• Nutrition Research and Practice
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• v.13 no.3
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• pp.247-255
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• 2019

BACKGROUND/OBJECTIVES: Accurate, early identification of acutely malnourished children has the potential to reduce related child morbidity and mortality. The current World Health Organisation (WHO) guidelines classify non-oedematous acute malnutrition among children under five using Mid-Upper Arm Circumference (MUAC) or Weight-for-Height Z-score (WHZ). However, there is ongoing debate regarding the use of current MUAC cut-offs. This study investigates the diagnostic performance of MUAC to identify children aged 6-24 months with global (GAM) or severe acute malnutrition (SAM). SUBJECTS/METHODS: Cross-sectional, secondary data from a community sample of children aged 6-24 months in Niger were used for this study. Children with complete weight, height and MUAC data and without clinical oedema were included. Using WHO guidelines for GAM (WHZ < -2, MUAC < 12.5 cm) and SAM (WHZ < -3, MUAC < 11.5 cm), the sensitivity (Se), specificity (Sp), predictive values, Youden Index and Receiver Operating Characteristic (ROC) curves were calculated for MUAC when compared with the WHZ reference criterion. RESULTS: Of 1161 children, 23.3% were diagnosed with GAM using WHZ, and 4.4% with SAM. Using current WHO cut-offs, the Se of MUAC to identify GAM was greater than for SAM (79 vs. 57%), yet the Sp was lower (84 vs. 97%). From inspection of the ROC curve and Youden Index, Se and Sp were maximised for MUAC < 12.5 cm to identify GAM (Se 79%, Sp 84%), and MUAC < 12.0 cm to identify SAM (Se 88%, Sp 81%). CONCLUSIONS: The current MUAC cut-off to identify GAM should continue to be used, but when screening for SAM, a higher cut-off could improve case identification. Community screening for SAM could use MUAC < 12.0 cm followed by appropriate treatment based on either MUAC < 11.5 cm or WHZ < -3, as in current practice. While the practicalities of implementation must be considered, the higher SAM MUAC cut-off would maximise early case-finding of high-risk acutely malnourished children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.6
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• pp.473-480
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• 2022

Purpose: Low bone mineral density (BMD) is a complication in children with inflammatory bowel disease (IBD). There are limited data evaluating dual-energy x-ray absorptiometry (DXA) as a screening tool for low BMD in children with IBD. We performed a single site retrospective analysis of DXA use. Methods: Children aged 5-18 years with IBD diagnosed between 2013 to 2017 at the Royal Children's Hospital, Australia, were included. Patient demographics, measures of disease activity, DXA scores, and factors related to BMD were collected. Results: Over a median follow up of 5.1 (4-6.4) years, 72/239 (30.1%) children underwent DXA, and 28/239 (11.7%) children had a second DXA. Our DXA practice differed to consensus guidelines regarding initial screening based on height and/or body mass index (BMI) z-score (8/17 [47.1%]), and repeat surveillance (13/42 [31.0%]). Children had a median lumbar spine (LS) z-score -0.80 (-1.65-0.075). Children with LS z-score≤-2.0 (n=14) had lower weight (6.57 [1.78-23.7] vs. 51.1 [26.5-68.7], p=0.0002) and height centiles (3.62 [1.17-17.1] vs. 42 [16.9-67.1], p=0.0001), and higher faecal calprotectin (FCP) (3041 [1182-4192] vs. 585 [139-2419], p=0.009) compared to children with LS z-score>-2.0. No fractures were reported. Of 28 children who underwent a second DXA 1.6 (1.1-2.2) years following initial DXA, no significant change in z-scores occurred. Conclusion: Children with IBD had low BMD. In addition to height centile and weight centile, FCP was associated with lower BMD, and should be considered in DXA screening guidelines. Greater clinician awareness of DXA consensus guidelines is required. Future prospective studies are required.

• Korean Journal of Community Nutrition
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• v.8 no.2
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• pp.160-170
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• 2003

Pregnant women in South Korea are a highly risk group fur iron deficiency anemia. Previous studies indicated that the 24-hour recall method was insensitive in distinguishing iron deficiency anemic women from normal women. This method is also impractical to when used at community health centers where no public health dietitians are employed. The objective of this study was to develop a convenient tool to evaluate the usual iron (Fe) intake of pregnant women. The study participants were 115 pregnant women (age 23 to 37 years) at gestational stage of 13 to 24 weeks. Anemic subjects were classified on the basis of their serum ferritin < 12.0 ${\mu}$g/L and hemoglobin < 12.0 g/dL levels. Food frequency questionnaires with 46, 29, and 15 commonly consumed food items were used to measure the usual intake of iron of the subjects. Hemoglobin and serum ferritin were measured from fasting blood samples. Nutrients intake was assessed on three consecutive days using the 24-hour recall method and the food record method. The iron index score calculated using the food frequency method showed a significantly positive correlation with iron intake for the three days dietary intake. The iron index showed a significantly difference (p < 0.05) between the normal and anemic groups. However, there was no significant difference in the iron intake between the anemic and the normal women as measured by the 24-hour recall and food record method. Our study indicated that the 29-food items questionnaire could be used as a screening tool to identify poor dietary intake of iron. (Korean J Community Nutrition 8(2) : 160170, 2003)

• Journal of Community Nutrition
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• v.8 no.3
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• pp.142-146
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• 2006

The aim of this study was to identify the drinking patterns and needs for nutritional education of male workers. The subjects in this study were 285 male workers in Ulsan City. The average age of the subjects was 41.2 years old, height was 171.8cm, weight was 69.6kg and Body Mass Index(BMI) was $23.6kg/m^2$. The subjects were classified into 3 drinking patterns such as 'normal drinker(ND)', 'excessive drinker(ED)', and 'alcoholic drinker(AD)' diagnosed by NAST (Alcoholism Screening Test of Seoul National Mental Hospital). Each group was 31.6%(ND), 43.2%(ED) and 25.3% (AD). The amount of one time drinking, frequency, kind of alcohol and spending money were significantly different among the groups. 87.8% of ND thought that the self identity of drinking habits was good. But twenty seven percent of AD thought that it was just not bad, one-half of them(51.4%) thought they seemed to have problems and 20.8% of them thought they were serious. 38.9%(AD), 22.8%(ED) and 6.7%(ND) of each group tried to abstain by turn. Reasons of trying to abstain were health problems, disharmony of family and bad influence on the business and job place. The methods of abstaining were to avoid a drinking gathering or to refuse drinking in the party. 70.8% of AD, 59.3% of ED and 40% of ND thought they needed to take an educational program about abstaining. 58.3% of AD, 43.1 % of ED and 31.1 % of ND answered they would join an alcohol program.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3271-3274
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• 2012

Purpose : This study was performed to assess whether the weight status is associated with screening rates of breast and cervical cancer in Korean women. Methods: Study participants included women aged between 30 and 80 years from the 4th Korea National Health and Nutrition Examination Survey from 2007 to 2009. Body mass index was classified into ${\sim}18.4kg/m^2$ (underweight), $18.5{\sim}22.9kg/m^2$ (normal), $23{\sim}24.9kg/m^2$ (overweight), $25.0{\sim}29.9kg/m^2$ (moderate obesity) and $30.0kg/m^2$~ (severe obesity) according to the Asia Pacific Standards of WHO recommended definition of obesity. Screening rates of breast and cervical cancer were estimated by the recommendation of the National Cancer Screening Program of the National Cancer Center, Korea. Results : The overall screening rates for breast and cervical cancer were 51.3% and 50.1%, respectively. After covariate adjustment, the screening rates for breast cancer (adjusted odds ratio, 0.70; 95% confidence interval, 0.51 to 0.97) and cervical cancer (adjusted odds ratio, 0.71; 95% confidence interval, 0.53 to 0.94) were significantly lower in the women with severe obesity. Conclusion: Obesity is associated with lower compliance with breast and cervical cancer screening guidelines in Korean women.

• Journal of Nutrition and Health
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• v.42 no.3
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• pp.234-245
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• 2009

Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

• Clinical Nutrition Research
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• v.5 no.4
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• pp.279-289
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• 2016

The adequate dietary intake is important to maintain the nutritional status of the patients after pancreatic cancer surgery. This prospective study was designed to investigate the dietary intake and the nutritional status of the patients who had pancreatic cancer surgery. Thirty-one patients (15 men, 16 women) were enrolled and measured body weight, body mass index (BMI), nutritional risk index (NRI), and Malnutrition Universal Screening Tool (MUST). Actual oral intake with nutritional impact symptoms recorded on the clinical research foam at every meal and medical information were collected from electronic medical charts. The rates of malnutrition at admission were 45.1% (14/31) and 28.9% (9/31) by NRI and MUST method, respectively, but those were increased to 87% (27/31) and 86.6% (26/31) after operation on discharge. The median values of daily intake of energy, carbohydrates, fat, and protein were 588.1 kcal, 96.0 g, 11.8 g, and 27.0 g, respectively. Most patients (n = 20, 64.5%) experienced two or more symptoms such as anorexia, abdominal bloating and early satiety. There were negative correlations between C-reactive protein (CRP) levels and the intake of total energy, protein, fat, and zinc. The rates of malnutrition were increased sharply after surgery and the dietary intake also influenced the inflammatory indicators. The results suggested that need of considering special therapeutic diets for the patients who received pancreatic surgery.

• Journal of Preventive Medicine and Public Health
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• v.52 no.3
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• pp.179-187
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• 2019

Objectives: In the USA, certain races and ethnicities have a disproportionately higher gastric cancer burden. Selective screening might allow for earlier detection and curative resection. Among a USA-based multiracial and ethnic cohort diagnosed with non-cardia gastric cancer (NCGC), we aimed to identify factors associated with curable stage disease at diagnosis. Methods: We retrospectively identified endoscopically diagnosed and histologically confirmed cases of NCGC at Mount Sinai Hospital in New York City. Demographic, clinical, endoscopic and histologic factors, as well as grade/stage of NCGC at diagnosis were documented. The primary outcome was the frequency of curable-stage NCGC (stage 0-1a) at diagnosis in patients with versus without an endoscopy negative for malignancy prior to their index exam diagnosing NCGC. Additional factors associated with curable-stage disease at diagnosis were determined. Results: A total of 103 racially and ethnically diverse patients were included. Nearly 38% of NCGC were stage 0-Ia, 34% stage Ib-III, and 20.3% stage IV at diagnosis. A significantly higher frequency of NCGC was diagnosed in curable stages among patients who had undergone an endoscopy that was negative for malignancy prior to their index endoscopy that diagnosed NCGC, compared to patients without a negative endoscopy prior to their index exam (69.6% vs. 28.6%, p=0.003). A prior negative endoscopy was associated with 94.0% higher likelihood of diagnosing curable-stage NCGC (p=0.003). No other factors analyzed were associated with curablestage NCGC at diagnosis. Conclusions: Endoscopic screening and surveillance in select high-risk populations might increase diagnoses of curable-stage NCGC. These findings warrant confirmation in larger, prospective studies.

• Nutrition Research and Practice
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• v.17 no.1
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• pp.62-72
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• 2023

BACKGROUND/OBJECTIVES: Many studies have revealed an association between fat mass and the obesity-related gene (FTO) and obesity. On the other hand, no meta-analysis was conducted with data from only Koreans. Therefore, this study performed a meta-analysis using Korean data to provide evidence for the association between FTO single nucleotide polymorphisms (SNPs) and the risk of obesity among Korean adults. SUBJECT/METHODS: Meta-analysis was finally conducted with data extracted from seven datasets of four studies performed on Korean adults after the screening passed. Five kinds of FTO SNPs (rs9939609, rs7193144, rs9940128, rs8050136, and rs9926289) were included, and the relationship between FTO SNPs and body mass index (BMI) was investigated using linear regression with an additive model adjusted for covariants, such as age, sex, and area. RESULTS: The minor alleles of FTO SNPs were associated with increased BMI (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.21-1.42). In sub-group analysis, FTO rs9939609 T>A was significantly associated with BMI (OR, 1.23; 95% CI, 1.06-1.42). The other FTO SNPs together were significantly associated with BMI (OR, 1.37; 95% CI, 1.25-1.49). The publication bias was not observed based on Egger's test. CONCLUSIONS: This meta-analysis showed that minor alleles in the FTO SNPs were significantly associated with an increased BMI among Korean adults. This meta-analysis is the first to demonstrate that minor alleles in the FTO SNPs contribute significantly to the increased risk of obesity among Korean adults using data from a Korean population.

• Journal of Preventive Medicine and Public Health
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• v.40 no.6
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• pp.505-511
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• 2007

Objectives : While cervical cancer is one of the leading cancers among women worldwide, there are a number of effective early detection tests available. However, the participation rates in cervical cancer screening among Korean women remain low. After the nationwide efforts in 1988 and thereafter to encourage participation in cervical cancer screening, few studies have investigated the effects of socioeconomic inequality on participation in cervical cancer screening. The purpose of this study was to investigate 1) the level of socioeconomic disparities in receiving cervical cancer screening by age group and 2) if there was an improvement in reducing these disparities between 1995 and 2001. Methods : Using data from the Korean National Health Status, Health Behavior and Belief Survey in 1995, the Korean National Health and Nutrition Examination Surveys from 1998 and 2001 (sample sizes of 2,297, 3,738, and 3,283), age-standardized participation rates were calculated according to education level, equivalized household income, and job status. Odds ratios and the relative inequality index (RII) were also calculated after controlling for age. Results : Women with lower education levels were less likely to attend the screening test, and the disparities by education level were most pronounced among women aged 60 years and older. The RIIs among women 60 years and older were 3.64, 4.46, and 8.64 in 1995, 1998, and 2001, respectively. Higher rates of participation were reported among those in the highest income category, which was more notable among the middle aged women (40s and 50s). An inconsistent trend in the rate of participation in cervical cancer screening by occupational level was found. Conclusions : Indicators of socioeconomic position seem to have varying impacts on the inequalities in the rates of participation in cervical cancer screening according to age group. These results demonstrate the need for more aggressive and age-based interventions and policy programs to eliminate the remaining inequalities.