Objectives: The purpose of this study was to discover the changes in obesity prevalence and dietary habits in Korean adults residing in various residential areas during the last 10 years. Methods: Data on Korean adults aged 19 years and above was obtained from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. The subjects were classified into metropolitan 4th : n=5,977, 7th : n=6,651), urban (4th : n=4,511, 7th : n=5,512) and rural (4th : n=3,566, 7th : n=2,570) based on their residence. The general characteristics, nutrient intake, intake amount, food groups, and healthy dietary factors were analyzed. The association between residential areas and obesity prevalence were analyzed by multiple logistic regression. Results: In urban and rural areas, the obesity rate increased in the 7thsurvey compared to the 4th survey, excluding the metropolitan area. The carbohydrate intake decreased, and lipid intake increased in the 7thsurvey compared to the 4thsurvey. Over the same period, the intake of cereals and vegetables decreased, and the intake of meat and processed foods increased. Rural residents had a higher intake of cereals and vegetables, and a lower intake of milk and processed foods than those in metropolitan areas and urban residents. The proportion of subjects who practiced a healthy diet increased in the 7th survey compared to the 4thsurvey. In the 4th survey, there was no relationship seen between the prevalence of obesity and the subject’s residential area, but in the 7thsurvey, the odds ratio of obesity was higher in rural areas than in the metropolitan areas, confirming the regional gap (OR: 1.16, 95% CI=1.00-1.36, p=0.044). Conclusions This study showed that the obesity prevalence increased in rural residents compared to metropolitan residents, indicating a gap between the regions. The nutrient intake and intake of food groups changed in the 10 years under consideration, and there were differences seen between regions. Therefore, it is necessary to formulate a policy that will reduce obesity prevalence and health inequalities between regions.

Objectives: The purpose of this study was to discover the changes in obesity prevalence and dietary habits in Korean adults residing in various residential areas during the last 10 years. Methods: Data on Korean adults aged 19 years and above was obtained from the 4th (2007-2009) and the 7th (2016-2018) Korea National Health and Nutrition Examination Survey. The subjects were classified into metropolitan 4th : n=5,977, 7th : n=6,651), urban (4th : n=4,511, 7th : n=5,512) and rural (4th : n=3,566, 7th : n=2,570) based on their residence. The general characteristics, nutrient intake, intake amount, food groups, and healthy dietary factors were analyzed. The association between residential areas and obesity prevalence were analyzed by multiple logistic regression. Results: In urban and rural areas, the obesity rate increased in the 7thsurvey compared to the 4th survey, excluding the metropolitan area. The carbohydrate intake decreased, and lipid intake increased in the 7thsurvey compared to the 4thsurvey. Over the same period, the intake of cereals and vegetables decreased, and the intake of meat and processed foods increased. Rural residents had a higher intake of cereals and vegetables, and a lower intake of milk and processed foods than those in metropolitan areas and urban residents. The proportion of subjects who practiced a healthy diet increased in the 7th survey compared to the 4thsurvey. In the 4th survey, there was no relationship seen between the prevalence of obesity and the subject’s residential area, but in the 7thsurvey, the odds ratio of obesity was higher in rural areas than in the metropolitan areas, confirming the regional gap (OR: 1.16, 95% CI=1.00-1.36, p=0.044). Conclusions This study showed that the obesity prevalence increased in rural residents compared to metropolitan residents, indicating a gap between the regions. The nutrient intake and intake of food groups changed in the 10 years under consideration, and there were differences seen between regions. Therefore, it is necessary to formulate a policy that will reduce obesity prevalence and health inequalities between regions.

OBJECTIVES: Although breakfast is important to nutrition balance, prevention of overeating, and weight control, people in their 20s (males: 55.1%, females: 49.9%) were reported to have the highest rate of skipping breakfast in 2016 Korea Health Statistics. This study aims to examine dietary habits and nutrient intake depending on breakfast frequency among young women in Seoul. METHODS: The subjects were 655 young women in Seoul from August to October 2016, and the survey was performed by using a questionnaire that included general characteristics, dietary habits, and eating behavior. Body composition was determined by bioelectric impedance analysis. Nutritional status was examined by the 24-hour recall method. RESULTS: The participants were classified by breakfast intake frequency; ‘≥ 5 times/week (n=160)’, ‘1–4 times/week (n=327)’, and ‘breakfast skipping (n=168)’. The ‘breakfast skipping’ group had lower frequency and regularity of meals. In addition, the ‘breakfast skipping’ group had a higher frequency of eating-out and late-night meals. There was no difference in total calories between the ‘breakfast skipping’ group and other groups, but the ‘breakfast skipping’ group had significantly low carbohydrate and fiber intakes. The participants showed lower intakes of calories, fiber, vitamin A, vitamin C, niacin, folic acid, calcium, potassium, and zinc in comparison with recommended intakes. Especially, the ‘breakfast skipping’ group had significantly lower fiber, vitamin A, vitamin C, calcium, potassium levels compared to the ‘≥ 5 times/week’ group. For Mean Adequacy Ratio (MAR), the ‘breakfast skipping’ group recorded a ratio of 0.60, which was lower than those of other groups. Index of Nutritional Quality (INQ) including fiber, vitamin C, calcium and phosphorus were significantly lower in the breakfast skipper group, compared to the breakfast eater group. CONCLUSIONS: The ‘breakfast skipping’ group showed low regularity of meals and a high frequency of eating-out and late-night meals. The breakfast regular eater group showed high intake of micronutrients and quality of meals was high in general. Skipping breakfast could lower nutrient intake and quality of meals, which requires attention.
Ascorbic Acid ; Body Composition ; Breakfast ; Calcium ; Electric Impedance ; Feeding Behavior ; Female ; Folic Acid ; Food Habits ; Humans ; Hyperphagia ; Korea ; Meals ; Methods ; Micronutrients ; Niacin ; Nutritional Status ; Nutritive Value ; Phosphorus ; Potassium ; Seoul ; Vitamin A ; Zinc

OBJECTIVES: Although breakfast is important to nutrition balance, prevention of overeating, and weight control, people in their 20s (males: 55.1%, females: 49.9%) were reported to have the highest rate of skipping breakfast in 2016 Korea Health Statistics. This study aims to examine dietary habits and nutrient intake depending on breakfast frequency among young women in Seoul. METHODS: The subjects were 655 young women in Seoul from August to October 2016, and the survey was performed by using a questionnaire that included general characteristics, dietary habits, and eating behavior. Body composition was determined by bioelectric impedance analysis. Nutritional status was examined by the 24-hour recall method. RESULTS: The participants were classified by breakfast intake frequency; ‘≥ 5 times/week (n=160)’, ‘1–4 times/week (n=327)’, and ‘breakfast skipping (n=168)’. The ‘breakfast skipping’ group had lower frequency and regularity of meals. In addition, the ‘breakfast skipping’ group had a higher frequency of eating-out and late-night meals. There was no difference in total calories between the ‘breakfast skipping’ group and other groups, but the ‘breakfast skipping’ group had significantly low carbohydrate and fiber intakes. The participants showed lower intakes of calories, fiber, vitamin A, vitamin C, niacin, folic acid, calcium, potassium, and zinc in comparison with recommended intakes. Especially, the ‘breakfast skipping’ group had significantly lower fiber, vitamin A, vitamin C, calcium, potassium levels compared to the ‘≥ 5 times/week’ group. For Mean Adequacy Ratio (MAR), the ‘breakfast skipping’ group recorded a ratio of 0.60, which was lower than those of other groups. Index of Nutritional Quality (INQ) including fiber, vitamin C, calcium and phosphorus were significantly lower in the breakfast skipper group, compared to the breakfast eater group. CONCLUSIONS: The ‘breakfast skipping’ group showed low regularity of meals and a high frequency of eating-out and late-night meals. The breakfast regular eater group showed high intake of micronutrients and quality of meals was high in general. Skipping breakfast could lower nutrient intake and quality of meals, which requires attention.
Ascorbic Acid ; Body Composition ; Breakfast ; Calcium ; Electric Impedance ; Feeding Behavior ; Female ; Folic Acid ; Food Habits ; Humans ; Hyperphagia ; Korea ; Meals ; Methods ; Micronutrients ; Niacin ; Nutritional Status ; Nutritive Value ; Phosphorus ; Potassium ; Seoul ; Vitamin A ; Zinc

PURPOSE: This study examined the food and nutrient intake of Korean elderly according to the anxiety and depressive condition using the data from the Korea National Health and Nutrition Survey (KNHANES) from 2013 to 2015. METHODS: The participants were 3,504 elderly people over 65 years of age (1,523 in men and, 1,981 in women). The dietary information was analyzed using the 24-hour recall data. The anxiety and depressive state was assessed using the self-reported scale EQ-5D in the quality of life dimension. The subjects were divided into the anxiety · depression group (AD) and non-anxiety · depression group (NAD) according to their anxiety and depressive conditions. RESULTS: In the male elderly, the AD group had a significantly lower education and economic level and higher proportion in living alone than the NAD group. The percentage of eating lunch and dinner alone in the male AD group was higher than that of the NAD group. The female AD group showed less a lower frequency of dinner than the NAD group. The male AD group had a lower consumption of total foods, fish and shellfishes, seaweeds, mushrooms, oils and fats, and seasonings than the NAD group. With regard to the nutrient intake, the male elderly NAD group had more sufficient nutrient intakes than the AD group. In particular, the daily intakes of dietary fiber, riboflavin, niacin, potassium and iron were significantly lower in the AD group. To compare with the nutrient density of the two groups, the vitamin C and niacin intakes were lower in the AD group than in the NAD group. Overall, the nutritional status of the male AD group was significantly lower than that of the NAD group. Meanwhile, the female elderly had showed a smaller difference in nutrient intake according to their anxiety and depressive condition. CONCLUSION: These results of this study show that more nutritional education and emotional support are needed to improve the nutritional status and health of the male elderly with anxiety or depression.
Agaricales ; Aged ; Anxiety ; Ascorbic Acid ; Depression ; Dietary Fiber ; Eating ; Education ; Fats ; Female ; Humans ; Iron ; Korea ; Lunch ; Male ; Meals ; NAD ; Niacin ; Nutrition Surveys ; Nutritional Status ; Oils ; Potassium ; Quality of Life ; Riboflavin ; Seasons ; Shellfish

PURPOSE: This study was conducted for evaluation of clinical uses of anterior cruciate ligament (ACL) reconstruction with an Achilles allograft using the remnant technique by comparison and analysis stability, functional assessment and results of second-look arthroscopy between the remnant technique and the non-remnanat technique. MATERIALS AND METHODS: A total of 48 patients who underwent ACL reconstruction using an Achilles allograft were selected and divided into two groups depending on the presence of remnant. The preserving group included 26 patients and non-preserving group included 22 patients. The two groups were compared and analyzed with regarding to stability (Stress view Lachman test, pivot shift test), functional assessment (International Knee Documentation Committee, Lysholm score, Tegner score, single hoop test, shuttle turn, carioca test), and the result of second-look arthroscopy (study design: prosepective cohort study). RESULTS: In the final result, the remnant group showed significant improvement in the Tegner and carioca tests compared with the non-remnant group (p<0.05). In second-look arthroscopy, the remnant group showed better coverage of synovium (p<0.05). CONCLUSION: ACL reconstruction with an Achilles allograft using the remnant technique showed better results in functional assessment and finding in second-look arthroscopy compared with the non-remnant technique group.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Arthroscopy ; Cohort Studies ; Humans ; Knee ; Synovial Membrane ; Transplantation, Homologous*

BACKGROUND: Metabolically healthy obese (MHO) is regarded as a transient concept. We examined the effect of the dynamic change of metabolic health status on the incidence of type 2 diabetes mellitus (T2DM) both in obese and normal weight individuals.METHODS: We analyzed 3,479,514 metabolically healthy subjects aged over 20 years from the Korean National Health Screening Program, who underwent health examination between 2009 and 2010, with a follow-up after 4 years. The relative risk for T2DM incidence until the December 2017 was compared among the four groups: stable metabolically healthy normal weight (MHNW), unstable MHNW, stable MHO, and unstable MHO.RESULTS: During the 4 years, 11.1% of subjects in the MHNW group, and 31.5% in the MHO group converted to a metabolically unhealthy phenotype. In the multivariate adjusted model, the unstable MHO group showed the highest risk of T2DM (hazard ratio [HR], 4.67; 95% confidence interval [CI], 4.58 to 4.77). The unstable MHNW group had a higher risk of T2DM than stable MHO group ([HR, 3.23; 95% CI, 3.16 to 3.30] vs. [HR, 1.81; 95% CI, 1.76 to 1.85]). The stable MHO group showed a higher risk of T2DM than the stable MHNW group. The influence of the transition into a metabolically unhealthy phenotype on T2DM incidence was greater in subjects with aged <65 years, women, and those with weight gain.CONCLUSION: Metabolically healthy phenotype was transient both in normal weight and obese individuals. Maintaining metabolic health was critical for the prevention of T2DM, irrespective of their baseline body mass index.
Body Mass Index ; Cohort Studies ; Diabetes Mellitus, Type 2 ; Female ; Follow-Up Studies ; Healthy Volunteers ; Humans ; Incidence ; Mass Screening ; Obesity ; Phenotype ; Weight Gain

PURPOSE: The aim of this study was to assess the diagnostic efficacy of noninvasive prenatal screening for trisomy 18 by assessing the levels of unmethylated-maspin (U-maspin) and fetal nuchal translucency (NT) thickness during the first trimester of pregnancy. MATERIALS AND METHODS: A nested case-control study was conducted using maternal plasma samples collected from 65 pregnant women carrying 11 fetuses with trisomy 18 and 54 normal fetuses. We compared the U-maspin levels, NT thicknesses, or a combination of both in the first trimester between the case and control groups. RESULTS: U-maspin levels and NT thickness were significantly elevated in the first trimester in pregnant women carrying fetuses with trisomy 18 when compared to those carrying normal fetuses (27.2 vs. 6.6 copies/mL, P<0.001 for U-maspin; 5.9 vs. 2.0mm, P<0.001 for NT). The sensitivities of the U-maspin levels and NT thickness in prenatal screening for fetal trisomy 18 were 90.9% and 90.9%, respectively, with a specificity of 98.1%. The combined U-maspin levels and NT thickness had a sensitivity of 100% in prenatal screening for fetal trisomy 18, with a specificity of 98.1%. CONCLUSION: A combination of U-maspin levels and NT thickness is highly efficacious for noninvasive prenatal screening of fetal trisomy 18 in the first trimester of pregnancy.
Case-Control Studies ; Epigenomics* ; Female ; Fetus ; Humans ; Mass Screening* ; Nuchal Translucency Measurement* ; Plasma ; Pregnancy ; Pregnancy Trimester, First* ; Pregnant Women ; Prenatal Diagnosis ; Sensitivity and Specificity ; Trisomy*

OBJECTIVE: To investigate the usefulness of MacArthur-Bates Communicative Development Inventories-Korean (M-B CDI-K) short form as a screening test in children with language developmental delay. METHODS: From April 2010 to May 2012, a total of 87 patients visited the department of physical medicine and rehabilitation of National Health Insurance Service Ilsan Hospital with the complaint of language developmental delay and were enrolled in this study. All patients took M-B CDI-K short form and Sequenced Language Scale for Infants (SELSI) or Preschool Receptive-Expressive Language Scale (PRES) according to their age. RESULTS: The study group consisted of 58 male patients and 29 female patients and the mean age was 25.9 months. The diagnosis are global developmental delay in 26 patients, selective language impairment in 31 patients, articulation disorder in 7 patients, cerebral palsy in 8 patients, autism spectrum disorder in 4 patients, motor developmental delay in 4 patients, and others in 7 patients. Seventy-one patients are diagnosed with language developmental delay in SELSI or PRES and of them showed 69 patients a high risk in the M-B CDI-K short form. Sixteen patients are normal in SELSI or PRES and of them showed 14 patients non-high risk in the M-B CDI-K short form. The M-B CDI-K short form has 97.2% sensitivity, 87.5% specificity, a positive predictive value of 0.97, and a negative predictive value of 0.88. CONCLUSION: The M-B CDI-K short form has a high sensitivity and specificity so it is considered as an useful screening tool in children with language developmental delay. Additional researches targeting normal children will be continued to supply the specificity of the M-B CDI-K short form.
Articulation Disorders ; Cerebral Palsy ; Autism Spectrum Disorder ; Child* ; Diagnosis ; Female ; Humans ; Infant ; Language Development Disorders ; Language Development* ; Male ; Mass Screening* ; National Health Programs ; Physical and Rehabilitation Medicine ; Sensitivity and Specificity

Background: Metabolic disturbances are modifiable risk factors for dementia. Because the status of metabolic syndrome (MetS) and its components changes over time, we aimed to investigate the association of the cumulative exposure to MetS and its components with the risk of dementia. Methods: Adults (n=1,492,776; ≥45-years-old) who received health examinations for 4 consecutive years were identified from a nationwide population-based cohort in Korea. Two exposure-weighted scores were calculated: cumulative number of MetS diagnoses (MetS exposure score, range of 0 to 4) and the composite of its five components (MetS component exposure score, range of 0 to 20). Hazard ratio (HR) and 95% confidence interval (CI) values for dementia were analyzed using the multivariable Cox proportional-hazards model. Results: Overall, 47.1% of subjects were diagnosed with MetS at least once, and 11.5% had persistent MetS. During the mean 5.2 years of follow-up, there were 7,341 cases (0.5%) of incident dementia. There was a stepwise increase in the risk of all-cause dementia, Alzheimer’s disease, and vascular dementia with increasing MetS exposure score and MetS component exposure score (each P for trend <0.0001). The HR of all-cause dementia was 2.62 (95% CI, 1.87 to 3.68) in subjects with a MetS component exposure score of 20 compared with those with a score of 0. People fulfilling only one MetS component out of 20 already had an approximately 40% increased risk of all-cause dementia and Alzheimer’s disease. Conclusion More cumulative exposure to metabolic disturbances was associated with a higher risk of dementia. Of note, even minimal exposure to MetS components had a significant effect on the risk of dementia.