• Korean Journal of Community Nutrition
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• v.2 no.5
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• pp.721-727
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• 1997

This study investigated whether dietary factors are more influential factor than other health behavior such as drinking, smoking and exercise on abnormal serum cholesterol level inspite of Korean dietary pattern differences compared to Europeans and Americans. A double case control study model has been used for the study design. One model consisted of high blood cholesterol cases and control. the other model consisted of low blood cholesterol cased and controls. 5.398 sedentary male workers who had taken medical examinations at a university hospital were used as the study subjects. Out of the study subjects, 36individuals with high blood cholesterol cases and 30 individuals with low blood cholesterol cases were selected. For the 66 individual control selection, the individual control selection, the individuals matching method was adopted. The food frequency method was used to collect the data for assessment of the dietary factors. A standardized questionnaire was used to investigate other health behavior. logistic regression analysis was employed to measure the relative importance between the factors considered. There were no statistically significant differences observed in nutrients consumption or other health behavior among the low, normal and high blood cholesterol groups, An overmatching effect had been suspected as the cause of those findings. However, the results of logistic regression analysis to identify the factors influencing high serum cholesterol showed that odd ratios of dietary factors such as tocopherol(3.0) and saturated fatty acid(1.6) were higher than I. I of smoking and 1.2 of drinking. Similar results were also observed incases of low serum cholesterol. The above findings imply that although the dietary pattern is quite different from that of Europeans and America, the dietary factor is still a significant factor for abnormal blood cholesterol in Koreans. Therefore, the dietary risk factor identified in high fat consumption populations are still relevant for the relatively healthy Korean as guideline for preventive health practices. (Korean J Community Nutrition 2(5) : 721∼727, 1997)

• Korean Journal of Community Nutrition
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• v.6 no.2
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• pp.162-171
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• 2001

This study was performed to investigate the relationship between obesity, health-related lifestyle, and dietary intake and serum lipid level in 96 male university students. Health-related lifestyle factors were obtained from questionnaires. Dietary intakes were evaluated with one-day 24-hr recall and two-day dietary record. Anthoropometric data were recorded and serum cholesterol and triacylglycerol concentrations were measured. 21.9%, 36.5%, 36.5%, and 6.2% of the subjects had levels beyond the normal range in serum total cholesterol(TC), HDL-cholesterol(HDL-C), LDL-cholesterol(LDL-C), and triacyglycerol respectively, and 57.3% of the subjects had more than one hyperlipidemic factor. TC was correlated positively with BMI(p〈0.01), waist length(p〈0.05), hip length(p〈0.05), and the amount of smoking(p〈0.05). HDL-C was correlated negatively with BMI(p〈0.05) and hip lenghth(p〈0.05). LTD-C was correlated positively with BMI(p〈0.01), water length(p〈0.05), hip length(p〈0.01), and coffee consumption(p〈0.05). TG was correlated positively with waist length(p〈0.01), waist-to-hip ratio(p〈0.05), and amount of smoking(p〈0.01) and negatively correlated with frequence of exercise(p〈0.05). Among nutrient intakes, only the ratio of protein to energy was correlated negatively with TC(p〈0.05). Logistic regression analysis revealed that BMI, waist length, hip length, waist-to-hip ratio, and amount of cigarette smoking were associated with an increased risk of hyper-TC. BMI, waist length, and hip length were associated with an increased risk of hypo-HDL-C. BMI and coffee consumption were associated with an increased risk of hyper-LDL-C. Amount of cigarette smoking was associated with an increased risk of hyper-TG. In conclusion, a high prevalence of hyperlipidemia in subjects was observed. Also obesity, smoking, and coffee consumption were observed to be highly with the risk of hyperlipidemia in subjects. These findings imply that these factors should be primarily considered in planing the nutrition education program for the prevention of cardiovascular disease in male university students.

• Korean Journal of Community Nutrition
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• v.19 no.1
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• pp.27-40
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• 2014

Dyslipidemia is a component of the metabolic syndrome and a risk factor for cardiovascular diseases. Nutrition counseling is important to improve dyslipidemia. The purpose of this study was to evaluate the effectiveness of nutrition counseling in adults with risk factors for dyslipidemia diagnosed by the national health screening program. The nutrition counseling for adults with risk factors for dyslipidemia was carried out at a public health center in Gyeonggi-do. Thirty four patients out of forty five participants in the program completed the nutrition counseling program. The nutrition counseling was provided 3 times during a 12-week period. Individualized nutrition counseling to improve dietary habits was conducted after examining participants' dietary intake through questionnaires about dietary habits and whether they practice dietary guidelines. Data about serum lipid profiles, body composition, nutrition knowledge, the practice of dietary guidelines, and dietary behavior were collected before and after nutrition counseling to evaluate the effectiveness of nutrition counseling. All data were statistically analyzed by SPSS program (Korea ver.18.0) and significant difference was evaluated by paired t-test and ${\chi}^2$-test. Body weight, body fat and WHR were significantly decreased after nutrition counseling. Total-cholesterol, TG, and LDL-cholesterol were significantly decreased but HDL-cholesterol did not show significant changes. Both scores of nutrition knowledge and the practice of dietary guidelines improved significantly (p < 0.001). This study shows that nutrition counseling helps to encourage healthy eating practices and to improve serum lipid profiles of adults with risk factors for dyslipidemia. Overall, results indicated that nutrition counseling resulted in positive changes to lower the reliance on medications. Therefore, nutrition counseling should be considered for the initial treatment of dyslipidemia.

• Journal of the Korean Society of Food Science and Nutrition
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• v.23 no.1
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• pp.170-179
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• 1994

Atherosclerosis, a multifactorial disease, is closely related to lipid nutrition , Data from well known epidemiological studies including Seven Country , Framinghsam Study and several intervention trials have confirmed that serum cholesterol is the major risk factor and elevation of LDL-cholesterol level is most undesriable. On the basis of results concurring in that dietary saturated fat and cholesterol increase serum cholesterol while polyunsaturated fat decrease it, changes in serum choesterol level have been predicted by regression equations developed by Keys et al. and other investigators. Effects of individual fatty acids on the level of serum cholesterol have been further differentiated by chain length, cis-trans isomers and n-6 vs n-3 polyunsaturated fatty acids. Among them the effect of n-3 fatty acids has been well recogniaed as antiplatelet activity, thus reducing the incidence of atherosclerosis. Role of vitamin E in prevention of atherosclerosis has been evovled from works showing that LDL oxdiation stimulates formation of ateroma and also from epidemiologic studies. Dietary recommendations at present are : (ⅰ) 30 and 10 cal % as upper limit of total and saturated fat intakes, respectively (ⅱ) no more than 300 mg cholesterol/day, (ⅲ) 1-2 g of n-3 fatty acid/day and (ⅳ) some increase RDA of vitamin E which is 8-10 TE.

• Journal of the Korean Dietetic Association
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• v.7 no.4
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• pp.313-319
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• 2001

High serum cholesterol level is a major risk factor for coronary heart disease(CHD). Nutrition therapy of hypocholesterolemic diets with increased physical activity is the essential step in the treatment of the hypercholesterolemic patients. The purpose of this study was to evaluate the short-term effect of intensive dietary therapy combined with regular exercise in lowering serum cholesterol level. Seventy three hypercholesterolemic outpatients(mean: 268.0$\pm$24.7mg/dL), aged 34 to 73(mean: 56$\pm$9.8yrs), who visited cardiology OPD of Yonsei Cardiovascular Center from April through October, 1998 were studied. Anthropometric measurements, usual nutrient intake survey using semiquantitative food frequency questionnaire, and daily nutrient intake analysis were performed. The nutrition counseling for the hypocholesterolemic diet and exercise therapy was performed individually. After a 4 week intensive dietary therapy, comparisons of body weight, nutrient intakes, and blood lipid concentrations were evaluated for the hypocholesterolemic effect of intensive diet therapy. After 4 weeks of intensive diet therapy, significant reductions in percent ideal body weight(p<0.01), saturated fat intake(p<0.01), and cholesterol intake(p<0.01) were observed. There were significant reductions in serum total cholesterol and LDL-cholesterol levels after 4 weeks of therapy by 8.1%(p<0.01) and 9.7%(p<0.01), respectively. Our results showed that intensive dietary therapy was effective in reductions of serum total and LDL-cholesterol levels. The goal for this dietary modification should not be temporary but rather be permanent in eating behavior accompanied by appropriately increased physical activity.

• Journal of the Korean Dietetic Association
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• v.11 no.1
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• pp.125-132
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• 2005

Hypercholesterolemia has been regarded as a major risk factor of coronary heart disease(CHD). CHD is increasing in recent years among Koreans due to westernization of lifestyle and dietary behaviors. In the United States, implementation of the National Cholesterol Education Program(NCEP) had resulted 40% decline in mortality from CHD. This study was designed to evaluate the effect of medical nutrition therapy on serum lipid levels and discuss the effective nutrition education contents. Thirty outpatients(Male 40%, female 60%) with hypercholesterolemia were educated by medical nutrition therapy(MNT) protocol. At first visit and after three months of MNT, we assessed serum lipid profile, body weight and surveyed general characteristics, lifestyle and food habits through questionnaire. After 12 weeks of MNT, there were significant reductions in serum cholesterol and low-density lipoprotein cholesterol(LDL-C). Foods habits and lifestyle were changed to the desirable patterns. These results indicate that lipid profile is improved by changes of dietary behaviors and lifestyle. Especially in case of obesity, cholesterol lowering effect of MNT was more powerful. Consequently, MNT is effective on reduction of serum lipids by behavior change in hypercholesterolemic patients.

• Journal of the Korean Society of Food Science and Nutrition
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• v.30 no.1
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• pp.168-174
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• 2001

This study was conducted to investigate correlation between soybean and their products consumption and risk factors for atherosclerosis in the healthyKorean adults. Health behaviors such as smoking, exercise, alcohol consumption and dietary patterns and nutrient intakes of 193 healthy adult subjects aged from 26 to 69 were assessed by using interview and semiquantitative food frequency questionnaire. The BMI, blood pressure and biochemical parameters of blood were examined as well as preferences for taste and family history of disease. Data were expressed as quartile according to soybean and their products consumption. The average daily soybean and their product consumption for 1st, 2nd, 3rd, and 4th percentile group were 36, 78, 112, and 182g, respectively. The more consumption of soybean and their products, the more intake of energy, protein, lipid, fiber, Ca, cholesterol as well as frequency of exercise, smoking and drinking. Serum TG, total cholesterol and LDL-cholesterol and AI as risk factors of atherosclerosis were positively correlated with smoking and drinking (p<0.05). Especially, serum TG was positively correlated with hypertension and BMI (p<0.01). But, no correlation between exercise, salty taste, meat preference, soybean products consumption and atherosclerosis risk factors was found, which means that life styles such as smoking and drinking rather than dietary habits might influence atherosclerosis in healthy adults. In conclusion, present soy products consumption should be increased by way of developing new generation soy products in order to exert anti-atherosclerotic effect by soybean in human.

• Journal of Physiology & Pathology in Korean Medicine
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• v.19 no.6
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• pp.1629-1635
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• 2005

Hyperlipidemia is caused by high dietary intake of cholesterol and saturated fats, and is known as a major risk factor for atherosclerosis. In the oriental medicine, Cheunggansoyo-san (CGSYS) has been used for supplementing hematopoietic function and for treating cardiovascular disorders. In the present study, CGSYS was administered into hyperlipidemic mice. Increases in body weight and cholesterol levels induced by hyperlipidemic diets for 6 weeks were significantly inhibited by CGSYS administration. Serum levels of glucose, triglyceride, SGOT, and SGPT values were all decreased by CGSYS treatment compared with hyperlipidemic dietary mice. Moreover, CGSYS decreased LDL-cholesterol, but increased HDL-cholesterol levels in hyperlipidemic mice. Thus, the present results suggest that CGSYS appears to De effective for down-regulating risk factors of hyperlipidemia.

• Asian-Australasian Journal of Animal Sciences
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• v.9 no.1
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• pp.1-25
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• 1996

The pathogenesis of atherosclerosis can not be summarized as a single process. Lipid infiltration hypothesis and endothelial injury hypothesis have been proposed and investigated. Recent developments show that there are many points of potential interactions between them and that they can actually be regarded as two phases of a single, unifying hypothesis. Among the many risk factors of atherosclerosis, plasma homocysteine and lipoprotein(a) draw a considerable interest because they are independent indicators of atherogenicity. Triglyceride (TG)-rich lipoproteins (chylomicron and VLDL) are not considered to be atherogenic but they are related to the metabolism of HDL cholesterol and indirectly related to coronary heart disease (CHD). LDL can of itself be atherogenic but the oxidative products of this lipoprotein are more detrimental. HDL cholesterol has been considered to be a favorable cholesterol. The so-called 'causalist view' claims that HDL traps excess cholesterol from cellular membranes and transfers it to TG-rich lipoproteins that are subsequently removed by hepatic receptors. In the so-called 'noncausalist view', HDL does not interfere directly with cholesterol deposition in the arterial wall but instead reflects he metabolism of TG-rich lipoproteins and their conversion to atherogenic remnants. Approximately 70-80% of the human population shows an effective feedback control mechanism in cholesterol homeostasis. Type of dietary fat has a significant effect on the lipoprotein cholesterol metabolism and atherosclerosis. Generally, saturated fatty acids elevate and PUFA lower serum cholesterol, whereas MUFA have no specific effect. EPA and DHA inhibit the synthesis of TG, VLDL and LDL, and may have favourable effects on some of the risk factors. Phospholipids, particularly lecithin, have an antiatherosclerotic effect. Essential phospholipids (EPL) may enhance the formation of polyunsaturated cholesteryl ester (CE) which is less sclerotic and more easily dispersed via enhanced hydrolysis of CE in the arterial wall. Also, neutral fecal steroid elimination may be enhanced and cholesterol absorption reduced following EPL treatment. Antioxidants protect lipoproteins from oxidation, and cells from the injury of toxic, oxidized LDL. The rationale for lowering of serum cholesterol is the strong association between elevation of plasma or serum cholesterol and CHD. Cholesterol-lowing, especially LDL cholesterol, to the target level could be achieved using diet and combination of drug therapy. Information on the link between cholesterol and CHD has decreased egg consumption by 16-25%. Some clinical studies have indicated that dietary cholesterol and egg have a significant hypercholesterolemic effect, while others have indicated no effect. These studies differed in the use of purified cholesterol or cholesterol in eggs, in the range of baseline and challenge cholesterol levels, in the quality and quantity of concomitant dietary fat, in the study population demographics and initial serum cholesterol levels, and clinical settings. Cholesterol content of eggs varies to a certain extent depending on the age, breed and diet of hens. However, egg yolk cholesterol level is very resistant to change because of the particular mechanism involved in yolk formation. Egg yolk contains a factor of factors responsible for accelerated cholesterol metabolism and excretion compared with crystalline cholesterol. One of these factors could be egg lecithin. Egg lecithin may not be as effective as soybean lecithin in lowering serum cholesterol level due probably to the differences of fatty acid composition. However, egg lecithin may have positive effects in hypercholesterolemia by increasing serum HDL level and excretion of fecal cholesterol. The association of serum cholesterol with egg consumption has been widely studied. When the basal or control diet contained little or no cholesterol, consumption of 1 or 2 eggs daily increased the concentration of plasma cholesterol, whereas that of the normolipemic persons on a normal diet was not significantly influenced by consuming 2 to 3 eggs daily. At higher levels of egg consumption, the concentration of HDL tends to increase as well as LDL. There exist hyper-and hypo-responders to dietary (egg) cholesterol. Identifying individuals in both categories would be useful from the point of view of nutrition guidelines. Dietary modification of fatty acid composition has been pursued as a viable method of modifying fat composition of eggs and adding value to eggs. In many cases beneficial effects of PUFA enriched eggs have been demonstrated. Generally, consumption of n-3 fatty acids enriched eggs lowered the concentration of plasma TG and total cholesterol compared to the consumption of regular eggs. Due to the highly oxidative nature of PUFA, stability of this fat is essential. The implication of hepatic lipid accumulation which was observed in hens fed on fish oils should be explored. Nutritional manipulations, such as supplementation with iodine, inhibitors of cholesterol biosynthesis, garlic products, amino acids and high fibre ingredients, have met a limited success in lowering egg cholesterol.

• Clinical and Experimental Pediatrics
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• v.55 no.4
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• pp.128-135
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• 2012

Purpose: Unbalanced diets and decreased physical activity have contributed to increased prevalence of obesity and metabolic syndrome in adolescents. We have performed a systematic review and data analysis to examine the association between dietary pattern and metabolic syndrome risk factors in adolescents. Methods: We searched the PubMed and BioMedLib databases for appropriate articles published during the past 10 years and selected 6 articles. The studies reviewed applied factor analysis or cluster analysis to extract dietary patterns. For data analysis, we examined the association between dietary patterns and the prevalence of metabolic syndrome risk factors using data of 3,168 adolescents (13 to 18 years) obtained from 4 consecutive Korean Nutrition Health and Nutrition Examination Surveys (1998, 2001, 2005, and 2007 to 2009). Results: Our systematic review confirmed that western dietary patterns are positively associated with metabolic syndrome risk factors such as obesity and elevated triglycerides, while traditional dietary patterns were negatively associated. Data analysis found that the number of adolescents aged 16 to 18 years who had "Rice & Kimchi" dietary pattern decreased, while the number having western dietary patterns increased during the 1998 to 2009 time frame. There were no changes in the dietary patterns in adolescents aged 13 to 15 years. The risk of elevated serum triglycerides and reduced serum high density lipoprotein cholesterol was high in the "Rice & Kimchi" dietary pattern compared to the other dietary pattern groups. Conclusion: Because adolescents' dietary patterns are changing continuously and have long-term effects, further studies on the dietary patterns of adolescents and their health effects into adulthood are necessary.