• Nutrition Research and Practice
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• v.13 no.3
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• pp.263-267
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• 2019

BACKGROUD/OBJECTIVES: Obesity is globally a major public health issue. Evidence suggests that elevated ferritin levels are associated with obesity, dyslipidemia, insulin resistance, and metabolic syndrome. This study was undertaken to examine the relationship between the serum ferritin level and depression in Korean male adults with respect to classification of the prevailing obesity. SUBJECTS/METHODS: This was a case-control study; subjects were classified into obese group (${\geq}25.0kg/m^2$, 28 subjects) and normal group ($18.5-22.9kg/m^2$, 27 subjects). A survey was conducted to assess the depression levels as per the guidelines suggested by the Center program for Epidemiological Studies-Depression (CES-D). Blood was collected from each group for assessing biomarkers, and isolated plasma was evaluated for fasting glucose, insulin, quantitative insulin sensitivity check index, and ferritin levels. Data were analyzed, and groups were compared with respect to Body Mass Index (BMI), depression scale and biomarkers. RESULTS: The average depression score of the obesity group was 16.86, which was higher than the normal group (12.56). Subjects scoring more than 16 points comprised 53.6% of the population in the obese group, which was more than double that in the normal group, as assessed by the CES-D program. Furthermore, the serum ferritin level of the obesity group was 207.12 ng/mL, which was higher than that of the normal group (132.66 ng/mL). Lastly, the BMI appeared to be significantly correlated with both depression (r = 0.320, P = 0.017) and elevated ferritin levels (r = 0.352, P = 0.008). CONCLUSION: This study provides evidence of existing correlation between ferritin and depression with obesity.

• Journal of Korean Academy of Nursing
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• v.52 no.2
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• pp.228-243
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• 2022

Purpose: The study aimed to translate the Couple Satisfaction Index (CSI 32) into Korean, to evaluate the reliability and validity of CSI 32 and short-form (CSI 16, 4) in the Korean context, and to determine a cut-off score for Korean couples. Methods: Korean Versions of the Couple Satisfaction Index (K-CSI) 32 was translated, back-translated, and reviewed by five bilingual experts. Confirmatory factor analysis (CFA) was conducted with data from a sample of 218 couples (N = 436) to test construct validity. Validity and reliability were evaluated. The receiver's operating characteristics curve analysis was used to obtain the cut-off score. Results: The construct validities of K-CSI 32, 16, and 4 were verified using one-factor structures. The results of CFA showed a slightly better fit for K-CSI 16 and 4 than for K-CSI 32. Convergent validity was supported by significant positive correlations of K-CSI with Kansas Marital Satisfaction Scale, Dyadic Adjustment Scale, and Family Relationship Assessment Scale. Moreover, the significant differences in K-CSI between normal and depressive group demonstrated known-group validity. Cut-off scores of 105.5 on K-CSI 32, 50.25 on K-CSI 16, and 13.25 on K-CSI 4 were validated to identify distressed couple relationships. Conclusion: For clinical practice, the reliable and valid K-CSI 32 has the potential to measure changes in couple satisfaction after couple therapy or interventions. Applying K-CSI 32 may facilitate research on couple and family relationships in nursing and contribute to the discussion on the role of couple satisfaction in mental health.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.147-159
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• 2022

BACKGROUND/OBJECTIVES: Complementary and alternative medicines can be used to alleviate climacteric symptoms that significantly affect the quality of life of postmenopausal women. Isoflavones are the most common plant-based therapies for postmenopausal changes, but the results of previous studies have been controversial. MATERIALS/METHODS: To investigate whether isoflavones would affect menopausal symptoms as well as ovarian hormones, we performed a systematic review and meta-analysis. The PubMed and EMBASE databases were used to perform the systematic search. Included studies were limited to randomized controlled trials (RCTs) assessing the impact of isoflavone supplementation on menopausal symptoms. RESULTS: Eleven studies were included for the final quantitative assessment. Isoflavone intervention was varied between 49.3 and 135 mg of isoflavones per day for 12 wk-2 yrs. The meta-analysis showed that supplementation of isoflavones significantly increased the estradiol levels (standardized mean difference [SMD] = 0.615, P = 0.035) and Kupperman index (SMD = 3.121, P = 0.003) but had no significant effect on hot flashes, follicle-stimulating hormone, and luteinizing hormone. However, both estradiol and the Kupperman index showed significant heterogeneity among studies (I² = 94.7%, P < 0.001 and I² = 98.1%, P < 0.001, respectively). CONCLUSIONS: Although the results showed a significant SMD in estradiol and the Kupperman index, the results should be interpreted with caution due to the high heterogeneity. Further validation with a larger RCT will be necessary. Overall, isoflavone supplementation has distinct effects on the climacteric symptoms and hormonal changes in postmenopausal women.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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• pp.73-93
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• 1996

This study aimed to analyse the test contents of the national examination for the registered nurses (NERN) over 3 years from 1991 to 1993 in Korea. In recent years in Korea, the MCQ(multiple choice question) has been showing to be a highly recognized method for assessing the qualification of registered nurses. Unfortunately, nursing faculties have found NERN had some bad MCQs through having evaluation workshop for Some MCQs often provide so many unwriting clues which become a bias of the results, and some items fell into the category of the lower level of educational taxonomy such as isolated recall a fact or data. Frequently the stems of the questions are ambigous, unclear, disputable, esoterical or trivial. Considering those fallacies of the national examination, it is very critical to review the test items to see whether it is of high quality, is more fair, reliable and objective in depth. Therefore, this study was done to provide data for the improvement of the test contents as well as the teachers's assessment skill. For this study, the ad hoc committee was composed of 16 members, including 5 education board members of Korean Academic Nurses Association and 11 nursing faculty members. This committee had one day panel discussion and filled the checklist for this study. The process of analysing data was held over 10 times during 1992-1994. The analysis focussed on educational taxonomy such as cognitive domain(knowledge), psychmotor domain (skill), affective domain(attitude) and the level of learning such as recall, understanding, problems solving, and learning area of theory and practice, and the learning content categorised by nursing process and disease process. The test analysed using difficulty index and the structure of the test items was analysed. The conclusions and suggestion as follows : 1. In learning area, the average ratio of the theory and practice was 1 : 1.1 which was less than 1 : 2 suggested by Korean National Health Institute, and the ratio was different by the 8 leaning subjects of nursing. 2. In category of the educational taxonomy, the knowledge domain was emphasized mostly（79. 7％）, the skill domain was 14.9％, and the attitude domain was 5.4％ only. 3. In the level of learning, generally, the test items of the level of recall（45.5％） and the understanding（46.3％） were covered almost and the problem solving was 8.1％. 4. In the learning contents, generally, the test items related to nursing process was 67.2％ and that of disease process was 32.8％. However, this proportion was different by the 8 leaning subjects. Even though the nursing diagnosis has been emphasized in nursing curricula recently, the test items of this was identified very few. 5. In the structure of the test item, some were not clear, incorrect grammar, unclear description and some have clues to answer. 6. In the item analysis, the non-acceptable level of the difficulty index (means too easy) was 65.7％, and the acceptable level was 33.9％. Considering the results we would like to suggest the followings, 1. Since the test items of knowledge domain was dominant, the test items of the practice domain and attitude domain should be emphasized more. 2. The regular review and analysis of NERN should be arranged in order to improve the quality of the test items which will give influence to the nursing education positively.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.1
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• pp.265-274
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• 2013

The purpose of this study was to investigate the dietary habits of the relevant factors according to the obesity status of children and adolescents. Services research studies conducted in the Ministry of Health, Welfare and Family Affairs of the '2009 Children and Youth Online Games and Family Activity Survey findings utilizing data. Study, the subjects utilized 9,462 elementary school students 2,778 people, 3,385 middle school students, high school students a total of 3,299 people were enrolled in the study. Were grouped according to the BMI of the study subjects. After dinner snack intake 18.5>BMI groups disagree 38.8%, 18.5${\leq}$BMI<23.0 group it was 41.1%, 23.5${\leq}$BMI<25.0 group it was 40.1%, $25{\leq}BMI$ groups disagree 37.4% response was highest(p=0.001). Investigate whether regular exercise every day, results showed that a high BMI index groups do not exercise more. Aggressiveness in time, such as physical education, the survey showed that a low BMI index group more likely to exercise vigorously. BMI index group of people around you and the speed of eating more meals were faster. If you let more to allow time to practice proper education of children and youth, health and enrich lives of the appropriation will be able to Services to live a healthy and happy life than to correct perceptions and lifestyles of children and adolescents. To do this, there is a need to educate parents, children and youth, as well as.

• Nutrition Research and Practice
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• v.12 no.3
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• pp.258-264
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• 2018

BACKGROUND/OBJECTIVES: Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants. SUBJECTS/METHODS: The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake. RESULTS: The total DQI-K score was calculated by summing the scores of the eight components (range 0-9). In the multivariable adjusted models, with good diet quality (score 0-4) as a reference, poor diet quality (score 5-9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06-1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk. CONCLUSIONS: A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.

• Nutrition Research and Practice
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• v.15 no.5
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• pp.604-612
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• 2021

BACKGROUND/OBJECTIVES: We aimed to investigate the association of waist circumference (WC) with body composition among individuals with a normal body mass index (BMI) to distinguish muscle and fat mass, as both affect health differently. SUBJECTS/METHODS: We analyzed dual-energy X-ray absorptiometry data (derived from the Korean National Health and Nutrition Survey, which includes information on fat and lean mass) of 7,493 adults with a normal BMI. Subjects were categorized into four groups of increasing WC. The fourth group was defined as being centrally obese. Each number of subjects are as follows: 1,870, 695, 231, and 39 among men and 3,054, 1,100, 406, and 98 among women. We conducted a sex-stratified linear regression analysis of body composition according to WC group after adjustments for covariates. RESULTS: We observed a positive association of body fat with increasing WC in both men and women (all P for trend: < 0.001). The adjusted mean values for percent body fat with 95% confidence intervals (CIs) according to the four WC groups in ascending order were 17.8 (17.5-18.3), 21.0 (20.6-21.5), 22.1 (21.5-22.8), and 25.1 (24.2-26.1) in men and 29.7 (29.4-30.0), 32.0 (31.6-32.3), 32.9 (32.4-33.4), and 34.7 (33.2-36.1) in women. However, there was an inverted J-shaped association between muscle mass and WC. The fourth group had a higher percent body fat and lower muscle mass than other groups. The adjusted mean values for appendicular skeletal muscle mass index (kg/m²) with 95% CIs according to the four WC groups in ascending order were 7.55 (7.51-7.59), 7.62 (7.56-7.68), 7.65 (7.56-7.74), and 7.22 (7.04-7.41) in men and 5.83 (5.80-5.85), 5.96 (5.92-6.00), 6.03 (5.96-6.10), and 5.88 (5.73-6.03). CONCLUSIONS: There was a positive association between body fat and WC among individuals with normal BMI; conversely there was an inverted J-shaped association between lean body mass and WC. Our findings support the WC measurement should be included in obesity evaluations for adults with a normal BMI.

• Journal of Korean Medicine for Obesity Research
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• v.20 no.1
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• pp.31-39
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• 2020

Objectives: Obesity is becoming more popular disease worldwide. Because of the side effects of conventional obesity treatment modality, herbal medicine treatment is becoming more preferred. Gambihwan which including Ephedra sinica Staph is widely used in traditional Korean Medicine practice for obesity treatment. Garcinia cambogia is a kind of health functional food that has body fat reducing effect. Nowadays, ephedra and Garcinia cambogia are often used simultaneously in clinical practice of Korean Medicine. However, the effectiveness and safety of combination therapy in obesity treatment is not well established. Methods: We conducted retrospective observational study to explore effectiveness and safety of combination therapy. We evaluated effect of combined treatment of Gambihwan and Garcinia cambogia on body weight, body mass index, body fat mass, and waist hip ratio reduction. We also assessed safety via liver function test and adverse event. Results: Finally, 23 patients were included. In paired t-test, body weight significantly decreased from 64.50±14.50 kg to 62.94±13.85 kg (P<0.001) and body mass index were also significantly decreased from 24.43±3.79 kg/㎡ to 23.83±3.59 kg/㎡ (P<0.001). Body fat mass was also reduced. Aspartate transaminase and alanine aminotransferase were not significantly increased. There were no drug-induced liver injury and no severe adverse event. Conclusions: In our retrospective review, we found combination therapy of Gambihwan and Garcinia cambogia reduce body weight, body mass index and body fat mass. There were no severe adverse event and drug induced liver injury which indicated safety of combination therapy in obesity treatment.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.153-165
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• 2020

Background: Well-validated risk prediction models help to identify individuals at high risk of diseases and suggest preventive measures. A recent systematic review reported lack of validated prediction models for low back pain (LBP). We aimed to develop prediction models to estimate the 8-year risk of developing LBP and its recurrence. Methods: A population based prospective cohort study using data from 435,968 participants in the National Health Insurance Service-National Sample Cohort enrolled from 2002 to 2010. We used Cox proportional hazards models. Results: During median follow-up period of 8.4 years, there were 143,396 (32.9%) first onset LBP cases. The prediction model of first onset consisted of age, sex, income grade, alcohol consumption, physical exercise, body mass index (BMI), total cholesterol, blood pressure, and medical history of diseases. The model of 5-year recurrence risk was comprised of age, sex, income grade, BMI, length of prescription, and medical history of diseases. The Harrell's C-statistic was 0.812 (95% confidence interval [CI], 0.804-0.820) and 0.916 (95% CI, 0.907-0.924) in validation cohorts of LBP onset and recurrence models, respectively. Age, disc degeneration, and sex conferred the highest risk points for onset, whereas age, spondylolisthesis, and disc degeneration conferred the highest risk for recurrence. Conclusions: LBP risk prediction models and simplified risk scores have been developed and validated using data from general medical practice. This study also offers an opportunity for external validation and updating of the models by incorporating other risk predictors in other settings, especially in this era of precision medicine.

• Journal of Nutrition and Health
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• v.53 no.4
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• pp.356-368
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• 2020

Purpose: Histidine-containing dipeptides, which are rich in chicken, have been reported to reduce the risk of metabolic abnormalities via anticarbonylation mechanism in animal models. To determine the effect of dietary histidine-containing dipeptides on metabolic risk factors in humans, the relation between chicken consumption and insulin resistance were determined in a population consuming high carbohydrate and low protein. Methods: A total of 7,183 subjects (2,929 men and 4,254 women) aged ≥ 50 years from the Korea National Health and Nutrition Examination Survey (KNHANES) were divided into three groups according to chicken consumption (rarely, monthly, and weekly), and evaluated for the metabolic risk factors using homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) in this cross-sectional study. The fourth and fifth (IV-1-3 & V-1) KNHANES, which had blood insulin data, were chosen for the current study. Results: The chicken consumption was significantly associated with insulin (p for trend = 0.018) and HOMA-IR (p for trend = 0.023) in men. In particular, the 'weekly' chicken consuming men in the lowest tertile (< 65.0%) of carbohydrate intake group had significantly lower HOMA-IR (p for trend = 0.033) and higher QUICKI (p for trend = 0.043) than the 'rarely' intake group. In addition, the odds ratio for abnormal HOMA-IR was 0.55 (95% confidence interval [CI], 0.31-0.99) and QUICKI was 0.47 (95% CI, 0.26-0.86) for the 'weekly' chicken consuming group. Conclusion: The 'weekly' chicken consumption had a beneficial effect on insulin resistance and it may partially be due to the major bioactive components in chicken, histidine-containing dipeptides.