It is well known that malnutrition is a predictor of mortality in hemodialysis patients. The number of diabetic nephropathy patients is increasing rapidly. This study aimed to investigate nutritional status and nutrient intake according to the presence of diabetes among hemodialysis patients. The nutritional intake and general characteristics of outpatients at Ajou University Hospital (24 with diabetes and 30 without diabetes) were investigated between July and September 2015. Patients' general data were collected, and nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA) was evaluated. Nutrient intakes were assessed according to 3-day food records. There was no significant difference regarding body weight between the two groups. However, the non-diabetic group showed a better nutritional status by Patient-Generated Subjective Global Assessment (PG-SGA) ($5.2{\pm}4.4$ vs. $8.0{\pm}4.3$ score, non-diabetics vs. diabetics, P<0.05). There was no difference in daily calorie intake ($1,473.9{\pm}370.5$ vs. $1,503.8{\pm}397.5kcal$) and protein intake ($60.3{\pm}19.7$ vs. $65.6{\pm}20.5g$) in those with diabetes. Intakes of vegetables protein, sodium, potassium, vitamin C, folic acid and fiber were significantly higher in the diabetic group compared to those of the non-diabetic group. There was no difference in daily nutrient intake between the hemodialysis weekday and weekend groups. The non-diabetic group had higher calorie and sodium intakes per meal in the hemodialysis weekday group, but the difference was not significant. Based on these results, intervention should be performed to improve nutritional status in consideration of diabetes and dietary patterns.

The purpose of this study was to determine the optimal recipe of rice cookies with two different amounts of Stevia rebaudiana leaf and grape seed oil, using a central composite design (CCD). In addition, mixing conditions of rice cookies were optimized by sensory evaluation and mechanical and physicochemical analysis using response surface methodology (RSM). RSM was used to obtain 10 experimental points (including two replicates of Stevia rebaudiana leaf and Grape seed oil), and the formulation of Stevia rebaudiana leaf added rice cookies was optimized using rheology. The results of mechanical and physicochemical analysis showed significant values for lightness, redness, yellowness, hardness, spread factor, loss rate, leavening rate, sweetness, moisture, pH, and density (P<0.001), results of the sensory evaluation showed significant values for color, flavor, taste, texture, appearance, and overall quality (P<0.05). As a results, optimal sensory ratio was found to be 1.98 g of Stevia rebaudiana leaf and 37.94 g of Grape seed oil.

Maintaining adequate fluid balance is essential for all biological functions in the body. The purpose of this study was to evaluate vulnerability to dehydration by analyzing age, gender, body mass index (BMI), and blood lipid parameters in health checkup examinees who visited Sahmyook Seoul Hospital for comprehensive health checkups. In a binary logistic regression analysis stratified by age and body mass index the odd ratio for dehydration was as high as 3.317 (95% CI: 1.666~6.605) in the 50s age group, 4.224 (95% CI: 2.038~ 8.755) in the 60s age group, and 4.610 (95% CI: 1.943~10.940) in the above 70s age group compared to 20s reference age group. Aged females showed greater vulnerability to dehydration with significance levels of P<0.01 and P<0.001. Compared to a normal weight (BMI: 18.5~22.9) the odd ratio was higher in males with an under weight (BMI: less than 18.5) (5.130 [95% CI: 1.631~16.132]) and in females with an over weight (BMI: 23.0~24.9) (1.500 [95% CI: 1.065~2.114]). In conclusion, our results showed that vulnerability to dehydration increased with age and was higher in under weight males and over weight females than that in normal weight.

Insufficient vitamin D intake is a major health problem around the world. Recently, many studies have suggested that vitamin D intake may influence insulin resistance. However, little is known about the association between vitamin D and diabetes mellitus. The aim of this study was to investigate the association between serum 25-hydroxy vitamin D (25(OH)D) levels and diabetes mellitus in Korean adults. This study was a cross-sectional analysis of 3,686 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) 2013~2014 aged 19 years and higher. The results showed that the mean serum 25-hydroxy vitamin D (25(OH)D) level in Korean adults was 16.77 ng/mL, and 74.2% of them had an insufficient serum 25-hydroxy vitamin D (25(OH)D) level (below 20 ng/mL). In normal and pre-diabetic groups, the serum 25-hydroxy vitamin D (25(OH)D) level significantly increased with age (P<0.001), but there was no significant difference relative to age in the diabetic group. Low vitamin D levels (25-hydroxy vitamin D < 10 ng/mL) were associated with increased fasting blood glucose levels, compared with optimal vitamin D levels (25-hydroxy vitamin D > 30 ng/mL), after adjusting for variables that may affect fasting blood glucose, but this result was not significant. In conclusion, although no significant association was observed between diabetes prevalence and vitamin D levels in this study, further studies are needed because the effect of vitamin D on diabetes remains controversial. This nutrient plays a crucial role in the body, and levels are insufficient in the Korean population.

Anemia, defined as a reduction in the hemoglobin concentration of blood, is common in diabetes mellitus (DM) patients, can be potentially caused by diabetes complications such as nephropathy. Recent research suggests that diabetes mellitus (DM) itself may be a major risk factor of anemia. However, there are few Korean studies on the relationship between diabetes mellitus (DM) and anemia. This study was performed to investigate the association between anemia and diabetes mellitus (DM) in Korean adults. A total of 10,151 Korean adults over aged 19 years (4,422 male, 5,729 female) were selected from the participants of the Korean National Health and Nutrition Examination Survey VI (KNHANES VI). Korean adults with anemia had a higher prevalence of diabetes mellitus (DM) than the normal adults (11.4% vs. 30.4% in male, 8.8% vs. 9.4% in female). The unadjusted odds ratio (OR) for anemia was greater in adults with DM than in normal male (OR=3.28; 95% CI: 2.27~4.73). After adjusting for other risk factors including age, education, family income, smoking, drinking, and menstrual status, anemia and diabetes were not associated (OR=1.33; 95% CI: 0.84~2.09). Similarly, there was no association between anemia and diabetes in female. In conclusion, this study shows that the prevalence of anemia is similar in diabetic and non-diabetic Korean adults after adjusting for multiple risk factors. Further research is required to elucidate the mechanism of anemia caused as a consequence of diabetes mellitus (DM).

This study was conducted to develop a nutritional education program based on the health belief model to improve nutritional status among Vietnamese female marriage immigrants in Korea. The education program was developed through literature review, focus group interviews, expert consultation, and pilot tests. Based on theoretical requirements and needs of beneficiaries, the education program was consisted of 16 sessions with nine topics: 'how to evaluate own dietary habits and nutritional status', 'health problems according to dietary habits and nutritional status', 'understanding six food groups', 'healthy eating plan', 'understanding food cultures of Korea and Vietnam', 'traditional and seasonal Korean foods', 'how to cook Korean food', 'nutrition management of family members', and 'practicing of healthy dietary life'. Program contents in each session consisted of activities that could induce outcome and value expectations, self-efficacy, perceived benefits, and barriers and cues to actions regarding dietary behavior. This nutritional education program based on the health belief model would be helpful to implement healthy diet behaviors in Vietnamese marriage immigrants and their families. Extension of these nutritional education programs to health centers and multicultural family support centers would improve the current poor nutrition status of Vietnamese marriage immigrant women. Further studies are needed to validate our program.

The purposes of this study were to assess energy expenditure of eight walking activities in normal weight and overweight or obese high school students and to evaluate the accuracy of two accelerometers worn on the ankle and waist. Thirty-five (male 17, female 18) healthy high school students participated in this study. They were classified into normal weight (n=21) and overweight or obese (n=14) groups. The subjects completed five treadmill walking activities (TW2.4, TW3.2, TW4.0, TW4.8, TW5.6), followed by three self-selected hallway walking activities (walk as if walking and talking with a friend: HWL, walk as if hurrying across the street at a cross-walk: HWB, walk as fast as you can but do not run: HWF). Energy expenditure and metabolic equivalents (METs) were measured using a portable indirect calorimeter, and predicted energy expenditures and METs were derived from two accelerometers placed on the ankle and waist. Measured energy expenditures per body weight (kg) of eight walking activities were significantly higher in the normal weight group than in the obese group and significantly higher in female than male. The ankle accelerometer overestimated energy expenditures and METs (bias 49.4~105.5%), whereas the waist accelerometer underestimated energy expenditures and METs (bias -30.3~-85.8). Except for HWF (fast) activity, METs of seven activities were moderate intensity based on Compendium METs intensity categories. HWF (fast) activity was vigorous intensity. METs from the ankle accelerometer were vigorous intensity except TW2.4 activity (moderate intensity). METs from the waist accelerometer were low intensity (TW2.4, TW3.2, TW4.0, TW4.8, HWL) and moderate intensity (TW5.6, HWB, HWF). Physical activity guidelines were developed based on measured physical activity level of high school students. Further studies should investigate the effects of body composition in larger subjects.

A menu labeling initiative is a lawful regulation with an aim to promote public health by providing customers the right to make informed menu choices. As college years are a critical period in which students form dietary habits, which are sustained throughout their lives, provision of nutritional information at the university dining services is important to students' health and life. Due to the lack of research on menu labeling at university dining services, the purpose of this study was to examine college students' attitudes and motivations toward menu labeling at university dining services, as well as their use intentions toward nutrition information at university dining services. Data were collected from a self-administered survey distributed to 484 college students who had experienced university dining services. Motivations of university students toward menu labeling were categorized into 'knowledge pursuit' and 'health pursuit'. Students' attitudes toward menu labeling had a positive effect on their intention to use menu labeling at university dining services. The findings of the study indicated that female students, or those who frequently used nutrition information, tended to have higher attitudes, motivations, and use intentions toward nutrition information. The study results suggest that facilitation of healthy eating environments at university dining services by offering nutrition information, and nutrition and health education is necessary.

The purpose of this study was to examine restaurant customers' use of menu labeling and their perception of menu labeling attributes. Further, the study investigated relations of menu labeling use behavior, and perception of menu labeling attributes with behavioral intentions toward menu labeling. Using a self-administered survey conducted for 2 weeks from the 2nd week of October, 2015, data were collected from restaurant customers who were exposed to menu labeling over 3 months at the time of the survey. A total of 426 respondents completed the survey. Respondents were asked about use of menu labeling, usefulness, ease of understanding, accuracy, and demographic information. There was a difference in menu labeling use behavior according to age, whereas respondents aged 50 years or over showed significantly higher use of menu labeling than those in 20s (P<0.001). Perceptions of menu labeling attributes positively affected behavioral intentions towards menu labeling. While all three menu labeling attributes, 'usefulness', 'ease of understanding', and 'accuracy', were positive factors for behavioral intentions towards menu labeling, usefulness was the biggest attribute explaining behavioral intentions (P<0.001). The study findings offer implications that can be applied to academics, the foodservice industry, and government in an attempt to nurture a healthy eating environment through provision of nutritional information at restaurants.