Wha Young Kim

Carbohydrate Intake Is Associated with Diet Quality and Risk Factors for Cardiovascular Disease in U.S. Adults: NHANES III

Objectives: To determine if carbohydrate intake, as a % of energy, was related to diet quality and risk factors for cardiovascular disease (CVD) in adults in a cross-sectional and population-based study in the U.S. Methods: Data from the third National Health and Nutrition Examination Survey (NHANES III, 1988–1994) were utilized. The nationally representative sample of the U.S. population (3,754 men, 4,074 women, ages 25 to 64 years) was divided into quintiles of carbohydrate intake (% of energy), which was examined in relation to risk factors for CVD: systolic blood pressure, body mass index (BMI), and concentrations of serum triglyceride, serum total and HDL cholesterol and plasma glucose. Results: When covariates (age, ethnicity, smoking, alcohol intake and total energy intake) were adjusted in multivariate analyses, carbohydrate intakes (% of energy) were inversely associated with BMI and serum total cholesterol concentration in men and BMI in women and positively associated with serum triglyceride concentration in women. When total sugar intake (% of energy) was further controlled as a step to understand the quality of carbohydrate, carbohydrate intakes (% of energy) was a stronger predictor of BMI and plasma glucose in men and BMI in women. A high carbohydrate diet (>57.4% of energy in men and >59.1% of energy in women) was associated with a low serum HDL-cholesterol concentration in men and high serum triglyceride in women. Conclusion: Moderately high carbohydrate (50% to 55% of energy) diets were associated with low CVD risks with favorable lipid profiles.

A randomized double-blind, placebo-controlled study to establish the effects of spirulina in elderly Koreans.

Aims: This study was conducted to determine the antioxidant capacity, immunomodulatory and lipid-lowering effects of spirulina in healthy elderly subjects and to document the effectiveness of spirulina as a functional food for the elderly. Methods: A randomized double-blind, placebo-controlled study was performed. The subjects were 78 individuals aged 60–87 years and were randomly assigned in a blinded fashion to receive either spirulina or placebo. The elderly were instructed to consume the spirulina or placebo at home, 8 g/day, for 16 consecutive weeks. Results: In male subjects, a significant plasma cholesterol-lowering effect was observed after the spirulina intervention (p < 0.05). Spirulina supplementation resulted in a significant rise in plasma interleukin (IL)-2 concentration, and a significant reduction in IL-6 concentration. A significant time-by-treatment intervention for total antioxidant status was observed between spirulina and placebo groups (p < 0.05). In female subjects, significant increases in IL-2 level and superoxide dismutase activity were observed (p < 0.05) after spirulina supplementation. There were significant reductions in total cholesterol in female subjects. Conclusions: The results demonstrate that spirulina has favorable effects on lipid profiles, immune variables, and antioxidant capacity in healthy, elderly male and female subjects and is suitable as a functional food.

Tumor Necrosis Factor (TNF-α) and C-reactive Protein (CRP) are Positively Associated with the Risk of Chronic Kidney Disease in Patients with Type 2 Diabetes

Purpose Chronic low-grade inflammation may induce chronic kidney disease in patients with type 2 diabetes. This study investigated the relation between inflammatory biomarkers and chronic kidney disease in patients with type 2 diabetes, which has not yet been reported in Asian populations. Materials and Methods A cross-sectional study was performed in 543 patients recruited from diabetic clinics for an ongoing, prospective study. Multivariate logistic regression was used to evaluate the association between inflammatory biomarkers and the presence of chronic kidney disease (estimated glomerular filtration rate < 60 mL/min per 1.73 m2 by the simplified Modification of Diet in Renal Disease equation using plasma creatinine). Results The risk of chronic kidney disease increased in the highest quartiles of C-reactive protein (CRP) [multivariate odds ratio (OR) = 3.73; 95% CI = 1.19-1.70] and tumor necrosis factor-α (multivariate OR = 4.45; 95% CI = 1.63-12.11) compared to the lowest quartiles after adjustments for age, sex, zinc intake, and other putative risk factors for chronic kidney disease. Conclusion Our results suggest that CRP and tumor necrosis factor-α may be independent risk factors for chronic kidney disease in patients with type 2 diabetes. A causal mechanism of this association should be evaluated in a follow-up study of Korean patients with type 2 diabetes.

Inhibition of CACO-2 cell proliferation by (n-3) fatty acids: possible mediation by increased secretion of insulin-like growth factor binding protein-6

Abstract The present study was performed to examine the effect of various polyunsaturated fatty acids (PUFAs) on the proliferation of the human colon adenocarcinoma cell line, Caco-2 cells. The ability of individual PUFAs to stimulate cell proliferation was examined by culturing cells in serum-free medium. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) inhibited cell proliferation, and therefore, cells cultured with 100 μM EPA or DHA reached much lower final densities compared to cells cultured with 2 μM linoleic acid (control) or 100 μM linoleic acid (LA). Insulin-like growth factors (IGFs) are autocrine and paracrine growth promoters of a variety of cells, and a family of IGF binding proteins (IGFBPs) modulates the biological actions of IGF-I and IGF-II. Since IGF-II has been shown to be an autocrine regulator of Caco-2 cells, we investigated the effects of these PUFAs on IGF-II and IGFBP secretion in association with Caco-2 cell proliferation. Immunoblot analysis of serum-free conditioned medium using a monoclonal anti-IGF-II antibody showed that concentrations of both mature 7,500 M r and higher M r forms of pro IGF-II were lower in conditioned medium by cells treated with EPA or DHA compared with LA. Ligand blot analysis revealed that the secretion of IGFBP-6 was significantly higher in cells treated with 100 μM EPA or DHA compared to LA. Northern blot analysis demonstrated that the steady state levels of IGFBP-6 mRNA were higher in cells cultured with EPA or DHA compared to the controls. Exogenously added IGFBP-6 inhibited Caco-2 cell proliferation. We propose that low IGF-II/IGFBP-6 ratios may have resulted in less free IGF-II and, consequently, the slower proliferation of Caco-2 cells treated with EPA or DHA.

Nutritional status of Vietnamese female marriage immigrants to Korea in relation to length of residence in Korea.

Aims: It was the aim of this study to assess the nutritional status of Vietnamese immigrants to Korea through marriage and to examine the association between their nutritional status and their length of residence in Korea. Methods: A cross-sectional analysis of a prospective cohort study was performed with Vietnamese immigrant wives to Korea (n = 890). Results: The mean age and length of residence in Korea were 23.5 and 2.0 years, respectively. The mean body mass index (BMI) and waist-to-hip ratio (WHR) were 20.9 and 0.82, respectively. Prevalence of underweight (BMI <18.5), overweight (BMI ≥25) and central obesity (WHR >0.85) were 18.3, 7.5 and 26.2%, respectively. As the length of residence in Korea increased, the prevalence of obesity and central obesity increased and the prevalence of underweight decreased. The prevalence of dyslipidemia was <10%. Daily food and daily nutrient intake, which was estimated by 1-day 24-hour recall, did not differ according to the length of residence in Korea. Conclusions: BMI, WHR and blood profiles of most subjects were in the normal ranges. As the length of residence in Korea increased, the prevalence of obesity increased. The usual intake of the subjects needs to be estimated by other dietary assessment methods.

Adiponectin gene SNP 276G → T, nutrient intakes, and cardiovascular disease risk in Korean type 2 DM patients

Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G-->T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G-->T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.

Development and evaluation of a food frequency questionnaire for Vietnamese female immigrants in Korea: the Korean Genome and Epidemiology Study (KoGES)

The objectives of this study were to develop a food-frequency questionnaire (FFQ) for Vietnamese female immigrants in Korea and to evaluate the validity of the FFQ. A total of 80 food items were selected in developing the FFQ according to consumption frequency, the contribution of energy and other nutrients, and the cooking methods based on one-day 24 hour recall (24HR) from 918 Vietnamese female immigrants between November 2006 and November 2007. The FFQ was validated by comparison with 24HR of 425 Vietnamese female immigrants between November 2008 and August 2009. The absolute nutrient intake calculated from the FFQ was higher than that estimated by 24HR for most nutrients. The correlation coefficients between 24HR and FFQ ranged from 0.10 (vitamin C) - 0.36 (energy) for crude intake, 0.05 (vitamin E) - 0.32 (calcium) for per 1000 kcal, and 0.08 (zinc) - 0.34 (calcium) for energy-adjusted, respectively. More than 70% of subjects were classified into the same or adjacent agreement groups for nutrients other than fiber, sodium, vitamin A, vitamin C, and vitamin E, while less than 10% of subjects were classified into complete disagreement groups. We conclude that the FFQ appears to be an acceptable tool for estimating nutrient intake and dietary patterns of Vietnamese female immigrants in Korea. Future studies to validate the FFQ using various biomarkers or other dietary assessment methods are needed.

Hypoadiponectinemia is strongly associated with metabolic syndrome in Korean type 2 diabetes patients.

Objective: To evaluate the relationship between serum adiponectin level, dietary intake, and metabolic syndrome (MetS) in type 2 diabetes mellitus (DM) patients, and to identify factors associated with serum adiponectin level. Methods: A cross-sectional study was performed using 789 type 2 DM patients (406 men and 383 women) 40–80 years old. Subjects were classified into 3 groups on the basis of serum adiponectin level. General characteristics and anthropometric, hematologic, and dietary data were obtained for each subject. Results: The prevalence of hypoadiponectinemia (<4.0 µg/mL) was 57.4% in men and 32.4% in women. Serum adiponectin level was negatively correlated with body mass index (BMI), waist circumference, body fat percentage, and serum concentrations of insulin and triglyceride, and was positively correlated with high-density lipoprotein (HDL)-cholesterol level. Even though the direct association of nutrient intake with serum adiponectin concentration was not strong, various contributing factors for hypoadiponectinemia were strongly correlated with micronutrient intake, such as calcium, iron, and niacin. Both sexes in the group with the lowest adiponectin concentration had a higher prevalence of MetS and MetS components than corresponding sexes in the group with the highest adiponectin concentration. Conclusions: Our findings show that hypoadiponectinemia is strongly associated with MetS in type 2 DM patients. Dietary intake may be indirectly associated with adiponectin levels through factors such as BMI, waist circumference, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, HDL-cholesterol, and blood pressure. Therefore, our results suggest that manipulation of the level of adiponectin may prevent MetS and reduce the risk of cardiovascular disease in type 2 DM patients.

Carbohydrate Intake Interacts With SNP276G>T Polymorphism in the Adiponectin Gene to Affect Fasting Blood Glucose, HbA1C, and HDL Cholesterol in Korean Patients With Type 2 Diabetes

Background/Objective: The SNP276G>T polymorphism in the adiponectin gene has been reported to be associated with type 2 diabetes and impaired glucose tolerance. The objective of this study was to examine whether SNP276G>T polymorphism influences the blood glucose levels in relation to dietary carbohydrate intake. Subjects/Methods: In an ongoing, prospective study, 673 patients with type 2 diabetes (339 men and 334 women, aged 40–85 years) were recruited from one of two diabetes clinics in Seoul, Korea. The levels of carbohydrate intake were categorized as <55%, 55%–65%, and >65% of total energy intake. Results: Significant gene–nutrient interactions between SNP276G>T polymorphism and the level of carbohydrate intake were found, which modulated plasma fasting blood glucose ( p = 0.0277), HbA1C ( p = 0.0407), and high-density lipoprotein (HDL) cholesterol ( p = 0.0134) concentrations. The G allele was associated with higher fasting blood glucose only in subjects consuming a low-carbohydrate diet (<55% of energy). However, when carbohydrate intake was intermediate (55%–65%), carriers of the T allele had greater fasting blood glucose and HbA1C concentrations. When carbohydrate intake was high (>65%), carriers of the T allele had greater HDL cholesterol concentrations. This interaction was significant even when carbohydrate intake was considered a continuous variable ( p = 0.0200 for fasting blood glucose, p = 0.0408 for HbA1C, and p = 0.0254 for HDL cholesterol), suggesting a strong dose–response relation. Conclusions: Our data show that the effect of the SNP276G>T polymorphism on plasma fasting blood glucose, HbA1C, and HDL cholesterol concentrations depends on dietary carbohydrate intake.

Effect of olfactory function on nutritional status of Korean elderly women

This study was undertaken to evaluate the chemosensory functions of Korean elderly women and to document the impact of olfactory dysfunction on dietary habits and nutritional and health status. The subjects were 41 elderly females aged from 61 to 81 years and an equal number of young female adults was included as a control group. The smell and taste thresholds were higher in elderly subjects than in young adults. The higher the smell threshold of the elderly, the lower the consumption of meats, eggs, and cereals, and also the lower the intakes of calories, protein, fat, carbohydrate and minerals. The smell threshold was negatively correlated with body weight, the muscle and bone masses and positively correlated with serum IL-6 level. Subjects in the highest smell threshold quartile complained more decreased appetite, food intake, and weight loss as they aged. Thus, olfactory dysfunction may have a profound effect on food intake and the nutritional status.