OBJECTIVES: Excess sodium intake has been linked to obesity and obesity-related indices. However, the scientific evidence for this association is inadequate. The purpose of this study was to investigate the association between urinary sodium excretion and obesity-related indices among Korean adults. METHODS: A convenience sample of 120 subjects (60 obese and 60 non-obese subjects) were recruited applying frequency matching for sex and age between two groups. Sodium intake level was assessed through 24-hour urine collection. Obesity-related metabolic risk factors, including fasting blood lipid indices, subcutaneous and visceral fat through computed tomography (CT), insulin resistance indices, blood pressure and liver enzymes were measured in all subjects. These obesity-related metabolic risk factors were compared between obese and non-obese group according to sodium excretion levels (<110 mEq/day, 110~180 mEq/day, >180 mEq/day). RESULTS: After adjusting for age, gender, health behaviors (smoking, exercise, drinking), and energy intake, several obesity-related metabolic risk factors, including abdominal circumference, body fat percentage, subcutaneous and visceral fat, triglyceride, and systolic blood pressure were found to be significantly deteriorated as the sodium excretion level increases. In addition, multivariate adjusted-odds ratios of abdominal obesity, high blood triglyceride, and high blood pressure were found significantly higher in the highest sodium excretion group compared to the lowest group. The mean number of metabolic syndrome risk factors was also significantly greater in the highest sodium excretion group than in the lowest group. CONCLUSIONS: The current study findings suggested that high sodium intake can affect obesity and metabolic syndrome risk negatively, implying the necessity of future research on low-sodium diet intervention in relation to obesity and related health problems.
Adipose Tissue ; Adult ; Blood Pressure ; Diet, Sodium-Restricted ; Energy Intake ; Fasting ; Health Behavior ; Humans ; Hypertension ; Insulin Resistance ; Intra-Abdominal Fat ; Liver ; Obesity ; Obesity, Abdominal ; Risk Factors* ; Sodium* ; Triglycerides ; Urine Specimen Collection

OBJECTIVETo investigate whether individualized low-protein diet intervention for patients with chronic kidney disease(CKD)could improve the general condition,slow the deterioration of renal function,and delay the time of entering dialysis.

METHODSForty CKD inpatients between July 2011 and July 2012 were randomly given with normal or individualized low-protein diet for six months according to random number table after signing informed consent. The levels of urine protein and biochemical indexes of renal function were measured at baseline and at the end of dietary intervention for six months, respectively.

RESULTSThe baseline urine protein level,renal function,and biochemical indexes were not significantly different between these two groups. The diastolic blood pressure,protein intake,blood urea nitrogen,uric acid, potassium, phosphorus, C-reaction protein,24-hour urea nitrogen,and urine protein after six months were significantly lower than those at baseline,that is,(101.70 ± 15.78)mmHg vs.(91.75 ±15.52) mmHg,(63.87 ± 24.70)g/d vs.(50.02 ± 14.07)g/d,(20.01 ± 7.69)mmol/L vs.(15.11 ± 4.90) mmol/L,(362.75 ± 84.56)Μmol/L vs.(302.20 ± 8.48)Μmol/L,(5.22 ± 0.75)mmol/L vs.(4.79±0.36) mmol/L,(2.07 ± 0.68) mmol/L vs.(1.57 ± 0.41) mmol/L,1.19 [0.65,4.17] mg/L vs. 0.74 [0.38,1.33] mg/L,70.6 [8.70,101.18] mmol/L vs. 16.93 [3.23,72.27] mmol/L,1.00 [0.30,1.00] g/d vs. 0.15 [0,0.83] g/d (all P<0.05),among which albumin and hemoglobin were significantly higher [(0.34 ± 0.07)g/L vs.(0.37 ± 0.05)g/L, (99.38 ± 21.89)g/L vs.(126.35 ± 14.11)g/L,respectively] in the individualized low-protein diet group. The difference was statistically significant (P<0.05). The most relevant for urine protein producing was prealbumin (r=0.924, P<0.05). The differences of blood urea nitrogen, potassium, sodium, calcium, phosphorus, 24-hour urea nitrogen, urine specific gravity, urine protein, and hemoglobin in six months in the individualized low-protein diet group were significantly better than those in the normal low protein-diet group (P<0.05).

CONCLUSIONSIndividualized low-protein diet intervention may have definite curative effectiveness in CKD patients. It can markedly improve the patients' condition,slow down the deterio-ration of renal function,and increase serum prealbumin levels that may reduce the generation of urine protein. It is worthy of wider clinical application.

Prevalence of non-alcoholic fatty liver disease (NAFLD) is about 20-25% in Korean adults population. Obesity is strongly associated with NAFLD and the prevention of obesity is a major public issue. Unfortunately, pharmacological treatment of obesity and NAFLD remains uncertain. Only weight loss by dietary changes been shown to lead to histological improvement in fatty liver. So the nutrition therapy is a cornerstone of treatment for NAFLD. Epidemiologic studies show that saturated fat, trans-fatty acid, carbohydrate, and simple sugar have strong correlation with intrahepatic fat accumulation. But, true associations with specific nutrients still remain unclear. Recently, fructose consumption has been rising in many countries and several epidemiologic studies show that fructose consumption has strong correlation with metabolic diseases. The consumption of excessively added sugar in the pathogenesis of steatohepatitis has received attention. Most clinicians agree with lifestyle modification are effective in histologic improvement. Total energy intake restriction is the most important action to reduce intrahepatic fat accumulation. Macronutrient composition may also have correlation with the development of NAFLD. To reduce the incidence of NAFLD, public statements on optimal dietary education program have been issused. Various specific dietary programs are suggested. Among them low fat diet and low carbohydrate diet are suggested in patients with NAFLD. However, there is no ideal diet to obtain the histological improvement in NAFLD. Further randomised controlled studies about specific diet are needed to determine the long-term benefit and histological improvement by ideal diet. Tailoring diet therapy to a patient's lifestyle is more important than universal specific dietary program.
*Diet ; Diet, Carbohydrate-Restricted ; Diet, Fat-Restricted ; Dietary Proteins/metabolism ; Energy Intake ; Fatty Acids, Monounsaturated/metabolism ; Fatty Liver/diet therapy/epidemiology/*etiology ; Humans

Dietary pattern analysis has emerged as important instruments to identify modifi able dietary risk factors for non-communicable diseases. The aim of this study was to determine the major dietary patterns among adolescents in Petaling District, Selangor and their associations with socio-demographic characteristics and obesity. An analytic cross- sectional study design was conducted in selected secondary schools in Petaling District. Sampling with probability proportionate to size was used and fi ve schools were selected. Self-administered semi-quantitative food frequency questionnaire was used for data collection. Weight was measured with a digital bathroom scale (TANITA model) and height was measured using SECA body meter. Principal component factor analysis using varimax orthogonal transformation was used to identify the dietary patterns. Chi square was used to test for associations of dietary patterns with socio-demographic characteristics and obesity. Three major dietary patterns were identifi ed: fi rstly, fruits and vegetables; secondly, sugar and fatand fi nally, meat and chicken which explained for 12.7%, 11.6% and 10.7% variation in food intake, respectively. There were signifi cant associations between ethnicity, religion, family income, educational level of parents and the dietary patterns. However, there was no signifi cant association between obesity and the dietary patterns. It may be more effective to describe a healthy diet using results of dietary pattern analysis in public health intervention, rather than describing single food items or nutrients. It is recommended that nutrition education programmes should be implemented in schools so as to prevent the development of obesity in the non-obese.
Diet, Western

The purpose of this study was to compare regional differences in salty taste assessments, nutrition knowledge, dietary attitudes and dietary behaviors associated with high-salt diets in four national regions in Korea (Region 1: Seoul, Sokcho, Region 2: Buyeo, Jecheon, Gong Ju, Region 3: Daegu, Gyeongsan, Region 4: Jeon Ju). Subjects were 860 persons who participated in sodium reduction campaign. The result of the salty taste assessment by region was not significantly different. The nutrition knowledge score of subjects in Region 1 was the highest. Dietary attitude scores that showed preference for high-salt diets of Region 2 and Region 4 subjects were higher than those of Regions 1 and 3 subjects (p < 0.001). Dietary behavior scores were not significantly different among regions. The correlation between sodium intake and salty taste assessment was significant (p < 0.01). Older subjects who had high blood pressure levels and lower nutrition knowledge were more likely to have high sodium intakes. Even though the salty taste assessment and dietary behavior scores by region were not significantly different, the salty taste assessment scores had a significant negative correlation with nutrition knowledge and had a significant positive correlation with dietary attitude and dietary behavior in terms of preference for high-salt diets. Therefore, nationwide education regarding salt intake reduction and health and a campaign to encourage favorable attitudes and behavioral changes regarding consumption of a no-salt / low-salt diet is needed.
Diet ; Diet, Sodium-Restricted ; Humans ; Hypertension ; Korea ; Nutrition Assessment ; Sodium

OBJECTIVES: This study aimed to compare customers' perceptions of the need for a low-sodium diet and sodium-reduced operations in the industry foodservice by age. The relationships between health concerns and perceptions of the need for sodium-reduced operations and low-sodium diets in the industry foodservice were analyzed.METHODS: A survey was conducted among 340 industry foodservice customers aged 20–50 years and residing in Seoul, Korea. This study investigated the respondents' health concerns, their perception of the need for sodium-reduced foodservice operations, their perception of a sodium-reduced diet, and the general details of the foodservices they used. A cross-tabulation analysis and ANOVA were performed to identify differences in measurement items by age, and a simple regression analysis was performed to examine relationships between measurement items.RESULTS: For the customers' perception of the need for a sodium-reduced foodservice operation, the item “it is necessary to provide separate spices and sauces to reduce sodium intake” achieved the highest score (3.88 points out of a possible 5 points). For the perception of a sodium-reduced diet, the item “I think it is helpful for one's health” obtained the highest score (4.13 points). Respondents' health concerns had a positive effect on increasing the level of perception of the need for sodium-reduced foodservice operations and that of a sodium-reduced diet.CONCLUSIONS: Foodservice nutritionists could help enhance their customers' perceptions of the needs for sodium-reduced foodservice operations and sodium-reduced diets by frequently providing them with sodium-related health information.
Diet ; Diet, Sodium-Restricted ; Korea ; Nutritionists ; Seoul ; Sodium ; Spices

Background: Due to the devolved nature of Philippine local governance, disaster management systems such as relief work and food aid pipelines, have been managed by local government units during natural disasters. Objectives: This study assessed the nutrient adequacy of food aid packs provided during natural disasters in the province of Albay. Specific objectives included assessment of the types of food and food sources, as well as the practices in the food aid pipeline, and assessment of the nutritional quality of food aid packs through comparison with the recommended energy/nutrient intake (REI/RNI) for Filipinos Methods: Key informant interviews were conducted to gather information on food sources and pipelines. Information on the quantities of food components in food aid packs distributed was also collected, and the free iFRNI software used to derive nutrient content. These quantities compared with the REI/RNI for the general population. Descriptive statistics on Microsoft Excel were used to calculate the mean, median and mode for macronutrients as well as Vitamin A and iron to determine the overall intake of individuals relying on these foods. Ethical clearance was secured from the University of the Philippines REB. Results: Analysis of the food components showed that the food aid packs were insufficient to meet the REI/RNI for the general population, particularly for food packs distributed on the barangay and city/municipal levels. Food was sourced from local suppliers as an emergency purchase during the forecast of a disaster, in place of the prescribed practice of stockpiling. Procured food would then be repacked and distributed on the provincial, city/municipal and barangay levels in a staggered schedule depending upon the length of the disaster or evacuation. Conclusion The food packs distributed by the barangay and city/municipal sub-units of the provincial government of Albay are insufficient to meet the daily caloric and micronutrient needs of a general population purely reliant on food aid after a natural disaster.
Natural Disasters Diet ; Vegetarian

Reducing caloric intake is important for weight loss and obesity; a reduction of ~500-700 kcal/day has been recommended previously. However, only a minority of individuals can successfully sustain such a reduced caloric intake. Therefore, many specialized diet programs have been proposed. Until now, many experts have recommended low-fat diets in various countries, but very-low-carbohydrate diets have recently garnered attention in Korea. The various effects of changing the dietary compositions of macro- and micronutrients have been debated. The majority of large-scale studies have demonstrated that total caloric intake, rather than the composition of macronutrients or the consumption of a specialized diet, is important for successful weight loss. While many cross-sectional studies have investigated specialized diet programs for patients with non-alcoholic liver disease, no randomized controlled studies have been performed, except for some that investigated the effect of high consumption of unsaturated fatty acids as part of the Mediterranean diet.
Cross-Sectional Studies ; Diet* ; Diet, Fat-Restricted ; Diet, Mediterranean ; Energy Intake ; Fatty Acids, Unsaturated ; Humans ; Korea ; Liver Diseases ; Micronutrients ; Non-alcoholic Fatty Liver Disease* ; Obesity ; Weight Loss

INTRODUCTION: Dietary intervention remains an important factor in the management of diabetes mellitus, and many patients have employed herbs and oils to help manage their chronic diseases. Extra virgin olive oil (EVOO) is widely known for its cardio-vascular benefits. However, its effect on the blood glucose of type 2 diabetes mellitus patients has not been extensively studied. In this study, we aimed to determine if the addition of EVOO to meals results in a lower postprandial blood glucose among type 2 diabetes mellitus patients. METHODS: Thirteen patients were included in this randomized controlled cross-over trial. They were randomized to receive a meal with or without EVOO followed by a one week washout period, where they were given the other intervention. The primary outcome is the trans-meal blood glucose, which was calculated as the percent change in two-hour postprandial blood glucose. RESULTS: In group A, there was a noted 88.55% increase in two-hour postprandial blood glucose in taking meals with EVOO, versus 72.11% change in meals without EVOO. The same was observed in Group B, with a 71.08% and 49.22% increase in two-hour postprandial blood glucose in meals with EVOO and without EVOO, respectively. The difference was significant with a p-value of 0.044. Free fatty acids inhibit glucose transport and insulin secretion, this effect may be more predominant in asian type 2 diabetes mellitus patients. CONCLUSION: This study found that adding extra virgin olive oil on top of meals provided no additional benefit in terms of post-prandial glucose excursion.
Diet, Diabetic

The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary therapies have an efficacy almost comparable to that of the KD. In addition, a diet rich in polyunsaturated fatty acids appears to increase the efficacy of diet therapy and reduce the complications of a high-fat diet. Here, we review the systematic information about lower-fat diets and better-quality dietary therapies and the current clinical status of each of these dietary approaches.
Child ; Diet ; Diet, Carbohydrate-Restricted ; Diet, High-Fat ; Epilepsy ; Fatty Acids, Unsaturated ; Humans ; Ketogenic Diet