Breastfeeding is associated with many health benefits to the mother but the association between osteoarthritis (OA) is not known. Menopause, a state of rapid estrogen loss, is associated with OA. To test whether lactation, another physiological state of low estrogen status, is associated with OA, a nationally representative dataset National Health and Nutrition Examination Survey (NHANES) 1999–2012 was analyzed. Information of OA diagnosis history and lactation for at least one month was self-reported by women 50 years and older that had given birth to at least one child. Women that breastfed for less than one month had a higher proportion of those that were 60 years and older, Hispanic (than non-Hispanic Black), and higher current/self-reported greatest body mass index. Women that breastfed for one month or longer had a higher proportion of those that had 3 or more children, higher poverty-income ratio, were post-menopausal and performed vigorous physical activity. Weighted percentage of OA patients was 22%, and did not differ between the two groups. However, when logistic regression was performed adjusting for multiple covariates, lactation for one month or longer was positively associated with OA. Women that breastfed for one month or longer had an adjusted odds ratio of 1.21 (95% confidence interval, 1.05–1.40) for OA compared to those that breastfed for less than one month. The results indicate that women that breastfed for at least one month have a higher risk of OA than women that delivered a child but breastfed for less than one month.
Adult* ; Body Mass Index ; Breast Feeding* ; Child ; Dataset ; Diagnosis ; Epidemiology ; Estrogens ; Female ; Hispanic Americans ; Humans ; Insurance Benefits ; Lactation ; Logistic Models ; Menopause ; Mothers ; Motor Activity ; Nutrition Surveys* ; Odds Ratio ; Osteoarthritis* ; Parturition

BACKGROUND/OBJECTIVES: Despite the widespread use of dietary assessment tools, the validity of food records has not been evaluated in Koreans. We assessed the accuracy of estimated food records and the effect of a short education session in young Korean women. SUBJECTS/METHODS: Thirty women (aged 18–23 yrs) each completed 3 food records during a controlled-feeding study. One educational session was provided on day 2 of the study. Food records were analyzed for the accuracy of food items and portion size estimation according to food group (grains; meat, fish, eggs, and beans; vegetables; fruit; dairy; and oils and sugars) and type of dish (rice, kimchi, soup, side dishes, spreads, beverages, and snacks). Reported food items were categorized as exact, close, or far matches, exclusions, or intrusions. Portion sizes were evaluated as accurate, similar, or inaccurate estimates, or missing. The means of days 2 and 3 were used to assess post-education results. Paired t-tests were performed to assess the effects of the education session. RESULTS: The mean percentages of exact matches, close matches, far matches, and exclusions on day 1 were 80.9%, 10.9%, 2.0%, and 6.2%, respectively, and mean intrusions observed were 0.1. The education session slightly increased the accuracy of recorded food items. The percentages of accurate, similar, and inaccurate estimates, and missing portion sizes were 11.7%, 19.8%, 12.2%, and 56.3%, respectively, at baseline. The percentage of missing portion size estimates decreased to 14.0% after the education session, resulting in an increase in the percentages of all other estimates. An increase was observed in the accuracy of reported portion sizes of vegetables, rice, and kimchi. CONCLUSIONS In young Korean women, estimated food records are highly accurate for food items but not for portion size estimates without prior education. A short education session can improve the accuracy of portion size estimation.

BACKGROUND/OBJECTIVES: Despite the widespread use of dietary assessment tools, the validity of food records has not been evaluated in Koreans. We assessed the accuracy of estimated food records and the effect of a short education session in young Korean women. SUBJECTS/METHODS: Thirty women (aged 18–23 yrs) each completed 3 food records during a controlled-feeding study. One educational session was provided on day 2 of the study. Food records were analyzed for the accuracy of food items and portion size estimation according to food group (grains; meat, fish, eggs, and beans; vegetables; fruit; dairy; and oils and sugars) and type of dish (rice, kimchi, soup, side dishes, spreads, beverages, and snacks). Reported food items were categorized as exact, close, or far matches, exclusions, or intrusions. Portion sizes were evaluated as accurate, similar, or inaccurate estimates, or missing. The means of days 2 and 3 were used to assess post-education results. Paired t-tests were performed to assess the effects of the education session. RESULTS: The mean percentages of exact matches, close matches, far matches, and exclusions on day 1 were 80.9%, 10.9%, 2.0%, and 6.2%, respectively, and mean intrusions observed were 0.1. The education session slightly increased the accuracy of recorded food items. The percentages of accurate, similar, and inaccurate estimates, and missing portion sizes were 11.7%, 19.8%, 12.2%, and 56.3%, respectively, at baseline. The percentage of missing portion size estimates decreased to 14.0% after the education session, resulting in an increase in the percentages of all other estimates. An increase was observed in the accuracy of reported portion sizes of vegetables, rice, and kimchi. CONCLUSIONS In young Korean women, estimated food records are highly accurate for food items but not for portion size estimates without prior education. A short education session can improve the accuracy of portion size estimation.

Calcium intake is essential for bone health, but young Korean women have low calcium intakes. Seaweeds have high calcium content, which may affect calcium metabolism. Twenty nine females aged 18–39 years with low calcium intake (< 400 mg/day) participated in a 19-day open-label randomized controlled trial. During the first five days, participants adhered to a controlled-feeding protocol followed by a two-week supplementation period in free-living conditions. The treatment group (n = 14) received an additional 200 mg Ca/day through Undaria pinnatifida and Porphyra in meals during the controlled-feeding period, and as U. pinnatifida noodles during days 6–19. Mineral intake (Ca, P, Mg, Na, and K) was assessed from diet composites and three 24-hour recalls during the controlled-feeding and free-living periods, respectively. Fasting serum levels of calcium, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D (1,25[OH]D), phosphorus, parathyroid hormone (PTH), and alkaline phosphatase (ALP) were assessed at baseline, day 6, and day 19. Statistical analyses were performed by Student's t-test and mixed ANOVA. Mean intakes of all minerals during days 1–5 and mean Ca and Mg intakes during days 6–19 were greater in the treatment group compared to the control group. No group effect or group and time interaction was observed in serum biomarkers. Serum 1,25(OH)D increased while PTH and ALP tended to decrease on day 6 but returned to baseline values on day 20. Short-term intake of U. pinnatifida and Porphyra does not affect calcium metabolism in young Korean women with low calcium intakes.

BACKGROUND/OBJECTIVES: Most child and adolescent food literacy measurement tools focus on nutrition and food safety. However, the importance of aspects related to the food system such as food distribution and food waste and their effects on environmental sustainability is growing. We therefore developed and validated a two-dimensional tool for children (8–12 years old) and adolescents (13–18 years old) that can comprehensively measure food literacy. The association of food literacy with diet quality and self-reported health was assessed. SUBJECTS/METHODS: First, we developed a food literacy conceptual framework that contains food system and literacy dimensions through a literature review, focus group interviews, and expert review. After a face validity study, we conducted the main survey (n = 200) to validate the questionnaire. Construct validity and reliability were assessed using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Cronbach's alpha. RESULTS: As a result of the Delphi study, content validity was confirmed for the remaining 30 items after two items were excluded (content validity ratio = 0.86). Eleven items were excluded from the EFA results, while the CFA results indicated appropriate fit indices for the proposed model (comparative fit index = 0.904, root mean square error of approximation = 0.068). The final food literacy questionnaire consisted of 19 questions and comprised 5 factors: production, distribution, selection, preparation and cooking, and intake. Food literacy was positively associated with diet quality, as assessed by the Nutrition Quotient score, in both children and adolescents and with self-reported health in adolescents. CONCLUSIONS Based on this integrated conceptual framework, a two-dimensional 19-item food literacy measurement tool was developed and verified for practical use to improve the diet quality and food-related environmental sustainability awareness of children and adolescents.

Adequate vitamin D status is essential for bone health. New randomized controlled trials investigating the effect of vitamin D supplementation on bone health have recently been published. This position statement updates and expands on the previous 2015 position statement of the Korean Society for Bone and Mineral Research on the adequate vitamin D status for healthy older adults (age ≥ 70 years) and those at high risk of osteoporosis and fracture (adults on osteoporosis medications) to maintain serum 25-hydroxy-vitamin D (25[OH]D) levels ≥ 20 ng/mL but < 50 ng/mL. A serum 25(OH)D level of 30 ng/mL may be beneficial for those on anti-resorptives. Vitamin D can be obtained from ultraviolet light exposure and diet. To reach the target vitamin D status through intake, adults must consume at least 400 IU/day to reach 20 ng/mL and 800 to 1,000 IU/day to reach 30 ng/mL. Foods familiar to the Korean diet that are high in vitamin D content or consumed frequently enough to positively impact vitamin D status are introduced in addition to the amount required to help reach one’s target vitamin D status.

Diet ; Female ; Humans ; Information Services ; Menopause ; Mustard Plant ; Quality of Life ; Seaweed ; Undaria

Smoking is a risk factor for various disease outcomes and is one of the modifiers of DNA methylation. We aimed to identify smoking-related DNA methylation sites (CpG-sites) and test whether one identified CpG-site is associated with smoking-related traits and pulmonary function. We obtained DNA methylation data of 209 men from the Korean Genome and Epidemiology Study analyzed by Illumina's HumanMethylation450 array. To identify smoking-related DNA methylation sites, epigenome-wide association analysis of smoking status was conducted, adjusting for age, area, current drinking status, and body mass index. We assessed the association between smoking intensity and DNA methylation of cg05951221 (AHRR), the CpG showing the strongest largest difference in DNA methylation among the 5 hypomethylated CpGs in current smokers compared to never smokers. The association between DNA methylation and pulmonary function was examined longitudinally resulting in a positive association between DNA methylation and forced expiratory volume in 1 second/forced vital capacity, regardless of adjustment for smoking status. This suggests that DNA methylation associates with long-term pulmonary function. Our study contributes to explaining the relationship between smoking and pulmonary function via DNA methylation.

PURPOSE: In the emergency department (ED), identification of the obstetrical and gynecologic history for diagnosis of child-bearing aged women who present with abdominal pain is very important. We compared the usefulness of self-registry using a tablet computer and a traditional paper registry for taking history of child-bearing aged women. METHODS: We reviewed the prospective registries of child-bearing aged women presenting with abdominal pain without underlying disease to the ED of the Seoul Metropolitan Boramae Medical Center. We used a paper version of this registry from April 2008 to April 2011. From May 2011 to October 2012, we used the Smart Medical Registry (SMR), where the patient used a tablet computer to record her own data. The registries of child-bearing aged women included information on the patient's basic information, medical history, gynecologic history, symptoms, physician's examination, and laboratory results. We performed statistical analysis of the difference between the paper registry and SMR. RESULTS: A total of 1193 patients were registered. Among them, 835 patients were registered using the SMR. There were no statistically significant differences in the patients' basic information and diagnostic classification. However, the SMR group reported more recent history of pelvic inflammatory disease (p<0.01), higher number of abortions (p<0.01), and higher number of sexual partners (p<0.01). CONCLUSION: Using the tablet computer based self-survey, patients had a more positive tendency toward answering privacy sensitive items. Therefore, it might be more useful and effective in obtaining sensitive, private information from patients.
Abdominal Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Medical History Taking ; Pelvic Inflammatory Disease ; Privacy ; Registries ; Seoul ; Sexual Partners

PURPOSE: In the emergency department (ED), identification of the obstetrical and gynecologic history for diagnosis of child-bearing aged women who present with abdominal pain is very important. We compared the usefulness of self-registry using a tablet computer and a traditional paper registry for taking history of child-bearing aged women. METHODS: We reviewed the prospective registries of child-bearing aged women presenting with abdominal pain without underlying disease to the ED of the Seoul Metropolitan Boramae Medical Center. We used a paper version of this registry from April 2008 to April 2011. From May 2011 to October 2012, we used the Smart Medical Registry (SMR), where the patient used a tablet computer to record her own data. The registries of child-bearing aged women included information on the patient's basic information, medical history, gynecologic history, symptoms, physician's examination, and laboratory results. We performed statistical analysis of the difference between the paper registry and SMR. RESULTS: A total of 1193 patients were registered. Among them, 835 patients were registered using the SMR. There were no statistically significant differences in the patients' basic information and diagnostic classification. However, the SMR group reported more recent history of pelvic inflammatory disease (p<0.01), higher number of abortions (p<0.01), and higher number of sexual partners (p<0.01). CONCLUSION: Using the tablet computer based self-survey, patients had a more positive tendency toward answering privacy sensitive items. Therefore, it might be more useful and effective in obtaining sensitive, private information from patients.
Abdominal Pain* ; Classification ; Diagnosis ; Emergencies* ; Emergency Medicine ; Emergency Service, Hospital* ; Female ; Humans ; Medical History Taking ; Pelvic Inflammatory Disease ; Privacy ; Registries ; Seoul ; Sexual Partners