An association between diet quality index for Koreans (DQI-K) and total mortality in Health Examinees Gem (HEXA-G) study

BACKGROUND/OBJECTIVES: Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants. SUBJECTS/METHODS: The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake. RESULTS: The total DQI-K score was calculated by summing the scores of the eight components (range 0–9). In the multivariable adjusted models, with good diet quality (score 0–4) as a reference, poor diet quality (score 5–9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06–1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk. CONCLUSIONS: A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.

Epidemiology and screening of gastric cancer in Korea

The age-standardized incidence and mortality rates of gastric cancer have been decreasing worldwide. However, due to the rapid increase in the aging population, the absolute number of cases is actually increasing, and some countries, including Korea, show a divergent trend in the incidence of gastric cancer in younger generations. Gastric cancer is the second most common cancer in Korea. In the present review, several epidemiologic factors associated with the risk of gastric cancer are evaluated, including family history of gastric cancer, Helicobacter pylori infection, cigarette smoking, and adverse dietary factors. The practice of and participation in gastric cancer screening are reviewed. Prevention strategies based on evidence from Korean epidemiologic studies and early detection by regular screening are important for the reduction of the burden from gastric cancer.

Epidemiology and screening of gastric cancer in Korea

The age-standardized incidence and mortality rates of gastric cancer have been decreasing worldwide. However, due to the rapid increase in the aging population, the absolute number of cases is actually increasing, and some countries, including Korea, show a divergent trend in the incidence of gastric cancer in younger generations. Gastric cancer is the second most common cancer in Korea. In the present review, several epidemiologic factors associated with the risk of gastric cancer are evaluated, including family history of gastric cancer, Helicobacter pylori infection, cigarette smoking, and adverse dietary factors. The practice of and participation in gastric cancer screening are reviewed. Prevention strategies based on evidence from Korean epidemiologic studies and early detection by regular screening are important for the reduction of the burden from gastric cancer.

Determinants of Poor Self-rated Health in Korean Adults With Diabetes / 예방의학회지

OBJECTIVES: Self-rated health is a measure of perceived health widely used in epidemiological studies. Our study investigated the determinants of poor self-rated health in middle-aged Korean adults with diabetes. METHODS: A cross-sectional study was conducted based on the Health Examinees Study. A total of 9759 adults aged 40 to 69 years who reported having physician-diagnosed diabetes were analyzed with regard to a range of health determinants, including sociodemographic, lifestyle, psychosocial, and physical variables, in association with self-rated health status using multivariate logistic regression models. A p-value <0.05 was considered to indicate statistical significance. RESULTS: We found that negative psychosocial conditions, including frequent stress events and severe distress according to the psychosocial well-being index, were most strongly associated with poor self-rated health (odds ratio [OR](Frequent stress events), 5.40; 95% confidence interval [CI], 4.63 to 6.29; OR(Severe distress), 11.08; 95% CI, 8.77 to 14.00). Moreover, younger age and being underweight or obese were shown to be associated with poor self-rated health. Physical factors relating to participants' medical history of diabetes, such as a younger age at diagnosis, a longer duration of diabetes, insulin therapy, hemoglobin A(1c) levels of 6.5% or more, and comorbidities, were other correlates of poor reported health. CONCLUSIONS: Our findings suggest that, in addition to medical variables, unfavorable socioeconomic factors, and adverse lifestyle behaviors, younger age, being underweight or obese, and psychosocial stress could be distinc factors in predicting negative perceived health status in Korean adults with diabetes.