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BACKGROUND: Malnutrition after gastrectomy is associated with a poor prognosis; however, no accurate model for predicting post-gastrectomy malnutrition exists. Hence, we conducted a retrospective study to develop a prediction model identifying gastric cancer patients at high risk of malnutrition after gastrectomy. METHOD: Gastric cancer patients who underwent curative gastrectomy with more than one weight measurement during a 3-year follow-up period were included. Malnutrition was defined as body mass index (BMI) < 18.5 kg/m2 according to the European Society of Clinical Nutrition and Metabolism diagnostic criteria. BMI-loss pattern was analyzed using a group-based trajectory model. A prediction model for malnutrition 6 months after gastrectomy was developed based on significant risk factors, and then validated. RESULTS: Overall, 1421 patients were examined. The BMI-loss trajectory model showed significant BMI loss at 6 months after gastrectomy. Severe BMI loss (mean 21.5%; n = 109) was significantly associated with the elderly, female sex, higher preoperative BMI, advanced cancer stage, open surgery, total gastrectomy, Roux-en-Y reconstruction, chemotherapy, and postoperative complications (all p < 0.05). Malnutrition 6 months after gastrectomy was observed in 152 (11.9%) of 1281 patients. Preoperative BMI, sex, and type of operation were included in the final prediction model as predictive factors (p < 0.05). The C-index of the developmental set and bootstrap validation of the prediction model was 0.91 (95% confidence interval 0.89-0.94) and 0.91, respectively. CONCLUSION: The prediction model for the risk of malnutrition 6 months after gastrectomy was accurately developed, with three independent risk factors: low preoperative BMI, female sex, and total or proximal gastrectomy.
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Desnutrição , Neoplasias Gástricas , Idoso , Índice de Massa Corporal , Detecção Precoce de Câncer , Feminino , Gastrectomia/efeitos adversos , Humanos , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/etiologia , Estudos Retrospectivos , Neoplasias Gástricas/cirurgia , Resultado do TratamentoRESUMO
This review paper describes our exploratory experimental studies on the functionality of sucrose and other sugars in cake-baking, and effects on cake quality. We have used the American Association of Cereal Chemists Method 10-90.01 as a base cake-baking method, and have applied Differential Scanning Calorimetry, Rapid Visco-Analyzer, and time-lapse photography analyses in experimental design studies of the effects of the following ingredient and formulation variables on cake quality (e.g. texture, color, moisture content) and other finished-product properties (e.g. shape, dimensions): (a) cake formula levels of sucrose and water, in terms of %Sucrose and Total Solvent; (b) concentration of sucrose or other sugars (e.g. xylose, ribose, fructose, glucose, maltose, polydextrose) vs. wheat flour starch gelatinization temperature and starch pasting during baking and gluten development during mixing; (c) unchlorinated flour vs. chlorinated flours (of varying pH); (d) cake formula %Sucrose and TS vs. cake color, shape, and dimensions; (e) cakes formulated with sucrose or other sugars (i.e. xylose, fructose, glucose), and variable %S and TS, and unchlorinated or chlorinated flour (pH 4.6), vs. cake color, shape, and dimensions.
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Farinha , Açúcares , Glutens , Amido , TriticumRESUMO
The many differences between cookie- and cracker-baking are discussed and described in terms of the functionality, and functional requirements, of the major biscuit ingredients--flour and sugar. Both types of products are similar in their major ingredients, but different in their formulas and processes. One of the most important and consequential differences between traditional cracker and cookie formulas is sugar (i.e., sucrose) concentration: usually lower than 30% in a typical cracker formula and higher than 30% in a typical cookie formula. Gluten development is facilitated in lower-sugar cracker doughs during mixing and sheeting; this is a critical factor linked to baked-cracker quality. Therefore, soft wheat flours with greater gluten quality and strength are typically preferred for cracker production. In contrast, the concentrated aqueous sugar solutions existing in high-sugar cookie doughs generally act as an antiplasticizer, compared with water alone, so gluten development during dough mixing and starch gelatinization/pasting during baking are delayed or prevented in most cookie systems. Traditional cookies and crackers are low-moisture baked goods, which are desirably made from flours with low water absorption [low water-holding capacity (WHC)], and low levels of damaged starch and water-soluble pentosans (i.e., water-accessible arabinoxylans). Rheological (e.g., alveography) and baking tests are often used to evaluate flour quality for baked-goods applications, but the solvent retention capacity (SRC) method (AACC 56-11) is a better diagnostic tool for predicting the functional contribution of each individual flour functional component, as well as the overall functionality of flours for cookie- and/or cracker-baking.
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Culinária/métodos , Farinha , Tecnologia de Alimentos/métodos , Sacarose , Fenômenos Químicos , Glutens , Temperatura Alta , Polímeros/química , Reologia , Soluções , Solventes/química , Amido/química , Sacarose/química , Triticum/química , Água , Xilanos/químicaRESUMO
This study explores the impact of milling methods on the quality and noodle-making performance by comparing jet-milled (WF-JM) and ultra-centrifugally milled (WF-UM) purple-colored whole wheat flours. WF-JM exhibits smaller starch granules and a fragmented protein matrix attributed to the increased milling pressure. Physicochemical analyses reveal lower moisture and higher damaged starch in WF-JM. Rheological analyses show lower viscosity in the WF-JM blends. The mixograph results reveal weaker dough-mixing stability and strength for WF-JM. Cooked noodles from WF-JM are uneven, in contrast to uniform WF-UM strands. Blending WF-UM enhances noodle quality. Overall, the noodle-making performance for WF-JM was inferior compared to WF-UM, confirming the significantly negative impact of damaged starch and fragmented protein matrix in whole wheat flour than the positive effect of particle size. This study highlights the complex interplay between milling methods, particle size, and physicochemical attributes, providing insights for optimizing whole wheat flour processing and product quality.
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Consumers' interest in healthy products is increasing. However, the production of excellent-quality whole wheat bread (WWB) faces challenges due to the reduced gluten functionality and varied particle sizes of whole wheat flour (WWF). This study aimed to explore the enhancement of purple-colored WWB quality by controlling the particle size of WWF and using dough improvers. Six purple-colored WWFs were obtained using an ultra-centrifugal mill with different sieve openings (0.5 and 1.0 mm) and rotor speeds (6000, 10,000, and 14,000 rpm). The average particle diameter (d50) of the smaller particle size group (S) and the larger particle size group (L) based on the sieve opening ranged from 115 to 258 µm and 294 to 492 µm, respectively. Group S demonstrated higher water absorption, damaged starch, and gluten strength compared to group L. Additionally, group S exhibited a greater bread volume and height compared to group L. Among the tested dough improvers (vital wheat gluten, vitamin C, enzymes, and emulsifiers), vital wheat gluten was the most effective in improving the quality of purple-colored WWB. The improvement effect was significantly greater in group S than in group L. These findings suggest that controlling the particle size of purple-colored WWFs and utilizing dough improvers can result in superior-quality WWB.
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The increasing demand for allergen-free and reduced-allergen foods has led to an investigation into the potential use of O-free wheat, a low-allergy wheat cultivar, in cookie production. This study focused on assessing the gluten composition of O-free flour and comparing its suitability for cookie making in comparison to flours with varying gluten strengths. Several analyses were conducted, including gluten composition, solvent retention capacity (SRC), thermal and pasting properties, dough-mixing characteristics, and cookie-making performance. The gluten composition of O-free flour by SDS-PAGE confirmed the absence of ω-gliadins and the reduced levels of low-molecular-weight glutenins and γ-gliadins. The SRC values of O-free flour fell between the flours with weak and medium gluten strengths. While thermal and pasting properties showed significant differences in sucrose solution but not across flour types, indicating similar starch structures, mixograms displayed distinct variations influenced by both sucrose solution and flour type, highlighting the importance of gluten quality and composition. Cookies made with O-free flour demonstrated similarities to those produced with weak gluten flour, known for their favorable cookie characteristics. This study emphasizes the significant influence of flour gluten composition on cookie-making performance and advocates for the adoption of O-free flour in the development of allergy-friendly cookies.
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This study explored the quality of hypoallergenic wheat ('O-free') developed in Korea and optimized the basic ingredients and processing conditions for making 'O-free' bread using response surface methodology. Water and yeast amounts and mixing and fermentation times were selected as factors, and each factor's tested range was set by a central composite design using Design Experts: water 52-60 g, yeast 1.5-4.5 g, mixing time 2.5-5 min, and fermentation time 50-70 min. Bread height, volume, and firmness were analyzed to determine bread quality. Flour quality analysis showed that 'O-free' flour's gluten strength was weak. 'O-free' flour exhibited inferior bread-making performance compared to representative bread flour. Water and yeast amounts and mixing time, except for fermentation time, affected bread quality significantly. The interaction between yeast and fermentation also affected bread quality significantly. The optimized condition for making bread using 'O-free' flour is 60 g of water, 2.6 g of yeast, 2.5 min of mixing time, and 70.0 min of fermentation time. In conclusion, 'O-free' flour with the changed gluten composition showed poor gluten strength and bread-making performance. However, modifying the formulation of the basic ingredients and processing conditions could significantly improve the production of high-quality hypoallergenic bread.
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This study has investigated the characteristics of dry noodles made with Korean domestic wheat flours using enzyme treatment for reducing water absorption to improve noodle-making performance. The water solvent retention capacity (SRC) values of flour treated with α-amylase and xylanase significantly decreased with increasing enzyme concentrations up to 0.025% (flour weight basis), which confirmed the enzyme effect on reducing the water absorption capacity of damaged starches and arabinoxylans. Enzyme-treated cooked noodles showed changes in textural characteristics, depended on the enzyme type, water amount, and drying method. Applying α-amylase for reducing the water absorption capacity of flour could mitigate the issue of inferior dry-noodle-making performance. Sensory evaluation showed improved preference attributes of cooked noodles with α-amylase treatment. In conclusion, the α-amylase application could improve the quality of dry-noodle made of Korean domestic wheat flour by diminishing the undesirable effect of damaged starch in flour related to noodle quality.
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The formula and processing parameters for gluten-free rice bread were optimized using a factorial design, including a center point. Gum concentration (GC), water amount (WA), mixing time (MT), and fermentation time (FT) were selected as factors, and two levels were used for each factor: 1 and 2% for GC; 80 and 100 g for WA; 5 and 10 min for MT; and 30 and 60 min for FT. The WA and FT were identified as the most significant factors in determining the quality of gluten-free rice bread with tamarind gum. Thus, the optimized formula and processing conditions for maximizing bread volume and minimizing bread firmness were 1% gum, 100 g water, 5 min MT, and 60 min FT. The addition of an anti-staling enzyme reduced the increase in bread firmness and the enthalpy of starch retrogradation, suggesting its potential for successful application in commercially manufactured rice bread with tamarind gum.
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This study was to compare the anticolitis activity of fresh Saengshik (FSS) with heated Saengshik (HSS) with dextran sulfate sodium (DSS)-induced experimental colitis mouse model. Both FSS- and HSS-fed colitis mice exhibited the effects of the increase in the body weight, the alleviation in the colon shortening, and the reduction of the ratio of colon weight to length. However, FSS-fed colitis mice showed a much more significant decrease in DSS-induced tissue damage by mucosal edema and crypt deficiency than did HSS-fed ones. Besides, FSS contributed to decreasing the serum levels of proinflammatory cytokines (tumor necrosis factor-alpha and interleukin-1 beta) and inhibiting the colonic mRNA expressions of these cytokines in colitis tissue of the mice. FSS also resulted in the lower colonic mRNA expression level of inflammation-related inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) in colitis mice than did HSS. Overall results confirmed Saengshik, especially FSS, inhibits more effectively against DSS-induced inflammation reaction in colitis mice than HSS.
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Produtos Biológicos/farmacologia , Produtos Biológicos/uso terapêutico , Colite/induzido quimicamente , Colite/tratamento farmacológico , Sulfato de Dextrana/efeitos adversos , Animais , Peso Corporal , Colite/patologia , Colo/efeitos dos fármacos , Colo/patologia , Ciclo-Oxigenase 2/metabolismo , Citocinas/metabolismo , Modelos Animais de Doenças , Inflamação/metabolismo , Interleucina-1beta/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Óxido Nítrico Sintase Tipo II/metabolismo , RNA Mensageiro/metabolismo , República da Coreia , Fator de Necrose Tumoral alfa/metabolismoRESUMO
For patients with short bowel syndrome who undergo ileostomy, nutritional management is essential to prevent complications associated with a high-output stoma (HOS). We report a practical example of ostomic, medical nutrition therapy provided by an intensive nutritional support team (NST). A 42-year-old male with a history of Crohn's disease visited Seoul National University Hospital for treatment of mechanical ileus. He underwent loop ileostomy after extensive small bowel resection. As his remaining small bowel was only 160 cm in length, the stomal output was about 3,000 mL/day and his body weight fell from 52.4 to 40.3 kg. Given his clinical condition, continuous tube feeding for 24 h was used to promote adaptation of the remnant bowel. Thereafter, an oral diet was initiated and multiple, nutritional educational sessions were offered by dietitians. Constant infusion therapy was prescribed and included in the discharge plan. Two months after discharge, his body weight had increased to 46.6 kg and his hydration status was appropriately maintained. This case suggests that the critical features of medical nutritional therapy for ostomy management are frequent assessments of fluid balance, weight history, and laboratory data and after nutritional interventions.
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The present study explored the applicability of tamarind gum in making gluten-free rice bread. Hydration properties of gums and pasting properties of rice flour with the gums were analyzed with Rapid ViscoAnalyzer. Batter properties and bread quality characteristics of rice bread containing gums were analyzed. Except for guar and xanthan gum, the final viscosity after hydration of other gums and the pasting properties of rice flour with the gums were similar. The batter properties and the quality of rice bread containing tamarind gum were equivalent or superior to those containing other gums. Cross-sections of rice bread showed that addition of tamarind gum and pectin resulted in a fine appearance, but pectin may not be preferred due to its lower pH causing unpleasant sour taste and smell of the rice bread containing the gum. Therefore, tamarind gum can be a useful gum for applying to make gluten-free rice bread.
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The effects of heat and pressure on protein denaturation in soy flour were explored by an experimental design that used pressure (atmospheric to 600 MPa), temperature (room to 90 °C), time (1 to 60 min), and type of aqueous plasticizer (NaCl, sucrose, betaine, and lactobionic acid (LBA)) as factors. When 50% (w/w) soy flour-water paste was high hydrostatic pressure (HHP)-treated for 20 min at 25 °C, the treatment at 200 MPa showed a small effect on denaturation of only the 7S soy globulin, but the treatment at 600 MPa showed a significant effect on denaturation of both the 7S and 11S soy globulins. The treatment at 60 °C showed a less-pronounced effect on denaturation of the 11S globulin, even at 600 MPa, but that at 90 °C showed a similar extent of denaturation of the 11S globulin at 600 MPa to that at 25 °C. Chaotropic 2N NaCl, 50% sucrose-, 50% betaine-, or 50% LBA-water solutions showed protective effects on protein denaturation during HHP treatment at 25 °C. Although LBA enhanced the extent of thermostability of soy protein less than did 2N NaCl, LBA exhibited better stabilization against pressure. The results from DSC analysis demonstrated that thermostable soy proteins were not always barostable.
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Varredura Diferencial de Calorimetria/métodos , Farinha/análise , Farinha/intoxicação , Glycine max/química , Proteínas de Soja/química , Globulinas/química , Temperatura Alta , Pressão Hidrostática , Pressão , Desnaturação Proteica , Cloreto de Sódio/análise , Sacarose/análiseRESUMO
Many individuals with short bowel syndrome (SBS) require long-term parenteral nutrition (PN) to maintain adequate nutritional status. Herein, we report a successful intestinal adaptation of a patient with SBS through 13 times intensive nutritional support team (NST) managements. A thirty-five-year-old woman who could not eat due to intestinal discontinuity visited Seoul National University Hospital for reconstruction of the bowel. She received laparoscopic Roux-en-Y gastric bypass (RYGB) due to morbid obesity in Jan 2013 at a certain hospital and successfully reduced her weight from 110 kg to 68 kg. However, after a delivery of the second baby by cesarean section in Jul 2016, most of small bowel was herniated through Peterson's defect, and emergent massive small bowel resection was performed. Thereafter, she visited our hospital for the purpose of intestinal reconstruction. In Sep 2016, she received side-to-side gastrogastrostomy and revision of double barrel enterostomy. The remaining small bowel included whole duodenum, 30 cm of proximal jejunum, and 10 cm of terminal ileum. Pylorus and ileocecal valves were intact. The patient given only PN after surgery was provided rice-based soft fluid diet after 10 day of operation. Through intensive nutritional management care, she could start solid meals, and finally stop the PN and eat only orally at 45 days postoperatively. Three nutritional interventions were conducted over 2 months after the patient was discharged. She did not require PN during this period, and maintained her weight within the normal weight range. Similar interventions could be used for other patients with malabsorption problems similar to SBS.
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Diabetes in pregnancy is associated with higher rates of miscarriage, pre-eclampsia, preterm labor, and fetal malformation. To prevent these obstetric and perinatal complications, women with diabetes have to control levels of blood sugar, both prior to and during pregnancy. Thus, individualized medical nutrition therapy for each stage of pregnancy is essential. We provided in-depth medical nutrition therapy to a 38-year-old pregnant woman with diabetes at all stages of pregnancy up to delivery. She underwent radiation therapy after surgery for breast cancer and was diagnosed with diabetes. At the time of diagnosis, her glycated hemoglobin level was 8.3% and she was planning her pregnancy. She started taking an oral hypoglycemic agent and received education regarding the management of diabetes and preconception care. She became pregnant while maintaining a glycated hemoglobin level of less than 6%. We provided education program for diabetes management during the pregnancy, together with insulin therapy. She experienced weight loss and ketones were detected; furthermore, she was taking in less than the recommended amount of foods for the regulation of blood sugar levels. By giving emotional support, we continued the counseling and achieved not only glycemic control but also instilled an appreciation of the importance of appropriate weight gain and coping with difficulties. Through careful diabetes management, the woman had a successful outcome for her pregnancy, other than entering preterm labor at 34 weeks. This study implicated that the important things in medical nutrition therapy for pregnant women with diabetes are frequent follow-up care and emotional approach through the pregnancy process.
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Impact of intestinal microbes on obesity and health is a new topic recently started to get attention. Comparing to the global concern and research trends, there are few research on the association between intestinal bacteria and life style disease in Korean. One voluntary case (female) was reported to show the change in gut microbiota and weight by diet intervention. She was overweight (BMI 23.2 kg/m(2)) and has abnormal liver function, and the causes of overweight were frequent drinking and meat consumption at the late evening hours. For 47 days, she was administered an improved diet on breakfast and dinner with reduction of meat consumption frequency by 50%. Alcohol consumption was reduced to once a week. As a result, she lost 3 kilograms of body weight. Her fecal sample was collected before and after the intervention, and gut microbiota change was compared using a high-throughput sequencing technique. After diet correction, the shift of gut microbiota was clearly observed with decreased proportion of Firmicutes (from 75.7% to 47.3% in total microbiota) but increased proportion of Bacteroidetes upto 47.7%. After incorporating the diet intervention, it is meaningful to confirm the changes in dominant gut microbiota and weight loss.