There are few studies reporting optimal waist circumference that can be utilized to prevent the incidence of cardiovascular disease (CVD). We evaluated the association of waist circumference and waist and hip circumference ratio (WHR) with incident cases of CVD developed over 6 years in a population-based prospective study including Korean adults. Analyses for receiver-operating characteristic (ROC) curve were performed with data for 1,733 men and 1,579 women who were aged 40 to 69 years and were free of a physician-diagnosis of CVD at baseline. Information on the diagnosis of CVD was periodically reported using interviewer-administered questionnaires and anthropometric measures were obtained by biennial health examinations. We newly identified 77 cases of CVD during a follow-up period between 2003 and 2008. On the basis of measures of diagnostic accuracy including minimum distance to ROC curve and Youden index, waist circumference of 85 cm for men, in particular for male nonsmokers, and of 80 cm for women and WHR of 0.88 to 0.90 for men and of 0.83 for women were found to be optimal cutoff points to identify individuals at CVD risks. The study also found that the use of the suggested optimal values for waist circumference show higher sensitivity and lower specificity compared with 90 cm for men and 85 cm for women, which are waist cutoff points given by the Korean Society for the Study of Obesity to define abdominal obesity for Korean adults. Although lower cutoff points of waist circumference (83 cm) and WHR (0.87) were observed to be optimal for male smokers compared with male nonsmokers, whether suggesting waist cutoff points specific to smokers is needed warrants further studies. After taking into account other cardiovascular risk factors including smoking, men with waist circumference of 85 cm or greater and women with 80 cm or greater were at an increased risk of CVD. Thus, these cutoff points of waist circumference may be able to capture more individuals at CVD risks contributing to the prevention of future development of CVD.
Adult ; Aged ; Cardiovascular Diseases ; Female ; Follow-Up Studies ; Hip ; Humans ; Incidence ; Male ; Obesity ; Obesity, Abdominal ; Prospective Studies ; Surveys and Questionnaires ; Risk Factors ; ROC Curve ; Sensitivity and Specificity ; Smoke ; Smoking ; Waist Circumference

Folate, vitamin B12, and homocysteine (HCY) are involved in the metabolism of nucleic acid precursors and it has been hypothesized that they also influence telomere length, a biomarker of aging. However, previous studies have reported inconsistent findings, and data for older adults are limited. Our study aimed to evaluate associations between leukocyte telomere length (LTL) and serum folate, vitamin B12, and HCY levels among adults aged 55 years and over. In a cross-sectional study in 798 men and women aged 55-79 years, serum folate, vitamin B12, and HCY levels were measured using chemiluminescent immunometric assays, and relative LTL was assessed using quantitative real-time polymerase chain reaction. To evaluate associations between LTL and serum folate, vitamin B12, and HCY levels, multiple linear regression models were used. In multiple models adjusted for age, sex, serum high sensitive C-reactive protein (hs-CRP) levels, and other potential confounding factors, we found no association between LTL and serum folate, vitamin B12, and HCY levels. However, we did find a significant inverse association between HCY levels and LTL in participants with serum hs-CRP levels of > or = 2 mg/L (p < 0.05). Moreover, there was a trend toward an association between HCY and vitamin B12 levels in these individuals (p = 0.08). In those with serum hs-CRP levels of < 2 mg/L, HCY was inversely associated with vitamin B12 levels (p < 0.001) and had no association with LTL. Our findings suggest that increased serum HCY levels, when combined with the presence of systemic inflammation, may play a role in accelerating biological aging.
Adult* ; Aging ; C-Reactive Protein ; Cross-Sectional Studies ; Female ; Folic Acid ; Homocysteine* ; Humans ; Inflammation* ; Leukocytes* ; Linear Models ; Male ; Metabolism ; Nucleic Acid Precursors ; Real-Time Polymerase Chain Reaction ; Telomere* ; Vitamin B 12* ; Vitamin B Complex ; Vitamins*

There are a few studies that reported the association of sleep duration with calorie intake and energy expenditure. Using cross-sectional data from a population-based prospective study, we evaluated the association of sleep duration with indicators of obesity including body mass index and waist circumference, calorie intake and its proportion of macronutrients, and physical activity. The study subjects were 4,226 male and female adults, who were aged 40 to 69 years and were free of diagnosed cardiovascular disease, diabetes mellitus, and dyslipidemia at baseline. Robust regression analysis was used to analyze associations. The study found that sleep duration is inversely associated with waist circumference, calorie intake, and percent of calories from fat intake and is positively associated with percent of calories from carbohydrate intake and physical activity. The inverse association between sleep duration and waist circumference was stronger among men than among women. The inverse association between sleep duration and calorie intake was stronger among women than among men and such association was also stronger among obese persons than those with a normal body mass index. The positive association between sleep duration and physical activity was strongly demonstrated regardless of sex or obesity. Physical activity is positively associated with sleep duration independent of potential confounding factors including age, sex, income, occupation, marital status, education, smoking status, waist circumference, calorie and macronutrient intake, and alcohol intake.
Adult ; Aged ; Body Mass Index ; Cardiovascular Diseases ; Diabetes Mellitus ; Dyslipidemias ; Energy Metabolism ; Female ; Humans ; Male ; Marital Status ; Motor Activity ; Obesity ; Occupations ; Prospective Studies ; Smoke ; Smoking ; Waist Circumference

BACKGROUND: A number of studies have reported future prevalence estimates for diabetes mellitus (DM), but these studies have been limited for the Korean population. The present study aimed to construct a forecasting model that includes risk factors for type 2 DM using individual- and national-level data for Korean adults to produce prevalence estimates for the year 2030. METHODS: Time series data from the Korea National Health and Nutrition Examination Survey and national statistics from 2005 to 2013 were used. The study subjects were 13,908 male and 18,697 female adults aged 30 years or older who were free of liver cirrhosis. Stepwise logistic regression analysis was used to select significant factors associated with DM prevalence. RESULTS: The results showed that survey year, age, sex, marital, educational, or occupational status, the presence of obesity or hypertension, smoking status, alcohol consumption, sleep duration, psychological distress or depression, and fertility rate significantly contributed to the 8-year trend in DM prevalence (P < 0.05). Based on sex-specific forecasting models that included the above factors, DM prevalence for the year 2030 was predicted to be 29.2% (95% confidence interval [CI], 27.6% to 30.8%) in men and 19.7% (95% CI, 18.2% to 21.2%) in women. CONCLUSION: The present study projected a two-fold increase in the prevalence of DM in 2030 compared with that for the years 2013 and 2014 in Korean adults. Modifiable factors contributing to this increase in DM prevalence, such as obesity, smoking, and psychological factors, may require attention in order to reduce national and individual costs associated with DM.
Adult ; Alcohol Drinking ; Birth Rate ; Depression ; Diabetes Mellitus ; Employment ; Female ; Forecasting ; Humans ; Hypertension ; Korea ; Liver Cirrhosis ; Logistic Models ; Male ; Nutrition Surveys ; Obesity ; Prevalence ; Psychology ; Risk Factors ; Smoke ; Smoking

No abstract available.
Adult ; Humans ; Prevalence ; Risk Factors

SUBJECTS/METHODS: A factorial randomized, double-blinded, placebo-controlled crossover study included 47 adults (25 men and 22 women) who were free of chronic disease.Stratified randomized allocation considered age and gender for three interventions, group A (supplementation with γ-PGA 600 mg; n = 16), group B (supplementation with VitB6 100 mg; n = 14), and group C (dual supplementation of both γ-PGA 600 mg and VitB6 100 mg;n = 17). Participants underwent a 1-mon intervention period, followed by a 1-mon washout period, and then a second 1-mon intervention period. Differences (mean ± SD) in nighttime sleep status before and after supplementation were compared between the placebo and intervention groups using nonparametric tests. RESULTS: Significant changes in sleep duration (0.27 ± 0.98 h, P < 0.05) and the Pittsburgh Sleep Quality Index global score (−0.52 ± 1.58, P < 0.05) indicating improved sleep status were observed in the intervention compared with the placebo of group C while no significant changes were observed in groups A and B. No statistical significance was detected between the intervention and the placebo; however, there was a greater increase in the group C intervention (4.59 ± 38.5 ng/mL) in serum serotonin concentrations than the groups A and B interventions. No side effects were observed. CONCLUSIONS On the basis of these findings, the dual supplementation of γ-PGA and VitB6 may be effective as functional food components to improve nighttime sleep status.Trial Registration: Clinical Research Information Service Identifier: KCT0005083

SUBJECTS/METHODS: A factorial randomized, double-blinded, placebo-controlled crossover study included 47 adults (25 men and 22 women) who were free of chronic disease.Stratified randomized allocation considered age and gender for three interventions, group A (supplementation with γ-PGA 600 mg; n = 16), group B (supplementation with VitB6 100 mg; n = 14), and group C (dual supplementation of both γ-PGA 600 mg and VitB6 100 mg;n = 17). Participants underwent a 1-mon intervention period, followed by a 1-mon washout period, and then a second 1-mon intervention period. Differences (mean ± SD) in nighttime sleep status before and after supplementation were compared between the placebo and intervention groups using nonparametric tests. RESULTS: Significant changes in sleep duration (0.27 ± 0.98 h, P < 0.05) and the Pittsburgh Sleep Quality Index global score (−0.52 ± 1.58, P < 0.05) indicating improved sleep status were observed in the intervention compared with the placebo of group C while no significant changes were observed in groups A and B. No statistical significance was detected between the intervention and the placebo; however, there was a greater increase in the group C intervention (4.59 ± 38.5 ng/mL) in serum serotonin concentrations than the groups A and B interventions. No side effects were observed. CONCLUSIONS On the basis of these findings, the dual supplementation of γ-PGA and VitB6 may be effective as functional food components to improve nighttime sleep status.Trial Registration: Clinical Research Information Service Identifier: KCT0005083

It has been suggested that iron overload, which indicates the accumulation of iron, generates cellular reactive oxygens and causes peroxide damages to the body. Such oxidative stresses, in a broader context, are also caused by lifestyles such as alcohol consumption and smoking. However, there are limited data on the association between these lifestyle factors and internal iron overload. In present study, we evaluated associations between lifestyle factors, such as smoking status, alcohol consumption, and physical activity, and serum markers of iron overload. In a population-based cross-sectional study including 2,347 Korean men and women aged 49–79 years, we assessed serum transferrin saturation (TSAT) levels and defined iron overload as TSAT levels > 50% for men and > 45% for women. After excluding persons with chronic diseases and iron deficiency, multivariate odds ratio (OR) and its 95% confidence interval (CI) were estimated to evaluate associations between lifestyle factors and iron overload in 1,973 participants. In all participants, we examined a significantly positive association between heavy alcohol consumption (> 30 g/day) and iron overload; heavy drinkers showed 1.6-fold higher OR (95% CI, 1.11–2.36) than non-drinkers. Stratified analysis by sex showed that this association was significant only among men. In addition, we observed a potential association between heavy smoking > 10 cigarettes/day and iron overload (p = 0.07). In stratified analysis by sex, we examined a significant association between smoking and iron overload only among women; former or current smokers had 1.9-fold higher OR (95% CI, 1.01–3.63) than never-smoker. Our findings suggest that heavy alcohol consumption and smoking may worsen iron accumulation in the body.
Adult* ; Alcohol Drinking ; Biomarkers ; Chronic Disease ; Cross-Sectional Studies ; Female ; Humans ; Iron Overload* ; Iron* ; Life Style* ; Male ; Motor Activity ; Odds Ratio ; Oxidative Stress ; Oxygen ; Smoke ; Smoking ; Transferrin

The present study investigated caffeinated beverage consumption and screen time in the association with excessive daytime sleepiness (EDS) and sleep duration. We conducted a cross-sectional study including 249 Korean male high school students. These participants responded to a questionnaire inquiring the information on lifestyle factors, consumption of caffeinated beverages, time spent for screen media, and sleep duration as well as to the Epworth Sleepiness Scale (ESS) questionnaire. EDS was defined as ESS scores of 9 or greater. Students with EDS consumed greater amount of chocolate/cocoa drinks and spent longer time for a TV and a mobile phone than those without EDS (p < 0.05). In addition, students with short sleep (≤ 6 hours) consumed greater amount of coffee than others whereas students with long sleep (> 8 hours) consumed greater amount of chocolate/cocoa drinks than others (p < 0.05). Screen time did not differ according to the categories of sleep duration. Although these findings do not support causal relationships, they suggest that screen time is associated with EDS, but not with sleep duration, and that consumption of certain types of caffeinated beverages is associated with EDS and sleep duration. Adolescents may need to reduce screen time and caffeine consumption to improve sleep quality and avoid daytime sleepiness.
Adolescent ; Beverages* ; Caffeine ; Cell Phones ; Coffee ; Cross-Sectional Studies ; Humans ; Life Style ; Male

Adult ; Body Mass Index ; Cholesterol ; Cholesterol, LDL ; Dairy Products ; Family Characteristics ; Female ; Humans ; Korea ; Logistic Models ; Male ; Prevalence ; Primary Prevention ; Prospective Studies ; Vegetables