Yoon Jung Yang

The Association Between Serum 25-Hydroxyvitamin D Concentration and Consumption Frequencies of Vitamin D Food Sources in Korean Adolescents

The objectives of this study were to investigate the status of vitamin D in Korean adolescents and to determine the association between serum 25-hydroxyvitamin D (25(OH)D) concentration and consumption frequencies of vitamin D food sources by season (June to November and December to May). The subjects were 1,579 adolescents aged 12-18 years participating in the 2008-2009 Korean National Health and Nutrition Examination Survey (KNHANES). Consumption frequencies of vitamin D food sources were estimated by using a qualitative food frequency questionnaire (FFQ). Thirteen food items were selected as vitamin D food sources including beef, egg, mackerel, tuna, yellow corvine, pollack, anchovy, mushroom, milk, yoghurt, ice cream, all fish and dairy products from the FFQ based on previous research. The data was analyzed using proc survey procedures. The deficiency (5.25-12 ng/mL), inadequacy (12-20 ng/mL) and sufficiency (> 20 ng/mL) proportions of serum 25(OH)D from June to November and December to May were 9.9%, 51.4%, 38.7%, and 39.4%, 51.4%, 9.2%, respectively. Mean serum 25(OH)D concentration was positively related to the consumption frequencies of mackerel, anchovy, all fish and milk. These results suggest high proportion (> 61%) of Korean adolescents were vitamin D deficiency or inadequacy, and serum 25(OH)D was associated with the consumption of vitamin D food sources including fish and milk.

Effects of Nutrition Education Using a Ubiquitous Healthcare (u-Health) Service on Metabolic Syndrome in Male Workers

The objective of this study was to investigate the effects of nutrition education based on ubiquitous healthcare (u-health) service on changes in dietary habits, nutrition intake, and risk factors for metabolic syndrome in male workers. In total, 72 male office workers with at least three risk factors of the National Cholesterol Education Program-Adult Treatment Panel III were recruited as subjects. Anthropometric measurements and biochemical analyses were conducted on all subjects. Dietary habits and nutrient intake were determined by a questionnaire using the 24-hour dietary recall method before and after nutrition education. Subjects measured their body composition, blood pressure, and physical activity more than once per week during the 12 weeks using the u-health care equipment and sent these data to a central database system using a personal computer. Individual nutrition counseling was provided four times on the first, fourth, eight, and twelfth weeks. The results showed significant decreases in abdominal circumference, body fat (%), diastolic blood pressure, serum triglycerides, and serum total cholesterol during the 12 weeks. Subjects with more than 12 measurements showed significant reductions in abdominal circumference, body fat (%), serum triglyceride, and serum total cholesterol. Mean intake of dietary fiber, animal calcium, potassium, vitamin C, and folic acid after nutrition education were higher than those before nutrition education. Participants showed significant increases in the frequencies of consuming protein foods (meat, fish, eggs, beans, tofu, etc. ) and vegetables. In conclusion, nutrition education through the u-health service resulted in positive effects on the risk factors for metabolic syndrome, nutrient intake, and dietary habits. (Korean J Nutr 2011; 44(3): 231 ~ 242)

Dietary Patterns Derived by Cluster Analysis are Associated with Cognitive Function among Korean Older Adults

The objective of this study was to investigate major dietary patterns among older Korean adults through cluster analysis and to determine an association between dietary patterns and cognitive function. This is a cross-sectional study. The data from the Korean Multi-Rural Communities Cohort Study was used. Participants included 765 participants aged 60 years and over. A quantitative food frequency questionnaire with 106 items was used to investigate dietary intake. The Korean version of the MMSE-KC (Mini-Mental Status Examination–Korean version) was used to assess cognitive function. Two major dietary patterns were identified using K-means cluster analysis. The “MFDF” dietary pattern indicated high consumption of Multigrain rice, Fish, Dairy products, Fruits and fruit juices, while the “WNC” dietary pattern referred to higher intakes of White rice, Noodles, and Coffee. Means of the total MMSE-KC and orientation score of the participants in the MFDF dietary pattern were higher than those of the WNC dietary pattern. Compared with the WNC dietary pattern, the MFDF dietary pattern showed a lower risk of cognitive impairment after adjusting for covariates (OR 0.64, 95% CI 0.44–0.94). The MFDF dietary pattern, with high consumption of multigrain rice, fish, dairy products, and fruits may be related to better cognition among Korean older adults.

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.

Interactions of single nucleotide polymorphisms with dietary calcium intake on the risk of metabolic syndrome

BACKGROUND Gene-nutrient interactions may be important in modulating susceptibility to metabolic disorders. OBJECTIVES The objectives of this study were to assess the association of dietary calcium intake with the risk of metabolic syndrome and to investigate the interaction effects between dietary calcium intake and candidate gene polymorphisms. DESIGN Subjects were participants in the Korea Association Resource project, which was initiated in 2007 as a large-scale, genomewide association analysis. A total of 8031 subjects were included in the study. Associations were assessed by using multivariable-adjusted logistic regression analyses. RESULTS High calcium intake appeared to be associated with a low risk of metabolic syndrome after covariates in both men (P-trend = 0.03) and women (P-trend = 0.0002) were controlled for. Among 27 single nucleotide polymorphisms (SNPs) selected as possible candidate gene polymorphisms affecting the risk of metabolic syndrome, 3 SNPs [rs6445834 in Rho guanine nucleotide exchange factor 3 (ARHGEF3), rs10850335 in T-box 5 (TBX5), rs180349 in BUD13 homolog (Saccaromyces cerevisiae) (BUD13)] showed significant interaction effects with calcium intake tertiles or sufficiency in both men and women. Subjects with major allele homozygotes of these gene polymorphisms and high calcium intakes generally had a lower risk of metabolic syndrome than did those with minor allele homozygotes and low calcium intakes. CONCLUSION Dietary calcium intake appears to be inversely associated with the risk of metabolic syndrome and may modulate susceptibility to the syndrome in subjects who are minor allele carriers of rs6445834 in ARHGEF3, rs10850335 in TBX5, or rs180349 in BUD13.

Comparison of Health Status and Nutrient Intake between Depressed Women and Non-depressed Women: Based on the 2013 Korea National Health and Nutrition Examination Survey

This study aimed to provide supporting data for the management of dietary habits in depression by comparing health and nutrition in adult Korean women according to depression status. A total of 2,236 women aged between 19 and 64 years who participated in the 2013 Korea National Health and Nutrition Examination Survey were divided into a depression group (n = 315) and a non-depression group (n = 1,921). Among 19–29-year-old women, the depression group showed higher proportions of individuals with impairment of everyday activities, menopause, and suicidal thoughts than the non-depression group. The depression group showed lower intake of cereal, chocolate, meat, and carbonated drinks, as well as a lower index of nutritional quality (INQ) for protein, iron, and niacin. Among 30–49-year-old women, the depression group showed higher proportions of individuals with impairment of everyday activities, chronic disease, stress, and suicidal thoughts. The depression group showed lower intake of rice with mixed grains and higher intake of instant and cup noodles than the non-depression group. Among 50–64-year-old women, the depression group showed higher proportions of individuals with impairment of everyday activities, menopause, stress, and suicidal thoughts. The depression group showed lower intake of vegetables, mushrooms, and seaweed, lower nutritional intake of fat, saturated fat, and n-3 fatty acids, as well as a lower INQ for niacin and a lower Recommended Food Score. For all age groups, individuals with depression showed poorer health and nutritional intake than healthy individuals, demonstrating a correlation of depression with health and nutritional intake.

Interaction between Single Nucleotide Polymorphism and Urinary Sodium, Potassium, and Sodium-Potassium Ratio on the Risk of Hypertension in Korean Adults

Hypertension is a complex disease explained with diverse factors including environmental factors and genetic factors. The objectives of this study were to determine the interaction effects between gene variants and 24 h estimated urinary sodium and potassium excretion and sodium-potassium excretion ratios on the risk of hypertension. A total of 8839 participants were included in the genome-wide association study (GWAS) to find genetic factors associated with hypertension. Tanaka and Kawasaki formulas were applied to estimate 24 h urinary sodium and potassium excretion. A total of 4414 participants were included in interaction analyses to identify the interaction effects of gene variants according to 24 h estimated urinary factors on the risk of hypertension. CSK rs1378942 and CSK-MIR4513 rs3784789 were significantly modified by urinary sodium-potassium excretion ratio. In addition, MKLN rs1643270 with urinary potassium excretion, LOC101929750 rs7554672 with urinary sodium and potassium excretion, and TENM4 rs10466739 with urinary sodium-potassium excretion ratio showed significant interaction effects. The present study results indicated that the mutant alleles of CSK rs1378942 and CSK-MIR4513 rs3784789 had the strongest protective effects against hypertension in the middle group of 24 h estimated urinary sodium-potassium excretion ratio. Further studies are needed to replicate these analyses in other populations.

The Effect of the Sodium to Potassium Ratio on Hypertension Prevalence: A Propensity Score Matching Approach

This study investigated the effect of the sodium to potassium ratio on hypertension prevalence and blood pressure. The study population was constructed by pooling the Korean National Health and Nutrition Examination Surveys between 2010 and 2014. The study population was divided into quartiles based on the sodium to potassium ratio, and the effect was inferred by the difference in hypertension prevalence across quartiles by six pairwise comparisons using a propensity score matching technique. The quartiles with the higher sodium to potassium ratio had higher hypertension prevalence rates based on the following pairwise comparisons: the first vs. third quartile, the first vs. fourth quartile, the second vs. third quartile, and the second vs. fourth quartile. The prevalence differences were 2.74% point (p < 0.05), 3.44% point (p < 0.01), 2.47% point (p < 0.05), and 2.95% point (p < 0.01), respectively. In addition, statistically significant higher systolic (p < 0.05) and diastolic blood pressure (p < 0.01) was observed in the second quartiles compared to the first quartiles. Because a strong association was also detected between the sodium to potassium ratio and blood pressure even at a low level of sodium to potassium ratio, a lower sodium to potassium ratio diet than a usual diet is recommended to control high blood pressure in Korea.

Calcium Intakes in Korean and American Populations

Calcium intake has been insufficient in all age groups in previous Korean national surveys. This study was conducted to investigate calcium intake in Korean and American populations at different ages. We analyzed two national survey data: the 2007~2009 Korean National Health and Nutrition Examination Survey (KNHANES) and the 2007~2008 National Health and Nutrition Examination Survey (NHANES). Statistically, survey procedures were applied using the weight, cluster, and strata variables. The mean calcium intake of Koreans at ages of 1~2 y, 3~5 y, 6~11 y, 12~18 y, 19~64 y, and 65+y was lower than American populations at those ages. The sufficient proportions based on Korean Estimated Average Requirement (EAR) of 1~2 y, 3~5 y, 6~11 y, 12~18 y, 19~64 y, and 65+y in Koreans were 45.5%, 33.1%, 24.3%, 16.6%, 32.7%, and 19.0%. While the sufficient rates based on American EAR of 1~3 y, 4~8 y, 9~13 y, 14~18 y, 19~30 y, 31~50 y, 51~70 y, and 71+y in US population were 88.5%, 54.4%, 35.2%, 35.8%, 55.3%, 55.2%, 40.6%, and 24.5%. Overall, the major foods contributing to calcium intakes in Koreans were milk, baechukimchi, and anchovies, whereas, milk products, pasta, or bread were major contributions to calcium in American populations. The calcium supplement intakes in the American population were 5.5 mg (1~2 y), 15.5 mg (3~5 y), 13.9 mg (6~11 y), 35.7 mg (12~18 y), 150.3 mg (19~64 y) and 334.4 mg ( y). These results suggest that Korean adolescents and older adults are the most insufficient in dietary calcium intakes among Koreans. In order to accurately estimate calcium intakes in Korean populations, calcium supplements and calcium-fortified foods should be considered.

Effects of the difference between actual body condition and body image perception on nutrient intake, weight control and mental health in Korean adults: Based on the 5th Korea National Health and Nutrition Examination Survey

Purpose: The objective of this study was to examine the effect of the body shape discordance, the difference between true body type based on body mass index (BMI) and self-recognized body image, on nutrient intake, weight control attempt, and mental health in Korean adults. Methods: Subjects were persons aged 19~64 years (4,382 men and 6,226 women) who participated in the 2010~2012 Korea National Health and Nutrition Examination Survey. Subjects were categorized as RL (Group recognized as lighter than BMI criteria), RA (Group with agreement between BMI criteria and self-recognized body image), and RH (Group recognized as heavier than BMI criteria) according to the difference between actual body type based on BMI and self-recognized body image. Results: Means of BMI in RH groups were lower than or equal to that of RA groups in all groups. No significant differences in total energy intake were observed among the three groups in men, but total energy intake was higher in the RL group than in the RH group in 30~49 year old women. Proportion of carbohydrate was the highest in the RL group among 30~49 year old women. RH groups paid more attention to weight control and had less weight gain than other groups. Higher proportions of depressive symptoms were reported in the RH group in 19~29 year old men, while a higher proportion of depressive symptoms were reported in the RL group in 50~64 year old men. Conclusion: The current findings suggest an association of perceiving body shape with energy intake, weight control attempt, or depressed mood in some age groups. Body image perception can influence eating, weight control attempt, and depressed mood, therefore proper body image perception should be established in Korean adults.Purpose: The objective of this study was to examine the effect of the body shape discordance, the difference between true body type based on body mass index (BMI) and self-recognized body image, on nutrient intake, weight control attempt, and mental health in Korean adults. Methods: Subjects were persons aged 19~64 years (4,382 men and 6,226 women) who participated in the 2010~2012 Korea National Health and Nutrition Examination Survey. Subjects were categorized as RL (Group recognized as lighter than BMI criteria), RA (Group with agreement between BMI criteria and self-recognized body image), and RH (Group recognized as heavier than BMI criteria) according to the difference between actual body type based on BMI and self-recognized body image. Results: Means of BMI in RH groups were lower than or equal to that of RA groups in all groups. No significant differences in total energy intake were observed among the three groups in men, but total energy intake was higher in the RL group than in the RH group in 30~49 year old women. Proportion of carbohydrate was the highest in the RL group among 30~49 year old women. RH groups paid more attention to weight control and had less weight gain than other groups. Higher proportions of depressive symptoms were reported in the RH group in 19~29 year old men, while a higher proportion of depressive symptoms were reported in the RL group in 50~64 year old men. Conclusion: The current findings suggest an association of perceiving body shape with energy intake, weight control attempt, or depressed mood in some age groups. Body image perception can influence eating, weight control attempt, and depressed mood, therefore proper body image perception should be established in Korean adults.