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The Effect of Eating Behavior on Being Overweight or Obese During Preadolescence.

Hye Ah LEE ; Won Kyung LEE ; Kyoung Ae KONG ; Namsoo CHANG ; Eun Hee HA ; Young Sun HONG ; Hyesook PARK

Journal of Preventive Medicine and Public Health.2011;44(5):226-233. doi:10.3961/jpmph.2011.44.5.226

OBJECTIVES: Being overweight or obese is central to metabolic syndrome, and these characteristics constitute dominant risk factors for chronic diseases. Although behavioral factors, including eating habits and sedentary lifestyles, are considered to be determinants of obesity, the specific childhood factors that contribute to this condition have not been clearly defined. METHODS: The subjects consisted of 261 children aged 7-9 years who were recruited from an elementary school during October 2003. Information was obtained from their parents using a questionnaire focused on eating behaviors and lifestyle factors, additional data were also collected via anthropometric measurements and biochemical examinations, including blood tests. RESULTS: A total of 48 (18.4%) of the 261 children were overweight, and 34 (70.8%) had at least one other component of metabolic syndrome. Eating behaviors emerged as significant lifestyle-related risk factors for being overweight or obese. Those who engaged in overeating more than twice per week had three times the risk of being overweight (odds ratio [OR], 3.10, 95% confidence interval [CI], 1.39 to 6.92), and those who ate rapidly had three times the risk of being overweight (OR, 3.28; 95% CI, 1.68 to 6.41). Those who had fewer family meals (fewer than 2?3/month) had a nine times higher risk of being overweight than those who had family meals more frequently (at least 1/day) (OR, 9.51; 95% CI, 1.21 to 74.82). CONCLUSIONS: This study showed that being overweight or obese during preadolescence is associated with a higher risk of metabolic syndrome and is related to unhealthy eating behaviors. Thus, weight-control strategies and healthy eating behaviors should be developed early in life to reduce the risk for metabolic syndrome.
Child ; *Feeding Behavior ; Female ; Humans ; Life Style ; Logistic Models ; Male ; Metabolic Syndrome X/etiology ; Obesity/*etiology ; Odds Ratio ; Overweight/*etiology ; Parents/psychology ; Questionnaires ; Risk Factors

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Relationship Between Blood Mercury Concentration and Waist-to-Hip Ratio in Elderly Korean Individuals Living in Coastal Areas.

Chang Hun YOU ; Byoung Gwon KIM ; Jung Man KIM ; Seung Do YU ; Yu Mi KIM ; Rock Bum KIM ; Young Seoub HONG

Journal of Preventive Medicine and Public Health.2011;44(5):218-225. doi:10.3961/jpmph.2011.44.5.218

OBJECTIVES: This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas. METHODS: The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis. RESULTS: The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) microg/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) microg/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] microg/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis. CONCLUSIONS: In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.
Adult ; Aged ; Asian Continental Ancestry Group ; Body Mass Index ; Cardiovascular Diseases/blood/etiology ; Cholesterol, HDL/blood ; Cholesterol, LDL/blood ; Female ; Humans ; Interviews as Topic ; Male ; Mercury/*blood ; Middle Aged ; Questionnaires ; Regression Analysis ; Republic of Korea ; Risk Factors ; Waist Circumference ; *Waist-Hip Ratio

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Preventable Lifestyle Risk Factors for Non-Communicable Diseases in the Pakistan Adolescents Schools Study 1 (PASS-1).

Ali Khan KHUWAJA ; Saleem KHAWAJA ; Komal MOTWANI ; Adeel Akbar KHOJA ; Iqbal Syed AZAM ; Zafar FATMI ; Badar Sabir ALI ; Muhammad Masood KADIR

Journal of Preventive Medicine and Public Health.2011;44(5):210-217. doi:10.3961/jpmph.2011.44.5.210

OBJECTIVES: The rising burden of preventable risk factors for non-communicable diseases (NCDs) among adolescents is a major public health challenge worldwide. We identified the preventable risk factors for NCDs in adolescents. METHODS: In a school-based study, pre-tested structured questionnaires were completed by 414 adolescents (14 to 17 years) at six schools in three cities in Pakistan. The chi-squared test and adjusted odds ratio (aOR) with 95% confidence interval (CI) were calculated in a multinomial logistic regression analysis. RESULTS: Over 80% of the adolescents had unhealthy diets, and 54% were physically inactive. Most adolescents were exposed to passive smoking, and 14% were also current smokers. More than one-third of participants chewed betel nut, and one-quarter used oral tobacco. More girls were physically inactive (OR, 4.07; 95% CI, 2.69 to 6.17), whereas a greater proportion of boys were current smokers (OR, 2.17; 95% CI, 1.19 to 3.91), exposed to passive smoking (OR, 2.57; 95% CI, 1.72 to 3.83), and using betel nut (OR, 2.03; 95% CI, 1.34 to 3.06). Only 3.1% of the participants were without any preventable lifestyle risk factor for NCDs, and over 80% had > or =2 factors. Co-existence of risk factors was independently associated with fathers being blue-collar workers (aOR, 3.57; 95% CI, 1.07 to 11.92) and parents not treating their child fairly (aOR, 5.05; 95% CI, 1.29 to 19.78). CONCLUSIONS: Most of the adolescents studied had preventable risk factors for NCDs. These results warrant comprehensive and integrated interventions to prevent lifestyle risk factors, and parents are front-line stakeholders.
Adolescent ; Female ; Humans ; *Life Style ; Logistic Models ; Male ; Motor Activity ; Odds Ratio ; Pakistan ; Questionnaires ; Risk Factors ; Schools ; Smoking/*prevention & control ; Tobacco, Smokeless

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Health Impact Assessment as a Strategy for Intersectoral Collaboration.

Eunjeong KANG ; Hyun Jin PARK ; Ji Eun KIM

Journal of Preventive Medicine and Public Health.2011;44(5):201-209. doi:10.3961/jpmph.2011.44.5.201

OBJECTIVES: This study examined the use of health impact assessment (HIA) as a tool for intersectoral collaboration using the case of an HIA project conducted in Gwang Myeong City, Korea. METHODS: A typical procedure for rapid HIA was used. In the screening step, the Aegi-Neung Waterside Park Plan was chosen as the target of the HIA. In the scoping step, the specific methods and tools to assess potential health impacts were chosen. A participatory workshop was held in the assessment step. Various interest groups, including the Department of Parks and Greenspace, the Department of Culture and Sports, the Department of Environment and Cleansing, civil societies, and residents, discussed previously reviewed literature on the potential health impacts of the Aegi-Neung Waterside Park Plan. RESULTS: Potential health impacts and inequality issues were elicited from the workshop, and measures to maximize positive health impacts and minimize negative health impacts were recommended. The priorities among the recommendations were decided by voting. A report on the HIA was submitted to the Department of Parks and Greenspace for their consideration. CONCLUSIONS: Although this study examined only one case, it shows the potential usefulness of HIA as a tool for enhancing intersectoral collaboration. Some strategies to formally implement HIA are discussed.
*Health Policy ; Humans ; Organizational Case Studies ; Politics ; *Public Health ; Public Policy ; Urban Health

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Social Network Effects on Post-Traumatic Stress Disorder (PTSD) in Female North Korean Immigrants.

Byungkyu LEE ; Yoosik YOUM

Journal of Preventive Medicine and Public Health.2011;44(5):191-200. doi:10.3961/jpmph.2011.44.5.191

OBJECTIVES: The goal of this paper is to examine the social network effects on post-traumatic sdress disorder (PTSD) in female North Korean immigrants who entered South Korea in 2007. Specifically, it attempts to verify if the density and composition of networks make a difference after controlling for the network size. METHODS: A multivariate logistic regression is used to probe the effects of social networks using the North Korean Immigrant Panel data set. Because the data set had only completed its initial survey when this paper was written, the analysis was cross-sectional. RESULTS: The size of the support networks was systematically related to PTSD. Female North Korean immigrants with more supporting ties were less likely to develop PTSD, even after controlling for other risk factors (odds-ratio for one more tie was 0.8). However, once we control for the size of the network, neither the density nor the composition of the networks remains statistically significant. CONCLUSIONS: The prevalence of the PTSD among female North Korean immigrants is alarmingly high, and regardless of the characteristics of supporting network members, the size of the supporting networks provides substantial protection. This implies that a simple strategy that focuses on increasing the number of supporting ties will be effective among North Korean immigrants who entered South Korea in recent years.
Adult ; Cross-Sectional Studies ; Democratic People's Republic of Korea ; Emigrants and Immigrants/*psychology ; Female ; Humans ; Interviews as Topic ; Life Change Events ; Logistic Models ; Middle Aged ; Odds Ratio ; Prevalence ; Risk Factors ; *Social Support ; Stress Disorders, Post-Traumatic/diagnosis/ethnology/*psychology

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Effects of Antiretroviral Therapy on the Survival of Human Immunodeficiency Virus-positive Adult Patients in Andhra Pradesh, India: A Retrospective Cohort Study, 2007-2013.

Ram BAJPAI ; Himanshu CHATURVEDI ; Lakshmanan JAYASEELAN ; Pauline HARVEY ; Nicole SEGUY ; Laxmikant CHAVAN ; Pinnamaneni RAJ ; Arvind PANDEY

Journal of Preventive Medicine and Public Health.2016;49(6):394-405. doi:10.3961/jpmph.16.073

OBJECTIVES: The survival outcomes of antiretroviral treatment (ART) programs have not been systematically evaluated at the state level in India. This retrospective study assessed the survival rates and factors associated with survival among adult human immunodeficiency virus (HIV)-infected patients in Andhra Pradesh, India. METHODS: The present study used data from 139 679 HIV patients aged ≥15 years on ART who were registered from 2007 to 2011 and were followed up through December 2013. The primary end point was death of the patient. Mortality densities (per 1000 person-years) were calculated. Kaplan-Meier and Cox-regression models were used to estimate survival and explore the factors associated with survival. RESULTS: The overall median follow-up time was 16.0 months (2.0 months for the deceased and 14.0 months for those lost to follow-up). Approximately 13.2% of those newly initiated on ART died during follow-up. Of those deaths, 56% occurred in the first three months. The crude mortality rate was 80.9 per 1000 person-years at risk. The CD4 count (adjusted hazard ratio [aHR],4.88; 95% confidence interval [CI], 4.36 to 5.46 for <100 cells/mm³ vs. >350 cells/mm³), functional status (aHR, 3.05; 95% CI, 2.82 to 3.30 for bedridden vs. normal), and body weight (aHR, 3.69; 95% CI, 3.42 to 3.97 for <45 kg vs. >60 kg) were strongly associated with the survival of HIV patients. CONCLUSIONS: The study findings revealed that high mortality was observed within the first three months of ART initiation. Patients with poor baseline clinical characteristics had a higher risk of mortality. Expanded testing and counseling should be encouraged, with the goal of ensuring early enrollment into the program followed by the initiation of ART in HIV-infected patients.
Acquired Immunodeficiency Syndrome ; Adult* ; Body Weight ; CD4 Lymphocyte Count ; Cohort Studies* ; Counseling ; Follow-Up Studies ; HIV ; Humans* ; India* ; Mortality ; Retrospective Studies* ; Survival Analysis ; Survival Rate

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A Qualitative Inquiry Into the Challenges of Medical Education for Retention of General Practitioners in Rural and Underserved Areas of Iran.

Sajad DELAVARI ; Mohammad ARAB ; Arash RASHIDIAN ; Saharnaz NEDJAT ; Rahmatollah Gholipour SOUTEH

Journal of Preventive Medicine and Public Health.2016;49(6):386-393. doi:10.3961/jpmph.16.062

OBJECTIVES: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. METHODS: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran’s health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. RESULTS: Iran’s medical education is faced with several challenges that were categorized in four main themes including student selection, medical students’ perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. CONCLUSIONS: Challenges that were found could have negative effects on retention. Modification in student’s perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.
Curriculum ; Delivery of Health Care ; Education ; Education, Medical* ; General Practitioners* ; Humans ; Iran* ; Rural Health ; School Admission Criteria ; Telephone

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Tobacco Use Among Students Aged 13-15 Years in South Korea: The 2013 Global Youth Tobacco Survey.

Sunhye CHOI ; Yoonjung KIM ; Jihye LEE ; Mina KASHIWABARA ; Kyungwon OH

Journal of Preventive Medicine and Public Health.2017;50(1):60-65. doi:10.3961/jpmph.16.079

OBJECTIVES: We examined the prevalence of tobacco use and exposure to secondhand smoke among middle-school students in Korea using the Global Youth Tobacco Survey (GYTS) in 2013. METHODS: The GYTS in Korea was conducted between July and August 2013 by the Korea Centers for Disease Control and Prevention. Data were collected using a self-administered anonymous questionnaire from a nationally representative sample of middle-school students aged 13-15 years in sampled classrooms. RESULTS: The GYTS in Korea was completed by 4235 students aged 13-15 years in 43 middle schools. Approximately one in five of the students (17.8%) reported that they had tried cigarettes in the past, while 5.2% reported currently being cigarette smokers. Current cigarette smoking was higher in boys (7.5%) than in girls (2.6%). Of the students, 29.7% had been exposed to secondhand smoke at home, 47.4% inside enclosed public places, and 53.9% in outdoor public places. Of the current cigarette smokers, 25.7% bought their cigarettes from a store despite a law prohibiting this. Additionally, 58.0% of students noticed point-of-sale tobacco advertisements or promotions, 66.8% of current cigarette smokers wanted to stop smoking, and 70.9% of students had been taught about the dangers of tobacco use in school. CONCLUSIONS: These findings provide an opportunity to develop, implement, and evaluate a comprehensive tobacco control policy. The results suggest that youth have relatively easy access to cigarettes and are regularly exposed to secondhand smoke in public places, as well as to point-of-sale tobacco advertisements and promotions. Strict enforcement of the ban on tobacco sales to youth, expanding smoke-free areas, and advertising bans are needed to reduce tobacco use among youth.
Adolescent* ; Anonyms and Pseudonyms ; Centers for Disease Control and Prevention (U.S.) ; Commerce ; Female ; Humans ; Jurisprudence ; Korea* ; Prevalence ; Republic of Korea ; Smoke ; Smoking ; Tobacco Products ; Tobacco Smoke Pollution ; Tobacco Use* ; Tobacco*

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Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20).

Min Woo JO ; Hyeon Jeong LEE ; Soo Young KIM ; Seon Ha KIM ; Hyejung CHANG ; Jeonghoon AHN ; Minsu OCK

Journal of Preventive Medicine and Public Health.2017;50(1):38-59. doi:10.3961/jpmph.16.081

OBJECTIVES: Few attempts have been made to develop a generic health-related quality of life (HRQoL) instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study. METHODS: After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey. RESULTS: Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20), incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality) in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2) were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001). CONCLUSIONS: A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.
Aged ; Female ; Focus Groups ; Humans ; Korea ; Quality of Life* ; Referral and Consultation ; Reproducibility of Results

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Evaluation of Geographic Indices Describing Health Care Utilization.

Agnus M KIM ; Jong Heon PARK ; Sungchan KANG ; Yoon KIM

Journal of Preventive Medicine and Public Health.2017;50(1):29-37. doi:10.3961/jpmph.16.099

OBJECTIVES: The accurate measurement of geographic patterns of health care utilization is a prerequisite for the study of geographic variations in health care utilization. While several measures have been developed to measure how accurately geographic units reflect the health care utilization patterns of residents, they have been only applied to hospitalization and need further evaluation. This study aimed to evaluate geographic indices describing health care utilization. METHODS: We measured the utilization rate and four health care utilization indices (localization index, outflow index, inflow index, and net patient flow) for eight major procedures (coronary artery bypass graft surgery, percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee replacement surgery, caesarean sections, hysterectomy, computed tomography scans, and magnetic resonance imaging scans) according to three levels of geographic units in Korea. Data were obtained from the National Health Insurance database in Korea. We evaluated the associations among the health care utilization indices and the utilization rates. RESULTS: In higher-level geographic units, the localization index tended to be high, while the inflow index and outflow index were lower. The indices showed different patterns depending on the procedure. A strong negative correlation between the localization index and the outflow index was observed for all procedures. Net patient flow showed a moderate positive correlation with the localization index and the inflow index. CONCLUSIONS: Health care utilization indices can be used as a proxy to describe the utilization pattern of a procedure in a geographic unit.
Angioplasty, Balloon, Coronary ; Arteries ; Cesarean Section ; Delivery of Health Care* ; Female ; Hip ; Hospitalization ; Humans ; Hysterectomy ; Insurance ; Knee ; Korea ; Magnetic Resonance Imaging ; National Health Programs ; Patient Acceptance of Health Care* ; Pregnancy ; Proxy ; Small-Area Analysis ; Transplants

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