Sangshin Park

Risk Factors for Microbial Contamination in Fruits and Vegetables at the Preharvest Level: A Systematic Review

The objective of this study was to perform a systematic review of risk factors for contamination of fruits and vegetables with Listeria monocytogenes, Salmonella, and Escherichia coli O157:H7 at the preharvest level. Relevant studies were identified by searching six electronic databases: MEDLINE, EMBASE, CAB Abstracts, AGRIS, AGRICOLA, and FSTA, using the following thesaurus terms: L. monocytogenes, Salmonella, E. coli O157 AND fruit, vegetable. All search terms were exploded to find all related subheadings. To be eligible, studies had to be prospective controlled trials or observational studies at the preharvest level and had to show clear and sufficient information on the process in which the produce was contaminated. Of the 3,463 citations identified, 68 studies fulfilled the eligibility criteria. Most of these studies were on leafy greens and tomatoes. Six studies assessed produce contamination with respect to animal host-related risk factors, and 20 studies assessed contamination with respect to pathogen characteristics. Sixty-two studies assessed the association between produce contamination and factors related to produce, water, and soil, as well as local ecological conditions of the production location. While evaluations of many risk factors for preharvest-level produce contamination have been reported, the quality assessment of the reviewed studies confirmed the existence of solid evidence for only some of them, including growing produce on clay-type soil, the application of contaminated or non-pH-stabilized manure, and the use of spray irrigation with contaminated water, with a particular risk of contamination on the lower leaf surface. In conclusion, synthesis of the reviewed studies suggests that reducing microbial contamination of irrigation water and soil are the most effective targets for the prevention and control of produce contamination. Furthermore, this review provides an inventory of the evaluated risk factors, including those requiring more research.

Association between adiponectin levels and coronary heart disease and mortality: a systematic review and meta-analysis

BACKGROUNDnOur aim was to systematically review prospective studies of the association of plasma adiponectin levels with the risk of coronary heart disease (CHD) events, cardiovascular mortality and all-cause mortality.nnnMETHODSnWe searched Medline, EMBASE, the Cochrane Library and CINAHL for reports published through October 2011. Search terms included adiponectin AND cardiovascular disease OR mortality. We included prospective studies lasting more than 1 year with plasma adiponectin levels at baseline and all-cause mortality and/or major cardiovascular morbidity and mortality as outcomes. We used a random-effects model to pool the data and conducted additional subgroup meta-analyses according to the pre-existence of CHD. Pooled relative risk (RR) was estimated by a 1-SD increase in the logarithmically transformed circulating adiponectin levels.nnnRESULTSnA total of 24 prospective studies were included in the meta-analysis. The pooled RR of adiponectin for CHD events (23 studies) was 1.03 [95% confidence interval (CI): 1.00, 1.06]. In subgroup analyses, the RR of adiponectin was 0.99 (95% CI: 0.94, 1.03) for new-onset CHD (17 studies), but there was an increased risk (RR = 1.12, 95% CI: 1.04, 1.22) for CHD recurrence (seven studies). A 10% increased risk (RR = 1.10, 95% CI: 1.04, 1.16) of all-cause mortality (six studies) and a 14% increased risk (RR = 1.14, 95% CI: 1.05, 1.23) of cardiovascular disease mortality (five studies) were observed.nnnCONCLUSIONSnNo association was observed between adiponectin levels and CHD events. Our results suggest that higher circulating adiponectin levels may be associated with an increased risk of CHD recurrence and all-cause/CVD mortality.

Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study.

IntroductionSeveral in vitro studies have suggested the effects of adipokines and insulin resistance on breast cancer cell proliferation and survival. However, little is known about the clinical significance of these findings.MethodsWe examined associations between breast cancer recurrence and adiponectin, leptin, insulin resistance, and metabolic syndrome (MetS) in a cohort of 747 patients from 2001 to 2004.ResultsAdjusted hazard ratios showed an inverse trend across the quartiles for serum adiponectin concentration in estrogen receptor (ER)/progesterone receptor (PR) -negative patients (P for trend = 0.027) but not in ER/PR-positive patients. Compared to the highest quartile for adiponectin level, the lowest quartile showed a hazard ratio of 2.82 (1.03 to 7.68). Homeostasis model assessment for insulin resistance (HOMA-IR) showed a positive trend for recurrence in the ER/PR-negative group (P for trend = 0.087) and a negative trend in the ER/PR-positive group (P for trend = 0.081). Leptin did not show any associations (P for trend >0.05). A linear trend was observed with the number of components of MetS in ER/PR-negative patients (P for trend = 0.044). This association disappeared when adjusted for adiponectin and HOMA-IR.ConclusionsAdiponectin and HOMA-IR have prognostic significance in breast cancer recurrence and interventions related to these factors may protect against recurrence in ER/PR-negative patients. These findings were not observed in the case of ER/PR-positive patients. Further evaluation of these insignificant associations is needed because it might be biased by adjuvant chemotherapy or other confounders.

Generic Escherichia coli Contamination of Spinach at the Preharvest Stage: Effects of Farm Management and Environmental Factors

The objective of this study was to determine the effects of farm management and environmental factors on preharvest spinach contamination with generic Escherichia coli as an indicator of fecal contamination. A repeated cross-sectional study was conducted by visiting spinach farms up to four times per growing season over a period of 2 years (2010 to 2011). Spinach samples (n = 955) were collected from 12 spinach farms in Colorado and Texas as representative states of the Western and Southwestern United States, respectively. During each farm visit, farmers were surveyed about farm-related management and environmental factors using a questionnaire. Associations between the prevalence of generic E. coli in spinach and farm-related factors were assessed by using a multivariable logistic regression model including random effects for farm and farm visit. Overall, 6.6% of spinach samples were positive for generic E. coli. Significant risk factors for spinach contamination with generic E. coli were the proximity (within 10 miles) of a poultry farm, the use of pond water for irrigation, a >66-day period since the planting of spinach, farming on fields previously used for grazing, the production of hay before spinach planting, and the farm location in the Southwestern United States. Contamination with generic E. coli was significantly reduced with an irrigation lapse time of >5 days as well as by several factors related to field workers, including the use of portable toilets, training to use portable toilets, and the use of hand-washing stations. To our knowledge, this is the first report of an association between field workers personal hygiene and produce contamination with generic E. coli at the preharvest level. Collectively, our findings support that practice of good personal hygiene and other good farm management practices may reduce produce contamination with generic E. coli at the preharvest level.

Health-related quality of life in metabolic syndrome: The Korea National Health and Nutrition Examination Survey 2005

AIMnThis study sought to assess the association between metabolic syndrome (MS) and health-related quality of life (HRQOL) in the general population.nnnMETHODSnWe analyzed data for 4463 adults, aged 30 years or older, from the Korea National Health and Nutrition Examination Survey 2005. EuroQol 5D, which measures two dimensions, the EuroQol 5D index score (EQ-5D) and the EuroQol visual analogue scale (EQ-VAS), was used to evaluate HRQOL.nnnRESULTSnMean scores for the EQ-5D in both sexes and EQ-VAS in women decreased with increasing number of MS components, and womens means for both scores were significantly lower than mens. In individual domains of HRQOL, men with more MS components tended to have higher odds ratios for decreased self-care, and women had decreased mobility, according to the EQ-5D. In men, high blood pressure led to decreased EQ-5D, and in women, abdominal obesity and high blood pressure did so. Additionally, we found that taking medication had an impact on decreased HRQOL, especially in subjects with impaired fasting glucose.nnnCONCLUSIONSnHRQOL was negatively associated with the number of MS components and it was decreased by taking hypoglycemic medications. This association differed by gender.

The Distribution of Intraocular Pressure and Its Association With Metabolic Syndrome in a Community

OBJECTIVESnThe current study was performed to assess the distribution of intraocular pressure (IOP) and its association with metabolic syndrome (MS) in a community.nnnMETHODSnWe measured IOP and MS components from 446 adults, age 20 or more years old, who reside in a community in Kyunggi Province, South Korea. We compared the level of IOP according to the number of metabolic abnormalities and between normal and abnormal metabolic components. Linear regression analyses were used to determine the relationship between IOP and metabolic components.nnnRESULTSnNo significant difference in IOP (mean +/- SE) was found between men (12.24 +/- 2.42) and women (12.55 +/- 2.41 mmHg, p > 0.1), while IOP of men tended to decrease as age increased (p for trend < 0.01). After adjusting for age, IOP of subjects with abdominal obesity in men and high blood pressure in women were significantly higher than those without abdominal obesity or high blood pressure (p < 0.05). Female subjects with MS showed significantly higher IOP than those without MS. Participants with more metabolic disturbances tended to have a greater IOP elevation with a linear trend after adjusting for age and sex. In the univariate regression analysis, age and waist circumference were significantly associated with IOP in men, but systolic and diastolic blood pressure were associated with IOP in women. In final multiple regression model, age, systolic blood pressure, and triglyceride were associated with IOP in women, and age in men.nnnCONCLUSIONSnThese findings suggest that MS and its components may be important determinants of elevated IOP.

Association between metabolic syndrome and bone mineral density in Korea: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008

Little is known regarding the exact relationship between osteoporosis and cardiovascular disease. Moreover, previous research on the relationships between components of metabolic syndrome (MetS) and bone mineral density (BMD) has primarily focused on women and older men; there have been few studies in younger men. We performed a cross-sectional study to assess whether MetS is associated with BMD in the femoral neck or lumbar spine in Korean adults. We further attempted to identify the MetS component, which is the most important factor in BMD. We performed a multiple regression analysis to analyze data on 2,989 subjects from the Fourth Korea National Health and Nutrition Examination Survey. We examined the association between MetS and individuals MetS components and BMD. After adjustment for age, height, weight, smoking status, alcohol consumption and exercise, waist circumference (WC) and diastolic blood pressure (DBP) showed independent negative associations with femoral neck and spine BMD in men in all age groups. Triglyceride concentration was also negatively associated with femoral neck BMD in younger men (<45xa0years). In premenopausal women, WC, DBP, and high-density lipoprotein cholesterol were negatively associated with spine BMD. In postmenopausal women, WC was negatively associated with femoral neck BMD. These results suggest that WC in men in all age groups may be the most important factor in bone mineral density.

The association between disturbed eating behavior and socioeconomic status: the Online Korean Adolescent Panel Survey (OnKAPS).

Background A limited amount of research, primarily conducted in Western countries, has suggested that higher socioeconomic status (SES) is associated with higher risk of eating disorders (EDs). However, little is known about this association in Asian countries. We examined the association of SES with disturbed eating behavior (DEB) and related factors in Korean adolescents. Subjects A nationwide online panel survey was conducted in a sample of adolescents (nu200a=u200a6,943, 49.9% girls). DEB was measured with the 26-item Eating Attitudes Test (EAT-26). Participants who scored ≥20 on the EAT-26 were considered to have DEB. Participants’ SES was determined based on self-reported household economic status. Results The prevalence of DEB was 12.7%: 10.5% among boys and 14.8% among girls. Both boys and girls with DEB were more likely to perceive themselves as obese, experience higher levels of stress, and have lower academic achievement. The risk for DEB was significantly higher in boys of higher SES than in those of middle SES (ORu200a=u200a1.45, 95%CIu200a=u200a1.05–1.99 for high SES; ORu200a=u200a5.16, 95%CI: 3.50–7.61 for highest SES). Among girls, higher risk of DEB was associated with the highest and lowest SES (ORu200a=u200a1.52, 95%CI: 1.13–2.06 for lowest SES; ORu200a=u200a2.22, 95%CI: 1.34–3.68 for highest SES). Conclusions Despite the lower prevalence of obesity in Korea compared with Western countries, the prevalence of DEB in Korean adolescents was high, especially among girls. Moreover, the association between SES and DEB followed a U-shaped curve for girls and a J-shaped curve for boys.

Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents.

BACKGROUND/OBJECTIVES There is little information on the association between weight misperception and eating behavior in Korean adolescents. Therefore, we investigated the association of food intake habits and dieting method and disturbed eating behavior (DEB) in relation to weight misperception. SUBJECTS/METHODS Data was collected by using a nationwide online panel survey from 6,943 adolescents enrolled in middle/high school. DEB was measured with the Eating Attitudes Test (EAT-26) and those who scored ≥ 20 on the EAT-26 were considered to have eating disorder. Logistic regressions were conducted to examine the association between weight misperception based on self-reported weight status and dieting method and eating behaviors. RESULTS The proportion of weight underestimation was 23.5% and that of overestimation was 24.0%. Weight overestimating girls were more likely to engage in various unhealthy dieting practices (OR = 1.69 for fasting; OR = 1.88 for laxative or diuretic use; OR = 2.05 for self-induced vomiting after meals; P < 0.05). Moreover, there was a strong association between overestimation and undesirable eating behaviors, especially among girls, e.g.: having breakfast (OR = 0.85), high consumption of fast foods (OR = 1.28) and regular sodas (OR = 1.39), but not among boys. In both genders, weight overestimation appears to be a major risk factor for DEB (OR = 1.34 for boys and OR = 1.41 for girls; P < 0.05). CONSLUSIONS Weight overestimation is associated with unhealthy weight control practices and eating behaviors. We particularly found a significant association between weight overestimation and DEB among nationwide Korean adolescents.

Farm Management, Environment, and Weather Factors Jointly Affect the Probability of Spinach Contamination by Generic Escherichia coli at the Preharvest Stage

ABSTRACT The National Resources Information (NRI) databases provide underutilized information on the local farm conditions that may predict microbial contamination of leafy greens at preharvest. Our objective was to identify NRI weather and landscape factors affecting spinach contamination with generic Escherichia coli individually and jointly with farm management and environmental factors. For each of the 955 georeferenced spinach samples (including 63 positive samples) collected between 2010 and 2012 on 12 farms in Colorado and Texas, we extracted variables describing the local weather (ambient temperature, precipitation, and wind speed) and landscape (soil characteristics and proximity to roads and water bodies) from NRI databases. Variables describing farm management and environment were obtained from a survey of the enrolled farms. The variables were evaluated using a mixed-effect logistic regression model with random effects for farm and date. The model identified precipitation as a single NRI predictor of spinach contamination with generic E. coli, indicating that the contamination probability increases with an increasing mean amount of rain (mm) in the past 29 days (odds ratio [OR] = 3.5). The model also identified the farms hygiene practices as a protective factor (OR = 0.06) and manure application (OR = 52.2) and state (OR = 108.1) as risk factors. In cross-validation, the model showed a solid predictive performance, with an area under the receiver operating characteristic (ROC) curve of 81%. Overall, the findings highlighted the utility of NRI precipitation data in predicting contamination and demonstrated that farm management, environment, and weather factors should be considered jointly in development of good agricultural practices and measures to reduce produce contamination.