Effect of 8-Week Nutrition Counseling to Increase Phytochemical Rich Fruit and Vegetable Consumption in Korean Breast Cancer Patients: A Randomized Controlled Trial

High fruit and vegetable consumption is associated with a lower risk of breast cancer. The incidence of breast cancer is continuously increasing in Korea, but only a few studies on nutrition intervention in breast cancer patients has been reported. The aim of this study was to investigate whether an 8-week nutrition intervention based on dietary counseling can promote fruit and vegetable consumption, increase serum antioxidant nutrient levels, and improve quality of life in Korean breast cancer patients. Sixty-one breast cancer patients received either standard care (n = 31) or nutrition counseling (n = 30). The standard care group was given brochures recommending phytochemical rich diet. The intervention group was provided with two nutrition counseling sessions and one cooking class session, thereby encouraged subjects to eat at least 10 or more servings of fruits and vegetables per day. After 8-week intervention, waist circumference in the intervention group was significantly decreased (p < 0.001) even though no difference was reported for body mass index. Energy intake (p = 0.007), fiber (p < 0.001), and antioxidant nutrient (vitamin A, C, E, and beta-carotene, p < 0.001, respectively) intakes were significantly increased. Serum antioxidant level was also increased significantly, i.e., vitamin A (p = 0.048); vitamin E (p = 0.004). Total vegetable intake (excluding kimchi intake) in the intervention group was increased from 425 g to 761 g (p < 0.001), fruit consumption was also increased from 232 g to 334 g (p < 0.001), while standard care group did not show any significant change. Our study showed that nutrition counseling and providing cooking tips helped to encourage the patient to consume and maintain more fruit and vegetable intakes.

Increased whole grain, fruits and vegetable intake reduced oxidative stress in high school students

There is increasing evidence that dietary factors in plant-based diets are important for the prevention of chronic disease. Especially, phytonutrients in fruits and vegetables have been recognized as major contributors for the decreased level of oxidative stress. In this study, the effect of switching the dietary habit to high consumption of fruits and vegetables were evaluated on the parameters of serum antioxidant status in healthy high school students. Forty one students participated in a randomized controlled trial and were assigned to the control group (n = 18) or the intervention group (n = 23). The intervention group was provided for 8 weeks with the main food source being whole grain and vegetables. Anthropometric measurements, blood parameters and dietary intakes were measured, and compared before and after study. After 8 weeks, weight and BMI were significantly decreased in the intervention group (p = 0.000). The serum diacron reactive oxygen metabolites (d-ROMs) test resulted in a significantly decreased level only in the intervention group (p < 0.05) after 8 weeks, but serum biological antioxidant potential (BAP) was increased significantly in both groups (p < 0.001). Intake of energy, total fat, cholesterol and sodium in the intervention group were significantly decreased after 8 weeks (p < 0.05). Also, the intervention group had significantly increased vitamin and phytonutrient intakes of all-trans-beta-carotene, alpha-carotene, alpha-tocopherol, ascorbic acid, and total phenols (p < 0.05). Overall, the results of this study suggest that whole grain, fruits, and vegetables supplementation showed improvement of the adolescent health.

Long-term vegetarians have low oxidative stress, body fat, and cholesterol levels

Excessive oxidative stress and abnormal blood lipids may cause chronic diseases. This risk can be reduced by consuming an antioxidant- and fiber-rich vegetarian diet. We compared biomarkers of oxidative stress, antioxidant capacity, and lipid profiles of sex- and age-matched long-term vegetarians and omnivores in Korea. Forty-five vegetarians (23 men and 22 women; mean age, 49.5 +/- 5.3 years), who had maintained a vegetarian diet for a minimum of 15 years, and 30 omnivores (15 men and 15 women; mean age, 48.9 +/- 3.6 years) participated in this study. Their 1-day, 24-h recall, and 2-day dietary records were analyzed. Oxidative stress was measured by the levels of diacron reactive oxygen metabolites (d-ROM). Antioxidant status was determined by the biological antioxidant potential (BAP) and levels of endogenous antioxidant enzymes such as superoxide dismutase, catalase, and glutathione peroxidase. We observed that vegetarians had a significantly lower body fat percentage (21.6 +/- 6.4%) than that of omnivores (25.4 +/- 4.6%; P < 0.004). d-ROM levels were significantly lower in vegetarians than those in omnivores (331.82 +/- 77.96 and 375.80 +/- 67.26 Carratelli units; P < 0.011). Additionally, total cholesterol levels in the vegetarians and omnivores were 173.73 +/- 31.42 mg/dL and 193.17 +/- 37.89 mg/dL, respectively (P < 0.018). Low-density lipoprotein cholesterol was 101.36 +/- 23.57 mg/dL and 120.60 +/- 34.62 mg/dL (P < 0.005) in the vegetarians and omnivores, respectively, indicating that vegetarians had significantly lower lipid levels. Thus, oxidative stress, body fat, and cholesterol levels were lower in long-term vegetarians than those in omnivores.

Nutritional Status and Hair Mineral Content of Elementary School Children with Behavioral Problems

This study was performed to assess the nutritional status and hair mineral content of children with behavioral problems and compare the values with a gender, age-matched control group. The subjects were recruited from S elementary school children in Seoul, Korea. Students scored higher than 60 points were diagnosed with behavioral problems according to the Korean-Child Behavior Checklist. Nutritional assessment of the two groups (behavior problem group: male n=15, female n=24; 9.6+/-1.6 years, control group: male n=16, female n=18; 9.5+/-1.9 years) was performed using a nutritional survey and by measuring hair mineral contents. In the results, food frequency questionnaire analysis showed that the intakes of anchovy (P<0.05), soybean curb (P<0.01), radish (P<0.05), bean sprouts (P<0.05), spinach (P<0.05), carrot (P<0.05), pumpkin (P<0.05), lettuce (P<0.05), cabbage (P<0.01), apple (P<0.05), and milk (P<0.01) were higher in the control group than the behavior problem group, whereas intakes of ramyeon (P<0.05), cookies (P<0.05), and coke (P<0.01) were higher in the behavior problem group than the control group. Intakes of most nutrients such as plant-derived protein (P<0.05), fiber (P<0.05), plant-derived calcium (P<0.05), phosphorus (P<0.05), plant-derived iron (P<0.05), vitamin B2 (P<0.05), vitamin B6 (P<0.05), vitamin C (P<0.01), vitamin E (P<0.05), and folate (P<0.05) were significantly higher in the control group than the behavior problem group. Hair analysis showed that the levels of arsenic (P<0.05), mercury (P<0.001), uranium (P<0.05), iron (P<0.001), boron (P<0.01), and germanium (P<0.001) were lower, but the levels of phosphate (P<0.05), chromium (P<0.001), sodium (P<0.05), and sulfur (P<0.001) were higher in the behavior problem group than the control group. Conclusively, behavioral problems constitute a complicated condition in which nutritional factors may play major roles. However, it is still under investigation as to whether or not modification of dietary habits or nutritional supplementation can improve children's behavior, since symptoms require a broad understanding of the environmental and genetic interactions.

Association between Hair Mineral Content and Nutritional Status in Vegetarians and Non-Vegetarians

Previous studies have shown that plant-based vegetarian diets, which typically contain a variety of antioxidants and dietary fiber, help reduce the risk of heart disease, diabetes, obesity, and cancer. However, some studies have reported that vegetarian diets can lead to deficiencies in protein and trace minerals compared to non-vegetarian diets. This study was conducted to compare anthropometric measurements, blood parameters, dietary intake, and hair mineral status in long-term vegetarians (MV; moderate vegan, LV; lacto-ovo vegetarian) and non-vegetarians (NV). Thirty MV (12 males, 18 females; mean age, 50.58 +/- 5.05 years), 15 LV (11 males, four females; mean age, 49.45 +/- 4.97 years), and 30 NV (15 males, 15 females; mean age, 48.90 +/- 3.62 years) participated. No significant differences were observed for age, height, weight, or body mass index, but body fat was significant lower in MV and LV males than that in NV males. White blood cell counts of MV, LV, and NV male subjects were significantly different. Dietary intake data showed that plant protein and plant iron intake were significantly higher in MV and LV than those in NV. Animal protein, animal fat, and animal iron intake were significantly higher in NV than those in MV and LV. A hair mineral analysis showed that calcium and iron were higher in the hair of MV and LV than those in NV. Zinc concentration in hair was not significantly different among the groups. The results suggest that vegetarian diets are adequate to sustain mineral status to at least the same degree as that of non-vegetarian diets.

The Effects of a Worksite On-line Health Education Program on Metabolic Syndrome Risk Factors and Nutrient Intakes of Male Workers

Worksite health promotion programs have been associated with reductions in health risks but are labor-intensive and costly to implement. Therefore, innovative strategies to provide a cost-effective approach to health education program are needed. The purpose of this study was to investigate the effects of a worksite on-line health education program by e-mail on metabolic syndrome risk factors and dietary intakes in male workers with metabolic syndrome. Anthropometric and biochemical parameters were measured and the nutrient intakes were assessed through FFQ. The diagnosis of metabolic syndrome was adapted from NCEP-ATP III with blood pressure, fasting blood glucose, triglyceride, HDL cholesterol, and Asia-Pacific definition with waist circumference. The education group consisted of 212 male workers and the non-education group of 236 age-matched male workers. The on-line health education program provided 10 sessions by e-mail. After a worksite on-line health education program, systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001) and fasting blood glucose (p < 0.001) were significantly decreased and HDL cholesterol (p < 0.001) was significantly increased in the education group. Intakes of total energy (p < 0.05), carbohydrate (p < 0.05), sodium (p < 0.05) were significantly decreased in the education group, but there were no significant differences in dietary intakes in the non-education group after a worksite on-line health education program. The results indicate that online health education program by e-mail is effective for improving metabolic syndrome risk factors and dietary intakes in male workers and show potential for use in the working setting.

Effect of 1 Year E-mail Nutrition Education after Face-to-Face Encounter at Worksite: Changes in Cardiovascular Risk Factors

Effective nutrition educations for prevention of chronic diseases for the general population are of great importance these days. The purpose of this study was to evaluate the feasibility of nutrition education for cardiovascular risk factor reduction by e-mail education in male workers. The participants were divided into three groups by age; 28-39 age group, 40-49 age group, and 50-59 age group who got regular checkups for anthropometry and biochemistry. The 1 year program consisted of 15 topics containing information about metabolic syndrome (MS) and healthy eating behavior (intake of salt, fat and alcohol). Seven hundred thirty nine participants volunteered for the study [28-39 age group, n = 240; body mass index (BMI) = 24.9 +/- 2.7 kg/m2: 40' group, n = 276; BMI = 24.8 +/- 2.6 kg/m2: 50' group, n = 223; BMI = 24.9 +/- 2.7 kg/m2]. Percentage body fat (p<0.05) and percentage of abdominal fat (p<0.05), total cholesterol (p<0.05), systolic blood pressure (p<0.05), and diastolic blood pressure (p<0.05) were significantly decreased in all participants after the 1 year program. The total number of participants who had MS was decreased from 216 to 199 and especially the incidence of MS was decreased 27% in the group of subjects who were under the age 39. The e-mail worksite nutrition education program shows a substantial contribution to the development of effective CVD and chronic disease control and lifestyle nutrition educations that are applicable to and attractive for the large population at risk.

Apolipoprotein E Phenotypes and the Relationship Among Lipid Levels, Nutrient Intakes, Lifestyles and Risk Factors Between Subjects with and without Hyperlipidemic Risk

This study was performed to investigate Apolipoprotein E phenotypes and the relationship among lipid levels, nutrient intakes, lifestyles and risk factors between subjects with and without hyperlipidemic risk. The data were collected from 675 industrial male workers who had completed annual medical examination. Compared to the normal group, the hyperlipidemic risk group in Apo E3 and E4 had significantly higher BMI (p < 0.05) and showed significantly higher body fat (%), waist circumference and WHR in all types of Apo E (p < 0.05). In addition, the hyperlipidemic risk group had significantly higher total cholesterol, LDL-cholesterol, triglyceride and AI than the normal group in all types of Apo E (p < 0.05). Intakes of protein, calcium, phosphorus, iron, vitamin A, vitamin B1, vitamin B2, vitamin C and niacin in Apo E3 were significantly lower in the hyperlipidemic risk group than in the normal group (p < 0.05). In the logistic regression analysis, after adjustment for other factors, Apo E2 + E4, waist and WHR were the significant risk factors associated with hyperlipidemia, but protein intakes were associated with significantly lower risks of hyperlipidemia (p < 0.05). In conclusion, genetic factor (Apo E2 or Apo E4), anthropometric index and nutrient intake seem to influence hyperlidemic risk. Further studies and efforts will be needed to evaluate the independent relationships among hyperlipidemic risk factors.

Blood Lipid Levels, Nutrient Intakes and Health-Related Lifestyles of Industrial Male Workers According to Apolipoprotein E Polymorphisms / 대한지역사회영양학회지

The purpose of this study was to investigate the association among nutrient intakes and health-related lifestyles with cardiovascular disease risk assessed by blood lipid profile according to Apolipoprotein E genotypes. Middle-aged industrial male workers who had completed their annual medical examination were recruited and data of 675 subjects who finished the nutrient survey were used in the analysis. Anthropometric parameters, dietary assessment (FFQ), health-related lifestyles and blood profiles were used for statistical analyses. Apo E genotype groups were classified into the following three genotypes: Apo E2 group (including E2/E2, E2/E3, E2/E4), Apo E3 group (including E3/E3), Apo E4 group (including E3/E4, E4/E4). The frequency of Apo E2, E3, and E4 allele were 13.3%, 75.0% and 11.7% respectively. There were no significant differences in the anthropometric parameters depending on different Apo E genotypes. Also, no significant differences in the nutrient intakes were found according to the genotype groups. The nutrient intakes of all subjects were similar to or higher than the level of KDRIs (Dietary Reference Intakes For Koreans) except for intakes of calcium (67.44% of KDRIs), vitamin A (73.83% of KDRIs) and vitamin B2 (78.02% of KDRIs). Also, there were no significant differences of health-related lifestyles according to Apo E genotype groups. As for the lipid profiles, Apo E4 group had significantly higher total and LDL-cholesterol concentrations than the Apo E2 group (p < 0.05). We confirmed that plasma total and LDL-cholesterol concentrations were greatly influenced by Apo E genotypes. However, nutrient intakes and health-related lifestyles were not associated with Apo E genotypes.

Growth and Development of Infants Fed Soy-Based Formulas over 3 Months / 대한지역사회영양학회지

The objective of this study was conducted to investigate growth and development status of infants fed soy-based formulas over 3 months. The height and weight were measured and Z-scores were calculated by using standard of the same age groups. Their mothers were interviewed using questionnaires including general and environmental characteristics, total food intakes, soy based formula intakes and Ewha infant development screening test. Main results were as follows: 1) Nutrient intake levels of subjects were similar to or more than the level of Korean Recommended Dietary Allowances except for intakes of vitamin E (79.89% RDA), and the average status of nutrient intakes of infants were fairly good. 2) Z-scores of height for age (HAZ) and Z-scores of weight for age (WAZ), Kaup index, WLI and Ewha Infant Developmental Screening Test score of subjects were in the normal growth range. 3) There were no significant differences among soy based formula intake percentile groups in HAZ, WAZ, Kaup index, WLI and Ewha Infant Developmental Screening Test score. 4) Total energy intake was positively correlated with HAZ (p < 0.01), WAZ (p < 0.01), and WLI (p < 0.05) in infants less than 12 month. Also, soy based formula energy intake was positively correlated with HAZ (p < 0.05) in infants less than 12 month. However, energy and soy based formula intake levels of infants over 12 month were not significant among variables. Considering results of this study, infants fed soy-based formulas over 3 months showed normal growth and development status. Further studies are needed to evaluate long-term growth and development in infants fed soy based formulas.