• Journal of Sasang Constitution and Immune Medicine
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• v.34 no.1
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• pp.46-57
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• 2022

Background Adherence to healthy diet acts as a key role to modify sedentary lifestyle in real life setting. Constitution type of traditional Korean medicine has been prediagnosed to risk factors of cardiometabolic diseases. This study aims to evaluate the associations between body composition and healthy eating status in Korean adults by their constitution type. Methods Of 4046 participants from Korean Medicine Daejeon Citizen Cohort study, Korean Medicine Daejeon Citizen Cohort (KDCC) study were included for analysis. Demographic, health-related behaviors and Korean Medicine (KM) type were surveyed based on a general health-related questionnaire. Anthropometric measurements and dietary factors by using Korean Healthy Eating Index (KHEI) were assessed only in the half of the original participants. Results 50.8% of Taeeum was observed from eligible 1967 participants (66.7%, women). The highest KHEI score was observed in soyang group (52.0±0.3, p=0.006) compared to other two groups. In taeeum group, lower appendicular skeletal muscle mass (ASM)(%)(Taeeum: 38.7±0.1 vs. Soeum/Soyang: 39.2±0.1, p < 0.05), and higher percent of body fat (PBF)(%) (Taeeum: 32.9±0.2 vs. Soeum/Soyang: 29.0±0.2, p < 0.05) by the lowest tertile (T1) of the KHEI score, respectively. When the KHEI score increased by 1 point in taeeum group, a positive relationship was observed, which increased by 0.015% of ASM, however, a negatively related to in which body fat mass (BFM) decreased by 0.022 kg and PBF decreased by 0.024%. Conclusion Customized nutritional management is required that could help maintaining physical health and diet by their constitution type.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4567-4575
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• 2016

A number of studies have evidenced the effect of modifiable lifestyle factors such as diet, breastfeeding and nutritional status on breast cancer risk. However, none have addressed the missing data problem in nutritional epidemiologic research in South America. Missing data is a frequent problem in breast cancer studies and epidemiological settings in general. Estimates of effect obtained from these studies may be biased, if no appropriate method for handling missing data is applied. We performed Multiple Imputation for missing values on covariates in a breast cancer case-control study of $C{\acute{o}}rdoba$ (Argentina) to optimize risk estimates. Data was obtained from a breast cancer case control study from 2008 to 2015 (318 cases, 526 controls). Complete case analysis and multiple imputation using chained equations were the methods applied to estimate the effects of a Traditional dietary pattern and other recognized factors associated with breast cancer. Physical activity and socioeconomic status were imputed. Logistic regression models were performed. When complete case analysis was performed only 31% of women were considered. Although a positive association of Traditional dietary pattern and breast cancer was observed from both approaches (complete case analysis OR=1.3, 95%CI=1.0-1.7; multiple imputation OR=1.4, 95%CI=1.2-1.7), effects of other covariates, like BMI and breastfeeding, were only identified when multiple imputation was considered. A Traditional dietary pattern, BMI and breastfeeding are associated with the occurrence of breast cancer in this Argentinean population when multiple imputation is appropriately performed. Multiple Imputation is suggested in Latin America's epidemiologic studies to optimize effect estimates in the future.

• Journal of Nutrition and Health
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• v.46 no.6
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• pp.521-530
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• 2013

Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake < 1.0 g/kg IBW, 11 men and 19 women) and adequate protein intake group (API, protein intake ${\geq}$ 1.0g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.

• Journal of the Korean Dietetic Association
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• v.15 no.3
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• pp.311-327
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• 2009

This study was performed to determine the health and nutritional risk factors associated with hypertension in Koreans over the age of 50 in a high-income class (more than twice as much family income as the 2005 Korean minimum cost of living, 668,540 Won). A total of 505 subjects aged over 50 from the 2005 Korean National Health and Nutrition Examination Survey (KNHANES) were divided into two groups: A hypertension group (HG) (N=151, Systolic Blood Pressure ${\geq}$140 mmHg or Diastolic Blood Pressure ${\geq}$90 mmHg) and normal group (NG) (N=354). Subjects who took hypertension medicines or underwent diet therapy were excluded. In HG, mean daily alcohol intake and the amount of alcohol consumption per one occasion were significantly higher than in NG, respectively. A greater number of hypertension subjects answered that they drank alcohol to reduce stress as compared to normal subjects. HG also took fewer dietary supplements than NG. Mean body mass index (BMI), waist circumference, fasting blood sugar level, and 2 hour postprandial blood sugar following a glucose load were significantly higher in HG than in NG, respectively. Also, iron, thiamin, and niacin intakes and the consumption frequency of seaweeds were significantly lower in HG than in NG, respectively. Finally, obesity (BMI ${\geq}$25 $kg/m^2$), abdominal obesity (waist circumference ${\geq}$90 cm for males, ${\geq}$ 80 cm for females), high blood sugar level 2 hours after an oral glucose load (${\geq}$140~200 mg/dl), and hypertriglyceridemia (serum TG ${\geq}$200 mg/dl) were related to a significantly higher risk of hypertension in the subjects (odds ratio: 1.884~3.040). In conclusion, dietary factors such as higher alcohol consumption; lower intakes of iron, thiamin, and niacin; lower consumption frequency of seaweeds; and metabolic syndrome were associated with hypertension in the study subjects.

• Korean Journal of Community Nutrition
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• v.19 no.2
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• pp.187-197
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• 2014

Objectives: This study was carried out to determine nutritional status of elderly patients in a long-term care hospital according to meal type and eating ability. Methods: Subjects were 47 female patients aged over 65 ($79.3{\pm}7.1$ years) who resided in a long-term care hospital in Seoul. Thirty seven patients who ate diet orally were grouped according to meal type (27 general diet and 10 soft diet) and eating ability (26 eating by oneself and 11 eaten with help) and 10 were on tube feeding. Nutritional status was determined by food consumption and mid-arm circumference. Results: The mean adequacy ratios (MARs) of 12 nutrients (protein, calcium, phosphorus, zinc, vitamin A, vitamin $B_1$, vitamin $B_2$, vitamin $B_6$, niacin, folic acid, vitamin C) were 0.687 for general diet, 0.565 for soft diet, 0.680 for eating by oneself and 0.677 for eaten with help, which were significantly lower than 0.982 for tube feeding (p < 0.05 or p < 0.01). The patients on tube feeding had significantly lower % arm circumference compared to those who ate general diet (84.0% vs. 95.4%, respectively, p < 0.05). Nutrients intakes, nutrient adequacy ratio (NAR) and index of nutritional quality (INQ) were not different between meal types as well as eating ability. The most insufficiently consumed nutrients by the patients on diet were folic acid, vitamin $B_2$, and calcium (NAR 0.334~0.453, 0.515~ 0.539, and 0.516~0.533, respectively). Conclusions: The results suggested that regardless of meal type or eating ability, the subjects who were on diets in this study might have inadequate intake of folic acid as well as vitamin $B_2$, and calcium, which need to be reflected on menu planning. The measurement of mid-arm circumference presented more risk of malnutrition of patients on tube feeding than those on diets, despite apparently better nutrient consumption.

• Nutritional Sciences
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• v.6 no.4
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• pp.239-245
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• 2003

The $\beta$3-adrenergic receptor ($\beta$3AR) plays a major role in thermogenesis and lipolysis in brown and visceral adipose tissue, and has been implicated in the pathogenesis of obesity and metabolic disorders. The purpose of this study was to estimate the effects of $\beta$3AR gene polymorphism on the risk of hyperglycemia in 980 Korean women who attended a weight loss program in a local clinic. Each subject s height, weight, BMI, WHR, obesity index and body composition were measured. The genotype of the $\beta$3AR gene in codon 64 was analyzed by the PCR RFLP method. Serum concentrations of fasting glucose, of total and HDL cholesterol, and of TG were determined. Genotype distributions were as follows : 67% WW type, 31% WR type, and 2% RR type. Among the many measured parameters, fasting glucose levels were significantly higher in the WR/RR type compared with the WW type (p=0.0ll). When the subjects were divided into two groups by a fasting blood glucose level higher or lower than 6.105mmol/L (110mg/dl), the frequency of hyperglycemia showed a significant difference in relation to $\beta$3AR genotype as measured by $\X^2$-analysis (p=0.014); the frequency of hyperglycemia was significantly higher (at 24.8%) in WR/RR type subjects, compared to 18.2% in WW type subjects. When all of the measured parameters were included in stepwise logistic regression analyses to find the risk factors for hyperglycemia, the odds ratios for hyperglycemia were 1.573 (p=0.0ll) for the WR/RR type of the $\beta$3AR gene, 1.053 (p=0.001) for TG, 1.044 (p=0.037) for BMI, and 1.026 for age (p=0.031). These data suggest that the WR/RR genotype of the $\beta$3AR has a very strong association with increased blood glucose level and might be a significant risk factor for hyperglycemia among Korean women.

• Korean Journal of Community Nutrition
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• v.19 no.2
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• pp.111-121
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• 2014

Objectives: In this study, perception of body image, eating attitudes and weight control were examined by the degree of obesity using Body Mass Index (BMI). Methods: Out of 420 questionnaires distributed to the female middle school students (aged 12-16 years), 407 were returned (97% response rate) and 395 were analyzed (94% analysis rate). Female students were divided into two groups based on the BMI percentile using the 2007 Korean National Growth Charts. (1) normal weight ($5^{th}$ percentile ${\leq}$ BMI < $85^{th}$ percentile) (2) obese ($85^{th}$ percentile ${\leq}$ BMI) by 2007 Korean National Growth Charts. Satisfaction of self-body shape, risk of disturbed eating attitudes (Eating Attitude Test : EAT-26), and weight control behaviors were examined. Results: Distribution of the subjects by BMI was 74.5% of normal and 25.5% of obese. There were significant differences between self-perceived current body image and self-perceived ideal body image. The dissatisfaction of body image was higher in obese than in normal groups (p<0.001). 51.4% of female students were unsatisfied with their body image, while 2.6% were very satisfied. Among the students unsatisfied with their body image, 150 (52.1%) were of normal weight and 48 (49.4%) were obese. EAT-26 total scores were significantly higher in the obese group ($16.42{\pm}8.23$) compared with normal group ($13.72{\pm}8.10$) (p<0.01). Attempted to weight control were significantly different by the BMI (p<0.001). Conclusions: This study concludes that there was desire to become thinner than current status in female students, even those with normal BMI. Many female students were dissatisfied with their body image and attempted to lose weight. It is harmful to their health and nutritional status if they choose undesirable methods. These findings suggested that there are needs to encourage female students for maintaining healthy weight. A higher score of EAT-26 was associated with dissatisfaction of selfbody image and this may lead to unhealthy behaviors in obese female students.

• Journal of Nutrition and Health
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• v.47 no.6
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• pp.403-415
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• 2014

Purpose: This study was conducted in order to investigate the nutrient and food intake status, and dietary quality in Korean adults according to abdominal obesity based on waist circumference. Methods: We analyzed data from the combined 2010~2012 KNHANES (Korean National Health and Nutrition Examination Survey). The analysis included 6,974 adults aged 40 to 64 years. In this study, according to abdominal obesity based on waist circumference (male ${\geq}$ 90 cm, female ${\geq}$ 85 cm), we classified the subjects into the obesity group (male, n = 775, female, n = 1,113) and control group (male, n = 2,038, female, n = 3,048). The nutrient and food group intake, ND (nutrient density), NAR (nutrient adequacy ratio), MAR (mean adequacy ratio), INQ (index of nutritional quality), DDS (dietary diversity score), and DVS (dietary variety score) were analyzed using data from the 24-recall method. Results: For male, no significant difference in quality index of the diet was observed between the obesity group and the normal group. In female, in diet quality (ND, NAR, and INQ), vitamin $B_2$ (ND, NAR, and INQ) calcium (NAR), phosphorous (ND, INQ) and potassium (ND) of the obesity group was significantly lower than those of the control group. DDS and DVS in the obesity group (3.57, 30.95) were significantly lower than those of the control group (3.68, 32.84) (p = 0.0043, 0.0002). DVS (DVS ${\geq}$ 39.9) showed association with lower risk of waist obesity in a logistic regression model after adjustments for multiple confounding factors including age, education, income, alcohol intake frequency, smoking, physical activity, energy intake, and body mass index (OR: 0.616, 95% CI: 0.420-0.903). Conclusion: In conclusion, females with abdominal obesity had lower micronutrient intake quality, DVS than those of the control group. In Korean females, food intake variety can adversely affect waist circumference.

• Journal of Preventive Medicine and Public Health
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• v.48 no.2
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• pp.94-104
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• 2015

Objectives: Mental health disorders and suicide are an important and growing public health concern in Korea. Evidence has shown that both globally and in Korea, obesity is associated with an increased risk of developing some psychiatric disorders. Therefore, we examined the association between distorted body weight perception (BWP) and suicidal ideation. Methods: Data were obtained from the 2007-2012 Korea National Health and Nutritional Evaluation Survey (KNHANES), an annual cross-sectional nationwide survey that included 14 276 men and 19 428 women. Multiple logistic regression analyses were conducted to investigate the associations between nine BWP categories, which combined body image (BI) and body mass index (BMI) categories, and suicidal ideation. Moreover, the fitness of our models was verified using the Akaike information criterion. Results: Consistent with previous studies, suicidal ideation was associated with marital status, household income, education level, and perceived health status in both genders. Only women were significantly more likely to have distorted BWP; there was no relationship among men. In category B1 (low BMI and normal BI), women (odds ratio [OR], 2.25; 95% confidence interval [CI], 1.48 to 3.42) were more likely to express suicidal ideation than women in category B2 (normal BMI and normal BI) were. Women in overweight BWP category C2 (normal BMI and fat BI) also had an increased OR for suicidal ideation (OR, 2.25; 95% CI, 1.48 to 3.42). Those in normal BWP categories were not likely to have suicidal ideation. Among women in the underweight BWP categories, only the OR for those in category A2 (normal BMI and thin BI) was significant (OR, 1.34; 95% CI, 1.13 to 1.59). Conclusions: Distorted BWP should be considered an important factor in the prevention of suicide and for the improvement of mental health among Korean adults, especially Korean women with distorted BWPs.

• Nutritional Sciences
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• v.2 no.2
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• pp.71-75
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• 1999

Epidemiologic studies consistently demonstrate an inverse relationship between risk for colon canter and consumption of fruits and vegetables. Wheat bran, flax and soy contain dietary fiber and phytochemicals, such as lignans and isoflavones, that may inhibit colon carcinogenesis. Orange juice contains hesperidin, a flavanone glucoside that protects against colon carcinogenesis. This study determined if feeding orange juice, wheat bran, soy and flaxseed (combined diet) would inhibit azoxymethane (AOM) induced colon cancer. Cancer was initiated in male Fisher 344 rats by injecting 15 mg AOM/kg of weight at 22 and 29 days of age. One week after the second AOM injection, rats (N = 30) in the combined diet group received dry diet containing wheat bran (4%), soy with ethanol soluble phytochemirals(13%) and flaxseed (8%) and orange juice replaced drinking water. The control group remained on the control diet and received distilled water to drink. The rats were killed 28 weeks later, and colon tissues and tumors were removed for histologic analysis. Feeding the combined diet significantly reduced tumor incidence (p < 0.05), however tumor multiplicity was not changed (p > 0.05, 0.9 tumors/rat fed the combined diet vs 1.2 for controls). Also, tumor burden was only marginally reduced in rats fed the combined diet vs control rats (65 vs 210 mg of tumor/rats, respectively). The reduction in tumor incidence was associated with a decreased labeling index and proliferation zone in normal appearing colon mucosa. Therefore, this study shows that phytochemicals in wheat bran, soy, flax and orange juice reduce colon carcinogenesis, presumably by decreasing cell proliferation and enhancing cell differentiation.