• Journal of Nutrition and Health
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• v.42 no.1
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• pp.38-47
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• 2009

The purpose of the study was to develop an eating habit checklist for screening elementary school children at risk of inadequate micronutrient intake. Eating habits, food intake, and anthropometric data were collected from 142 children (80 boys and 62 girls) in the $4^{th}$ to $6^{th}$ grades of elementary schools. Percentage of Recommended Intakes (RI) and Mean Adequacy Ratio (MAR) of six micronutrients; vitamin A, riboflavin, vitamin C, calcium, iron, zinc, and the number of nutrients the children consumed below EAR among the six nutrients were used as indices to detect the risk of inadequate micronutrient intake. Pearson correlation coefficients were calculated between eating habit scores and inadequate micronutrient intake indices in order to select questions included in the checklist. Meal frequency, enough time for breakfast, regularity of dinner, appetite, eating frequencies of Kimchi, milk, fruits and beans showed significant correlations with indices of inadequate micronutrient intake. Stepwise regression analysis was performed to give each item a different weight by prediction strength. To determine the cut-off point of the test score, sensitivity, specificity, and positive predictive values were calculated. The 8-item checklist with test results from 0 to 12 points was developed, and those with equal or higher than 6 points were diagnosed as high-risk group of inadequate micronutrient intake, and those with 4 or 5 points were diagnosed as moderate-risk group. Among our subjects 14.1% was diagnosed as high-risk group, and 30.3% as moderate-risk group. The proportions of the subjects who consumed below EAR of all micronutrients but vitamin C were highest in the high-risk group, and there were significant differences in the proportions of the subjects with intake below EAR of all micronutrients except vitamin B6 among the three groups. This checklist will provide a useful screening tool to identify children at risk of inadequate micronutrient intake.

• Journal of Nutrition and Health
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• v.42 no.2
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• pp.119-127
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• 2009

Malnutrition of hospitalized patients can adversely affect clinical outcomes and cost. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those possess practical pitfalls of requiring much time and labor to administer and may not be highly applicable to a Korean population. This study sought to develop and evaluate a Nutrition Risk Screening Tool (NRST) which is simple and quick to administer and widely applicable to Korean hospitalized patients with various diseases. The study was also designed to generate a screening tool predictable of various clinical outcomes and to validate it against the Nutritional Risk Screening 2002 (NRS 2002). Electronic medical records of 424 patients hospitalized at a general hospital in Seoul during a 14-month period were abstracted for anthropometric, medical, biochemical, and clinical outcome variables. The study employed a 4-step process consisting of selecting NRST components, searching a scoring scheme, validating against a reference tool, and confirming clinical outcome predictability. NRST components were selected by stepwise multiple regression analysis of each clinical outcome (i.e., hospitalization period, complication, disease progress, and death) on several readily available patient characteristics. Age and serum levels of albumin, hematocrit (Hct), and total lymphocyte count (TLC) remained in the last model for any of 4 dependent variables were decided as NRST components. Odds ratios of malnutrition risk based on NRS 2002 according to levels of the selected components were utilized to frame a scoring scheme of NRST. A NRST score higher than 3.5 was set as a cut-off score for malnutrition risk based on sensitivity and specificity levels against NRS 2002. Lastly differences in clinical outcomes by patients' NRST results were examined. The results showed that the NRST can significantly predict the in-hospital clinical outcomes. It is concluded that the NRST can be useful to simply and quickly screen patients at high-nutritional risk in relation to prospective clinical outcomes.

• Korean Journal of Community Nutrition
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• v.19 no.6
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• pp.527-536
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• 2014

Objectives: The aim of this study was to assess how nutrient intakes are related to risk factors for metabolic syndrome according to dietary patterns in the middle-aged adults. Methods: The subjects (n = 187; 47 men, 140 women) consisted of middle-aged adults over 30 years old in Ilsan area. The metabolic syndrome was diagnosed according to the data collected from each subject, including anthropometric measurements and blood analyses. The dietary patterns were derived from the average of two-day dietary intake data. Results: Factor analysis identified three major dietary patterns which were "Meats and alcohol", "Mixed grains, vegetables and fruits", and "Rice, Kimchi and fish & shellfish". The daily intakes of energy, protein, and sodium increased across quartiles of "Meats and alcohol" pattern scores (p < 0.05), whereas the intakes of carbohydrates, potassium, calcium, and fiber increased across quartiles of "Mixed grains, vegetables and fruits" pattern scores (p < 0.001). The "Meats and alcohol" pattern scores were positively correlated with protein and sodium intakes but inversely correlated with carbohydrates, fiber and potassium intakes which were adjusted for age, sex and energy (p < 0.05). The highest quartile pattern score of "Meats and alcohol" pattern had elevated odds ratio of abdominal obesity and metabolic syndrome (p < 0.05). The risk of hypertriglyceridemia decreased in the highest quartile of "Mixed grains, vegetables and fruits" pattern (OR 0.35, 95% CI 0.12-1.00). Conclusions: Our results suggested that reducing the consumption of meat and alcohol along with increasing fruits, vegetables and mixed grains would be helpful for preventing the metabolic syndrome and chronic diseases.

• Journal of radiological science and technology
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• v.32 no.3
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• pp.285-291
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• 2009

The aim of the present study was undertaken to investigate the association between diagnostic indices of metabolic syndrome(MetS) with carotid intima-media thickness using ultrasonography. The participants in the study were 315 male employees without carotid atherosclerosis and other cardiovascular disease. This study was approved by the Institutional Review Board of Occupational Safety and Health Research Institute. Written informed consent for the participants in this study was obtained from all individuals. Anthropometric parameters and biochemical characteristics were done using each specific equipments and the NCEP-ATP III criteria were used to define MetS. They were examined by B-mode ultrasound to measure the carotid intima-media thickness(carotid IMT) at the near and far walls of common carotid and bifurcation(bulb). The mean carotid IMT was $0.739{\pm}0.137\;mm$ and it's thickness significantly increased with the increase in age. Also, amounts of systolic and diastolic blood pressure, triglyceride and fasting glucose were significantly increased with the increase in age. Carotid IMT were significantly correlated with BMI(r=0.170, p=0.004), systolic(r=0.148, p=0.011) and diastolic blood pressure(r=0.123, p=0.036) and HDL-cholesterol(r=-0.164, p=0.005). On multiple logistic regression analysis for the diagnostic indices of MetS, carotid IMT were significantly associated with blood pressure(OR=4.220, p<0.01) and MetS(OR=1.301, p<0.05). The results indicate that blood pressure and MetS are important risk factors for carotid atherosclerosis.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• Journal of the Korean Society of Food Science and Nutrition
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• v.46 no.7
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• pp.868-875
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• 2017

The aim of the present study was to investigate antioxidant nutrient intake and risk of metabolic syndrome based on stress level in rural Korean women. Subject were participants from the Multi-Rural Communities Cohort Study, which was a part of the Korean Genome and Epidemiology Study. According to scores of the Psychosocial Well-Being Index Short-Form, a total of 10,111 subjects were classified into 'low stress group (n=8,015)' from 0 to 26 points and 'high stress group (n=2,096)' above 27 points. Data were collected using self-administered questionnaires, anthropometric measurements, and blood chemical analysis. Dietary nutrient consumption was assessed by a semi-quantitative food frequency questionnaire. High stress group showed lower intake of antioxidant nutrients, such as vitamin A, vitamin C, vitamin E, folate, zinc, and carotene compared to the low stress group. Intake of fruits and vegetable was lower in the high stress group compared to the low stress group. Subjects with high stress showed higher risk of hypertension [odd ratio (OR), 95% confidence interval (CI)=1.226 (1.112~1.351)] and hypertriglyceridemia [OR, 95% CI=1.227 (1.110~1.356)] than subjects with low stress. High stress group had a significantly greater odds ratio for metabolic syndrome compared with the low stress group [OR, 95% CI=1.216 (1.101~1.342]). Thus, the present study suggests that high stress might be associated with low intake of antioxidant nutrients and high risk of metabolic syndrome in rural Korean women.

• Journal of Sasang Constitutional Medicine
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• v.15 no.1
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• pp.60-71
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• 2003

The purpose of this study was to investigate the effects of medical nutrition therapy(MNT) on plasma lipid levels of hyperlipidemic patients with apo E3 genotype according to Sasang Constitutions. From March to July, 2001, the 33 hyperlipidemic patients admitted to K University Medical Center were studied. The study subjects were classified according to their Sasang constitutions by QSCC II questionnaire which have been used at K University Oriental Medical Center. The anthropometric assessments, blood analysis, and apo E genetic typing were carried out. Nutrient intake was determined by food record method of food taken during two weekdays and one weekend. The MNT including the instruction for hypolipidemic and hypocholesterolemic diet (step l diet) was performed for 12 weeks. The results are as follow; (1) The mean age of hyperlipidemic patients was $49.91{\pm}8.48$ years. (2) The distributions of Sasang Constitution were 60.6% of Tae-eum, 21.2% of So-yang, and 18.2% of So-eum. The distributions of apo E genotype were 6.5% of apo E2/3, 78.8% of apo E 3/3, and 15.2% of apo E 3/4. (3) The nutrient consumption of the apo E3 subjects before the MNT showed lower calorie, iron, calcium, and vitamin B2 intakes than the RDAs for each nutrients with no significant differences among the constitutions. After 12-week of MNT, only the fat consumption was decreased in the Tae-eum group. The MNT did not change the pattern of food intake. (4) The plasma level of triglyceride, total cholesterol, and LDL-C were not changed after MNT in the three constitutional groups. The level of HDL-C was significantly increased significantly in Tae-eum and So-yang group and the level of homocystein was lowered in Tae-eum group after MNT. It could be concluded that the 12-weeks MNT with hypolipidemic and hypocholesterolemic diet did not change the level of total cholesterol, triglyceride, and LDL-C effectively regardless of Sasang constitutions even though the subjects' dietary intake was improved by MNT.

• Journal of the Korean Society of Food Science and Nutrition
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• v.34 no.1
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• pp.42-56
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• 2005

Hyperlipidemia is one of the risk factors for coronary artery disease. Despite of epidemiological evidence that tea consumption is associated with the reduced risk of coronary heart disease, experimental studies designed to show that drinking tea affects blood lipid concentration or oxidative stress have been unsuccessful. The purpose of this study was to investigate whether functional tea (three servings/day) supplement with medical nutrition therapy (MNT) lead to a beneficial outcomes in mildly hyperlipidemic adults. From February to October, 2003, the 43 hyperlipidemic (23 men, 20 women) subjects (total cholesterol$\geq$200 mg/dL or triglyceride$\geq$150 mg/dL) admitted to K Medical Center were studied. Subjects were randomly divided into 3 groups; placebo tea (PT), half dose of functional tea (HFT), full dose of functional tea (FFT). During 12 weeks of study period, the subjects were given placebo or functional tea daily with MNT. Anthropometric measurements, blood chemical analysis including lipid levels, total superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels, and dietary assessment were carried out at the beginning and end of experiment. The effects of functional tea were compared with the placebo in randomized clinical trial study. The placebo was prepared to match with the functional tea in color and taste. After the 12 weeks of MNT, the subjects had regular and balanced meal pattern. Consumption of foods high in cholesterol and saturated fat, salty foods, fried foods, and instant foods decreased significantly in all three groups (p<0.05). Intake of energy and cholesterol also decreased (p<0.05). Drinking three servings per day (390 mL/day) of functional tea significantly reduced the levels of blood triglyceride (HFT, 42.5%; FFT, 29.4%), total cholesterol (HFT, 8.5%; FFT, 13.7%), and atherogenic index (HFT, 14.6%; FFT, 21.7%). Whereas no changes were found in the LDL-, HDL-cholesterollevels, and LDL/HDL ratio. Plasma homocysteine (Hcy) concentration decreased significantly (p<0.05) in functional tea groups (HFT, 14.9%; FFT, 14.1%). SOD increased significantly (p<0.05) in HFT (8.3%). GSH-Px increased significantly (p<0.05) in FFT (12.8%). In conclusion, the MNT improved the dietary habits, in addition, functional tea supplement decreased blood lipid levels and Hcy, and increased SOD and GSH-Px levels. These results indicate that functional tea consumption may decrease the risk of cardiovascular disease via improving blood lipid levels and antioxidant status.

• Journal of Preventive Medicine and Public Health
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• v.30 no.1 s.56
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• pp.45-59
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• 1997

It has been known that there is a tracking phenomenon in the level of serum lipids. However, no study has been performed to examine the change and tracking of serum lipids in Korean adolescents. The purpose of this study is to examine the changes of serum lipids in Korean adolescents from 12 to 16 years of age, and to examine whether or not there is a tracking phenomenon in serum lipids level during the period. In 1992 serum lipids(total cholesterol(TC), triglyceride(TG), LDL cholesterol(LDL-C), HDL cholesterol(HDL-C)) were measured in 318 males, 365 females who were 12 years of age in Kangwha county, Korea. These participants have been followed up to 1996 and serum lipids level were examined in 1994 and 1996. Among the participants 162 males and 147 females completed all three examinations in fasting state. To examine the effect of eliminating adolescents with incomplete data, we compared serum lipids, blood pressure and anthropometric measures at baseline between adolescents with complete follow-up and adolescents who were withdrawn. To examine the change of serum lipids we compared mean values of serum lipids according to age in males and females. Repeated analysis of variance was used to test the change according to age. We used three methods to examine the existence of tracking. First, we analyzed the trends in serum lipids over 4-year period within quartile groups formed on the basis of the first-year serum lipids level to see whether or not the relative ranking of the mean serum lipids among the quartile groups remained in the same group for 4-year period. Second, we quantified the degree of tracking by calculating Spearman's rank correlation coefficient between every tests. Third, the persistence extreme quartile method was used. This method divides the population into quartile groups according to the initial level of blood lipids and then calculates the percent of the subjects who stayed in the same group at follow-up measurement. The decreases in levels were noted during 4 years for TC, LDL-C, primarily for boys. The level of HDL-C decreased between baseline and first follow-up for both sexes. Tracking, as measured by both correlation coefficients and persistence extreme quartiles, was evident for all of the lipids. The correlation coefficients of TC between baseline and 4 years later in boys and girls were 0.55 and 0.68, respectively. And the corresponding values for HDL-C were 0.58 and 0.69. More than 50% of adolescents who belonged to the highest quartile group in TC, HDL-C and LDL-C at the baseline were remained at the same group at the examination performed 2 years later for both sexes. The probabilities of remaining at the same group were more than 35% when examined 4 years later. The tracking phenomenon of TG was less evident compared with the other lipids. Percents of girls who stayed at the same group 2 years later and 4 years later were 42.9% and 25.7%, respectively. It was evident that serum lipid levels tracked in Korean adolescents. Researches with longer follow-up would be needed in the future to investigate the long-term change of lipids from adolescents to adults.