Development of a semi-quantitative food frequency questionnaire for dietary intake of elementary school children: data from the Seventh Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES@#In Korea, studies of diet in elementary school children are hindered by the need for a comprehensive dietary assessment tool. Thus, the aim of this study was to develop a semi-quantitative food frequency questionnaire (FFQ) for Korean elementary school children. @*SUBJECTS/METHODS@#The 24-h recall data for 1,624 subjects aged 6−11 yrs from the seventh Korea National Health and Nutrition Examination Survey were used to extract the items included in the questionnaire. The FFQ items were developed by selecting major dishes based on the results of nutritional contribution and between-person variability for energy and 14 nutrients (carbohydrate, protein, fat, crude fiber, calcium, phosphorous, iron, sodium, potassium, vitamin A, thiamin, riboflavin, niacin, and vitamin C). We selected the major dishes with over 90% of the total contribution to each nutrient and with over 90% of the accumulated R 2 for each nutrient. Among the 452 dishes, we selected 248 dishes contributing more than 1% of the total consumption. @*RESULTS@#Finally, the FFQ included 107 items combined from 248 dishes based on nutrient profile and recipe. The FFQ items accounted for an average of 88.6% of the energy, 14 nutrient intakes, and 91.4% of the between-person variability. Quantities of dietary intake were assessed by 9 categories of frequency and 3 categories of portion size. Percentages of coverage for energy, protein, fat, carbohydrate, and calcium were 90.2%, 87.8%, 89.9%, 90.8%, and 88.7%, respectively. @*CONCLUSIONS@#We developed a dish-based, semi-quantitative FFQ comprising 107 items for Korean elementary school children aged 6 to 11. Further studies are needed to evaluate the reproducibility and validity of this FFQ for elementary school children.

Evidence and suggestions for establishing vitamin D intake standards in Koreans for the prevention of chronic diseases

BACKGROUND/OBJECTIVES@#Vitamin D is produced in the skin during sun exposure and is also ingested from foods. The role of vitamin D needs to be considered in the prevention and management of various diseases. Moreover, since the majority of Koreans spend their days indoors, becoming susceptible to the risk of vitamin D deficiency. The current study aims to prepare a basis for determining dietary reference intake of vitamin D in Korea, by reviewing the evidence against various diseases and risks.MATERIALS/METHODS: Literature published in Korea and other countries between 2014 and 2018 was prioritized based on their study design and other criteria, and evaluated using the RoB 2.0 assessment form and United States Department of Agriculture Nutrition Evidence Library Conclusion Statement Evaluation Criteria. @*RESULTS@#Of the 1,709 studies, 128 studies were included in the final systematic analysis after screening. To set the dietary reference intakes of vitamin D based on the selected articles, blood 25(OH)D levels and indicators of bone health were used collectively. Blood vitamin D levels and ultraviolet (UV) exposure time derived from the Korean National Health and Nutrition Examination Survey were analyzed to establish the dietary reference intakes of vitamin D for each stage of the life cycle. The adequate intake levels of vitamin D, according to age and gender, were determined to be in the range of 5–15 μg/day, and the tolerable upper intake level was established at 25–100 μg/day. @*CONCLUSIONS@#The most important variable for vitamin D nutrition is lifestyle. A balanced diet comprising foods with high contents of vitamin D is important, as is vitamin D synthesis after UV exposure. The adequate intake level of vitamin D mentioned in the 2015 Dietary Reference Intakes for Korean (KDRI) remained unchanged in the 2020 KDRI for the management of vitamin D nutrition in Koreans.

Dietary Reference Intakes for Koreans with special consideration to older adults

BACKGROUND/OBJECTIVES@#The Dietary Reference Intakes for Koreans (KDRIs) were revised in 2020. Due to the rapidly aging Korean population, special consideration was given to reclassify the KDRI age group categories of older adults. This article examines the evidence for modifying the current KDRI age group ranges of older adults (65–74 and ≥ 75 yrs). @*SUBJECTS/METHODS@#We first reviewed the domestic and international data on the elderly, following which we received expert opinions on age classification from the KDRI Advisory Committee. Finally, the 6th and 7th (2013–2017) Korea National Health and Nutrition Examination Survey (KNHANES) data were used to analyze the nutritional intake statuses by considering the age of older adults. @*RESULTS@#According to the review results of domestic and international data and the inputs received from the expert advisory committee, the minimum age considered for the elderly was maintained at 65 yrs. However, the KNHANES data was analyzed to review whether there was a need to subdivide the later periods. Examining the differences in nutrient intakes by age group through the interaction effect term of the piecewise linear regression model revealed the interaction effect was maximum in the groups divided by 65 yrs (50–64 and 65–80), as compared to the groups divided by 70 yrs (50–69 and 70–80) and 75 yrs (50–74 and 75–80). The mean adequacy ratio was calculated per 1 yr of age, and a 3-yr (age) moving average analysis was performed to examine the change in the trends of overall nutrient intake. However, it was challenging to secure a scientific basis for subdivision into age groups in older adults from the results obtained. @*CONCLUSIONS@#This study could not find any scientific evidence for modifying the KDRI age groups for older adults.

Validation of Foot Pressure Variables during Walking according to Glycated Hemoglobin Levels / 임상당뇨병

The purpose of this study was to explore the variables of foot pressure according to glycated hemoglobin level during walking in diabetic patients with pes rectus. The subjects of this study were 39 people (78 feet) in their 40s and 60s, and they were divided into 11 pre-diabetic patients (22 feet) and 14 diabetic patients (28 feet) based on glycated hemoglobin; 14 patients without diabetes (28 feet) was used as a control. Foot pressure was measured using the EMED-LE Measurement system. The sole of the foot was divided into 12 parts, each of which was analyzed for pressure, force, contact area, and grounding time. For statistics, nonparametric Kruskal–Wallis and Wilcoxon signed rank test were used. Prediabetic and diabetic patients had lower hindfoot and second and third metatarsal foot pressure but higher first and third toe pressure compared to those without diabetes. In addition, the maximum and minimum force were high in all parts of the sole, and the contact time was long, signifying strong downward force for a long duration. Measurement of foot pressure by parts allowed detailed analysis of abnormal foot pressure and is valuable as basic data for diagnosis, prediction, and treatment of diabetic foot. Based on these data, maximum and minimum pressure better explain the problem of plantar pressure distribution rather than mean maximum pressure.

Western dietary pattern is associated with higher risk of lower lean muscle mass in Korean postmenopausal women: data from the Korea National Health and Nutrition Examination Survey 2008–2011

BACKGROUND/OBJECTIVES@#In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. @*SUBJECTS/METHODS@#The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. @*RESULTS@#The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. @*CONCLUSIONS@#The study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

The development of the 2020 Dietary Reference Intakes for Korean population: Lessons and challenges / 한국영양학회지

The discovery of the relationship between nutrients and deficiency diseases during the 100 years from the mid-1800s to the mid-1900s was a breakthrough that led to advances in the study of nutrition. The Recommended Dietary Allowances (RDA) were created as a quantitative standard for avoiding diseases caused by nutrient deficiency. In addition, a reductionism paradigm has become generally accepted among nutrition scholars in health and disease, which focused on the properties of individual nutrients, content in foods, cellular levels, and mechanisms of action. The reductionist paradigm worked very well for the prevention and treatment of malnutrition diseases. However, as the incidence of nutrient deficiencies decreased and that of chronic diseases increased, the nutrition goals have been changed to secure safe and adequate nutrient intake and to reduce chronic disease risks. Accordingly, Dietary Reference Intakes (DRIs), a set of nutrient-based reference values, were designed to replace the RDA. The revised Korean DRIs were published for 40 nutrients in 2020. However, there is still room for improvement in the reference intake levels targeted at reducing the risk of chronic disease. The reductionist approach can no longer be practical because chronic diseases are related to the interactions between multi-components in the foods and multi-targets in the body. Therefore, a second innovative leap is needed following the nutrition development breakthrough made over 100 years ago. To this end, the nutrition paradigm must evolve from reductionism to a holism approach. Cutting-edge scientific technologies, such as metabolomics, transcriptomics, microbiomics, and should also be acceptable in nutrition science based on the knowledge gained from basic nutrition studies. bioinformatics,

Validation of soy isoflavone intake and its health effects: a review of the development of exposure biomarkers

BACKGROUND/OBJECTIVES@#It is difficult to consistently demonstrate the health effects of soy isoflavones owing to the multitude of factors contributing to their bioavailability. To accurately verify these health effects, dietary isoflavone intake should be measured using a biologically active dose rather than an intake dose. This concept has been expanded to the development of new exposure biomarkers in nutrition research. This review aims to provide an overview of the development of exposure biomarkers and suggest a novel research strategy for identifying the health effects of soy isoflavone intake.MATERIALS/METHODS: We cover recent studies on the health effects of soy isoflavones focusing on isoflavone metabolites as exposure biomarkers. @*RESULTS@#Compared to non-fermented soy foods, fermented soy foods cause an increased concentration of isoflavones in the biofluid immediately following ingestion. The correlation between exposure biomarkers in blood and urine and the food frequency questionnaire was slightly lower than that of corresponding 24-h dietary recalls. Urinary and blood isoflavone levels did not show a consistent association with chronic disease and cancer risk. @*CONCLUSION@#It is crucial to understand the variable bioavailabilities of soy isoflavones, which may affect evaluations of soy isoflavone intake in health and disease. Further studies on the development of valid exposure biomarkers are needed to thoroughly investigate the health effects of isoflavone.

Western dietary pattern is associated with higher risk of lower lean muscle mass in Korean postmenopausal women: data from the Korea National Health and Nutrition Examination Survey 2008–2011

BACKGROUND/OBJECTIVES@#In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. @*SUBJECTS/METHODS@#The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. @*RESULTS@#The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. @*CONCLUSIONS@#The study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

The fruit of Acanthopanax senticosus Harms improves arterial stiffness and blood pressure: a randomized, placebo-controlled trial

BACKGROUND/OBJECTIVES@#Arterial stiffness and endothelial dysfunction are 2 of the independent predictors for cardiovascular disease, while Acanthopanax senticosus Harms (ASH) is a traditional medicinal plant that can improve cardiovascular health. This study aimed to investigate the efficacy of the fruit of ASH on vascular function in apparently healthy subjects. @*SUBJECTS/METHODS@#A 12-week, randomized, double-blind, placebo-controlled design, consisting of healthy adults with at least 2 of the following 3 conditions: borderline high blood pressure (BP; 120 mmHg ≤ systolic BP ≤ 160 mmHg or 80 mmHg ≤ diastolic BP ≤ 100 mmHg), smoking (≥10 cigarettes/day), and borderline blood lipid levels (220 ≤ total cholesterol ≤ 240, 130 ≤ low density lipoprotein cholesterol ≤ 165, or 150 ≤ triglyceride ≤ 220 mg/dL). Randomly assigned 76 subjects who received a placebo or 2 doses of ASH fruit (low, 500 mg/day; high, 1,000 mg/day) completed the intervention. Brachial-ankle pulse wave velocity (baPWV), flow-mediated dilation, carotid intima-media thickness, and BP were measured both at baseline and following the 12-week intervention. Endothelial nitric oxide synthase (eNOS) phosphorylation was assessed by western blotting. @*RESULTS@#Compared with the placebo group, the low-dose group showed more significant changes after the 12-week intervention period in terms of systolic BP (0.1 vs. −7.7 mmHg; P = 0.044), baPWV (31.3 vs. −98.7 cm/s; P = 0.007), and the ratio of phospho-eNOS/eNOS (0.8 vs. 1.22; P = 0.037). @*CONCLUSIONS@#These results suggest that ASH fruit extract at 500 mg/day has the potential to improve BP and arterial stiffness via endothelial eNOS activation in healthy adults with smoking and the tendency of having elevated BP or blood lipid parameters.

Development of Gender-Sensitive Comprehensive Health Matrix: A Comparative Study on the Cases of Sustainable Development Goals Countries and North Korea Based on Gender-Sensitive Indicators

Purpose@#South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. @*Methods@#An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focusgroup discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. @*Results@#The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. @*Conclusion@#A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

Development of Gender-Sensitive Comprehensive Health Matrix: A Comparative Study on the Cases of Sustainable Development Goals Countries and North Korea Based on Gender-Sensitive Indicators

Purpose@#South Korea ranked 18th out of the 162 participating countries in the 2019 report on sustainable development goals (SDGs). Among the 17 specified goals, it has the most difficulty in achieving gender equality (SDG 5). This shortcoming is manifested in the lack of studies on gender-sensitive indicators. The study aims to establish the significance of the development of a comprehensive health matrix to concretize the concept of gender-sensitivity which is often considered as abstract. @*Methods@#An integrated analysis of health determinants was conducted through a convergence study involving medical, social and natural sciences. This analysis was based on both literature reviews and focusgroup discussions. The 6 following focal points were chosen based on the SDGs: gender equality, medicine, education, economy, nutrition, and environment. Objective quantitative indicators were then designated to each of the 6 areas and comparatively analyzed for South Korea, North Korea, and the other SDGs countries. Four areas on sexual and reproductive health were also selected. @*Results@#The results indicated that South Korea scored much lower than North Korea and the other SDGs countries in terms of gender equality. It was also behind North Korea in education, although North Korea had a comparatively lower ranking in the rest of the areas. On the other hand, it fared better than the aforementioned countries with respect to environment, nutrition, medicine, and economy. @*Conclusion@#A comprehensive gender-sensitive health matrix was developed to refine the abstract concept of gender-sensitivity through objective quantitative indicators that assess the health status of a country by means of a scoring system. Gender equality was also confirmed as a common and significant component in the disciplines of sexual and reproductive health and comprehensive health.

Validation of initial nutrition screening tool for hospitalized patients / 한국영양학회지

PURPOSE: Poor nutrition in hospitalized patients is closely linked to an increased risk of infection, which can result in complications affecting mortality, as well as increased length of hospital stay and hospital costs. Therefore, adequate nutritional support is essential to manage the nutritional risk status of patients. Nutritional support needs to be preceded by nutrition screening, in which accuracy is crucial, particularly for the initial screening. To perform initial nutrition screening of hospitalized patients, we used the Catholic Kwandong University (CKU) Nutritional Risk Screening (CKUNRS) tool, originally developed at CKU Hospital. To validate CKUNRS against the Patient-Generated Subjective Global Assessment (PG-SGA) tool, which is considered the gold standard for nutritional risk screening, results from both tools were compared. METHODS: Nutritional status was evaluated in 686 adult patients admitted to CKU Hospital from May 1 to July 31, 2018 using both CKUNRS and PG-SGA. Collected data were analyzed, and the results compared, to validate CKUNRS as a nutrition screening tool. RESULTS: The comparison of CKUNRS and PG-SGA revealed that the prevalence of nutritional risk on admission was 15.6% (n = 107) with CKUNRS and 44.6% (n = 306) with PG-SGA. The sensitivity and specificity of CKUNRS to evaluate nutritional risk status were 98.7% (96.8 ~ 99.5) and 33.3% (28.1 ~ 39.0), respectively. Thus, the sensitivity was higher, but the specificity lower compared with PG-SGA. Cohen's kappa coefficient was 0.34, indicating valid agreement between the two tools. CONCLUSION: This study found concordance between CKUNRS and PG-SGA. However, the prevalence of nutritional risk in hospitalized patients was higher when determined by CKUNRS, compared with that by PG-SGA. Accordingly, CKUNRS needs further modification and improvement in terms of screening criteria to promote more effective nutritional support for patients who have been admitted for inpatient care.

Erratum: Authorship Correction. Association of coffee consumption with health-related quality of life and metabolic syndrome in Korean adults: based on 2013 ~ 2016 Korea National Health and Nutrition Examination Survey / 한국영양학회지

The original version of this article contained an error in authorship. The correct information of authorship should be as follows. The authors would like to apologize for any inconvenience caused.

Food and Nutrient Intake Level by the Risk of Osteoporosis and Cardiovascular Disease in Postmenopausal Women: The use of the 5th Korean National Health and Nutrition Examination Surveys (2010–2011) / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. METHODS: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010–2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. RESULTS: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin B2 levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin B2 was inadequately consumed by all groups. CONCLUSIONS: These results suggest that it is necessary to increase the intake of vitamin B2 and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

Food and Nutrient Intake Level by the Risk of Osteoporosis and Cardiovascular Disease in Postmenopausal Women: The use of the 5th Korean National Health and Nutrition Examination Surveys (2010–2011) / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects. METHODS: A total of 1,131 post-menopausal women aged over 45 years, who took the 2010–2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups. RESULTS: Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin B2 levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin B2 was inadequately consumed by all groups. CONCLUSIONS: These results suggest that it is necessary to increase the intake of vitamin B2 and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

A big picture view of precision nutrition: from reductionism to holism / 한국영양학회지

PURPOSE: This review describes the historical changes in nutrition philosophy from a reductionist to a holistic approach during the 20th century. Also, the role and efficient use of a holistic approach to precision nutrition are discussed. RESULTS: Over the past century, significant progress has been made in human nutrition research, unraveling fundamental mechanisms of single nutrients on single targets or pathways. This kind of a reductionist approach has helped to save populations from nutrient deficiency diseases and improve associated health outcomes in large parts of the world. However, a new set of nutrition problems, like obesity and diet-related chronic diseases, are growing each year worldwide, increasing the financial burden on the health care system. A linear cause-effect association between single nutrients and a single physiologic effect, is insufficient to solve the complex nutrition-health relationships. Research that involves a more holistic rather than reductionist approach is needed to tackle a new set of nutrition problems. Recent advances in technology, informatics, and statistical methods are enabling an understanding of the diversity of individuals and the complex interactions between foods and human bodies, leading to the concept of “precision nutrition.” CONCLUSION: The emerging goal of precision nutrition is to provide tailored dietary advice for maintaining health and preventing obesity and diet-related chronic diseases. The parts are already being installed. To grab the complexity, reductionism and holism must be used interdependently.

Dietary intake of n-3 and n-6 polyunsaturated fatty acids in Korean toddlers 12–24 months of age with comparison to the dietary recommendations

BACKGROUND/OBJECTIVES: Adequate dietary fatty acid intake is important for toddlers between 12–24 months of age, as this is a period of dietary transition in conjunction with rapid growth and development; however, actual fatty acid intake during this period seldom has been explored. This study was conducted to assess the intake status of n-3 and n-6 polyunsaturated fatty acids by toddlers during the 12–24-month period using 2010–2015 Korea National Health and Nutrition Examination Survey data. SUBJECTS/METHODS: Twenty-four-hour dietary recall data of 12–24-month-old toddlers (n = 544) was used to estimate the intakes of α-linolenic acid (ALA; 18:3n-3), eicosapentaenoic acid (EPA; 20:5n-3), docosahexaenoic acid (DHA; 22:6n-3), linoleic acid (LA; 18:2n-6), and arachidonic acid (AA; 20:4n-6), as well as the major dietary sources of each. The results were compared with the expected intake for exclusively breastfed infants in the first 6 months of life and available dietary recommendations. RESULTS: Mean daily intakes of ALA, EPA, DHA, LA, and AA were 529.9, 22.4, 37.0, 3907.6, and 20.0 mg/day, respectively. Dietary intakes of these fatty acids fell below the expected intake for 0–5-month-old exclusively breastfed infants. In particular, DHA and AA intakes were 4 to 5 times lower. The dietary assessment indicated that the mean intake of essential fatty acids ALA and LA was below the European and the FAO/WHO dietary recommendations, particularly for DHA, which was approximately 30% and 14–16% lower, respectively. The key sources of the essential fatty acids, DHA, and AA were soy (28.2%), fish (97.3%), and animals (53.7%), respectively. CONCLUSIONS: Considering the prevailing view of DHA and AA requirements on early brain development, there remains considerable room for improvement in their intakes in the diets of Korean toddlers. Further studies are warranted to explore how increasing dietary intakes of DHA and AA could benefit brain development during infancy and early childhood.

Association of coffee consumption with health-related quality of life and metabolic syndrome in Korean adults: based on 2013 ~ 2016 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study examined the association of the type and frequency of coffee consumption with the health-related quality of life and metabolic bio-markers in adult men and women from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey (KNHANES). METHODS: A total of 11,201 subjects (4,483 men and 6,718 women) were classified according to the type of coffee consumption (non-coffee, black coffee, 3-in-1 coffee) and type and frequency of coffee consumption (non-coffee, ≤2 times/day of black coffee, > 2 times/day of black coffee, ≤2 times/day of 3-in-1 coffee, > 2 times/day of 3-in-1 coffee) using food frequency questionnaires. Dietary nutrient intake data were assessed using food frequency questionnaires. The health-related quality of life was measured using the EuroQol-5 dimension (EQ-5D) and EQ-5D index score. Data on metabolic bio-markers were obtained from a health examination. RESULTS: Among men and women, the proportion of subjects with an energy intake below the estimated energy requirement (EER) was lower among the 3-in-1 coffee consumption group, and the proportion of subjects with iron intakes below the estimated average requirements (EAR) was lower among the 3-in-1 coffee consumption group. Women (OR: 0.810, 95% CI: 0.657 ~ 0.998) with the ≤2 times/day of 3-in-1 coffee had a lower risk of impaired health-related quality of life (lowest 20% level in the EQ-5D score) compared to the non-coffee consumers after a multivariable adjustment. In both men and women, the type and frequency of coffee consumption was not associated with metabolic bio-markers risk after multivariable adjustment. CONCLUSION: These results suggest that 3-in-1 coffee consumption may be associated with a lower risk of impaired health-related quality of life and may not be associated with the metabolic bio-markers risk in adult men and women.

Platycodi radix beverage ameliorates postprandial lipemia response through lipid clearance of triglyceride-rich lipoprotein: A randomized controlled study in healthy subjects with a high-fat load

BACKGROUND/OBJECTIVES: Elevation of postprandial lipemia characterized by a rise in triglyceride (TG)-rich lipoproteins can increase the risk of atherogenesis. The objective of this study was to investigate postprandial lipemia response to a single dietary fat/sugar load test and monitor beneficial changes induced by the consumption of Platycodi radix (AP) beverage in healthy subjects. SUBJECTS/METHODS: A total of 52 subjects were randomly assigned to either placebo or AP beverage group with a high-fat shake in a randomized controlled crossover trial. Postprandial blood was collected at 0, 1, 2, 4, and 6 h and analyzed for TG and lipoprotein lipase mass. Inhibition of pancreatic lipase was determined in vitro. RESULTS: AP inhibited pancreatic lipase activity in vitro (IC₅₀ = 5 mg/mL). Compared to placebo beverage, AP beverage consumption with a high-fat shake induced significant increase of plasma lipoprotein lipase mass (P = 0.0111, β estimate = 4.2948) with significant reduction in very low-density lipoprotein (VLDL) TG concentration (P = 0.038, β estimate = −52.69) at 6 h. Based on significant correlation between high-fat dietary scores MEDFICTS and postprandial TG responses in VLDL (P = 0.0395, r = 0.2127), subgroup analysis revealed that 6 h-postprandial VLDL TG response was significantly decreased by AP consumption in subjects with MEDFICTS ≥ 40 (P = 0.0291, β estimate = −7214). CONCLUSIONS: AP beverage might have potential to alleviate postprandial lipemia through inhibiting pancreatic lipase activity and elevating lipoprotein lipase mass. Subgroup analysis revealed that subjects with high-fat dietary pattern could be classified as responders to AP beverage among all subjects.

Metabolites profiling and hypolipidemic/hypocholesterolemic effects of persimmon (Diosyros kaki Thumb.) by different processing procedures: in vitro and in vivo studies / 한국영양학회지

PURPOSE: Our previous study demonstrated that persimmon (Diospyros kaki Thumb.) at different stages of ripening provided different protective effects against high-fat/cholesterol diet (HFD)-induced dyslipidemia in rats. In this study, we compared the metabolites profile and gene expressions related to triglyceride (TG)/cholesterol metabolism in vitro and in vivo after treating with persimmon water extracts (PWE) or tannin-enriched persimmon concentrate (TEP). METHODS: Primary and secondary metabolites in test materials were determined by GC-TOF/MS, UHPLC-LTQ-ESI-IT-MS/MS, and UPLC-Q-TOF-MS. The expression of genes related to TG and cholesterol metabolism were determined by RT-PCR both in HepG2 cells stimulated by oleic acid/palmitic acid and in liver tissues obtained from Wistar rats fed with HFD and PWE at 0, 150, 300, and 600 mg/d (experiment I) or TEP at 0, 7, 14, and 28 mg/d (experiment II) by oral gavage for 9 weeks. RESULTS: PLS-DA analysis and heatmap analysis demonstrated significantly differential profiling of metabolites of PWE and TEP according to processing of persimmon powder. In vitro, TEP showed similar hypolipidemic effects as PWE, but significantly enhanced hypocholesterolemic effects compared to PWE in sterol regulatory element-binding protein 2 (SREBP2), HMG-CoA reductase (HMGCR), proprotein convertase subtilisin/kexin type 9 (PCSK9), cholesterol 7α-hydroxylase (CYP7A1), and low density lipoprotein receptor (LDLR) gene expression. Consistently, TEP and PWE showed similar hypolipidemic capacity in vivo, but significantly enhanced hypocholesterolemic capacity in terms of SREBP2, HMGCR, and bile salt export pump (BSEP) gene expression. CONCLUSION: These results suggest that column extraction after hot water extraction may be a good strategy to enhance tannins and long-chain fatty acid amides, which might cause stimulation of hypocholesterolemic actions through downregulation of cholesterol biosynthesis gene expression and upregulation of LDL receptor gene expression.