Korean children were < Korean Adequate Intake, and approximately half of the subjects had < Korean EAR for calcium and for folate. Many young children in Kwangju, Korea, likely have inadequate status of calcium, folate, and vitamin E

Economic Burden of Schizophrenia in South Korea

This study estimates the treated prevalence of schizophrenia and the annual costs associated with the illness in Korea in 2005, from a societal perspective. Annual direct healthcare costs associated with schizophrenia were estimated from National Health Insurance and Medical Aid records. Annual direct non-healthcare costs were estimated for incarceration, transport, community mental health centers, and institutions related to schizophrenia. Annual indirect costs were estimated for the following components of productivity loss due to illness: unemployment, reduced productivity, premature mortality, and caregivers' productivity loss using a human capital approach based on market wages. All costs were adjusted to 2005 levels using the healthcare component of the Consumer Price Index. The treated prevalence of schizophrenia in 2005 was 0.4% of the Korean population. The overall cost of schizophrenia was estimated to be $3,174.8 million (3,251.0 billion Won), which included a direct healthcare cost of$ 418.7 million (428.6 billion Won). Total direct non-healthcare costs were estimated to be $121 million (123.9 billion Won), and total indirect costs were estimated at$ 2,635.1 million (2,698.3 billion Won). Unemployment was identified as the largest component of overall cost. These findings demonstrate that schizophrenia is not rare, and that represents a substantial economic burden

The First Report of Fetal Alcohol Effect in a 12 Year-Old Child in Korea

We present the first report of fetal alcohol effect in a 12 year-old child in Korea. The mother had consumed 162 g of alcohol per week continuously during pregnancy. His first febrile seizure occurred before he was 1 year old, and became more frequent 2 years later. He started showing signs of right paraplegia when he was 3.5 years old and brain MRI revealed periventricular leucomalacia near the left ventricle. He was microcephalic and his growth was retarded. He was irritable, impatient, impulsive, and inattentive, and showed disinterest in school activities and aggressive and dangerous behavior. After the diagnosis of attention deficit/hyperactivity disorder was made, psychopharmacological treatment and family support was initiated. After 10 months, he still had intermittent ideas of reference, although the aggressive behavior, inattentiveness, and impulsivity had improved. Using this case study, we stress the importance of maternal alcohol history in patients with these characteristics

Correlation between attention deficit hyperactivity disorder and sugar consumption, quality of diet, and dietary behavior in school children

This study investigated the correlation between consumption of sugar intake by fifth grade students in primary schools and development of Attention Deficit Hyperactivity Disorder (ADHD). A total of 107 students participated, and eight boys and one girl (8.4% of the total) categorized as high risk for ADHD according to diagnostic criteria. There were significant differences in the occupations and drinking habits of the respondents' fathers between the normal group and risk group. In a comparison of students' nutrition intake status with daily nutrition intake standards for Koreans, students consumed twice as much protein as the recommended level, whereas their calcium intake was only 60% of the recommended DRI (dietary reference intake). Regarding intake volume of vitamin C, the normal group posted 143.9% of the recommended DRI, whereas the risk group showed only 65.5% of the recommended DRI. In terms of simple sugar intake from snacks, students in the normal group consumed 58.4 g while the risk group consumed 50.2 g. These levels constituted 12.5% of their total daily volume of sugar intake from snacks, which is higher than the 10% standard recommended by the WHO. In conclusion, children who consumed less sugar from fruit snacks or whose vitamin C intake was less than RI was at increased risks for ADHD (P < 0.05). However, no significant association was observed between total volume of simple sugar intake from snacks and ADHD development

Non-cancer Diseases of Korean Atomic Bomb Survivors in Residence at Hapcheon, Republic of Korea

Many Koreans, in addition to Japanese, were killed or injured by the atomic bombs detonated over Hiroshima and Nagasaki, Japan, in 1945. Our study examined non-cancer diseases of Korean A-bomb survivors in residence at Hapcheon, Republic of Korea and evaluated whether they had significantly higher prevalence of non-cancer diseases than non-exposed people. We evaluated a number of tests, including anthropometric measurements, blood pressure, blood chemistry, hepatitis B surface antigen, and urinalysis, of survivors (n=223) and controls (n=372). Univariate analysis revealed significantly lower fasting glucose and creatinine, and higher diastolic blood pressure, aspartate aminotransferase, alanine aminotransferase, and blood urea nitrogen levels in the survivors than in the controls. The calculation of crude prevalence ratios (PRs) revealed that A-bomb survivors had a significantly higher prevalence of hypertension (PR, 1.16; 95% CI, 1.00-1.35) and chronic liver disease (2.20; 1.59-3.06) than controls. After adjusting for covariates (age, sex, body mass index, marital status, education, alcohol consumption, and smoking), A-bomb survivors had a significantly higher prevalence of hypertension (1.24; 1.06-1.44), chronic liver disease (2.07; 1.51-2.84), and hypercholesterolemia (1.79; 1.11-2.90) than controls. This study suggests that A-bomb exposure is associated with a higher prevalence of non-cancer diseases in Korean survivors

Occupational Infection in Korea

Occupational infection is a human disease caused by work-associated exposure to microbial agents through human and environmental contact. According to the literature, occupational infection was the third leading cause of occupational disease (861 cases, 8.0%), and health care, agricultural, forestry, and fishery workers were risk groups in Korea. In addition, most high-risk groups have not been protected by workers' compensation, which could lead to underestimation of the exact spectrum and magnitude of the problem, and may also result in a lack of development and implementation of occupational infection management. Through a review of national guidelines and documentations on prevention and control of occupational infection, a management strategy would promote adherence to worker safety regulations if it is explicit with regard to the agent and mode of infection in each of the high-risk groups

Measuring the Burden of Disease in Korea

This paper provides an overview of the Korean Burden of Disease (KBoD) study, which was the first such study to assess the national burden of disease using disability-adjusted life years (DALYs) in an advanced Asian country. The KBoD study generally followed the approach utilized in the original Global Burden of Disease study (GBD), with the exception of the disease classification and epidemiological data estimation methods used, and the relative weightings of disabilities. The results of the present study reveal that the burden of disease per 100,000 of the Korean population originates primarily from; cancer (1,525 Person Years, PYs), cardiovascular disease (1,492 PYs), digestive disease (1,140 PYs), diabetes mellitus (990 PYs), and certain neuro-psychiatric conditions (883 PYs). These results are largely consistent with those of developed countries, but also represent uniquely Korean characteristics