Achievement of the nutrition minimum service standard at Manokwari District Hospital in West PapuaBackground: There are three indicators of nutrition services that are regulated in the hospital Minimum Service Standards (MSS), namely the timeliness of food distribution, patient's plate waste, and the accuracy of the patient’s diet. The achievement of minimum service standards as the indicator of quality for nutrition services at Manokwari District Hospital has not yet been known.Objective: To find out the implementation of minimum service standards for nutrition services,i.e. the promptness of food distribution, the proportion of plate waste, and accuracy of the patient’s diet at Manokwari District Hospital. Methods: This was a mixed-method study conducted at Manokwari District Hospital, West Papua, from January until March of 2018. A quantitative approach with patient samples was carried out to quantify the achievement of MSS for nutrition service. Punctuality of food distribution and accuracy of the diet was measured using observational sheets while the patient’s plate waste was determined using food weighing. A qualitative approach through in-depth interviews with patients, nutritionists, cooks, food service workers, and nurses was performed to explore the influencing factors. Results: The percentage of timeliness of patient food distribution was only 37.1%, the waste of patients’ food reached 34.5% and the accuracy of the patient's diet was only 83.87%. These were affected by poor human resource management, inadequate hospital facilities, and foods brought from outside of the hospital. Conclusions: Promptness of patient’s food distribution, plate waste and diet accuracy in Manokwari District Hospital has not reached the minimum service standard for nutrition service.

The increasing prevalence of obesity and sedentary lifestyles has led to a higher incidence of metabolic syndrome (MetS) worldwide as well as in Taiwan. Middle-aged women are at a greater risk of MetS, type 2 diabetes, and cardiovascular disease than men because they have more subcutaneous fat and larger waist circumferences compared with men with equal visceral fat levels. In this study, we investigated the effects of calorie restriction (CR) and fish oil supplementation (CRF) on middle-aged Taiwanese women with MetS. An open-label, parallel-arm, controlled trial was conducted for 12 weeks. A total of 75 eligible participants were randomly assigned to the CR or CRF group. Both the dietary intervention groups were further divided into two age groups: ≤45 and >45 years. Changes in MetS severity, inflammatory status, iron status, and red blood cell fatty acid profile were evaluated. A total of 71 participants completed the trial. Both dietary interventions significantly ameliorated MetS and improved the participants' inflammatory status. CR significantly increased the total iron-binding capacity (TIBC) whereas CRF increased hepcidin levels in women aged >45 years. Furthermore, CRF significantly increased the n-6/n-3 and arachidonic acid/docosahexaenoic acid ratios. Both interventions improved the anthropometric and MetS characteristics, including body weight, blood glucose and triglyceride levels, and the score of the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity check index. In conclusion, the 12-week dietary interventions improved the abnormal metabolic status of middle-aged obese women. CRF was demonstrated to be more effective in ameliorating postprandial glucose level and TIBC in women aged >45 years than in those aged ≤45 years.

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The increasing prevalence of obesity and sedentary lifestyles has led to an increased incidence of metabolic syndrome (MetS) worldwide. In Taiwan, middle-aged women are at a greater risk of MetS, type 2 diabetes, and cardiovascular disease than men are because they have more subcutaneous fat and larger waist circumferences compared to men with equal visceral fat levels. This study investigated the effects of calorie restriction supplemented with fish oil (CRF) in middle-aged women with MetS. For 12 weeks, 75 eligible participants were randomly assigned either calorie restriction (CR) or CRF. Both dietary intervention groups were further divided into two age groups: ≤45 and >45 years. The changes in MetS severity, inflammatory status, iron status, and red blood cell fatty acid profile were evaluated. Seventy-one participants completed the trial. Both dietary interventions significantly ameliorated MetS and improved the participants’ inflammatory status. CR significantly increased total iron binding capacity, whereas CRF increased hepcidin levels. Furthermore, CRF significantly increased the n-6/n-3 and arachidonic acid/docosahexaenoic acid ratios. In conclusion, CR and CRF improved the anthropometric and MetS characteristics of early-middle aged women, including body weight, blood glucose levels, triglyceride levels, as well as the scores for the homeostasis model assessment of insulin resistance and quantitative insulin sensitivity cheque index. Dietary intervention was more effective in >45-year-old women than ≤45-year-old women.