Impact of nutritional status and dietary quality on stroke: do we need specific recommendations?

Stroke, one of the most prevalent geriatric diseases, is a leading cause of death worldwide that often results in permanent physical disability and decreased quality of life, and can have a negative impact on families both financially and emotionally. Although many previous studies have shown relationships between the risk of stroke and nutritional factors, clear dietary recommendations for the prevention and reduction of stroke recurrence have not been established. Several factors should be considered to control and manage stroke. For example, a considerable number of patients with stroke are poorly nourished, have several comorbidities and undesirable health-related behaviors may be present. Stroke patients are less likely to consume beneficial foods, have poorer eating habits and have impoverished dietary quality. In addition, psychological factors such as depression must also be considered in stroke management. Given these factors, dietary recommendations for stroke patients should be established. In this article, we summarized the nutritional status and dietary quality of stroke patients. We also suggested some nutritional guidelines for stroke patients and for those who are at risk for stroke.

Nurses' positive attitudes to nutritional management but limited knowledge of nutritional assessment in Korea.

BACKGROUND: Nurses' involvement in nutritional management has received greater emphasis as an accountable factor for the nutritional status of patients. Studies have shown that there are deficiencies in awareness of the importance of nutritional assessment and limited nutritional knowledge in nurses. AIM: The purpose of this study was to investigate nutritional attitudes and knowledge of nurses working in the hospital environment. METHODS: A questionnaire survey was conducted. It is focused on nutritional management with regard to assessment of nutritional status and implementation of nutritional care. Nurses were recruited from the university hospital in Seoul, Korea. FINDINGS: A majority of nurses had positive attitudes towards patients' nutritional status and had a high desire to receive nutritional information. However, they had limited knowledge of nutrition, especially nutritional assessment criteria which are basic to the evaluation of patient's nutritional status. Nurses did not perform the nutritional assessment appropriately in practice. CONCLUSIONS: These findings suggest that nurses have limited nutritional knowledge and they use nutritional assessment criteria poorly in clinical settings. This study provides a framework for developing nutritional management programmes and a standardized protocol for nutritional assessment.

Comparative effect of seeds of Rhynchosia volubilis and soybean on MG-63 human osteoblastic cell proliferation and estrogenicity.

The seeds of Rhynchosia volubilis (SRV) (Leguminosae) and soybean have been used in oriental folk medicine to prevent postmenopausal osteoporosis. Their beneficial effects are caused by a high content of isoflavone, which function as partial agonists or antagonists of estrogen. To compare the estrogenic effects of SRV and soybean on the MG-63 osteoblastic cell proliferation, 70% methanol extracts of SRV or soybean were treated on MG-63 cells. Although biphasic over a concentration range of 0.001 mg/ml-0.1 mg/ml, both SRV and soybean extracts increased MG-63 cell proliferation. However SRV was more effective at increasing the cell proliferation that paralleled with the greater estrogenic effects as determined by estrogen receptor alpha (ERalpha) expression, an estrogenic response element (ERE)-luciferase activity and the selective expression of insulin-like growth factor-I (IGF-I). SRV-induced IGF-I expression resulted from increases in the mRNA levels. Despite the increased expression of ERbeta, ERE activity and IGF-I expression by soybean were lower than those by SRV. Furthermore, the comparable estrogenic effects between SRV and the combined treatment of genistein and daidzein standards at 0.5 x 10(-8) M, which is a concentration of these two isoflavones similar to that of SRV at 0.001 mg/ml, demonstrate that the greater estrogenicity of SRV for MG-63 cell proliferation is mediated by the synergism of low levels of isoflavones for the selective expression of IGF-I.

Regional biosynthesis of prostaglandins and hydroxyeicosatetraenoic acids from arachidonic acid in the rat stomach tissue.

The present study was conducted to determine regional differences in the biosynthesis of prostaglandins (PGs) and hydroxyeicosatetraenoic acids (HETEs) in the rat stomach tissue (fundus, corpus and pyloric antrum) from radioactive arachidonic acid (AA). The radioactive metabolites were validated by RP-HPLC using non-radioactive AA as substrate. PGE(2) was the major prostanoid in the tissue(.) The relative ratio of PGE(2):PGF(2)alpha:PGD(2) in the whole stomach was 1:0.5:0.1. Regionally, the fundus biosynthesized the largest amount of all three cyclo-oxygenase products. Among the lipoxygenase metabolites, 15S-HETE was the predominant product, while 12S-HETE was found to be the lowest. The relative ratio of 15S-HETE:5S-HETE:12S-HETE in the whole stomach was 1:0.6:0.4. Interestingly, the generation of lipoxygenase products was the highest in the pyloric antrum when compared to fundus or corpus. Thus, the regional differences in the biosyntheses of gastric PGs and monohydroxy fatty acids may be relevant to our understanding of corresponding differences in mucosal resistance or susceptibility to gastric disease.

Free radical scavenging effect of Diospyros kaki, Laminaria japonica and Undaria pinnatifida.

Diospyros kaki folium, Laminaria japonica thallus and Undaria pinnatifida thallus have been used traditionally in Korea to promote maternal health. The scavenging activity against DPPH (1,1-diphenyl-2-picrylhydrazyl) radicals of the methanol extracts of these plants were investigated. The extract of D. kaki was found to be the most potent, with an IC(50) value of 0.11 mg/ml.

Appetite sensations and eating behaviors to complete fasting in obese and non-obese individuals.

OBJECTIVE: To investigate the response of appetite sensations and eating behaviors to fasting in obese and non-obese individuals. DESIGN: Prospective study on inpatients enrolled in weight loss program including fasting at the obesity clinic, an oriental medical center in Seoul, Korea. SUBJECTS AND MEASUREMENTS: For seven obese (body mass index BMI> or =30) and 11 non-obese (BMI<30) patients, the modified visual analog scale (VAS) was administered three times per day throughout 9 days of complete fasting. Three-Factor Eating Questionnaire (TEEQ) was administered before and 18 days after the complete fasting period. RESULTS: After treatment, average weight losses were 7.4 kg (3.0 BMI) for the obese group and 6.7 kg (2.6 BMI) for the non-obese. TFEQ scales did not differ by weight status at both before and after treatments. Eighteen days after the fasting, an increase of restraint of eating was found only for the non-obese. There was a decrease of disinhibition of eating regardless of weight status. During fasting, desire to eat, hunger and prospective consumption decreased for the non-obese, while these appetite sensations tended to increase slightly for the obese. CONCLUSIONS: BMI, independent of dieting status, appeared to be related to appetite sensations except for satiety during fasting, but not before and 18 days after fasting.

Soybean ethanol extract increases the function of osteoblastic MC3T3-E1 cells.

To investigate the bioactivities of soybean, which act on bone metabolism, we studied the effect of a soybean ethanol extract on the activity of osteoblast MC3T3-E1 cells. Soy extract (0.01-0.1 g/l) dose-dependently increased survival (P<0.05) and DNA synthesis (P<0.05) of MC3T3-E1 cells. In addition, soy extract (0.05 g/l) increased alkaline phosphatase activity (P<0.05) and collagen synthesis (P<0.05) of MC3T3-E1 cells. Moreover, the anti-estrogen tamoxifen eliminated the stimulation of MC3T3-E1 cells on the proliferation, ALP activity and collagen synthesis by soy extract, indicating that the main action of the soy extract on osteoblastic MC3T3-E1 cells is similar to that of estrogen effects. Treatment with soy extract prevented apoptosis, as assessed by a one-step sandwich immunoassay and DNA gel electrophoresis studies. This effect may be associated with the activation of the estrogen receptor, since we observed soy extract-mediated survival against apoptosis was blocked by the estrogen receptor antagonist tamoxifen in cells, further supporting a receptor-mediated mechanism of cell survival. These results suggest that osteoblast function is promoted by soy extract and that the estrogen receptor is involved in the response, thereby playing an important role in bone remodeling. In conclusion, soy extract has a direct stimulatory effect on bone formation in cultured osteoblastic cell in vitro. Presumably, dietary soy products are useful in the prevention of osteoporosis.