Lack of Association between Self-reported Saltiness of Eating and Actual Salt Intake / 가정의학회지

BACKGROUND: Reducing salt intake is known to be an important factor for lowering blood pressure and preventing cardiovascular disease. Estimating amount of salt intake is a necessary step towards salt intake reduction. Self-reported saltiness of diet is a method most easily used to measure a patient's salt intake. The purpose of this study was to examine the value of self-reported saltiness of diet in measuring salt intake. METHODS: We used data from 681 participants who visited a health center at a university hospital between August 2003 and November 2005. A self-administered questionnaire was used to collect information on self-reported saltiness of diet, other dietary habits and lifestyle factors. Salt intake was estimated on the basis of 24-hour dietary recall with a computer-aided nutritional analysis program (CAN-Pro 2.0, Korean Nutrition Society). RESULTS: There was no statistically significant difference between the mean salt intake of the self-reported salty diet group (13.7 +/- 4.8 g/d) and the self-reported unsalty diet group (13.3 +/- 4.4 g/d). If we assume calculated salt intake as the gold standard, the sensitivity and specificity of self-reported saltiness were 39.5% and 63.6%, respectively. Salt intake was increased with higher calorie intake, frequency of eating breakfast (> or =5 times/wk) and being satiated with usual diet in men, but it was increased only with higher calorie intake in women. Regardless of actual salt intake, the group satiated with a usual diet tended to be in the group of self-reported salty diet. CONCLUSION: Self-reported saltiness of diet was not associated with actual salt intake. Further studies will be needed on the simpler and more objective tools to estimate salt intake.

Physical Activity and Physical Fitness as Predictors of All-Cause Mortality in Korean Men

We examined the associations between physical activity (PA), fitness and all-cause mortality and compared their contributions, taking smoking status into consideration. A retrospective cohort study of 18,775 men was carried out between May 1995 and December 2003. Fitness was measured by maximum oxygen uptake and regular PA was defined as at least three times a week, for more than 30 min of leisure time PA. During the mean 6.4 yr of follow-up, 547 deaths were recorded. The hazard ratio (HR) (95% confidence interval [CI]) of regular PA for all-cause mortality was 0.63 (0.52-0.76). The HRs (95% CIs) for men with middle and highest tertile levels of fitness were decreased by 0.58 (0.47-0.70) and 0.58 (0.45-0.75) in comparison to men with lowest one. The inverse association between fitness and mortality was significant among the men who did not engage in regular PA, but not among those who did (p for interaction=0.031). Smoking status did not influence on the associations between regular PA, fitness and mortality. Our result suggested that regular PA and fitness predicted mortality in men. The influence of fitness on mortality was pronounced in the men who did not engage in regular PA.

Relationship between the Awareness and Health Behavior in Middle-aged Koreans

BACKGROUND: Despite growing awareness of health behavior, making actual behavioral change seems to be more complex. This study assessed factors influencing discrepancy between the awareness and health behavior in Korean middle-aged people. METHODS: A random-digit-dial telephone survey of 1,047 middle-aged Koreans was carried out in 2004. Through the survey, the agreement between the level of awareness and health behavior was analyzed. And factors related to health-risk behaviors in the group of appropriate awareness were analyzed. RESULTS: In the group of appropriate awareness, males tended to be smokers, problem-drinkers and were not maintaining normal weight. In men, younger age, longer work-hours and more frequent stress were significantly related to both smoking and problem-drinking despite appropriate awareness. Higher income and blue-color working class were also predictors for the problem- drinking. In women, older age, lower education, lower income and comorbid disease were significantly related to abnormal weight. Physical inactivity was significantly related to lower education, longer working hours and lower income. CONCLUSION: This study showed that sociodemographic factors and stress were related with health-risk behavior with appropriate awareness in middle-aged people. These findings are expected to have implications for development of health promotion program focusing on stress management, improvement of sociocultural perception and simultaneous intervention for both smoking and alcohol. For middle-aged Korean women, more efforts must be made to remove economical and sociocultural barriers.

Knowledge and Attitudes of Family Physician and Oncologist toward Cancer Pain Management in Korea

BACKGROUND: Two representative groups of family physicians and oncologists were surveyed concerning their knowledge and attitudes toward cancer pain management (CPM). METHODS: A questionnaire, designed to assess knowledge (13 items) and attitudes (6 items) toward CPM, was sent to 2,200 members of Korean Association of Family Medicine and 800 members of Korean Cancer Association. RESULTS: Three hundreds and eighty eight family physicians (17.6%) and one hundred and forty seven oncologists (18.4%) responded and completed the questionnaire. They had inadequate knowledge toward CPM, especially, chance of respiratory depression, tolerance to adverse effect, ceiling effect, risk of addiction, and use of adjuvants. Most of the physicians had positive attitude toward importance of CPM, best judge of pain severity, and priority of CPM but had negative attitude toward concerns about potential problem of addiction and earlier prescription of maximum dose of opioid. Family physicians displayed more lack of knowledge about CPM in 9 of 13 items and more negative attitudes toward 4 of 6 items. Adjustment for demographic characteristics and experiences in cancer patients with pain showed that while family physicians had poor knowledge of tolerance to confusion, they had more adequate knowledge on the effect of antidepressant and had positive attitude towards best judge of pain severity and priority of CPM. Poor knowledge about CPM was rated by 66.3% of physicians as the most important barrier to adequate CPM. CONCLUSION: These findings that most of the physicians had poor knowledge and negative view toward CPM suggest a continuous need for comprehensive education program focused on CPM for physicians.