The prevalence of childhood and adolescent obesity has increased and exacerbated during the coronavirus disease 2019 pandemic, both in Korea and globally. Childhood and adolescent obesity poses significant risks for premature morbidity and mortality. The development of serious comorbidities depends not only on the duration of obesity but also on the age of onset. Obesity in children and adolescents affects almost all organ systems, including the endocrine, cardiovascular, gastrointestinal, reproductive, nervous, and immune systems. Obesity in children and adolescents affects growth, cognitive function, and psychosocial interactions during development, in addition to aggravating known adult comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, nonalcoholic fatty liver disease, obstructive sleep apnea, and cancer. Childhood and adolescent obesity are highly associated with increased cardiometabolic risk factors and prevalence of metabolic syndrome. The risk of cardiovascular and metabolic diseases in later life can be considerably decreased by even a small weight loss before the onset of puberty. Childhood and adolescent obesity is a disease that requires treatment and is associated with many comorbidities and disease burdens. Therefore, early detection and therapeutic intervention are crucial.
Purpose: Dietary fiber is a component of carbohydrate that is linked closely with the carbohydrate quality, but few studies have investigated the association of high fiber intake with the cardiometabolic risk factors in Koreans. This study examined the association of high fiber and high carbohydrate intake with the cardiometabolic risk factors among Korean adults. Methods: This study included 15,095 adults aged ≥20 years, who participated in the 2013 ~ 2017 KNHANES. The dietary intake was obtained using a 24-h dietary recall method. The associations of high fiber and high carbohydrate intake with metabolic syndrome and dyslipidemia were examined by sex using multiple logistic regression analysis. Results: The median of dietary fiber was 23.6 g/day in men and 20.0 g/day in women. Dietary fiber intake increased gradually as dietary carbohydrate groups increased except for ≥80% of energy from the carbohydrate group. Women in the highest quintile of fiber intake showed a 33% lower risk of metabolic syndrome compared with those in the third quintile. When stratified into low fiber (LF) and high fiber (HF) groups using Adequate Intake of fiber for Koreans, men in the third quartile of carbohydrate intake showed a 44% and 51% higher risk of metabolic syndrome and atherogenic dyslipidemia than in the first quartile, respectively, but only in the LF group. Women in the second quartile of carbohydrate intake showed an 83% higher risk of hypercholesterolemia than in the first quartile in the LF group. On the other hand, as no significant association was observed between the carbohydrate intake and metabolic diseases among the HF groups in both sexes. Conclusion: These findings suggest that a high fiber intake might be associated with a reduced risk of metabolic syndrome and high carbohydrate intake with a low dietary fiber intake might be associated with an increased risk of several metabolic abnormalities among Korean adults. Further prospective studies will be needed to confirm the effects of high fiber and high carbohydrate intake on the cardiometabolic risk factors among Koreans.
Purpose: This study was conducted to better understand the illness experiences and palliative care needs in community-dwelling persons with cardiometabolic diseases. Methods: This qualitative descriptive study was conducted with 11 patients (and three family members) among 28 patients contacted. Interviews were led by the principal investigator in her office or at participants' home depending on their preference. All interviews were digitally recorded and transcribed by a research assistant. The interviews were analyzed by two independent researchers using a conventional method. Results: Participants' ages ranged from 42 to 82 years (nine men and two women). Three themes were identified: (1) same disease, but different illness experiences; (2) I am in charge of my disease(s); (3) preparation for disease progression. Participants were informed of the name of their disease when they were diagnosed, but not provided with explanation of the diagnosis or meant or how to do self-care to delay the disease progression, which increased the feelings of uncertainty, hopelessness and anxiety. Taking medication was considered to be the primary treatment option and self-care a supplemental one. Advanced care plans were considered when they felt the progression of their disease(s) while refraining from sharing it with their family or health care professionals to save their concerns. All participants were willing to withhold life-sustaining treatment without making any preparation in writing. Conclusion: Education on self-care and advanced care planning should be provided to community-dwelling persons with cardiometabolic diseases. A patient-centered education program needs to be developed for this population.
Purpose: This study evaluated the glycemic response of diets using estimated glycemic load (eGL), which had been developed for mixed meals for Korean adults, and examined its associations with cardiometabolic risk factors among Korean adults. Methods: A total of 4,655 men and 6,760 women aged 19 years and above were included from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey. eGL was calculated by each meal (breakfast, lunch, dinner, and snack) and then summed to give daily total eGL. A multiple logistic regression analysis was used to examine the association. Results: Mean daily total eGL was 112.6 in men and 99.3 in women. Daily total eGL was positively associated with carbohydrate and fiber intakes, but negatively associated with protein and fat intakes in both men and women (p < 0.05 for all). Daily total eGL showed an inverse association with HDL-cholesterol level in both men and women (p = 0.0036 for men and p = 0.0008 for women). Men in the highest quintile of daily total eGL showed a 66% increased risk of hypercholesterolemia (OR, 1.66; 95% CI, 1.10 ~ 2.50; p for trend = 0.0447) compared with those in the lowest quintile. Conclusion: These findings suggest that eGL based on carbohydrate, protein, fat and fiber intakes can reflect glycemic response and therefore can be used as an index for dietary planning, nutrition education and in the food industry.
The purpose of this study was to identify the effect of dance sport participation on body composition and cardiometabolic parameters in obese middle aged women, by analyzing the current literature(2005-2015). The data from 9 studies were included in this systematic review and meta-analysis, and Comprehensive Meta Analysis(CMA) Version 2.0 was used for statistical analysis. A total of 197 middle aged women(intervention group: n=98, control group: n=99) were included in this analysis. An average duration of the dance sports intervention was 12.2 weeks, 3.13 session per week and 75 minutes per session. Significant reduction in body weight, body fat percent, triglyceride, low density lipoprotein LDL-Cholesterol and leptin were observed while significant increase in high density lipoprotein HDL-cholesterol was observed after the intervention. There were large effect size in percent body fat, total cholesterol, HDL-cholesterol and LDL-cholesterol while medium and small effect size were observed for triglyceride and body weight, leptin, insulin and glucose, respectively. In conclusion, dance sport participation resulted in positive changes in body composition and cardiometabolic parameter in middle aged women.
BACKGROUND/OBJECTIVES: Although previous experimental studies reported the health benefits of foods rich in phytochemicals, few epidemiologic studies have investigated the associations between phytochemicals and metabolic disorders. This study aimed to calculate a phytochemical index (PI) and examine its association with metabolic syndrome in the Korean population. SUBJECTS/METHODS: Data of Korean adults aged ≥ 19 years who participated in the 2008-2016 Korea National Health and Nutrition Examination Surveys were analyzed. The PI was calculated using 24-hour intake recall data regarding whole grains, vegetables, fruits, legumes, nuts and seeds, and soybeans and soy products. Demographic and lifestyle data were obtained using self-administered questionnaires. A multivariable logistic regression was performed to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the prevalence of metabolic syndrome and its components according to PI quintiles. RESULTS: Overall, 31,319 adults were evaluated. Compared with men, women had a higher median PI level (9.96 vs. 13.63) and significantly higher caloric intake levels from most PI components (P < 0.05), except for soy products. After adjusting for multiple confounding variables, participants in the highest PI quintile had significantly lower prevalences of abdominal obesity (OR: 0.90, 95% CI: 0.81-0.99), hyperglycemia (OR: 0.83, 95% CI: 0.74-0.94), high blood pressure (OR: 0.82, 95% CI: 0.73-0.93), hypertriglyceridemia (OR: 0.84, 95% CI: 0.75-0.94), and metabolic syndrome (OR: 0.78, 95% CI: 0.69-0.88). CONCLUSIONS: Higher intakes of phytochemical-rich foods are associated with a lower prevalence of metabolic dysregulation and consequently, cardiometabolic diseases.
Hypogonadism is a clinical syndrome that results in hormone deficiency and can be classified as 1) primary caused by the gonadal failure and 2) secondary by the hypothalamus-pituitary gland dysfunction and/or cardiometabolic complications. Recently the presence of thyroid hormone receptors in different testicular cell types was demonstrated, and thus thyroid dysfunctions would be another cause of secondary hypogonadism. Thus, we investigated the effects of perinatal hypothyroidism on hypogonadism in male Sprague-Dawley rats. Perinatal hypothyroidism was induced by daily administration of 0.05% 6-propyl-2-thiouracil (PTU) by tap water from gestation day 15, which were compared with negative control (PTU (-)) group. At postnatal day 28, hypothyroid pups were divided into 2 groups: PTU (+) group - continued PTU treatment and PTU (+/-) group - stopped PTU until postnatal day 49. Body weights, dehydrotesosterone (DHT), and testosterone levels were checked 2 and 3 weeks after grouping. Body weights were significantly decreased in PTU(+) and PTU(+/-) groups compared with PTU (-) group at postnatal day 28. 3 weeks later, PTU (+/-) group significantly gained weight compared with PTU (+) group. DHT and testosterone levels significantly decreased with PTU treatment, but increased 3 weeks after stopping PTU administration. Perinatal PTU-induced hypothyroid hypogonadism was sustained for 2 weeks after stopping PTU administration, but restored gonadal hormone levels 3 weeks after stopping PTU. These results suggest that researchers should design an experiment on hypothyroid hypogonadism based on the estimated period.
The presence of artificial light enables humans to be active 24 h a day. Many people across the globe live in a social culture that encourages staying up late to meet the demands of various activities, such as work and school. Sleep deprivation (SD) is a severe health problem in modern society. Meanwhile, as with cardiometabolic disease, there was an obvious tendency that coronary heart disease (CHD) to become a global epidemic chronic disease. Specifically, SD can significantly increase the morbidity and mortality of CHD. However, the underlying mechanisms responsible for the effects of SD on CHD are multilayered and complex. Inflammatory response, lipid metabolism, oxidative stress, and endothelial function all contribute to cardiovascular lesions. In this review, the effects of SD on CHD development are summarized, and SD-related pathogenesis of coronary artery lesions is discussed. In general, early assessment of SD played a vital role in preventing the harmful consequences of CHD.
Objectives: Epidemiological evidence linking long working hours and shift work to metabolic syndrome remains inadequate. We sought to evaluate the impact of reducing working hours on metabolic syndrome. Methods: We compared the prevalence of metabolic syndrome among male manual workers in a manufacturing company (N = 371) before and after the introduction of policy to reduce daily work hours from 10 to 8 hours. Components of metabolic syndrome were measured in periodic health examinations before the intervention, 6-9 months after, and 1.5-2 years after the intervention. Generalized estimating equation models were used to estimate changes in the prevalence of metabolic syndrome. Analyses were stratified by day work versus shift work. Results: The results showed a significantly decreased prevalence of metabolic syndrome 6-9 months following the intervention in day workers (risk ratio = 0.68, 95% confidence interval 0.52-0.88), but the benefit disappeared after 1.5-2 years. Shift workers showed a decreased prevalence of metabolic syndrome for the whole follow-up duration after the intervention, although the change was not statistically significant. Conclusion: Reducing working hours was associated with short-term improvement in metabolic syndrome in male manual workers.
Ultra-processed foods, falling under group 4 of the Nova classification system, are manufactured from processed food ingredients such as oils, fats, sugars, starch, and protein isolates, containing minimal to no whole food. They commonly incorporate flavorings, colorings, emulsifiers, and various cosmetic additives to enhance their palatability. Ultra-processed foods have become increasingly prevalent in contemporary society owing to their convenience, affordability, extended shelf life, and enhanced taste and aroma through additives. This surge in the consumption of ultra-processed foods has sparked discussions regarding its adverse health effects. Numerous studies have highlighted that an increased intake of ultra-processed foods elevates the risk of metabolic disorders, such as cardiovascular diseases, obesity, and diabetes, along with an increased risk of various cancers. Moreover, its association with an increased mortality risk underscores the importance of recognizing that opting for these foods based solely on taste and convenience is risky. Thus, by recognizing dietary habits as modifiable factors that can prevent health issues, maintaining a balanced diet with diverse nutrient intakes is crucial for overall health. Therefore, raising awareness and understanding of ultra-processed food consumption can significantly contribute to promoting healthy lifestyles.
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