The funding acknowledgment in this article was omitted as published.

OBJECTIVES: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. METHODS: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. RESULTS: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher (3.82 ± 0.22%) than the normal group (2.73 ± 0.09%) and sarcopenia group (3.17 ± 0.22%) (p < 0.000). The odd ratios (ORs) for the ≥7.5% 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). CONCLUSIONS: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.
Absorptiometry, Photon ; Blood Pressure ; Cardiovascular Diseases* ; Cholesterol ; Cholesterol, HDL ; Cholesterol, LDL ; Cohort Studies ; Education ; Female ; Glucose ; Humans ; Korea* ; Muscle, Skeletal ; Nutrition Surveys* ; Obesity* ; Prevalence ; Risk Factors ; Sarcopenia* ; Triglycerides ; Waist Circumference ; Young Adult

This study was conducted to validate a food frequency questionnaire (FFQ) to assess vitamin K intake in clinical and research settings based on data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). We collected a subset of data on informative food items using the 24-hour recall method from adults aged 19 to 64 years from KNHANES V. The cumulative percent contribution and cumulative multiple regression coefficients for vitamin K intake from each food were computed. Twenty-five foods items were selected for the FFQ to assess vitamin K intake. The FFQ was validated against intakes derived from a 5-day food record (5DR) (n = 48). To assess the reliability of the FFQ, participants completed the self-administered FFQ (FFQ1) and a second FFQ (FFQ2) after a 6-month period (n = 54). Data were analyzed using Pearson's correlation coefficients, the cross-classification method, and Bland-Altman plots. Mean intakes were similar for vitamin K between the FFQ and dietary records, with significant correlations observed (r = 0.652), and cross-classification analyses demonstrated no major misclassification of participants into intake quartiles. Bland-Altman plots showed no serious systematic bias between the administrations of the two dietary assessment methods over the range of mean intakes. FFQ reliability was high, with a Pearson's correlation coefficient of 0.560. This pilot study shows promising validation and reliability evidence for the use of this FFQ, which is focused on vitamin K intake in adults, as an efficient screening tool in clinical and research settings.
Adult* ; Bias (Epidemiology) ; Diet Records ; Humans ; Korea ; Mass Screening ; Methods ; Nutrition Surveys ; Pilot Projects ; Reproducibility of Results* ; Vitamin K* ; Vitamins*

The purpose of this study was performed to evaluate the prevalence of overweight and to compare the dietary behaviors, nutrient intake and physical activities of specialized game high school students. Total of 163 subjects participated and their weight, height, waist circumference, hip circumference and bone status by a quantitative ultrasound method were measured. The subjects were surveyed by a self-administered questionnaire about general characteristics, dietary behaviors and physical activities. Nutrient intakes of the subjects were assessed by semi-quantitative food frequency questionnaire. The subjects were divided into four groups on their obesity level by BMI. The prevalence of underweight, normal, overweight and obese group was 6%, 58%, 16%, and 20% respectively. BMI was negatively correlated with bone mineral density (p < 0.01) and positively correlated with WHR (p < 0.01). The dietary guideline compliance score for "Enjoy Korean rice food style" was 2.63, followed by "Prepare food sanitarily" 2.48, "Do not skip breakfast" 2.29, "Eat a variety of vegetables, fruits, dairy products daily" 2.25, "Drink water instead of beverage" 2.10, "Choose less fried foods" 2.09 and "Maintain healthy weight" 1.91. The exercise frequency of walking was not significantly different between groups; however, heavy exercise frequency was significantly lower in underweight group than the other groups (p < 0.05). The energy intake was 2153 kcal, which was 81.2% of the Estimate Energy Requirement, and the intake of calcium and vitamin B2 was 66.7% and 77.8% of KDRIs. Particularly, the intake of iron, vitamin A and vitamin C was about 59.4%, 52.2% and 55.4% of KDRIs and INQ was 0.71, 0.63 and 0.65 respectively, and intake of folic acid fell behind 39.1% of KDRIs and INQ was 0.46. Our study suggests that the systematic and continuous nutrition education will have to be provided at schools to improve dietary and health behaviors and prevent chronic metabolic disease for students of specialized game high school.
Ascorbic Acid ; Bone Density ; Calcium ; Compliance ; Dairy Products ; Energy Intake ; Folic Acid ; Fruit ; Health Behavior ; Hip ; Humans ; Iron ; Metabolic Diseases ; Motor Activity ; Obesity ; Overweight ; Prevalence ; Surveys and Questionnaires ; Riboflavin ; Thinness ; Vegetables ; Vitamin A ; Waist Circumference ; Walking ; Water

Osteoprotegerin (OPG) plays a core role in bone reformation by antagonizing the effect of receptor activator of nuclear factor kappa-B ligand (RANKL), and mediates vascular calcification in cardiovascular disease patients. Thus, we aimed to examine the relationship between serum OPG levels and cardiovascular factors and inflammatory markers in metabolic syndrome patients (MS). This cross-sectional study included 96 men who visited the diet clinic between May and July 2011. Patients were classified into 2 groups based on NCEP-ATP guidelines: normal and with MS (n = 50 and 46, respectively). Physical measurements, biochemical assay were measured. Serum OPG and IL-6, diponectin and hs-CRP were assessed. MS were aged 50.02 +/- 10.85 years, and normal patients 52.07 +/- 9.56 years, with no significant differences. Significant differences were not observed in BMI between the 2 groups. Moreover, significant differences were not observed in serum OPG, however, the serum OPG level (4.41 +/- 1.86 pmol/L) differed significantly between an overweight MS (BMI > 25) and normal patients. OPG was correlated to age (r = 0.410, p = 0.000), HDL-cholesterol (r = 0.209, p = 0.015), and log adiponectin (r = 0.175, p = 0.042). Multiple regression analyses using the enter method showed that age (beta = 0.412, p = 0.000) and BMI (beta = 0.265, p = 0.000) considerably affected OPG. In conclusion, out study showed that serum OPG levels are correlated with cardiovascular risk factors, such as BMI, HDL-cholesterol and adiponectin in MS and adiponectin, suggesting that serum OPG has potential as a cardiovascular disease indicator and predictor.
Adiponectin ; Aged ; Cardiovascular Diseases ; Cross-Sectional Studies ; Diet ; Humans ; Interleukin-6 ; Male ; Obesity ; Osteoprotegerin ; Overweight ; Plasma ; Risk Factors ; Vascular Calcification

An increase in the prevalence of dyslipidemia has been strongly associated with the mortality rate of cardiovascular disease. We conducted a cross-sectional analysis to determine the relationship between dietary patterns and dyslipidemia in adult men aged 40–64 years. A total of 5,643 subjects from the Korean Genome and Epidemiology Study (KoGES) were selected for the final analysis. We analyzed 24-hour dietary recall data. Using principal component analysis, 3 dietary patterns were identified: rice based Korean food pattern, flour based western dietary pattern, and convenience food dietary pattern. The flour based western dietary pattern was significantly and positively associated with total cholesterol, and low density lipoprotein (LDL) cholesterol (p for trend < 0.05). With regard to the rice based Korean food pattern, the group with the highest factor score had a significantly lower risk of hyper LDL cholesterolemia (odds ratio [OR], 0.802; 95% confidence interval [CI], 0.698–0.922) and high total cholesterol levels (OR, 0.868; 95% CI, 0.761–0.990) than the group with the lowest factor score. For the flour based western dietary pattern the group with the highest factor score showed a significantly high risk of hyper LDL cholesterolemia (OR, 1.189; 95% CI, 1.033–1.367; p for trend < 0.05) than the group with the lowest factor score. Our results showed that the rice based Korean food pattern protected against dyslipidemia. In contrast, the western staple pattern, which is rich in flour and processed foods, was independently associated with dyslipidemia in urban male residents of Korea.
Adult ; Cardiovascular Diseases ; Cholesterol ; Cross-Sectional Studies ; Diet ; Diet, Western ; Dyslipidemias ; Epidemiology ; Fast Foods ; Flour ; Genome ; Humans ; Korea ; Lipoproteins ; Male ; Mortality ; Prevalence ; Principal Component Analysis ; Urbanization

BACKGROUND/OBJECTIVES: Inflammation is often associated with chronic diseases, and numerous studies suggest that certain foods can modulate inflammatory status. This study aimed to assess the impact of intensive nutrition education on glycemic control and inflammation in patients with diabetes mellitus using the Korean food-based index of dietary inflammatory potential (FBDI). SUBJECTS/METHODS: A total of 120 patients (male: 70, 58.3%) were randomly divided into two groups of 60 each, to be given intensive nutritional education (IE) and basic nutritional education (BE), respectively. As part of the nutrition education intervention, basic diabetesrelated nutrition education was provided to both groups initially. In addition, the IE was provided two face-to-face nutrition education sessions based on FBDI over six months, and text transmissions were made at least eight times. We surveyed the anthropometric measurements, biochemical indicators, inflammatory markers, and dietary intake before and after the interventions. We analyzed the effects of the intensive nutrition education using the t-test, χ 2 test and paired t-test. RESULTS: Of the subjects, 76.7% (46/60) of the IE and 86.7% (52/60) of the BE completed the study. The results of the paired t-test to evaluate the effectiveness of nutrition education using FBDI showed that high density lipoprotein-cholesterol increased significantly from 42.6 mg/dL before intervention to 49.2 mg/dL after intervention (P = 0.009), tumor necrosis factor-α significantly decreased from 1.25 pg/mL before intervention to 1.11 pg/mL after intervention (P =.012) in the IE. Also, glycated hemoglobin decreased from 8.0% to 7.5% in the IE but increased from 7.4% to 7.7% in the BE, and the differences between the groups were significant (P= 0.008). CONCLUSION These findings suggest that providing intensive FBDI-based education on antiinflammatory foods positively affected glycemic control and inflammatory status in diabetes patients. Therefore, practical dietary plans using FBDI should be considered for diabetes patients to prevent increased inflammation.

BACKGROUND/OBJECTIVES: The dietary intake of foods with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is known to adversely affect patients with irritable bowel syndrome (IBS). However, the effects of FODMAP have been studied predominantly among Western populations. This study aimed to identify foods high in FODMAP content which form a part of the Korean adult diet and obtain basic data for the preparation of IBS guidelines. SUBJECTS/METHODS: An online survey of 1,000 adults from the general population in the age group of 20 to 40 years was performed. Data from 787 participants (men, 386; women, 401) were analyzed. The general characteristics of the participants, health status, IBS diagnosis using the Rome III diagnostic criteria, semi-quantitative food frequency questionnaire findings, and food items causing symptoms were analyzed. RESULTS: Overall, 169 participants (21.5%) had IBS. The contribution of the FODMAP nutrients in both IBS and healthy groups was as follows: fructan > lactose > excess fructose > sorbitol > mannitol > galacto-oligosaccharides (GOS). The fructan intake was 4.6 ± 2.2 g/day and 4.3 ± 2.5 g/day in the IBS and healthy groups (P = 0.014), respectively. In the IBS group, the ratio of the intake of fructan to the total FODMAP intake was 39.5%, 29.8%, and 5.8% through onions, garlic, and bananas, respectively. CONCLUSIONS Fructan was the FODMAP nutrient most consumed by Korean adults.Therefore, given the difference in the dietary habits of each country’s population, the dietary guidelines for IBS should be country specific.

OBJECTIVES: This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density. METHODS: The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than 25 kg/m2 and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed. RESULTS: Normal weight women were 56.03 ± 3.76 years old and obese women were 58.09 ± 5.13 years old and there was no significant difference in age between the two groups. The T-score of bone mineral density was 0.03 ± 1.06 in normal weight women and -0.60 ± 1.47 in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women (6.09 ± 3.37 ng/mL) compared to obese women in (9.01 ± 4.99 ng/mL) (p<0.05). The total score of diet quality index-international was 70.41±9.34 in normal weight women and 64.93 ± 7.82 in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (β=-0.048, p<0.05), triglyceride (β=-0.005, p<0.05) and HDL-cholesterol (β=0.034, p<0.01), moderation of DQI-I (β=-0.231, p<0.05) affected T-score significantly. CONCLUSIONS: The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.
Adipose Tissue ; Anthropometry ; Biomarkers* ; Body Mass Index ; Bone Density* ; Cholesterol ; Diet* ; Female ; Humans ; Leptin ; Metabolism ; Methods ; Obesity ; Reference Values ; Sodium ; Triglycerides