Relationship between metabolic syndrome and intake of ultraprocessed foods in Korean adults:based on 6th and 7th Korea National Health and Nutrition Examination Survey (2013–2018)

BACKGROUND/OBJECTIVES@#Metabolic syndrome is closely associated with lifestyle factors, including diet and nutritional intake. Modern trends show a shift in food consumption from healthy home-cooked meals to processed and instant foods. Therefore, this study analyzed the association between ultra-processed food intake and the development of metabolic syndrome in Korean adults based on the data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2013–2018. @*SUBJECTS/METHODS@#The subjects of this study were 17,414 adults aged 19–80 years who participated in the 6th–7th KNHANES. Processed food was classified into four categories, NOVA1 to NOVA4, using 24-h recall data. The higher the NOVA category, the more processed the food. Statistical analysis was conducted using logistic regression to investigate the prevalence of metabolic syndrome according to the consumption of ultra-processed foods. @*RESULTS@#Among the diagnostic criteria for metabolic syndrome, hypertension (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.62–0.85; Q4 vs. Q1, P-trend < 0.001) and high triglycerides (OR, 0.83; 95% CI, 0.72–0.94; Q4 vs. Q1, P-trend < 0.001) showed a correlation with the percentages of energy consumed from ultra-processed foods. The OR for metabolic syndrome, according to the percentages of energy consumed from ultra-processed foods, is shown only for men. The OR showed that the percentages of energy consumed from ultraprocessed foods were associated with increased metabolic syndrome. @*CONCLUSIONS@#This study suggests that consumption of ultra-processed foods raises the risk of metabolic syndrome especially among men. To prevent metabolic syndrome, it is necessary to prepare appropriate dietary guidelines for Korean adults.

Survey of Foodservice Management Status according to Welfare Facility Type for Disabled Persons

This study aimed to determine foodservice and hygiene management statuses at welfare facilities catering to disabled persons by facility type to provide basic data for foodservice management guidelines. An online survey was distributed to workers at 1,984 welfare facilities for disabled persons in Korea, and 531 facilities responded, which represented a response rate of 26.8%. The survey requested general information about the facilities, facility users, meals, hygiene, and management. Statistical analyses were performed, and frequency analysis and the chi-square test were used to investigate responses by facility type. The survey results revealed that daycare centers were most common and accounted for 27.4% of responses. Residential facilities for the severely disabled and sheltered workshops accounted for 16.9% and 16.4%, respectively, and residential facilities by disability type accounted for 13.0%. The presence of dietitians at welfare facilities varied by facility type. Welfare centers for the disabled (94.7%) had the highest percentage of dietitians, followed by residential facilities for the severely disabled (87.8%). On the other hand, sheltered workshops and daycare centers for disabled persons had the lowest percentages of dietitians (10.3% and 4.1%, respectively). This study highlights the variations that exist in foodservice management across different welfare facilities for disabled persons and emphasizes the challenges faced by those responsible for managing foodservices and maintaining hygiene, particularly in large facilities with no dietitians. Therefore, we recommend tailored meal management guidelines be developed for each type of welfare facility for disabled persons.

Minor alleles in the FTO SNPs contributed to the increased risk of obesity among Korean adults: meta-analysis from nationwide big data-based studies

BACKGROUND/OBJECTIVES@#Many studies have revealed an association between fat mass and the obesity-related gene (FTO) and obesity. On the other hand, no meta-analysis was conducted with data from only Koreans. Therefore, this study performed a meta-analysis using Korean data to provide evidence for the association between FTO single nucleotide polymorphisms (SNPs) and the risk of obesity among Korean adults.SUBJECT/METHODS: Meta-analysis was finally conducted with data extracted from seven datasets of four studies performed on Korean adults after the screening passed. Five kinds of FTO SNPs (rs9939609, rs7193144, rs9940128, rs8050136, and rs9926289) were included, and the relationship between FTO SNPs and body mass index (BMI) was investigated using linear regression with an additive model adjusted for covariants, such as age, sex, and area. @*RESULTS@#The minor alleles of FTO SNPs were associated with increased BMI (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.21–1.42). In sub-group analysis, FTO rs9939609 T>A was significantly associated with BMI (OR, 1.23; 95% CI, 1.06–1.42). The other FTO SNPs together were significantly associated with BMI (OR, 1.37; 95% CI, 1.25–1.49). The publication bias was not observed based on Egger’s test. @*CONCLUSIONS@#This meta-analysis showed that minor alleles in the FTO SNPs were significantly associated with an increased BMI among Korean adults. This meta-analysis is the first to demonstrate that minor alleles in the FTO SNPs contribute significantly to the increased risk of obesity among Korean adults using data from a Korean population.

Evaluation of medical nutrition therapy using the food-based index of dietary inflammatory potential (FBDI) in diabetes mellitus patients

BACKGROUND/OBJECTIVES@#Inflammation is often associated with chronic diseases, and numerous studies suggest that certain foods can modulate inflammatory status. This study aimed to assess the impact of intensive nutrition education on glycemic control and inflammation in patients with diabetes mellitus using the Korean food-based index of dietary inflammatory potential (FBDI). @*SUBJECTS/METHODS@#A total of 120 patients (male: 70, 58.3%) were randomly divided into two groups of 60 each, to be given intensive nutritional education (IE) and basic nutritional education (BE), respectively. As part of the nutrition education intervention, basic diabetesrelated nutrition education was provided to both groups initially. In addition, the IE was provided two face-to-face nutrition education sessions based on FBDI over six months, and text transmissions were made at least eight times. We surveyed the anthropometric measurements, biochemical indicators, inflammatory markers, and dietary intake before and after the interventions. We analyzed the effects of the intensive nutrition education using the t-test, χ 2 test and paired t-test. @*RESULTS@#Of the subjects, 76.7% (46/60) of the IE and 86.7% (52/60) of the BE completed the study. The results of the paired t-test to evaluate the effectiveness of nutrition education using FBDI showed that high density lipoprotein-cholesterol increased significantly from 42.6 mg/dL before intervention to 49.2 mg/dL after intervention (P = 0.009), tumor necrosis factor-α significantly decreased from 1.25 pg/mL before intervention to 1.11 pg/mL after intervention (P =.012) in the IE. Also, glycated hemoglobin decreased from 8.0% to 7.5% in the IE but increased from 7.4% to 7.7% in the BE, and the differences between the groups were significant (P= 0.008). @*CONCLUSION@#These findings suggest that providing intensive FBDI-based education on antiinflammatory foods positively affected glycemic control and inflammatory status in diabetes patients. Therefore, practical dietary plans using FBDI should be considered for diabetes patients to prevent increased inflammation.

The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis

BACKGROUND/OBJECTIVES@#The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. @*SUBJECTS/METHODS@#A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. @*RESULTS@#This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2 ; 95% confidence interval [CI], 1.59–2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2 ; 95% CI, 1.13–1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2 ; 95% CI, 0.1–1.51; P < 0.05; I2 = 95%). @*CONCLUSIONS@#Quantitative synthesis of the systematic reviews has shown that crosssectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

Effectiveness of a mobile health intervention on weight loss and dietary behavior changes among employees with overweight and obesity: a 12-week intervention study investigating the role of engagement / 대한지역사회영양학회지

Objectives@# This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness. @*Methods@# The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention. @*Results@# After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior. @*Conclusions@# The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.

Comparison of the levels of energy intake from dish and food groups by gender and age among Korean obese adults: data obtained from the 2013-2018 Korea National Health and Nutrition Examination Survey / 한국영양학회지

Purpose@#To provide the primary data on dietary guidelines for the management of obesity, we analyzed the intake rate of food groups and dish groups according to obesity and age.Data were obtained from the Korea National Health and Nutrition Examination Survey (KNHANSE, 2013–2018). @*Methods@#This study analyzed the data of 21,184 adults aged 19-64 years, obtained from the KNHANSE 2013–2018. The 24-hour recall was performed and the food groups were classified into six representative food groups (grains, meat·fish·eggs·legumes, vegetables, fruits, milk and dairy, and oil and sugar), and ‘alcohol’ and ‘others’. The dish groups were classified into a total of twenty-four types. @*Results@#The normal group included 9,004 subjects (42.5%), while the obese group had 12,180 subjects (57.5%). The food groups showing significant differences according to obesity were grains (p < 0.001), meat/fish/egg/legumes (p < 0.001), and vegetables (p < 0.001); similar results were obtained in both male and female. Comparing the intake rate of food groups and dish groups targeting only the obese group according to age, the food groups showing significance between the obese group and the normal group were grains (p < 0.001) and vegetables (p < 0.001), with significantly increased intake in both genders. Considering the dish groups, significant increases were determined for stews (p < 0.001), seasoned vegetables (p < 0.001), and kimchi (p < 0.001) in male, and for rice (p < 0.001), seasoned vegetables (p < 0.001), kimchi (p < 0.001), and rice cakes (p < 0.001) in female. @*Conclusion@#The results of this study determined that the intake ratio of food and dish groups differs by age in obese adults. We believe that our results can be used as primary data for forming dietary guidelines for obese adults in the future.

Domestic development situation of precision nutrition healthcare (PNH) system based on direct-to-consumer (DTC) obese genes / 한국영양학회지

In the era of the fourth industrial revolution technology, the inclusion of personalized nutrition for healthcare (PNH), when establishing a healthcare platform to prevent chronic diseases such as obesity, diabetes, cerebrovascular and cardiovascular disease, pulmonary disease, and inflammatory diseases, enhances the national competitiveness of global healthcare markets. Furthermore, since the government experienced COVID-19 and the population dead cross in 2020, as well as numerous health problems due to an increasing super-aged Korean society, there is an urgent need to secure, develop, and utilize PNHrelated technologies. Three conditions are essential for the development of PNH technologies. These include the establishment of causality between obesity genome (genotype) and prevalence (phenotype) in Koreans, validation of clinical intervention research, and securing PNH-utilization technology (i.e., algorithm development, artificial intelligence-based platform, directto-customer [DTC]-based PNH, etc.). Therefore, a national control tower is required to establish appropriate PNH infrastructure (basic and clinical research, cultivation of PNHrelated experts, etc.). The post-corona era will be aggressive in sharing data knowledge and developing related technologies, and Korea needs to actively participate in the large-scale global healthcare markets. This review provides the importance of scientific evidence based on a huge dataset, which is the primary prerequisite for the DTC obesity gene-based PNH technologies to be competitive in the healthcare market. Furthermore, based on comparing domestic and internationally approved DTC obese genes and the current status of Korean obesity genome-based PNH research, we intend to provide a direction to PNH planners (individuals and industries) for establishing scientific PNH guidelines for the prevention of obesity.

Relationship between diet quality and sarcopenia in elderly Koreans: 2008–2011 Korea National Health and Nutrition Examination Survey

BACKGROUND/OBJECTIVES@#Given the increasing proportion of the Korean population that is aged 65 years and older, the present study analyzed the relationship between diet quality and sarcopenia in elderly persons by using data from the 2008–2011 Korea National Health and Nutrition Examination Survey (KNHANES). @*SUBJECTS/METHODS@#Data for 3,373 persons aged 65 years and over (men: 1,455, 43.1%) were selected from the 2008–2011 KNHANES. Sarcopenia assessments are based on a formula that divides a subject's appendicular skeletal muscle mass (ASM) by their weight (wt) and multiplies that result by 100 ([ASM/wt] × 100). Sarcopenia is present if the subject's result was less than one standard deviation (SD) below the sex-specific mean for a young reference group. For evaluation of diet quality, data obtained via the 24-hour recall method were used to calculate the Diet Quality Index for Koreans (DQI-K). A general linear model was applied in order to analyze general information and nutritional intake according to sarcopenia status. For analysis of the relationship between diet quality and sarcopenia, a binominal logistic regression analysis was undertaken. @*RESULTS@#The sarcopenia prevalence rate among the study subjects aged 65 years and over was 37.6%. The DQI-K of those without sarcopenia was 3.33 ± 0.04 points, while that of those with sarcopenia was 3.45 ± 0.04 points (P < 0.05). The relationship between diet quality and sarcopenia revealed that subjects aged 75 and older had a poor diet quality, and their odds ratio (OR) of sarcopenia presence was significantly higher (OR: 1.807, 95% confidence interval: 1.003–3.254, P < 0.05). @*CONCLUSIONS@#This study revealed that poor diet quality was related to sarcopenia presence in Koreans aged 75 and older. In order to improve the diet quality of the elderly (aged 75 and older), it is necessary to develop dietary improvement guidelines.

Development of a food-based index of dietary inflammatory potential for Koreans and its relationship with metabolic syndrome

BACKGROUND/OBJECTIVES: Inflammation is known to be a risk factor for metabolic diseases. This study aimed to develop a Food-based Index of Dietary Inflammatory Potential (FBDI) and examine its association with metabolic biomarkers. SUBJECTS/METHODS: This study analyzed the raw data from the 2012-2014 Korean Genome and Epidemiology Study data of 17,771 people. To analyze the relationship between foods consumed by Koreans and inflammation, we conducted a correlation analysis between 51 food groups and hs-CRP levels. The FBDI was developed from 17 food groups selected by multiple regression method. We examined whether FBDI was associated with metabolic markers (waist circumference, blood pressure, fasting glucose, triglyceride, and HDL-cholesterol) in the 6th Korea National Health and Nutrition Examination Survey (KNHANES). We used binary logistic regression analysis to examine the association. RESULTS: The FBDI model included seven of the anti-inflammatory food groups and three of the pro-inflammatory food groups. The FBDI formula was calculated by multiplying the intake of food group by β-coefficients derived from the multiple regression model based on the correlation analysis. The FBDI was significantly associated with waist circumference (P < 0.001), blood pressure (P < 0.001), triglyceride level (P < 0.001), and HDL-cholesterol (P < 0.001) level among adults aged 20–64 years in the KNHANES. The prevalence of metabolic syndrome was 2.618 times higher in the group with the highest FBDI than in the group with the lowest one (95% confidence interval: 1.778–3.856, P for trend < 0.001). CONCLUSIONS: This study established an FBDI reflecting food intake patterns of Koreans, which showed a significant relationship with the prevalence of metabolic syndrome.

A Relationship between Dietary Patterns and Dyslipidemia in Urban-dwelling Middle-Aged Korean Men: Using Korean Genome and Epidemiology Study (KoGES)

An increase in the prevalence of dyslipidemia has been strongly associated with the mortality rate of cardiovascular disease. We conducted a cross-sectional analysis to determine the relationship between dietary patterns and dyslipidemia in adult men aged 40–64 years. A total of 5,643 subjects from the Korean Genome and Epidemiology Study (KoGES) were selected for the final analysis. We analyzed 24-hour dietary recall data. Using principal component analysis, 3 dietary patterns were identified: rice based Korean food pattern, flour based western dietary pattern, and convenience food dietary pattern. The flour based western dietary pattern was significantly and positively associated with total cholesterol, and low density lipoprotein (LDL) cholesterol (p for trend < 0.05). With regard to the rice based Korean food pattern, the group with the highest factor score had a significantly lower risk of hyper LDL cholesterolemia (odds ratio [OR], 0.802; 95% confidence interval [CI], 0.698–0.922) and high total cholesterol levels (OR, 0.868; 95% CI, 0.761–0.990) than the group with the lowest factor score. For the flour based western dietary pattern the group with the highest factor score showed a significantly high risk of hyper LDL cholesterolemia (OR, 1.189; 95% CI, 1.033–1.367; p for trend < 0.05) than the group with the lowest factor score. Our results showed that the rice based Korean food pattern protected against dyslipidemia. In contrast, the western staple pattern, which is rich in flour and processed foods, was independently associated with dyslipidemia in urban male residents of Korea.

Sarcopenia and Sarcopenic Obesity and Their Association with Cardiovascular Disease Risk in Postmenopausal Women: Results for the 2008-2011 Korea National Health and Nutrition Examination Survey / 대한지역사회영양학회지

OBJECTIVES: This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women. METHODS: We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass. RESULTS: The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher (3.82 ± 0.22%) than the normal group (2.73 ± 0.09%) and sarcopenia group (3.17 ± 0.22%) (p < 0.000). The odd ratios (ORs) for the ≥7.5% 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy). CONCLUSIONS: Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

Development of dietary pattern evaluation tool for adults and correlation with Dietary Quality Index

BACKGROUND/OBJECTIVES: As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index. SUBJECTS/METHODS: A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire comprised 61 questions for assessing dietary habits. A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area. Principal component analysis with varimax rotation was performed to identify dietary behavior patterns. Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality. The correlation between dietary pattern scores and DQI-I scores was also analyzed. RESULTS: The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions). The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01). CONCLUSIONS: The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.

Development of dietary pattern evaluation tool for adults and correlation with Dietary Quality Index

BACKGROUND/OBJECTIVES: As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased. This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index. SUBJECTS/METHODS: A draft dietary pattern evaluation tool was generated by analyzing previous studies. The draft questionnaire comprised 61 questions for assessing dietary habits. A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area. Principal component analysis with varimax rotation was performed to identify dietary behavior patterns. Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality. The correlation between dietary pattern scores and DQI-I scores was also analyzed. RESULTS: The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions). The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01). CONCLUSIONS: The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.

Validity and Reliability of a Self-administered Food Frequency Questionnaire to Assess Vitamin K Intake in Korean Adults

This study was conducted to validate a food frequency questionnaire (FFQ) to assess vitamin K intake in clinical and research settings based on data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). We collected a subset of data on informative food items using the 24-hour recall method from adults aged 19 to 64 years from KNHANES V. The cumulative percent contribution and cumulative multiple regression coefficients for vitamin K intake from each food were computed. Twenty-five foods items were selected for the FFQ to assess vitamin K intake. The FFQ was validated against intakes derived from a 5-day food record (5DR) (n = 48). To assess the reliability of the FFQ, participants completed the self-administered FFQ (FFQ1) and a second FFQ (FFQ2) after a 6-month period (n = 54). Data were analyzed using Pearson's correlation coefficients, the cross-classification method, and Bland-Altman plots. Mean intakes were similar for vitamin K between the FFQ and dietary records, with significant correlations observed (r = 0.652), and cross-classification analyses demonstrated no major misclassification of participants into intake quartiles. Bland-Altman plots showed no serious systematic bias between the administrations of the two dietary assessment methods over the range of mean intakes. FFQ reliability was high, with a Pearson's correlation coefficient of 0.560. This pilot study shows promising validation and reliability evidence for the use of this FFQ, which is focused on vitamin K intake in adults, as an efficient screening tool in clinical and research settings.

Relationship between Bone Mineral Density and Bone Metabolic Biochemical Markers and Diet Quality Index-International(DQI-I) in Postmenopausal Obese Women / 대한지역사회영양학회지

OBJECTIVES: This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density. METHODS: The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than 25 kg/m2 and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed. RESULTS: Normal weight women were 56.03 ± 3.76 years old and obese women were 58.09 ± 5.13 years old and there was no significant difference in age between the two groups. The T-score of bone mineral density was 0.03 ± 1.06 in normal weight women and -0.60 ± 1.47 in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women (6.09 ± 3.37 ng/mL) compared to obese women in (9.01 ± 4.99 ng/mL) (p<0.05). The total score of diet quality index-international was 70.41±9.34 in normal weight women and 64.93 ± 7.82 in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (β=-0.048, p<0.05), triglyceride (β=-0.005, p<0.05) and HDL-cholesterol (β=0.034, p<0.01), moderation of DQI-I (β=-0.231, p<0.05) affected T-score significantly. CONCLUSIONS: The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.

Development of Job Standards of Clinical Dietitian for the Clinical Nutrition Therapy to Cancer Patients in Hospitals

The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring.evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.

Development of Job Standards for Clinical Dietitians Administering Clinical Nutrition Therapy to Diabetic Patients in Hospitals

This study was conducted to develop job standards for clinical dietitian administering clinical nutrition therapy to diabetic patients in hospitals. Based on DACUM (Developing A Curriculum) analysis of 17 members including clinical dietitians, professors majoring in clinical nutrition and researchers, information on duties, tasks and task elements of clinical dietitians for diabetes care were derived and applied to diabetes mellitus-specific clinical nutrition care in hospitals for evaluation. The final developed job standards for clinical dietitians for diabetes care included four duties, 19 tasks and 56 task elements. The duties consisted of nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring . evaluation. For application of diabetes mellitus-specific job standards in clinical nutrition care, 108 work activities were developed and classified into 90 basic and 18 recommended types. Performance rates of standardized jobs were 80.2% at nutrition assessment, 99.6% at nutrition diagnosis, 78.5% at nutrition intervention, and 32.9% at nutrition monitoring . evaluation. These results can be applied as guidelines to implement jobs for diabetes mellitus-specific clinical nutrition services in clinical settings. In addition, they would be useful for education standards in educational institutions for education and training of clinical dietitian.

Association of Dietary Quality Indices with Glycemic Status in Korean Patients with Type 2 Diabetes

The present study was performed to evaluate the relationship between dietary quality indices including the Diet Quality Index-International (DQI-I), Alternate Healthy Eating Index (AHEI), and Healthy Diet Indicator (HDI) and glycemic status in Korean patients with type 2 diabetes. A total of 110 consecutive outpatients with type 2 diabetes who visited 2 university hospitals in Seoul and Seongnam from April 2004 to November 2006 were enrolled as subjects. At the time of enrollment, anthropometric parameters, dietary habits, experience of exercise, and metabolic parameters were obtained. Experienced registered dietitians collected one-day dietary intake using the 24-hour recall method. The mean scores for DQI-I, AHEI, and HDI were 68.9 +/- 8.2, 39.4 +/- 8.9, and 5.0 +/- 1.3, respectively. After adjustment for age, body mass index, and energy intake, DQI-I and HDI were found to have a significant correlation with hemoglobin A1c (HbA1c) (r = -0.21, p < 0.05; r = -0.28, p < 0.05), fasting plasma glucose (r = -0.21, p < 0.05; r = -0.23, p < 0.05), and postprandial 2-h glucose (r = -0.30, p < 0.05; r = -0.26, p < 0.05, respectively). However, AHEI did not have a significant correlation with HbA1c. In conclusion, the DQI-I and HDI may be useful tools in assessing diet quality and adherence to dietary recommendations in Korean patients with type 2 diabetes. Future research is required to determine whether the dietary quality indices have predictive validity for dietary and glycemic changes following diet education in a clinical setting.

Effect of the Telephone-Delivered Nutrition Education on Dietary Intake and Biochemical Parameters in Subjects with Metabolic Syndrome

As prevalence of metabolic syndrome has rapidly increased over the past decade, lifestyle changes including dietary habits are considered as a therapeutic cornerstone for metabolic syndrome, cardiovascular complications and type 2 diabetes. We evaluated the effectiveness of a telephone-delivered nutrition education to improve metabolic parameters compared with a single-visit with a dietitian in subjects with metabolic syndrome. A total of seventy-one adults who met diagnostic criteria for the metabolic syndrome were randomly assigned to either the single-visit group or the in-depth nutrition education group during a 3-month intervention study period. The in-depth telephone-delivered nutrition education group had an initial visit with a dietitian and additional two telephone counseling during the first 4 weeks of the study periods. Sixty-six subjects completed a 3-month intervention study. The trial examined participant's anthropometric changes and dietary intakes as well as changes in the metabolic syndrome factors. At the end of the trial, the in-depth nutrition education group showed significantly higher reduction in weight, body fat and abdominal circumference compared with the other group (p < 0.05). In the in-depth nutrition groups, the prevalence of metabolic syndrome was decreased to 45.5%, while 69.7% of the subjects were metabolic syndrome patients in the single-visit group (p < 0.05). These results demonstrate that the telephone-intervention counseling is a feasible mean to deliver dietary intervention in patients with metabolic syndrome.