BACKGROUND: Dietary patterns have a significant impact on prognosis, recurrence, and survival in patients with cancer. This study investigated dietary patterns using the Diet Quality Index-International (DQI-I) in cancer survivors compared to those in the general population without cancer.METHODS: Using the Korea National Health and Nutrition Examination Survey VI data, cancer survivors were defined as those diagnosed with cancer more than 1 year before the survey. The associations between possible predictors and the DQI-I score were examined using t-tests and analysis of variance. Adjusted multiple linear regression analysis was performed to compare the differences in DQI-I scores between cancer survivors and controls.RESULTS: In univariate analysis of 9,351 subjects (433 cancer survivors and 8,918 controls), age, sex, body mass index, marital status, education level, income, residential area, smoking status, and alcohol consumption were associated with the DQI-I score (each P-value < 0.05). After adjustment, cancer survivors showed higher DQI-I scores than the controls (67.40±8.90 vs. 65.50±9.40, P-value=0.007). In subgroup analysis, cancer survivors within 5 years after cancer diagnosis showed higher DQI-I scores than the controls (68.70±8.30 vs. 65.50±9.40, P-value=0.034), whereas those who survived beyond 5 years post-diagnosis did not show significant differences from the controls (66.70±9.20 vs. 65.50±9.40, P-value=0.063).CONCLUSION: Cancer survivors within 5 years of cancer diagnosis showed better dietary patterns than those in the general population. However, the differences were not observed after 5 years post-diagnosis. To reduce the risks of second primary cancer and mortality, targeted inventions for dietary habits are necessary for long-term survivors of cancer.
Alcohol Drinking ; Body Mass Index ; Diagnosis ; Diet ; Education ; Food Habits ; Humans ; Inventions ; Korea ; Linear Models ; Marital Status ; Mortality ; Neoplasms, Second Primary ; Nutrition Surveys ; Prognosis ; Recurrence ; Smoke ; Smoking ; Survivors

BACKGROUND: Several studies have shown that negative mental health increases risky health behavior and mortality risk. We investigated the relationship between mental health and health behavior, and the causal association between mental health and mortality risk. METHODS: We used data from the 8-year (2006–2014) Korean Longitudinal Study of Aging with a cohort of 10,247 individuals (whom we divided into a younger group aged <65 years and an older group aged ≥65 years). Mental health was assessed with the following factors: depression, social engagement, and satisfaction of life. Health behavior was assessed with smoking, alcohol use, and regular exercise. Mortality risk was calculated using survival status and survival months as of 2014. Multiple logistic regression and Cox proportional hazard analysis were performed. RESULTS: Negative mental health was associated with current smoking and sedentary life style, but not with alcohol consumption. In addition, it was associated with an increase in all-cause mortality risk. The increase in mortality risk in the highest quartile (vs. lowest) was 1.71 times (hazard ratio [HR], 1.71; 95% confidence interval [CI], 1.12–2.62) and 2.07 times (HR, 2.07; 95% CI, 1.60–2.67) for the younger and older group, respectively. CONCLUSION: Our results show that mental health affects health behavior and mortality risk. A key inference from this study is that improving mental health can lead to positive changes in health behavior and reduce the risk of mortality.
Aging ; Alcohol Drinking ; Cohort Studies ; Depression ; Health Behavior ; Life Style ; Logistic Models ; Longitudinal Studies ; Mental Health ; Mortality ; Smoke ; Smoking

Despite the great socioeconomic burden of stroke, there have been few reports of stroke statistics in Korea. In this scenario, the Epidemiologic Research Council of the Korean Stroke Society launched the “Stroke Statistics in Korea” project, aimed at writing a contemporary, comprehensive, and representative report on stroke epidemiology in Korea. This report contains general statistics of stroke, prevalence of behavioral and vascular risk factors, stroke characteristics, pre-hospital system of care, hospital management, quality of stroke care, and outcomes. In this report, we analyzed the most up-to-date and nationally representative databases, rather than performing a systematic review of existing evidence. In summary, one in 40 adults are patients with stroke and 232 subjects per 100,000 experience a stroke event every year. Among the 100 patients with stroke in 2014, 76 had ischemic stroke, 15 had intracerebral hemorrhage, and nine had subarachnoid hemorrhage. Stroke mortality is gradually declining, but it remains as high as 30 deaths per 100,000 individuals, with regional disparities. As for stroke risk factors, the prevalence of smoking is decreasing in men but not in women, and the prevalence of alcohol drinking is increasing in women but not in men. Population-attributable risk factors vary with age. Smoking plays a role in young-aged individuals, hypertension and diabetes in middle-aged individuals, and atrial fibrillation in the elderly. About four out of 10 hospitalized patients with stroke are visiting an emergency room within 3 hours of symptom onset, and only half use an ambulance. Regarding acute management, the proportion of patients with ischemic stroke receiving intravenous thrombolysis and endovascular treatment was 10.7% and 3.6%, respectively. Decompressive surgery was performed in 1.4% of patients with ischemic stroke and in 28.1% of those with intracerebral hemorrhage. The cumulative incidence of bleeding and fracture at 1 year after stroke was 8.9% and 4.7%, respectively. The direct costs of stroke were about ₩1.68 trillion (KRW), of which ₩1.11 trillion were for ischemic stroke and ₩540 billion for hemorrhagic stroke. The great burden of stroke in Korea can be reduced through more concentrated efforts to control major attributable risk factors for age and sex, reorganize emergency medical service systems to give patients with stroke more opportunities for reperfusion therapy, disseminate stroke unit care, and reduce regional disparities. We hope that this report can contribute to achieving these tasks.
Adult ; Aged ; Alcohol Drinking ; Ambulances ; Atrial Fibrillation ; Cerebral Hemorrhage ; Emergency Medical Services ; Emergency Service, Hospital ; Epidemiology ; Female ; Hemorrhage ; Hope ; Humans ; Hypertension ; Incidence ; Korea ; Male ; Mortality ; Prevalence ; Reperfusion ; Risk Factors ; Smoke ; Smoking ; Stroke ; Subarachnoid Hemorrhage ; Writing

Elevated high-sensitivity C reactive protein (hs-CRP) levels and metabolic syndrome are considered important predictors of cardiovascular mortality. This study examined the influence of the alcohol consumption level on the hs-CRP level and the prevalence of metabolic syndrome in South Koreans. The study subjects were 3,884 participants (≥19 years) from the KNHANES in 2015. The subjects were divided into four groups according to their alcohol consumption; None (none-alcohol consumption), Low (less than 15 g/day), Medium (15~29.9 g/day), and High (over than 30 g/day). The odds ratio for high-risk hs-CRP of men was significantly lower in the Low or Medium groups compared to the None group. In women, the odds ratio for high-risk hs-CRP was not decreased in the Low or Medium groups but was significantly higher in the High group than in the None group. Compared to nondrinkers, the prevalence of metabolic syndrome was lower in the Low group and Medium group in both men and women, whereas it was significantly higher in the High group in men only. In particular, the prevalence of low HDL-cholesterol was lower in all drinking groups. When the confounding factors were adjusted, the odds ratio for low HDL-cholesterol appeared to decline in the Low groups in both men and women. On the other hand, in the Medium group, women showed an elevated odds ratios of high blood pressure (HBP) and high fasting plasma glucose but men showed an elevated odds ratios of HBP and high triglyceride levels. The overall results suggest that low alcohol consumption is more appropriate than medium alcohol consumption. Nevertheless, more study will be needed to evaluate the appropriate alcohol consumption level.
Alcohol Drinking ; Blood Glucose ; C-Reactive Protein ; Drinking ; Fasting ; Female ; Hand ; Humans ; Hypertension ; Male ; Mortality ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Triglycerides

In the ranking of cancer incidence in the year, female breast cancer was the highest cancer after thyroid cancer in 2004–2015, and became the most common cancer in 2016, exceeding the cases of thyroid cancer. The incidence rates of breast cancer have increased steadily over the past two decades and are expected to continue to increase in the next decades, although the incidence rates of all other cancers has declined in Korea. Most of the established risk factors of breast cancer are primarily related to female sex hormones. Other known risk factors are alcohol drinking, a family history of breast cancer, genetic predisposition, and benign breast conditions. Some risk factors, such as physical activity, breastfeeding, and number of children, are modifiable factors that can be targeted for risk reduction. This article summarizes the descriptive epidemiological characteristics of breast cancer in Korea that have been reported and identifies the specific characteristics and secular trends in incidence, mortality, and survival rates of breast cancer up to the present day. It is uncertain whether the risk factors established in western populations will also be valid for the Korean population. To explore this question, we summarize the results from international collaborative studies and meta-analyses of risk factors of breast cancer published to date. The results for Koreans are summarized and described based on results from population-based or nested case-control studies, hospital case-community control studies, cohort studies, and meta-analyses conducted in Korea. This study will be helpful for risk assessment, interventions, and prevention of breast cancer.
Alcohol Drinking ; Breast Feeding ; Breast Neoplasms ; Breast ; Case-Control Studies ; Child ; Cohort Studies ; Epidemiology ; Female ; Genetic Predisposition to Disease ; Gonadal Steroid Hormones ; Humans ; Incidence ; Korea ; Mortality ; Motor Activity ; Risk Assessment ; Risk Factors ; Risk Reduction Behavior ; Survival Rate ; Thyroid Neoplasms

Rapid aging, economic development, lifestyle westernization, hygiene improvement, and scientific development have contributed for the epidemiologic changes of gastric cancer. This study aimed to review the descriptive epidemiology, risk factors, and prevention of gastric cancer in Korea. Age-standardized incidence and mortality of gastric cancer have decreased and showed age effect and cohort effect. Annual percent change in the incidence of gastric cancer has been prominent in recent years. Major risk factor of gastric cancer is Helicobacter pylori infection. Although H. pylori infection was associated with only non-cardia gastric cancer in meta-analysis, H. pylori infection was associated with both non-cardia and cardia gastric cancer in Asian studies. The estimated population attributable fraction of H. pylori regarding gastric cancer incidence was about 76% in Korean. Cigarette smoking and alcohol drinking was associated with gastric cancer regardless of cardia and non-cardia gastric cancer. Cigarette smoking was estimated to be responsible for 28% of gastric cancer incidence in men and 2% in women. Obesity was risk factor for cardia gastric cancer but not non-cardia gastric cancer. This discrepancy between cardia and non-cardia gastric cancer was consistently shown in epidemiologic studies in Korea. Salt intake was also well-known risk factor of gastric cancer and prevalence of high sodium intake more than 2,000mg in Korean was 81.5%. For primary prevention of gastric cancer, eradication of H. pylori and life-style modification including no smoking, no alcohol drinking, weight control, and low sodium intake are important. Gastric endoscopy is recommended for secondary prevention of gastric cancer.
Aging ; Alcohol Drinking ; Asian Continental Ancestry Group ; Cardia ; Cohort Effect ; Economic Development ; Endoscopy ; Epidemiologic Studies ; Epidemiology ; Female ; Helicobacter pylori ; Humans ; Hygiene ; Incidence ; Korea ; Life Style ; Male ; Mortality ; Obesity ; Prevalence ; Primary Prevention ; Risk Factors ; Secondary Prevention ; Smoke ; Smoking ; Sodium ; Stomach Neoplasms

Alcohol consumption has increased over the past 40 years in Korea concomitantly with the country's rapid socioeconomic development. As a result, alcohol-related deaths and mortality continue to increase in Korea. This review will summarize the recent epidemiology of alcoholic liver disease in Korea.
Alcohol Drinking ; Alcoholics* ; Epidemiology* ; Health Policy ; Humans ; Korea* ; Liver Diseases, Alcoholic* ; Mortality

BACKGROUND/OBJECTIVES: Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants. SUBJECTS/METHODS: The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake. RESULTS: The total DQI-K score was calculated by summing the scores of the eight components (range 0–9). In the multivariable adjusted models, with good diet quality (score 0–4) as a reference, poor diet quality (score 5–9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06–1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk. CONCLUSIONS: A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.
Adult ; Alcohol Drinking ; Body Mass Index ; Cholesterol ; Cohort Studies ; Diet* ; Energy Intake ; Fruit ; Humans ; Korea ; Male ; Mortality* ; Nutrition Policy ; Smoke ; Smoking ; Sodium ; Vegetables

BACKGROUND: Critical limb ischemia has been identified as a risk factor for the incidence of postoperative delirium in elderly patients. Limb amputation is the last option in critical limb ischemia treatments. We investigated the incidence and predisposing factors of postoperative delirium in patients undergoing major leg amputation. METHODS: From January 2012 to December 2016, 121 patients aged over 60 years who had undergone major leg amputation were enrolled in this study. Various factors related to the patients’ outcomes were assessed, including demographic, preoperative laboratory, anesthetic, surgical, and postoperative indicators. RESULTS: Twenty two patients were excluded and 99 patients were assigned to either the delirium group or no delirium group. Forty of them (40%) developed a delirium during 30 days postoperatively. Univariate analysis implied that end-stage renal disease on hemodialysis, alcohol consumption, C-reactive protein, staying in an intensive care unit (ICU), duration of an ICU stay, occurrence of complications, and mortality during six months, were the factors that accounted for significant differences between the two groups. In multivariate analysis, three factors were significantly related to the development of delirium: mortality during six months (odds ratio [OR] = 13.86, 95% CI [2.10–31.90]), alcohol (OR = 8.18, 95% CI [1.13–16.60]), and hemodialysis (OR = 4.34, 95% CI [2.06–93.08]). CONCLUSIONS: Approximately 40% of the elderly patients suffered from postoperative delirium in major leg amputation. Identifying those with risk factors for postoperative delirium and intervening at the early stage will be of great benefit in major leg amputations for the elderly population.
Aged* ; Alcohol Drinking ; Amputation* ; C-Reactive Protein ; Causality ; Delirium* ; Extremities* ; Humans ; Incidence ; Intensive Care Units ; Ischemia* ; Kidney Failure, Chronic ; Leg* ; Mortality ; Multivariate Analysis ; Renal Dialysis ; Retrospective Studies* ; Risk Factors

PURPOSE: Low muscle strength is central to geriatric physical disabilities and mortality. The purpose of the present study was to examine handgrip strength (HGS) and its associated factors among community-dwelling older people in Sri Lanka. METHODS: A cross-sectional study was conducted in the Kandy district using multistage sampling. A total of 999 older people were recruited, with a female preponderance. Data were collected using interviewer-administered questionnaires on demographic characteristics, depression, and physical activity. Anthropometric measurements including weight, height, mid-upper arm circumference, calf circumference, and HGS were recorded. Complex sample general linear model was used to examine the association between HGS and its associated factors. RESULTS: The mean highest HGS of the study group was 12.56 kg (95% confidence interval: 11.94–13.19). Male older people had a higher HGS (17.02, 95% confidence interval: 15.55–18.49 kg) than females (10.59, 95% confidence interval: 10.12–11.06 kg). For both men and women, older age was associated with lower HGS, while mid-upper arm circumference was associated with better HGS. Diabetes mellitus, vegetarian diet, and alcohol consumption were associated with HGS for women only. CONCLUSION: Men had a higher HGS compared with women. Age, mid-upper arm circumference, diabetes mellitus, vegetarian diet, and alcohol consumption were factors associated with HGS among community-dwelling older people in Kandy district, Sri Lanka. HGS can be used as a feasible strategy to improve health status of older people by community health nurses.
Aged* ; Alcohol Drinking ; Arm ; Cross-Sectional Studies* ; Depression ; Diabetes Mellitus ; Diet, Vegetarian ; Female ; Hand Strength ; Humans ; Independent Living ; Linear Models ; Male ; Mortality ; Motor Activity ; Muscle Strength ; Nurses, Community Health ; Sri Lanka*