A Pilot Study for Development of a Gender Variable Model for Health Research in Korea

Background@#For gendered innovations to be streamlined in health research, researchers need tools to measure gender variables quantitatively. Because gender is a sociocultural concept which varies by culture, it is important to check feasibility of using tools developed in western countries before using them in Korea. The objective of this study is to conduct a pilot study for adapting a questionnaire measuring gender variables from the literature for the Korean population. @*Methods@#The research was conducted in two steps: 1) modification of questionnaire by an expert group, and 2) an on-line survey of 3,000 adults, in three age groups, balanced in sex. The questionnaire was composed of 7 gender variables with 2 to 6 items, constituting a total of 24 5-point Likert scale items. Gender variable scores were calculated as the average of Z-scores of items pertaining to each variable. @*Results@#Participants were 45.6% men, 43.9% women, and 10.5% other gender. Scores of five gender variables-caregiver tension, work tension, independence, emotional intelligence, and discrimination-were significantly different among sex and gender groups. Among gender variables, work strain, caregiver strain, and discrimination had notable influences on health status and health-related behaviors among survey participants. @*Conclusions@#Several gender variables were related to health status and health behaviors in Korean adults. This is the first attempt in Korea to quantify gender characteristics to be used for health research. Further studies are needed to verify the questionnaire and methods developed in this study for use with diagnosed disease outcomes.

Gender Analysis of Food Items Selection for Food Frequency Questionnaire Development

BACKGROUND@#The aims of this study were 1) to compare foods between men and women with high contributions to absolute intake and the variability in energy and nutrient intakes, which are common criteria of selecting foods for food frequency questionnaire (FFQ), 2) to analyze possible inaccuracies due to not taking gender into consideration.@*METHODS@#The study used 1-day 24 hour recall data of 7,952 participants (n=3,250 men, n=4,702 women) aged 19–64 years who participated in the 2013–2014 Korea National Health and Nutrition Examination Survey. Foods which have high possibility of being included in FFQ items, called candidate foods, were selected by analyzing their contribution to absolute intake and variability in the intakes of energy and 15 nutrients in total participants, men and women.@*RESULTS@#The number of candidate foods selected was 133 for total participants, 126 for men, and 153 for women. Intakes of candidate foods for total participants were significantly higher in energy and six nutrients out of selected 16 nutrients than those of candidate foods for men only. On the contrary, all nutrient intakes of candidate foods for total participants were significantly lower than those of candidate foods for women only.@*CONCLUSIONS@#Differences were revealed between men and women not only in the total numbers, but also in the selected food items from the candidate foods for FFQ. Thus, developing FFQs without considering gender may produce systematic errors in dietary assessment, possibly in different directions for men and women.

Gender Perspectives on the Relationship between Red and Processed Meat Intake and Colorectal Cancer: A Systematic Review and Meta-Analysis

BACKGROUND@#Men and women choose different food items, and consume different amounts of food, due to biological, cultural, and social differences. However, when dietary assessment instruments are developed, gender differences in food selection and/or the portion sizes are often not considered.@*METHODS@#Prospective cohort studies with men and women that examined the association between red or processed meat intake and colorectal cancer and published up to July 2017, were identified using PubMed. Studies were categorized as gender-specific (GS) group if the Food Frequency Questionnaire was developed using gender-specific data, and as not gender-specific (NGS) group if not gender-specific data were used.@*RESULTS@#For cohort studies that reported combined intake estimates of men and women, a 100 g/day increment in red and processed meat intake was positively associated with a risk of colorectal or colon cancer in GS group (relative risk [RR], 1.23; 95% confidence interval [CI], 1.14–1.32) but not in NGS group (RR, 1.13; 95% CI, 0.90–1.35). For processed meat, the RR for 50 g/day increase was 1.28 (95% CI, 1.15–1.40) in GS group and 1.15 (95% CI, 1.03–1.27) in NGS group.@*CONCLUSIONS@#Gender differences need to be considered during development of dietary assessment tools because this may improve the quality of the findings of nutritional epidemiological studies.

Experiences with a graduate course on sex and gender medicine in Korea / 보건의료교육평가

No abstract available.

Gender Analysis of Food Items Selection for Food Frequency Questionnaire Development

BACKGROUND: The aims of this study were 1) to compare foods between men and women with high contributions to absolute intake and the variability in energy and nutrient intakes, which are common criteria of selecting foods for food frequency questionnaire (FFQ), 2) to analyze possible inaccuracies due to not taking gender into consideration. METHODS: The study used 1-day 24 hour recall data of 7,952 participants (n=3,250 men, n=4,702 women) aged 19–64 years who participated in the 2013–2014 Korea National Health and Nutrition Examination Survey. Foods which have high possibility of being included in FFQ items, called candidate foods, were selected by analyzing their contribution to absolute intake and variability in the intakes of energy and 15 nutrients in total participants, men and women. RESULTS: The number of candidate foods selected was 133 for total participants, 126 for men, and 153 for women. Intakes of candidate foods for total participants were significantly higher in energy and six nutrients out of selected 16 nutrients than those of candidate foods for men only. On the contrary, all nutrient intakes of candidate foods for total participants were significantly lower than those of candidate foods for women only. CONCLUSIONS: Differences were revealed between men and women not only in the total numbers, but also in the selected food items from the candidate foods for FFQ. Thus, developing FFQs without considering gender may produce systematic errors in dietary assessment, possibly in different directions for men and women.

Gender Perspectives on the Relationship between Red and Processed Meat Intake and Colorectal Cancer: A Systematic Review and Meta-Analysis

BACKGROUND: Men and women choose different food items, and consume different amounts of food, due to biological, cultural, and social differences. However, when dietary assessment instruments are developed, gender differences in food selection and/or the portion sizes are often not considered. METHODS: Prospective cohort studies with men and women that examined the association between red or processed meat intake and colorectal cancer and published up to July 2017, were identified using PubMed. Studies were categorized as gender-specific (GS) group if the Food Frequency Questionnaire was developed using gender-specific data, and as not gender-specific (NGS) group if not gender-specific data were used. RESULTS: For cohort studies that reported combined intake estimates of men and women, a 100 g/day increment in red and processed meat intake was positively associated with a risk of colorectal or colon cancer in GS group (relative risk [RR], 1.23; 95% confidence interval [CI], 1.14–1.32) but not in NGS group (RR, 1.13; 95% CI, 0.90–1.35). For processed meat, the RR for 50 g/day increase was 1.28 (95% CI, 1.15–1.40) in GS group and 1.15 (95% CI, 1.03–1.27) in NGS group. CONCLUSIONS: Gender differences need to be considered during development of dietary assessment tools because this may improve the quality of the findings of nutritional epidemiological studies.

Use of Dietary Supplements and Determinants of Taking Dietary Supplements by Gender in the Korean Population: Using the 4(th) Korean National Health and Nutrition Examination Survey (2007-2009) / 대한지역사회영양학회지

OBJECTIVES: Although dietary supplements use in Korea has been rapidly increasing and women are more likely to take dietary supplements more than men, only a few studies have been conducted to investigate factors contributing to gender differences in dietary supplement use in the Korean population. The aim of this study is to evaluate the prevalence of dietary supplement use and also identify gender-specific key factors that contribute to it using the data of the 4th KNHANES. METHODS: Subjects were divided into user and non-user groups according to the answer given to the question that asked whether they had used any dietary supplement for more than 2 weeks on a regular basis during the previous year. Factors related to dietary supplement use were examined by general characteristics, health behavior and eating behavior. RESULTS: Prevalence of dietary supplement use was 13.6% for men and 20.6% for women. Users were more likely to be middle-aged, have higher income and education, have a spouse, or reside in dong areas in both men and women. Regarding health behaviors, men with desirable lifestyle behavior were more likely to take dietary supplements, while men who smoked were less likely to take dietary supplements. Regarding disease history, both men and women with a current disease had higher odds of taking supplements. With regard to dietary behavior, frequent eating out and nutrition attitude were associated with higher odds of taking supplements in both men and in women. CONCLUSIONS: Health or dietary behavior related factors that were associated with taking supplements differed by gender. These findings can be useful for planning gender-specific dietary education and health programs.

Dietary evaluation of a low-iodine diet in Korean thyroid cancer patients preparing for radioactive iodine therapy in an iodine-rich region

BACKGROUND/OBJECTIVES: Despite the importance of a low-iodine diet (LID) for thyroid cancer patients preparing for radioactive iodine (RAI) therapy, few studies have evaluated dietary intake during LID. This study evaluated the amount of dietary iodine intake and its major food sources during a typical diet and during LID periods for thyroid cancer patients preparing for RAI therapy, and examined how the type of nutrition education of LID affects iodine intake. SUBJECTS/METHODS: A total of 92 differentiated thyroid cancer patients with total thyroidectomy were enrolled from Seoul National University Hospital. All subjects completed three days of dietary records during usual and low-iodine diets before 131I administration. RESULTS: The median iodine intake was 290 µg/day on the usual diet and 63.2 µg/day on the LID. The major food groups during the usual diet were seaweed, salted vegetables, fish, milk, and dairy products and the consumption of these foods decreased significantly during LID. The mean energy intake on the LID was 1,325 kcal, which was 446 kcal lower than on the usual diet (1,771 kcal). By avoiding iodine, the intake of most other nutrients, including sodium, was significantly reduced during LID (P < 0.005). Regarding nutritional education, intensive education was more effective than a simple education at reducing iodine intake. CONCLUSION: Iodine intake for thyroid cancer patients was significantly reduced during LID and was within the recommended amount. However, the intake of most other nutrients and calories was also reduced. Future studies are needed to develop a practical dietary protocol for a LID in Korean patients.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged > or = 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

The Impact of Low Adherence to the Low-iodine Diet on the Efficacy of the Radioactive Iodine Ablation Therapy

To improve the efficacy of radioactive iodine (RAI) therapy for differentiated thyroid cancer patients, a low-iodine diet (LID) prior to the therapy is recommended. In iodine-rich areas such as Korea, however, a strict LID is very difficult to maintain. We experienced the cases of three patients showing low adherence to the LID before initial RAI therapy, and analyzed the main food source supplying iodine during the LID, and examined the influence of the poorly maintained LID on the efficacy of RAI therapy. The dietary intake during the LID periods were assessed using three-day dietary records and remnant thyroid activity after the second RAI administration was also evaluated. All patients' mean daily iodine intake during two-week LID periods exceeded the 100 microg guideline set by the Korean Thyroid Association (median 110.9 microg, ranges 100.4-117.0 microg). Although the typical food sources of iodine intake are seaweeds in Korea, salted vegetables were the main contributor to the patients' iodine intake during the LID periods. Remnant thyroid activity was shown on a follow-up scan in all of 3 patients suggesting low efficacy of RAI therapy. In summary, the patients with low adherence to the LID guideline showed unsuccessful remnant ablation, and the main food source of iodine was salted vegetables. Further studies are necessary to examine the relationship between adherence of the LID and RAI efficacy according to dietary iodine intake levels, as well as food sources that cause low adherence to the LID. These data can then be used to develop more practical LID guidelines.