• Korean Journal of Community Nutrition
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• v.15 no.5
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• pp.694-703
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• 2010

Recent studies have reported that a subset of obese individuals who were metabolically healthy but obese had more favorable clinical outcomes than obese subjects with metabolic disturbances. The purpose of this study was to evaluate the distribution and agreement of obesity subtypes according to body mass index (BMI) and metabolic syndrome (MS). Furthermore, we examined the differences of nutrient intake among the groups. Data was analyzed for 1,095 female subjects older than 40 years using Korean National Health and Nutrition Survey in 2008. The degree of obesity was classified by two methods, using BMI (obese ${\geq}\;25\;kg/m^2$, not obese < $25\;kg/m^2$) and MS (meet ${\geq}\;3$ criteria among 5 index: waist circumference, triglyceride, glucose, HDL-cholesterol and blood pressure). Subjects were divided into 4 groups according to $2{\times}2$ cross table: non-obese without MS, non-obese with MS, obese without MS and obese with MS. Nutrient intakes were compared among 4 groups. The results showed that the proportions of non-obese without MS, non-obese with MS, obese without MS and obese with MS were 47.6%, 13.6%, 16.6%, and 22.2% of total subjects, respectively. The agreement (kappa value) of two methods was 0.354 (fair) in total subjects, 0.365 (fair) in 40-60 year old subjects and 0.304 (fair) in ${\geq}\;61$ year old subjects. In ${\geq}\;61$ years old subjects, intakes of percentage energy from carbohydrate, percentage of energy from fat, calcium, phosphorous, sodium, vitamin A, carotene, thiamine, riboflavin and niacin were significantly different among the groups. In contrast, the subjects of 40-60 years old, no differences in nutrient intakes were observed. In conclusion, there were differences in nutrient intakes among the groups subdivided by obesity and MS, especially in elderly female subjects. Individualized dietary guideline for subtype of obesity will be needed to treat metabolic disturbance of obesity.

• 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.

• Korean Journal of Community Nutrition
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• v.18 no.1
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• pp.65-76
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• 2013

The purpose of this study was to investigate the effects of a nutrition education and personalized lunch service program in a senior welfare center. A total of 30 elderly (14 males, 16 females) aged 62~89 years participated in this study. Nutrition education lessons (2 hour/lesson/week) were provided for 4 weeks. Also, ten weeks from week 3rd to week 12th, personalized lunch providing 1/3 personal needed energy was served 5 times for a week. After the nutrition intervention program, we compared anthropometric characteristics, blood biochemical characteristics, nutrition knowledge, dietary attitude and dietary intake using 24 hr recall with those before the intervention. The body weight (p < 0.001) and body mass index (BMI) (p < 0.001) were decreased. There were significant increases in score of nutrition knowledge (p < 0.01) and consumption of milk & milk products for snacks. There was a positive effect on fasting blood sugar (FBS) showing significant decreases in portion of impaired fasting glucose and diabetes mellitus (p < 0.05). Also, serum triglyceride (TG) was significantly decreased (p < 0.05). In evaluation of nutrient intake by Dietary Reference Intakes for Koreans (KDRIs), riboflavin (p < 0.01), vitamin C (p < 0.001), calcium (p < 0.05) were positively improved. The index of nutritional quality (INQ) and intakes of vitamin C (p < 0.001), riboflavin (p < 0.05), Ca (p < 0.01) and Fe (p < 0.05) were increased. In conclusion, this nutrition education and lunch service program providing 1/3 personal needed energy can be used to develop and implement a tailored nutritional intervention programs in the setting of a community senior welfare center to improve health and nutritional status of Korean elderly.

• Journal of Nutrition and Health
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• v.36 no.1
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• pp.83-92
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• 2003

Improving dietary patterns, na, in turn, improving nutritional status, is now viewed as a key to improve public health and to prevent chronic diseases. There has been a peat needs to assess diet quality to identify nutritional risk group, however, little research has been done on methods to assess overall diet quality. The purpose of this study was to develope a mini dietary assessment (MDA) index for evaluation of overall dietary quality. A 10-component system was devised based on dietary guidelines and food Tower for Koreans. The system contained 4 food elements of which use is encouraged, such as milk, meat, vegetables, fruits, and 3 food elements of which use is limited, such as fat, salt, or sugar. Also the included were elements on dietary regulation and variety. A subject is to check one of ‘always' 'generally'seldom', which has score of 5, 3, and 1, respectively, so the total possible index score is 50. This index is to use without dietary survey and is to use even by non-nutritionist. A sample of 432 healthy males and females in their 30's and 40's contributed diet intake data based on 24-hour recall for the validation of MDA. The mean MDA score was 31.34 of a possible 50 points. The main nutrients for each MDA component was correlated very well with the results of 24-hour recall. Also, very good correlation was found between healthy eating index (HEI) score and MDA score. However, some of MDA components were needed a modification of term or/and statement. So the Uh was revised and another effort for validation was made with new sample of 169 subjects and even better correlation was found. The revised MDA could be used with minor modification to assess diet quality and to screen nutritional status. (Korean J Nutrition 36(1): 83-92, 2003)

• Nutritional Sciences
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• v.1 no.1
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• pp.34-41
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• 1998

This study examined the proper roles of dietitian and nurse-teacher in the weight control program (WCP) in schools and the effect of the WCP on subjects with respect to anthropometric measurements, nutrition knowledge, dietary attiude, and behavior changes. The program consisted of six sessions of nutrition education and frequent face-to-face nutrition counseling. Subjects were 22 obese children in the 4th and 5th grade who underwent counseling and 18 obese children in another school who served as a control group. After two months of WCP, obesity index such as .elative body weight (RBW, from 135.7 to 132.5), tricep skinfold thickness (TSFT, from 34.9 to 32.8 mm), and body fat content (from 32.0 to 29.8%) had decreased significantly in the experimental group, while the control group showed no significant differences in these indices. The reductions in obesity indices were maintained in the experimental group except for fat content (32.6%), which returned to its original value within six months. The control group significantly increased fat content in the same period (from 31.2% to 36.2%). Both groups decreased RBW, TSFT, and fat content while midarm circumference and waist/hip ratio remained the same after one year. Subjects' nutrition knowledge was improved with average test scores from 15.1 to 16.7 while nutrition attitude and behavior test scores remained unchanged suggesting that behavior modification may require more time than knowledge acquirement. These results suggest that proper nutrition counseling can initiate weight reduction. However, the maintenance of controlled weight requires changes in attitude and behavior which have not been achieved by the present WCP. The role of school dietitian for WCP in this study was limited to assisting the nurse-teacher in nutrition education. Expansion of dietitian's role in nutrition education and counseling is needed.

• Journal of the Korean Society of Food Culture
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• v.10 no.4
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• pp.345-355
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• 1995

This study estimated the status of dietary intake of 258 children from ages 3 to 6 living in Seoul and analyzed the correlation between the degree of children's nutrition awareness and dietary intake, to provide some basic informations on nutrition education program for their health promotion. Average height and weight of the children were 110.5 cm and 19.7 kg. And their body mass index was 16.2 and obesity index was 6.5%. Proportions of carbohydrate, protein and fat to the total calorie intakes were on the average 55.8%, 15.6% and 28.6%. Calorie intake proportion of breakfast, lunch, dinner and snack were 20.9%, 21.9%, 22.3% and 34.9%. In protein intake, proportion of animal and vegetable protein was 1.4, in fat intake pattern, P/M/S ratio was 1.2/1.2/1.0. As a consequence of analyzing the correlation between children's nutrition awareness and dietary intake, children of high awareness degree to the food value did not intake much calorie and carbohydrate, and did not choose cereals and starches, condensed fat food. As a result, dietary intake of pre-school children showed very good but partially showed a problem of over and under nutrition in quantity or in quality we hope that the result of this study could be helpful for the nutrition education program for the health and nutrition of the pre-school children.

• Korean Journal of Community Nutrition
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• v.25 no.5
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• pp.406-415
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• 2020

Objectives: The aim of this study was to compare the nutritional intake and Diet Quality Index-International (DQI-I) of gynecological cancer survivors and normal women. Methods: This study compared the anthropometric indices, dietary behavior, nutritional intake, and DQI-I in women with previous history of breast or uterine cancer [Gynecological cancer survivors group (GCSG, n=126)] and normal women [Normal control group (NCG, n=7,011)] using the 2013~2016 Korea National Health and Nutrition Examination Survey data. Results: Body mass index and waist circumference were lower in the GCSG compared the NCG. The frequency of skipping breakfast and eating out was higher in the NCG compared to GCSG. Energy and fat intake were significantly higher in the NCG than in the GCSG, whereas intake of all minerals and vitamins (excluding thiamine), and dietary fiber intake were higher in GCSG. It was observed that the fatty acid intake of the GCSG was significantly lower than that of the NCG. The diet quality evaluation using DQI-I results showed that GCSG was higher in the "within-group" diet variety and adequacy of vegetable group than the NCG, whereas the intake level of the fruit group was higher in NCG. Besides, protein, calcium, and vitamin C intake were higher in the GCSG than in the NCG. The GCSG showed higher levels of total fat and saturated fat moderation than the NCG, whereas cholesterol moderation showed the opposite results. The results of DQI-I comparison according to the cancer survival years showed that the overall score and scores related to diet adequacy and balance were higher in the below 5-year group, whereas the over 5-year group scored higher in terms of moderation of diet. Conclusions: The results of this study suggest that a chronic disease based management approach is needed in cancer survivors. The study provides important data which can help in the preparation of guidelines for long-term lifestyle and diet management, in these patients.

• Korean Journal of Community Nutrition
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• v.19 no.5
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• pp.490-498
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• 2014

Objectives: This study was conducted to propose the need of re-establishing the criteria of the body weight classification in the elderly. We compared the Asia-Pacific Region Criteria (APR-C) with Entropy Model Criteria (ENT-C) using Morbidity rate of chronic diseases which correlates significantly with Body Mass Index (BMI). Methods: Subjects were 886 elderly female participating in the 2007-2009 Korea National Health and Nutrition Examination Survey (KNHANES). We compared APR-C with those of ENT-C using Receiver Operating Characteristics (ROC) curve and logistic regression analysis. Results: In the case of the morbidity of hypertension, the results were as follows: Where it was in the T-off point of APR-C, sensitivity was 67.5%, specificity was 43.1%, and Youden's index was 10.6. While in the cut-off point of ENT-C, it was 56.7%, 56.6%, and 13.3 respectively. In the case of the morbidity of diabetes, the results were as follows: In the cut-off point of APR-C, Youden's index was 14.2. While in the cut-off point of ENT-C, it was 17.2 respectively. The Area Under the ROC Curve (AUC) of the subjects who had more than 2 diseases among hypertension, diabetes, and dyslipidemia was 0.615 (95% CI: 0.578-0.652). Compared to the normal group, the odds ratio of the hypertension group which will belong to the overweight or obesity was 1.79 (95% CI: 1.30-2.47) in the APR-C, and 2.04 (95% CI: 1.49-2.80) in the ENT-C (p < 0.001). Conclusions: We conclude that the optimal cut-off point of BMI to distinguish between normal weight and overweight was $24kg/m^2$ (ENT-C) rather than $23kg/m^2$ (APR-C).

• Journal of Nutrition and Health
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• v.38 no.6
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• pp.445-454
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• 2005

The purpose of this study was to compare the validity of obese index among body mass index (BMI), waist to hip ratio (WHR), and waist circumference (WC) and to determine which is the best in relation to cardiovascular disease (CVD) risk in Korean elderly more than 65 ages. Data from the 1998 Korean Health and Nutrition Survey were used (n=1017). Anthropometric indices and CVD risk factors were measured, and chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator Characteristic (ROC) curves were used in the analysis. Anthropometric values were decreased in both male and female when ages were goes up. In female elderly, it specially showed the characteristics of upper body fat and systolic blood pressure risk (p<0.05). Among life style factors the current smokers were prevalent in obese male (p<0.05), but not prevalent in female having obese or upper body fat. Also, person with upper body obesity have more exercise than that of normal group (p<0.01). Mean BMI values of the current smoker was lower than that of normal group in both sexes (p<0.01). Mean BMI value of person with other risk factors were higher than that of normal groups (p<0.05). Among 7 CVD risk factors in partial correlation analysis, WC had the highest correlation coefficient in 5 in male, whereas BMI in 4 in female. In ROC analyses of 12 risk factors and health conditions, the largest area under curve of obese indices for risk factors were WC>WHR>BMI in male and BMI>WHR>WC in female. The optimal cutoff values of each index (BMI : WHR : WC) for one or more risk factors were 19.02 : 0.84 : 71.3 in male and 19.04 : 0.88 : 85.6 in female. In conclusion, Most Korean elderly showed non-obese and abdominal obesity likewise other Asians. Also CVD risk factors were prevalent in Korean elderly within normal limits of obese indices. Therefore the upper body fat indices reflected in the aged whose muscle mass is replaced by fat must be used as an indicator of CVD risk together with BMI. Although WHR was the worst index based on partial correlation analysis and so located between BMI and WC in ROC curve analysis in both sexes, it need to be use with WC to screen the cardiovascular risk group.

• Korean Journal of Community Nutrition
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• v.15 no.1
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• pp.1-14
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• 2010

It is suggested that evaluation of diet quality may be a great indicator of nutritional assessment. The aim of this study was to evaluate the diet quality of children and adolescents based on nutrient and food group intake and Diet Quality Index-International (DQI-I). This survey was conducted through questionnaires and diet record survey to 477 students (elementary school students; n = 131, middle school students; n = 136, and high school students; n = 210). The results showed that high school students were significantly more often to skip breakfast compared with the other groups. The middle and high school students consumed significantly higher intakes of food and energy compared to the elementary school students. Also the number of nutrients in Index of Nutritional Quality (INQ) < 1.0 of high school students were significantly higher than that of elementary and middle school students. The Korean's dietary diversity score (KDDS) of elementary school, middle school and high school students were 4.1, 4.4 and 4.3 respectively. The average DQI-I of elementary school, middle school and high school students were 66.7, 65.5, and 63.7, respectively and there was significant difference. Also, middle school students showed to have higher score in variety and adequacy category compared with the other groups, and elementary school students appeared to have higher score in moderation category. In conclusion, high school students appeared to have unhealthy dietary habits in terms of high frequency of skipping breakfast and lower INQ and DQI-I score compared to the elementary school and middle school students. Therefore, the proper dietary management should be needed for high school students.