Globally, the problem of obesity is increasing, and the prevalence of obesity in Korea is also rising rapidly. Obesity is a risk factor for cardiometabolic diseases including type 2 diabetes mellitus, hypertension, cardiovascular disease, and some types of cancer. Therefore, prevention of various metabolic diseases or symptom relief through effective treatment of obesity is a very important problem. According to the obesity guidelines of the Obesity Society of Korea in 2018, obesity medication is recommended for patients with a body mass index (BMI) of 30 kg/m² or more or a BMI of 27 kg/m² or more, and one or more obesity accompanying diseases (type 2 diabetes, hypertension, dyslipidemia). In this case, it is recommended that the basic treatment for obesity (diet, exercise, and behavior therapy) should be performed in parallel with Saxenda® treatment. The glucagon-like peptide 1 analogue, Saxenda®, has been validated as a long-term effective and safe treatment for obesity, and is expected to be a promising drug for the treatment of obesity and the prevention of pre-diabetes in the future. However, in Korea, where non-standard obesity treatments are widely practiced, it is necessary to improve the health of obese patients by being treated with Saxenda® along with diet, exercise and behavior therapy.
Behavior Therapy ; Body Mass Index ; Cardiovascular Diseases ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diet ; Glucagon-Like Peptide 1 ; Humans ; Hypertension ; Korea ; Metabolic Diseases ; Metabolism ; Obesity ; Prevalence ; Risk Factors ; Specialization

Controlling dyslipidemia is important for the prevention and treatment of cardiovascular diseases. This review introduces dietary management recommendations from the 2015 Korean Guidelines for the Management of Dyslipidemia, which were established by the Korean Society of Lipidology and Atherosclerosis. To prevent dyslipidemia, controlling dietary energy consumption to maintain a healthy body weight is important, due to the positive relationship among overweight, obesity, and dyslipidemia. It is recommended that less than 30% of total daily calories come from dietary fat. Rather than simply decreasing the consumption of total fat, it is suggested that the consumption of saturated and trans fatty acid is less than 7% and 1%, respectively, of total daily calories. To reduce serum total triglycerides, the consumption of dietary carbohydrates is advised not to take excessive, and in particular a reduction in the consumption of simple sugars. The consumption of dietary fiber, which is rich in foods such as whole grains and vegetables, is recommended at 25 grams per day. Also, based on studies on the relationship between disease and dietary patterns, it is advised to maintain a diverse and balanced diet that includes vegetables, fruits, dairy products and whole grains, rather than a diet consisting of meat, noodles, and alcohol. Focusing on lifestyle behavioral strategies that target diet management to improve dyslipidemia could be highly effective in facilitating the risk reduction of cardiovascular disease and enhancing pharmacotherapeutic interventions.
Atherosclerosis ; Body Weight ; Carbohydrates ; Cardiovascular Diseases ; Dairy Products ; Diet Therapy ; Diet* ; Dietary Carbohydrates ; Dietary Fats ; Dietary Fiber ; Dyslipidemias* ; Edible Grain ; Fruit ; Life Style ; Meat ; Obesity ; Overweight ; Risk Reduction Behavior ; Triglycerides ; Vegetables

BACKGROUND: Data regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND) Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients. METHODS: Type 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests. RESULTS: Three thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs) only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively. CONCLUSION: In our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.
Aspirin ; Blood Pressure ; Busan ; Cardiovascular Diseases ; Cohort Studies ; Demography ; Diabetes Mellitus, Type 2 ; Diet ; Drug Therapy ; Hospitals, General* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypertension ; Hypoglycemic Agents ; Insulin ; Korea ; Platelet Aggregation Inhibitors ; Prescriptions* ; Prevalence ; Prospective Studies ; Pulse Wave Analysis

INTRODUCTIONDyslipidaemia leads to atherosclerosis and is a major risk factor for cardiovascular diseases. In clinical trials, 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, or statins, have been shown to effectively reduce dyslipidaemia. Despite the availability and accessibility of statins, myocardial infarctions and cerebrovascular accidents remain among the top causes of mortality in developed countries, including Singapore. This enigma could be attributed to suboptimal adherence to statin therapy. The present literature review aimed to evaluate patients' perceptions of statin therapy.

METHODSWe searched PubMed and other databases for articles published in English from October 1991 to May 2012 containing keywords such as 'patient', 'views', 'perceptions', 'adherence', 'statin' and 'dyslipidaemia'. Of the 122 eligible studies retrieved, 58 were reviewed. The findings were categorised and framed in accordance with the Health Belief Model.

RESULTSPatients with dyslipidaemia appeared to underestimate their susceptibility to dyslipidaemia-related complications, partly due to their demographic profiles. Failure to appreciate the severity of potential complications was a major hindrance toward adherence to statin therapy. Other factors that affected a patient's adherence included lack of perceived benefits, perceived side effects, the cost of statins, poor physician-patient relationship, and overestimation of the effectiveness of diet control as a treatment modality.

CONCLUSIONExisting evidence suggests that the cause of poor adherence to statin therapy is multifactorial. The use of the Health Belief Model to present the results of our literature review provides a systematic framework that could be used to design a patient-centric approach for enhancing adherence to statin therapy.

Attitude to Health ; Cardiovascular Diseases ; drug therapy ; Diet ; Dyslipidemias ; drug therapy ; Health Education ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Medication Adherence ; Myocardial Infarction ; drug therapy ; Patient Acceptance of Health Care ; Physician-Patient Relations ; Risk Factors ; Singapore ; Stroke ; drug therapy

High fruit intake has been shown to reduce the risk of cardiovascular disease and some forms of cancer; however, the association between fruit intake and glycemic control in diabetes has been reported inconsistently. Some health professionals often have concerns about the sugar content in fruit and advise individuals with diabetes to restrict their fruit intake. Recent nutrition recommendations for the management of diabetes have emphasized individualized nutrition therapy based on a varied diet including whole grains, vegetables, and fruits, however. Higher fruit intake may reduce the risk of diabetes. Fruit intake should not be restricted and we recommend 2 exchanges (100-300 g) of fruit intake for diabetic patients.
Blood Glucose ; Cardiovascular Diseases ; Edible Grain ; Diabetes Mellitus ; Diet ; Fruit* ; Health Occupations ; Humans ; Nutrition Therapy ; Vegetables

Obese patients have been increasing with the development of a social economy. Obesity is a disease with high mortality rates due to associated cardiovascular disease and diabetes. Diet or exercise therapy, medications, bariatric surgery are used for treating obesity. However, although bariatric surgery is safe and effective, it is expensive, and reoperation is a burden if patients fail to lose weight. Operative complications are also a problem. The recent development of endoluminal techniques may permit obesity treatment and many endoscopic procedures have been attempted. The role of endoscopy for treating obesity is treating the postoperative complications of bariatric surgery, for example, a stricture or widening of the anastomosis, fistula, or leaks. Second, endoscopic applications could be used for weight reduction to temporarily bridge surgery for high-risk patients with obesity, and for reducing weight in patients unable to undergo surgery. This article provides a brief overview of bariatric surgery and its complications and introduces several endoscopic applications to treat obesity.
Bariatric Surgery ; Cardiovascular Diseases ; Constriction, Pathologic ; Diet ; Endoscopy ; Exercise Therapy ; Fistula ; Humans ; Obesity ; Postoperative Complications ; Reoperation ; Weight Loss

The implementation of effective dietary strategies is important for diabetes management. Dietary carbohydrate is the main factor determining blood sugar level, especially in the postprandial period. Carbohydrate-rich diets can have deleterious effects on glycemic control in diabetic patients and may play an important role in the development of cardiovascular diseases. Low glycemic diets have been reported to have beneficial effects for diabetes control and cardiovascular risk factors. However, according to the American Diabetes Association recommendations for medical nutrition therapy, monitoring carbohydrate intake, whether by carbohydrate counting, exchange, or experience-based estimation, remains a key strategy for achieving glycemic control, with the use of the glycemic index and glycemic load recommended only as an auxiliary method that may provide a modest additional benefit for glycemic control over the effects observed when total carbohydrate is considered alone. Recently, an increasing amount of clinical evidence supports the efficacy of low glycemic diets for the management of diabetes. The development of practical methods to apply the glycemic index and glycemic load to the management of diabetes in clinical settings is warranted.
Blood Glucose ; Cardiovascular Diseases ; Diet ; Dietary Carbohydrates ; Glycemic Index ; Humans ; Hyperglycemia ; Nutrition Therapy ; Postprandial Period ; Risk Factors

PURPOSE: This study examined the effects of a nutrition education program on self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease (CVD). METHOD: Sixty-four CVD subjects (37 experimental, 27 control) were recruited from a cardiac center, at a university hospital located in D city, Korea. All subjects attended a first heart camp where pretest measures were performed, and a second heart camp at 6 months for the posttest measures. During the 6 month study period, the experimental group was required to attend five monthly nutrition education sessions, while the control group received only routine outpatient follow-ups. Data were analyzed by chi-square-test and independent t-test using the SPSSWIN 11.5 program. RESULT: Group comparisons revealed that the experimental group had significantly more improved self-efficacy, frequency of food selection, gustation of salt, systolic blood pressure, and serum total-cholesterol compared to the control group. CONCLUSION: A nutrition education program may be effective in improving self-efficacy, diet behavior pattern and cardiovascular risk factors for patients with cardiovascular disease.
Adaptation, Psychological ; Aged ; Aged, 80 and over ; Cardiovascular Diseases/*diet therapy ; Chi-Square Distribution ; Counseling ; Diet ; Female ; Food Habits/*psychology ; Health Promotion ; Humans ; Male ; Middle Aged ; Patient Education as Topic ; Program Evaluation ; Risk Factors ; *Self Efficacy

This study was performed to investigate the effects of nutrition education program in physical health, nutritional status and health-related quality of life (HRQoL )of the Elderly in Seoul. Nutrition education program was consisted of healthy eating, prevention and diet therapy of obesity, diabetes, cardiovascular disease, and osteoporosis. Seventy eight free-living elderly people (13 male, 65 female ), aged > or =60 years participated in this program. Before and after nutri-tion education program, we surveyed the general characteristics, physical health, general health, nutrition status, and health-related quality of life to the subjects. All the subjects were divided into program completers (N =47 )and non-completers (N =31 ). All the data were analyzed by student t-test, chi-square test, paired t-test, and marginal homo-geneity test using SPSS 9.0 version at p <0.05. After nutrition education program, physical activity and ADL maintained, however IADL improved in program noncompleters. In eating habits, 'slow eating' significantly improved in program completers in program completers. Nutrition knowledge and recognition scores were significantly increased in both groups, and accuracy score was significantly increased in program completers. However, nutrient-intakes of %RDA were not significantly changed in both groups, and it seemed to be more influenced by other factors such as 'family income' or 'family type' than by the nutrition education program. In HRQoL, social functioning was improved after nutrition education program in both groups (p <0.05 ). The nutrition education program has more effects on the pro-gram completers than on the noncompleters, and it is also needed social supports for the Elderly to fulfill their nutrient requirements.
Activities of Daily Living ; Aged* ; Cardiovascular Diseases ; Diet Therapy ; Eating ; Education* ; Female ; Humans ; Male ; Motor Activity ; Nutritional Status* ; Obesity ; Osteoporosis ; Quality of Life* ; Seoul*

PURPOSE: The purpose of this study were to investigate the effects of a 12-week brisk walking program on triglycerides (TG) and apolipoprotein B (Apo B) and to compare these effects to those of a brisk walking plus diet program in middle-aged overweight/obese (BMI> or =23) Korean women with hypertriglyceridemia. METHOD: This analysis was done with nineteen middle-aged overweight/obese Korean women who completed either the brisk walking program (9 women) or the brisk walking plus diet program (10 women) for 12 weeks. The brisk walking consisted of walking for 20 to 50 minutes/day at an intensity of 40 to 70% of heart rate reserve (HRR) for 3 to 6 days/week. The diet consisted of 60 minutes of group education and 20 to 30 minutes of individual counseling every week. TG and Apo B were assessed pre- and post-intervention. RESULTS: TG and Apo B decreased significantly after the brisk walking program (Z = -2.31, p = 0.021; Z = -2.59, p = 0.009). TG and Apo B lowering effects of the brisk walking program were not significantly different from those of the brisk walking plus diet program (U = 37.0, p = 0.549; U = 42.0, p = 0.842). CONCLUSION: Brisk walking can be an effective intervention for overweight/obese middle-aged women with hypertriglyceridemia in reducing cardiovascular risk by lowering TG and Apo B levels. Adding diet to brisk walking may have no additional significant effects on changes in TG and Apo B.
Adult ; Apolipoproteins B/blood ; Body Mass Index ; Cardiovascular Diseases/etiology/prevention & control ; Combined Modality Therapy ; Counseling/organization & administration ; Diet, Fat-Restricted/*methods ; Energy Intake ; Exercise Test ; Exercise Therapy/education/*methods ; Female ; Heart Rate ; Humans ; Hypertriglyceridemia/blood/complications/epidemiology/*prevention & control ; Korea/epidemiology ; Middle Aged ; Nursing Evaluation Research ; Obesity/complications/epidemiology/*prevention & control ; Patient Education as Topic/organization & administration ; Prevalence ; Risk Reduction Behavior ; Triglycerides/blood ; *Walking