Yong Soon Park

Association between Coffee Consumption and Renal Impairment in Korean Women with and without Diabetes: Analysis of the Fourth Korea National Health and Nutrition Examination Survey in 2008

Background Recent studies suggest that coffee consumption has an influence on kidney function. This study investigated the relationship between habitual coffee consumption and renal impairment in Korean women, in consideration of diabetic status. Methods This study involved 2,673 women aged 35 to 84 years who had participated in the Fourth Korea National Health and Nutrition Examination Surveys, conducted in 2008. Habitual coffee consumption was classified into three categories: less than 1 cup per day, 1 cup per day, and 2 or more cups per day. Renal function impairment was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m2 by the Modification of Diet in Renal Disease equation. Results The prevalence of diabetes and renal function impairment was higher in women who drank < 1 cup of coffee per day. Compared with drinking < 1 cup of coffee per day, the odds ratio (OR) for renal function impairment was significantly lower (OR, 0.59; 95% confidence interval [CI], 0.37 to 0.95; P = 0.03) in those who habitually drank ≥ 2 cups per day after adjusting for multiple confounding factors. When data were stratified according to the presence of diabetes, coffee consumption ≥ 2 cups of coffee per day showed an inverse association with renal function impairment in only diabetic women (OR, 0.14; 95% CI, 0.02 to 0.88; P = 0.04), compared with consumption < 1 cup of coffee per day. Conclusion In a representative sample of Korean women, coffee consumption was significantly associated with a decreased risk of renal impairment especially in middle and elderly-aged diabetic women.

Factors That Predict Persistent Smoking of Cancer Survivors.

We conducted this cross-sectional study to elucidate factors that predict persistent smoking of the Korean cancer survivors. The subjects were 130 adult (≥19 yr old) cancer survivors who were smokers at the diagnosis of cancer and have participated in the Korean National Health and Nutrition Examination Surveys conducted from 2007 to 2011. We categorized them into the persistent smokers and the quitters, according to change in smoking status between the time of cancer diagnosis and the time of the survey. Factors associated with persistent smoking were evaluated using the multiple logistic regression analysis. During 7.52 yr (standard deviation = 0.34) after the cancer diagnosis, 59.6% of the 130 cancer survivors have continued to smoke. After adjusting for covariates, following factors were independently associated with the risk of persistent smoking: female, low income, high-risk alcohol use, high body mass index (≥ 25 kg/m2), presence of household members who smoke, and longer duration of smoking. Alcohol Use Disorders Identification Test showed a positive association with the risk of persistent smoking (P for trend = 0.012). In conclusion, more efforts for smoking cessation should be in place for the cancer survivors with those risk factors associated with the persistent smoking.

Factors Associated with Persistent Smoking after the Diagnosis of Cardiovascular Disease

Background Although cigarette smoking is a major modifiable risk factor for the occurrence of primary and secondary cardiovascular disease (CVD), not all survivors from CVD attacks can successfully stop smoking. However, little is known about the factors associated with the change in smoking behavior after CVD attack. Methods Study subjects included 16,807 participants (≥19 years) in the fourth Korean National Health and Nutrition Examination Surveys. From them, we selected 180 persons who had previous CVD diagnosis (angina pectoris, myocardial infarction, or stroke) and were smoking at the time of CVD diagnosis. Then, we categorized the 180 persons into two groups according to change in smoking status after the CVD: quitter and non-quitter. Logistic regression analysis was done to evaluate multivariable-adjusted association. Results Even after CVD diagnosis, 63.60% continued to smoke. Fully-adjusted analysis revealed that regular drinking (odds ratio [OR], 4.44) and presence of smokers among family members (OR, 5.86) were significantly (P < 0.05) associated with greater risk of persistent smoking, whereas lower education level (OR, 0.20), larger amount of smoking (OR, 0.95), longer time since diagnosis (OR, 0.88), and diabetes (OR, 0.36) were significantly (P < 0.05) associated with decreased risk of persistent smoking after CVD. Conclusion A great proportion of CVD patients tended to continue smoking in the Korean population. In order to reduce smoking rates among CVD patients further, more aggressive efforts towards smoking cessation should be continuously made with consideration of individual socioeconomic, behavioral, and clinical characteristics of CVD patients.

Light coffee consumption is protective against sarcopenia, but frequent coffee consumption is associated with obesity in Korean adults

Few studies have examined the effects of coffee on body composition in the general population. In this cross-sectional study, we hypothesized that coffee consumption is protective against obesity and sarcopenia in Korean adults. The study included 6906 subjects aged ≥40 years who participated in the Korean National Health and Nutrition Examination Survey in 2009-2010. Body composition was measured using dual-energy x-ray absorptiometry, and obesity was determined according to the body mass index (BMI) and waist circumference (WC). Sarcopenia was defined as an appendicular skeletal muscle mass divided by height-squared that was below the lower quintile of the study population. Participants were classified into 4 groups according to the degree of coffee consumption (<1/d, 1/d, 2/d, and ≥3/d).The numbers of participants who were obese by BMI, obese by WC, and sarcopenic were 2390 (35.5%), 2033 (28.5%), and 1438 (20.0%), respectively. On multiple logistic regression analyses, the odds ratio (OR) of sarcopenia was lower in men who drink coffee once a day compared to those who rarely drink coffee (OR: 0.69, 95% confidence interval [CI]: 0.50-0.94). Women who consumed coffee ≥3 times/d had higher obesity ORs than those who rarely drink coffee according to both obesity indices (OR: 1.57, 95% CI, 1.18-2.10 for obesity by BMI; OR: 1.33, 95% CI: 1.01-1.75 for obesity by WC). Light coffee consumption was protective against sarcopenia in men, whereas frequent coffee consumption produced a higher risk for obesity, especially in women.

Low muscle mass is associated with metabolic syndrome in Korean adolescents: the Korea National Health and Nutrition Examination Survey 2009-2011.

Little is known about the relationship between low muscle mass (LMM) and metabolic risk factors in adolescents. We hypothesized that LMM in adolescents is associated with metabolic syndrome (MetS) and its components in Korean adolescents. This cross-sectional study included 1420 participants (749 males and 671 females), aged 12 to 19 years, who participated in the 2009-2011 Korea National Health and Nutrition Examination Surveys. Appendicular skeletal muscle mass was divided by body weight, and any value below the lower quintile of the study population, according to each age and sex category, was considered to represent LMM. A participant was considered to have MetS if he/she demonstrated at least 3 of the National Cholesterol Education Program-Adult Treatment Panel III criteria. The overall prevalence of MetS was 4.9%, with a prevalence of 7.1% in males and 2.3% in females. Low muscle mass significantly increased the risk of MetS, after adjusting for potential covariates (odds ratio [OR], 5.28; 95% confidence interval, 2.76-10.13). Similarly, the ORs for the MetS components were significantly higher in individuals with LMM than in those without LMM. In the subgroup analysis, LMM was significantly associated with MetS in both adolescent boys and girls. In addition, the adjusted OR was significantly higher in individuals with LMM than in those without, after stratifying the groups by age. In conclusion, our results suggest that adolescents with LMM may have a high risk of MetS. Public health initiatives are needed to develop interventions for preventing and treating LMM in adolescents.

Low dietary energy intake is associated with sarcopenia in cancer survivors: An analysis based on the Korean National Health and Nutrition Examination Survey 2008–2011

As cancer survivors increase, management of their long-term health consequences becomes important. Sarcopenia could negatively affect on their clinical outcome and quality of life. We hypothesized that sarcopenia would be more prevalent in cancer survivors and that are associated with dietary intake. This study was conducted to compare nutritional intake and body composition, considering sarcopenia, between cancer survivors and healthy individuals using Korean National Health and Nutrition Examination Surveys conducted from 2008 to 2011. The participants were 259 adult cancer survivors and 1,295 healthy counterparts who underwent body composition tests and had no chronic diseases. Sarcopenia was defined as a condition with a skeletal muscle mass below the cut-off value (men < 6.58 kg/m2 and women < 4.59 kg/m2) adjusted for height. The prevalence of sarcopenia was higher in non-obese male cancer survivors (32.6% vs 16.0%, P=0.034) compared with healthy individuals. On the contrary, sarcopenia was more common in obese female survivors (35.1% vs 15.0%, P=0.005) than their healthy counterparts. Multivariable logistic analyses revealed that age increase by 1 year (aOR=1.025; 95% CI: 1.001-1.049), male gender (aOR=3.688; 95% CI: 6.061-90.910), and a lower BMI (aOR=33.201; 95% CI: 13.639-80.823) were significantly associated with the increased risk of sarcopenia. Increased energy intake by 100 kcal/day (aOR=0.930; 95% CI: 0.869-0.995) had a protective effect against sarcopenia. Our results suggest that male cancer survivors are high risk group of sarcopenia, especially when they are non-obese. More dietary energy intake may be needed to prevent sarcopenia.

Body Composition, Sarcopenia, and Suicidal Ideation in Elderly Koreans: Hallym Aging Study

This study was conducted to assess the relationship between body composition and suicidal ideation among the Korean elderly population (n = 302; ≥ 65 years) who participated in the Hallym Aging Study in 2010. Body composition was measured using dual-energy X-ray absorptiometry, and obesity was measured by the indices of body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and body fat percentage. Sarcopenia was defined as presence of both low muscle mass and low muscle function. Suicidal ideation was assessed using the Beck Scale for Suicide Ideation. We found no differences in body composition measures between subjects with suicidal ideation and those without. In the logistic regression analyses, there were no significant relationships for suicidal ideation according to body composition measures, including BMI, WC, WHR, WHtR, and body fat percentage in both sexes. After adjusting for age, smoking status, alcohol drinking, regular exercise, medical comorbidities, monthly income, education level, and presence of depressive symptoms, the odds ratio (OR) of suicidal ideation was higher in elderly men with sarcopenia compared to those without, whereas no significant relationships were observed in elderly women (OR 8.28, 95% confidence interval [CI] 1.20–61.34 in men; OR 0.79, 95% CI 0.07–8.43 in women). Sarcopenia is closely associated with an increased risk of suicidal ideation in elderly men.

Coffee consumption and coronary heart disease risk as estimated using the Framingham risk score

BACKGROUND AND OBJECTIVES Although concerns regarding the influence of coffee consumption on human health have accompanied the massive increase in coffee consumption, the effects of coffee intake on the risk for coronary heart disease (CHD) remain controversial. Therefore, we evaluated the association between coffee consumption and CHD risk as estimated using the Framingham risk model in Korean adults. METHODS AND STUDY DESIGN This cross-sectional study involved 3,987 participants aged 30-74 years who participated in the fifth Korea National Health and Nutrition Examination Survey conducted in 2010. The frequency of coffee consumption was self-reported and classified into 4 categories (non-drinker, 1, 2, and >=3 cups/day). The 10-year risk for CHD was determined from the Framingham risk score. RESULTS Across the levels of coffee consumption, there were significant differences in the frequency of smoking among men and advanced age, low high-density lipoprotein cholesterol level, diabetes, and smoking among women. In the multiple logistic regression analyses, the adjusted odds ratios (95% CI) for >=20% 10-year CHD risk was 0.211 (0.060-0.745) for women who consumed >=3 cups of coffee per day compared with women who consumed <1 cup per day. For women, a significant dose-response inverse association between the level of coffee consumption and 10-year CHD risk persisted even after adjusting for multiple confounding factors. For the men, however, there was no significant association between coffee consumption and 10-year CHD risk. CONCLUSIONS Coffee consumption is associated with a lower risk for CHD in Korean women.