Association between seafood intake and frailty according to gender in Korean elderly: data procured from the Seventh (2016–2018) Korea National Health and Nutrition Examination Survey / 한국영양학회지

Purpose@#This study investigates the association between seafood consumption and frailty according to gender in the Korean elderly. @*Methods@#Cross-sectional data from the Seventh (2016–2018) Korea National Health and Nutrition Examination Survey was procured for this study. Data from 3,675 subjects (1,643 men and 2,032 women) aged ≥ 65 years were analyzed. Levels of seafood intake were assessed by a one-day 24-hour dietary recall, and subjects were classified into three tertiles by gender according to frailty phenotype: robust, pre-frail, and frail. Multinomial logistic regression analysis was performed to clarify the association between seafood consumption and frailty for each gender. @*Results@#The prevalence of frailty was determined as 13.4% for men and 29.7% for women. Participants with a higher seafood intake had higher intakes of grains, fruits, and vegetables, while the intake of meat was significantly lower. In both men and women, the group with higher seafood intake showed higher energy and micronutrient intakes. The frail prevalence and frailty score were significantly low in the highest tertiles of seafood consumption compared to the lowest tertile in men and women (p < 0.001). After adjusting for confounder, the highest tertile of seafood consumption showed a decreased risk of frailty compared to the lowest tertile only in women (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.32–0.78; p-trend = 0.008 vs. HR, 0.52; 95% CI, 0.32–0.83; p-trend = 0.008;respectively). @*Conclusion@#Results of this study suggest that seafood consumption potentially decreases the risk of frailty in the elderly.

Effects of quercetin on the improvement of lipid metabolism through regulating hepatic AMPK and microRNA-21 in high cholesterol diet-fed mice / 한국영양학회지

Purpose@#Quercetin is a polyphenolic flavonoid abundant in many fruits and vegetables. It has potential health-beneficial properties, such as antioxidant, anti-obesity, anti-cancer, anti-diabetic and anti-inflammatory effects. The purpose of this study was to investigate whether the lipid metabolism improvement effect of quercetin affected the regulation of AMP-activated protein kinase (AMPK) activity and microRNA (miR)-21 expression in the liver of mice fed a high-cholesterol diet. @*Methods@#Male C57BL/6J mice were fed with normal diet, quercetin-free diet and diets containing 0.05% or 0.1% quercetin for six weeks. Hypercholesterolemia was induced by adding 1% cholesterol and 0.5% cholic acid to all diets. Serum and liver triglyceride (TG), and total cholesterol (TC) concentrations were analyzed using a commercial enzymatic colorimetric kit.AMPK activity was quantified using an AMPK kinase assay kit. The levels of miR-21 and genes involved in lipid metabolism were measured by real-time quantitative polymerase chain reaction. @*Results@#Supplementation of quercetin reduced serum and hepatic TG and TC levels without changing body weight and food intake. Dietary quercetin significantly inhibited the mRNA levels of hepatic sterol-regulatory element binding protein-1c, acetyl-CoA carboxylase 1 and fatty acid synthesis, which are involved in hepatic lipogenesis. Dietary quercetin enhanced AMPK activity and suppressed miR-21 expression, promoting hepatic lipid accumulation. @*Conclusion@#These results suggest that the lipid-lowering effect of quercetin on the serum and liver of mice may be partially mediated by the regulation of lipogenic gene expression, AMPK activity and miR-21 expression in the liver of mice fed a high-cholesterol diet.

Precision nutrition: approach for understanding intra-individual biological variation / 한국영양학회지

In the past few decades, great progress has been made on understanding the interaction between nutrition and health status. But despite this wealth of knowledge, health problems related to nutrition continue to increase. This leads us to postulate that the continuing trend may result from a lack of consideration for intra-individual biological variation on dietary responses. Precision nutrition utilizes personal information such as age, gender, lifestyle, diet intake, environmental exposure, genetic variants, microbiome, and epigenetics to provide better dietary advices and interventions. Recent technological advances in the artificial intelligence, big data analytics, cloud computing, and machine learning, have made it possible to process data on a scale and in ways that were previously impossible. A big data platform is built by collecting numerous parameters such as meal features, medical metadata, lifestyle variation, genome diversity and microbiome composition. Sophisticated techniques based on machine learning algorithm can be used to integrate and interpret multiple factors and provide dietary guidance at a personalized or stratified level. The development of a suitable machine learning algorithm would make it possible to suggest a personalized diet or functional food based on analysis of intra-individual metabolic variation.This novel precision nutrition might become one of the most exciting and promising approaches of improving health conditions, especially in the context of non-communicable disease prevention.

The development of resources for the application of 2020 Dietary Reference Intakes for Koreans / 한국영양학회지

The recommended meal composition allows the general people to organize meals using the number of intakes of foods from each of six food groups (grains, meat·fish·eggs·beans, vegetables, fruits, milk·dairy products and oils·sugars) to meet Dietary Reference Intakes for Koreans (KDRIs) without calculating complex nutritional values. Through an integrated analysis of data from the 6th to 7th Korean National Health and Nutrition Examination Surveys (2013–2018), representative foods for each food group were selected, and the amounts of representative foods per person were derived based on energy. Based on the EER by age and gender from the KDRIs, a total of 12 kinds of diets were suggested by differentiating meal compositions by age (aged 1–2, 3–5, 6–11, 12–18, 19–64, 65–74 and ≥ 75 years) and gender.The 2020 Food Balance Wheel included the 6th food group of oils and sugars to raise public awareness and avoid confusion in the practical utilization of the model by industries or individuals in reducing the consistent increasing intakes of oils and sugars. To promote the everyday use of the Food Balance Wheel and recommended meal compositions among the general public, the poster of the Food Balance Wheel was created in five languages (Korean, English, Japanese, Vietnamese and Chinese) along with card news. A survey was conducted to provide a basis for categorizing nutritional problems by life cycles and developing customized web-based messages to the public. Based on survey results two types of card news were produced for the general public and youth. Additionally, the educational program was developed through a series of processes, such as prioritization of educational topics, setting educational goals for each stage, creation of a detailed educational system chart and teachinglearning plans for the development of educational materials and media.

Inhibitory effect of water-soluble mulberry leaf extract on hepatic lipid accumulation in high-fat diet-fed rats via modulation of hepatic microRNA-221/222 expression and inflammation / 한국영양학회지

Purpose@#This study investigated the effects of water-soluble mulberry leaf extract (ME) on hepatic lipid accumulation in high-fat diet-fed rats via the regulation of hepatic microRNA (miR)-221/222 and inflammation. @*Methods@#Male Sprague-Dawley rats (4 weeks old) were randomly divided into 3 groups (n = 7 each) and fed with 10 kcal% low-fat diet (LF), 45 kcal% high-fat diet (HF), or HF + 0.8% ME for 14 weeks. Lipid profiles and cytokine levels of the liver and serum were measured using commercial enzymatic colorimetric and enzyme-linked immunosorbent assay, respectively.The messenger RNA (mRNA) and miR levels in liver tissue were assayed by real-time quantitative reverse-transcription polymerase chain reaction. @*Results@#Supplementation of ME reduces body weight and improves the liver and serum lipid profiles as compared to the HF group. The mRNA levels of hepatic peroxisome proliferatoractivated receptor-gamma, sterol regulatory element binding protein-1c, fatty acid synthase, and fatty acid translocase, which are genes involved in lipid metabolism, were significantly downregulated in the ME group compared to the HF group. In contrast, the mRNA level of hepatic carnitine palmitoyl transferase-1 (involved in fatty acid oxidation) was upregulated by ME supplementation. Furthermore, administration of ME significantly downregulated the mRNA levels of inflammatory mediators such as hepatic tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), monocyte chemoattractant protein-1, and inducible nitric oxide synthase. The serum levels of TNF-α, IL-6, and nitric oxide were also significantly reduced in ME group compared to the HF group. Expression of hepatic miR-221 and miR-222, which increase in the inflammatory state of the liver, were also significantly inhibited in the ME group compared to the HF group. @*Conclusion@#These results indicate that ME has the potential to improve hepatic lipid accumulation in high-fat diet-fed rats via modulation of inflammatory mediators and hepatic miR-221/222 expressions.

Effects of mulberry fruit juice powder on inflammation and microRNA-132/143regulation in 3T3-L1 adipocytes / 한국영양학회지

Purpose@#Mulberry (Morus alba L.) fruit is widely grown in Asia and consumed as fresh fruit, jam, and juices. The fruit has beneficial health effects, including anti-diabetic, anti-tumor, and anti-obesity properties. However, the mechanisms by which mulberry fruit juice powder (MJ) regulates inflammatory microRNAs (miRs) are not yet known. This study investigated the effect of mulberry fruit juice powder on the regulation of inflammation and miR-132/143 during 3T3-L1 adipocyte differentiation. @*Methods@#The 3T3-L1 cells were induced to differentiate for 2 days and then treated with various concentrations of MJ for 7 days. Cytotoxicity was determined by evaluating cell viability using a water-soluble tetrazolium salt-8 assay kit. Intracellular lipid accumulation was evaluated by oil-red O staining. The levels of the expression of genes involved in adipogenesis and inflammation, and miR-132/143 were measured by quantitative real-time polymerase chain reactions. @*Results@#MJ showed no cytotoxic effect on 3T3-L1 adipocytes at concentrations below 100 ng/ mL. Intracellular lipid accumulation was reduced by MJ treatment at concentrations of 100 ng/mL. The messenger RNA (mRNA) levels of proliferator-activated receptor-γ, cytosinecytosine-adenosine-adenosine-thymidine/enhancer-binding protein-α, and adipocyte protein 2, which are involved in adipogenesis, were suppressed by MJ. A reduction was also seen in mRNA levels of genes related to the inflammatory response, such as tumor necrosis factor-α, interleukin-6, monocyte chemoattractant protein-1, and inducible nitric oxide synthase. The expression of the inflammatory miR-132 and miR-143 was also decreased by MJ. @*Conclusion@#These results suggest that MJ may suppress adipogenesis and inflammation through the regulation of miR-132/143 expression in 3T3-L1 adipocytes. Thus, MJ may be useful as a food agent that prevents obesity-associated inflammation.

Association between frailty and dietary intake amongst the Korean elderly: based on the 2018 Korean National Health and Nutrition Examination Survey / 한국영양학회지

Purpose@#Frailty is a clinical syndrome in older adults, and adequate nutrition is a modifiable factor in preventing the condition. The current study aims to investigate the association between frailty and dietary intake in the Korean elderly. @*Methods@#This cross-sectional study included data from the 2018 Korean National Health and Nutrition Examination Survey of 1,268 subjects (535 men and 733 women) aged 65 years or older. Frailty was defined as having more than three of the following 5 modified Fried frailty phenotype criteria: unintentional weight loss, exhaustion, walking difficulties, weakness, and low physical activity. Dietary intake was assessed by applying the one-day 24-hour dietary recall. The association between frailty and dietary intakes were analyzed by multiple logistic regression. @*Results@#Totally, 9.7% men and 21.9% women were classified as the frail group. Increasing levels of frailty were proportional to a decreased mean nutrient adequacy ratio in both genders. Moreover, the total food intake was significantly low in the frail elderly. In male subjects, multiple logistic regression analyses after adjusting covariates showed that the odds ratio (OR) of frailty in the highest tertile of the consumption of fruits (OR [95% confidence interval, CI] = 0.34 [0.13–0.93], p-trend = 0.021) were significantly lower than values obtained in the lowest tertile. In females, the highest tertile of fish and shellfish intake showed a significantly lower OR for frailty (OR [95% CI] = 0.55 [0.30–0.99], p-trend = 0.045), as compared with the lowest tertile. @*Conclusion@#The present study indicates that high intake of fruits for men, and fish and shellfish for women, are probably linked with lowering the risk of frailty in the elderly.

Western dietary pattern is associated with higher risk of lower lean muscle mass in Korean postmenopausal women: data from the Korea National Health and Nutrition Examination Survey 2008–2011

BACKGROUND/OBJECTIVES@#In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. @*SUBJECTS/METHODS@#The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. @*RESULTS@#The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. @*CONCLUSIONS@#The study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

Effects of isorhamnetin on the regulation of mitochondrial function in C2C12 muscle cells / 한국영양학회지

Purpose@#Muscle mitochondria play a key role in regulating fatty acid and glucose metabolism. Dysfunction of muscle mitochondria is associated with metabolic diseases such as obesity and type 2 diabetes. Isorhamnetin (ISOR), also known as 3-O-methylquercetin, a quercetin metabolite, is a naturally occurring flavonoid in many plants. This study evaluated the effects of ISOR on the regulation of the mitochondrial function of C2C12 muscle cells. @*Methods@#C2C12 muscle cells were differentiated for 5 days, and then treated in various concentrations of ISOR. Cytotoxicity was determined by assessing cell viability using the water-soluble tetrazolium salt-8 assay principle at different concentrations of ISOR and time points. Levels of the mitochondrial DNA (mtDNA) content and gene expression were measured by quantitative real-time polymerase chain reaction. The citrate synthase (CS) activity was quantified by the enzymatic method. @*Results@#ISOR at a concentration of 10 μM did not show any cytotoxic effects. ISOR increased the mtDNA copy number in a time- or dose-dependent manner. The messenger RNA levels of genes involved in mitochondrial function, such as peroxisome proliferator-activated receptor-γ coactivator-1α, and uncoupling protein 3 were significantly stimulated by the ISOR treatment.The CS activity was also significantly increased in a time- or dose-dependent manner. @*Conclusion@#These results suggest that ISOR enhances the regulation of mitochondrial function, which was at least partially mediated via the stimulation of the mtDNA replication, mitochondrial gene expression, and CS activity in C2C12 muscle cells. Therefore, ISOR may be useful as a potential food ingredient to prevent metabolic diseases-associated muscle mitochondrial dysfunction.

Trends in food and nutrient intake over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES@#We aimed to examine the current status and trends of food and nutrient intake in the Korean population over the past 20 years using the data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#We conducted a survey of 116,284 subjects over the age of one year in Korea, who participated in the KNHANES between 1998 and 2018. We collected data on the subjects’ intake for the day before using the 24-hour recall method. The annual percent change (APC) in the food groups and nutrient intake were calculated using SAS and Joinpoint software. @*RESULTS@#The intake of grains (APC=-0.4, p<0.05) and vegetables (APC=-0.8, p<0.05) was observed to decrease. In contrast, the intake of beverages, meat, dairy, and eggs increased. In particular, beverage intake increased by more than four times (APC=9.2, p<0.05). There was no significant change in energy intake. However, the proportion of energy intake from carbohydrates decreased by approximately 5%p (APC=-0.3, p<0.05), whereas that from fat increased by approximately 5%p (APC= 1.1, p<0.05). Additionally, there were decreases in the proportion of energy intake from breakfast and homemade meals and increases in the energy intake from snacks, dining out, and convenience food. The intake of vitamin C (APC=-3.2, p<0.05) and sodium (APC=-2.3, p<0.05) significantly decreased. @*CONCLUSIONS@#Over the past 20 years, there has been decreases in the intake of grains, vegetables, carbohydrates, sodium, and vitamin C and increases in the intake of beverages, dairy, meat, eggs, and fat. Since nutritional status is an important factor in the prevention and management of chronic diseases, it should be continuously monitored.

Effects of isorhamnetin on the regulation of mitochondrial function in C2C12 muscle cells / 한국영양학회지

Purpose@#Muscle mitochondria play a key role in regulating fatty acid and glucose metabolism. Dysfunction of muscle mitochondria is associated with metabolic diseases such as obesity and type 2 diabetes. Isorhamnetin (ISOR), also known as 3-O-methylquercetin, a quercetin metabolite, is a naturally occurring flavonoid in many plants. This study evaluated the effects of ISOR on the regulation of the mitochondrial function of C2C12 muscle cells. @*Methods@#C2C12 muscle cells were differentiated for 5 days, and then treated in various concentrations of ISOR. Cytotoxicity was determined by assessing cell viability using the water-soluble tetrazolium salt-8 assay principle at different concentrations of ISOR and time points. Levels of the mitochondrial DNA (mtDNA) content and gene expression were measured by quantitative real-time polymerase chain reaction. The citrate synthase (CS) activity was quantified by the enzymatic method. @*Results@#ISOR at a concentration of 10 μM did not show any cytotoxic effects. ISOR increased the mtDNA copy number in a time- or dose-dependent manner. The messenger RNA levels of genes involved in mitochondrial function, such as peroxisome proliferator-activated receptor-γ coactivator-1α, and uncoupling protein 3 were significantly stimulated by the ISOR treatment.The CS activity was also significantly increased in a time- or dose-dependent manner. @*Conclusion@#These results suggest that ISOR enhances the regulation of mitochondrial function, which was at least partially mediated via the stimulation of the mtDNA replication, mitochondrial gene expression, and CS activity in C2C12 muscle cells. Therefore, ISOR may be useful as a potential food ingredient to prevent metabolic diseases-associated muscle mitochondrial dysfunction.

Trends in food and nutrient intake over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey / 한국역학회지

OBJECTIVES@#We aimed to examine the current status and trends of food and nutrient intake in the Korean population over the past 20 years using the data from the Korea National Health and Nutrition Examination Survey (KNHANES). @*METHODS@#We conducted a survey of 116,284 subjects over the age of one year in Korea, who participated in the KNHANES between 1998 and 2018. We collected data on the subjects’ intake for the day before using the 24-hour recall method. The annual percent change (APC) in the food groups and nutrient intake were calculated using SAS and Joinpoint software. @*RESULTS@#The intake of grains (APC=-0.4, p<0.05) and vegetables (APC=-0.8, p<0.05) was observed to decrease. In contrast, the intake of beverages, meat, dairy, and eggs increased. In particular, beverage intake increased by more than four times (APC=9.2, p<0.05). There was no significant change in energy intake. However, the proportion of energy intake from carbohydrates decreased by approximately 5%p (APC=-0.3, p<0.05), whereas that from fat increased by approximately 5%p (APC= 1.1, p<0.05). Additionally, there were decreases in the proportion of energy intake from breakfast and homemade meals and increases in the energy intake from snacks, dining out, and convenience food. The intake of vitamin C (APC=-3.2, p<0.05) and sodium (APC=-2.3, p<0.05) significantly decreased. @*CONCLUSIONS@#Over the past 20 years, there has been decreases in the intake of grains, vegetables, carbohydrates, sodium, and vitamin C and increases in the intake of beverages, dairy, meat, eggs, and fat. Since nutritional status is an important factor in the prevention and management of chronic diseases, it should be continuously monitored.

Western dietary pattern is associated with higher risk of lower lean muscle mass in Korean postmenopausal women: data from the Korea National Health and Nutrition Examination Survey 2008–2011

BACKGROUND/OBJECTIVES@#In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1–2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. @*SUBJECTS/METHODS@#The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008–2009) and V (2010–2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45–86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. @*RESULTS@#The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; ‘Diverse’, ‘Western’, ‘Traditional’, and ‘Snacks and beverages’. The ‘Western’ pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07–2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. @*CONCLUSIONS@#The study findings suggest that the ‘Western’ dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.

Association between Metabotropic Glutamate Receptor 1 Polymorphism and Cardiovascular Disease in Korean Adults

OBJECTIVE: The mGluR1 (metabotropic glutamate receptor 1) gene, a G protein–coupled receptor, is known to mediate perceptions of umami tastes. Genetic variation in taste receptors may influence dietary intake, and in turn have an impact on nutritional status and risk of chronic disease. We investigated the association of mGluR1 rs2814863 polymorphism with lipid profiles and cardiovascular disease (CVD) risk, together with their modulation by macronutrient intake in Korean adults. METHODS: The subjects consisted of 8,380 Koreans aged 40-69 years participating in the Anseong and Ansan Cohort Study, which was a part of the Korean Genome Epidemiology Study (KoGES). Data was collected using self-administered questionnaires, anthropometric measurements, and blood chemical analysis. RESULTS: Carriers of C allele at mGluR1 rs2814863 was associated with decreased high density lipoprotein cholesterol (HDL-C) and increased triglyceride as compared to carriers of TT. Also, carriers of the C allele showed higher fat intake and lower carbohydrate intake than those with carriers of TT. After adjustment for multiple testing using false-discovery rate method, the significant difference of HDL-C, triglyceride, dietary fat, and carbohydrate across genotypes disappeared. Gene-diet interaction effects between rs2814863 and macronutrients intake were not significantly associated with HDL-C and triglyceride levels. However, carriers of C allele demonstrated significantly higher odds of CVD {odds ratio=1.13, 95% CI=1.02-1.25} compared with carriers of TT. CONCLUSIONS: Our findings support significant associations between the mGluR1 rs2814863 genotype and CVD-related variables in Korean adults. However, these associations are not modified by macronutrient intake.

Enteral Nutrition Support in Coronary Care Unit Patients Receiving Extraocorporeal Membrane Oxygenation: An Observational Case Study

PURPOSE: Enteral feeding remains controversial in patients receiving extracorporeal membrane oxygenation (ECMO), particularly in those treated with a high-dose vasopressor. This study examined the safety and feasibility of enteral nutritional support for patients undergoing ECMO in a cardiac care unit (CCU). METHODS: Adult patients admitted to the CCU undergoing ECMO from January 2014 to May 2015 were included. Patients with <48 hours of support, undergoing ECMO at another hospital, and inaccurate medical records were excluded. RESULTS: Among the 14 patients undergoing ECMO in the CCU, 2 patients were diagnosed with malnutrition and the others were in the normal state in the initial assessment. On the other hand, they had the malnutrition risk factors (anorexia, weight loss, fluid retention, and hypermetabolic state). Thirteen patients received enteral nutrition and 1 patient had possible oral intake. The average initiation day of enteral nutrition was 2.0±1.6 days on ECMO. The mean duration of enteral nutrition was 5.2±4.9 days and the target goal was achieved within 3 days. There were no serious adverse effects for enteral nutrition but 3 patients had gastrointestinal problems (diarrhea and anorexia), and gastrointestinal bleeding occurred in 1 patient. In 1 case, enteral nutrition had to be stopped due to the prone position. Overall, 5 patients were cured, 3 patients recovered through heart transplantation, and 6 patients died. CONCLUSION: Most CCU patients receiving ECMO were well nourished but had the malnutrition risk factors in progress. These results suggest that enteral feeding might be safe and feasible in patients treated with ECMO but there were minor side effects.

Diet management for dyslipidemia

Controlling dyslipidemia is important for the prevention and treatment of cardiovascular diseases. This review introduces dietary management recommendations from the 2015 Korean Guidelines for the Management of Dyslipidemia, which were established by the Korean Society of Lipidology and Atherosclerosis. To prevent dyslipidemia, controlling dietary energy consumption to maintain a healthy body weight is important, due to the positive relationship among overweight, obesity, and dyslipidemia. It is recommended that less than 30% of total daily calories come from dietary fat. Rather than simply decreasing the consumption of total fat, it is suggested that the consumption of saturated and trans fatty acid is less than 7% and 1%, respectively, of total daily calories. To reduce serum total triglycerides, the consumption of dietary carbohydrates is advised not to take excessive, and in particular a reduction in the consumption of simple sugars. The consumption of dietary fiber, which is rich in foods such as whole grains and vegetables, is recommended at 25 grams per day. Also, based on studies on the relationship between disease and dietary patterns, it is advised to maintain a diverse and balanced diet that includes vegetables, fruits, dairy products and whole grains, rather than a diet consisting of meat, noodles, and alcohol. Focusing on lifestyle behavioral strategies that target diet management to improve dyslipidemia could be highly effective in facilitating the risk reduction of cardiovascular disease and enhancing pharmacotherapeutic interventions.

Association Between Subjective Stress and Cardiovascular Diseases in Korean Population

OBJECTIVES: The purpose of this study was to investigate the effects of subjective stress levels on various characteristics, dietary intake, and cardiovascular disease (CVD) among Korean people. METHOD: This study conducted analyses on subjective stress levels and demographic-, socioeconomic-, health-related factors, dietary intake and CVD of 15,474 subjects aged over 20 years from the 5th Korean National Health and Nutrition Examination Survey database. In addition, the presence of CVD including angina, myocardial infarction, and stroke was analyzed. RESULTS: The responses of 25.6% of the subjects were that they felt high levels of stress. Significant differences in age, gender, education level, occupation, marital status, smoking and drinking status were observed by subjective stress levels (p<0.001 for all except p=0.035 for drinking status). After adjustment for non-modifiable covariates and modifiable covariates, subjects with high levels of stress showed an increase in the risk of angina, myocardial infarction-angina, and CVD, compared to those with low levels of stress [OR (95% CI) for non-modifiable covariates: 1.41 (1.04-1.90, p<0.05), 1.36 (1.06-174, p<0.05), and 1.30 (1.07-1.58, p<0.001)] and [OR (95% CI) for modifiable covariates: 1.44 (1.05-1.97, p<0.05), 1.41 (1.09-1.83, p<0.001), and 1.37 (1.12-1.68, p<0.001)]. Also, subjects with high levels of stress consumed more dietary fat than those with low levels of stress, but the opposite trend was observed regarding the consumption of carbohydrates (p<0.001 for both). CONCLUSION: Our findings showed that subjective stress levels adjusted for modifiable risk factors induced increased occurrence of CVD than that adjusted for non-modifiable risk factors.

A study on body awareness and dietary life of adults who perform regular exercise / 한국영양학회지

This study was conducted in order to investigate body awareness and dietary life according to gender. Subjects of the study were 120 men and 127 women aged 20 to 30 years, who exercise regularly at a fitness center in Seoul. The subjects were asked to fill out a questionnaire on body awareness, reason for regular exercise, dietary behaviors, and nutrition knowledge. The percentage of overweight and obesity was 69.2% in men, and 25.2% in women. The percentage of subjects who considered themselves as overweight was 38.3% in men and 59.8% in women. Intake of protein in men was higher than the recommended nutrient intake (RNI). Intake of energy in women was lower than the estimated energy requirement (EER). Men who considered themselves as overweight showed lower energy intake than men who considered their body weight as under and normal, whereas no difference in energy intake was observed between women who considered themselves as overweight and women who considered their body weight as under and normal.

Dietary Behaviors Related to Metabolic Syndrome in Korean Adults / 대한지역사회영양학회지

This study was conducted to investigate the cross-sectional associations between dietary factors and the risk of metabolic syndrome (MetS) in 12,755 subjects (males 5,146, females 7,609) aged 19 years or above using data from the 4th (2007-2009) Korea National Health and Nutrition Examination Survey (KNHANES). The prevalence of MetS in Korean adults was 23.6% (males 26.1%, females 20.9%) with the criteria for modified National Cholesterol Education Program Adult Treatment Panel III. While males had a higher prevalence of abdominal obesity, hyperglycemia, hypertriglyceridemia, and high blood pressure than females, the prevalence of low HDL-cholesterol level was higher in females than in males. Among dietary guidelines, the response of 'yes' for asking practice of 'avoiding salty foods', and 'eating moderately and increasing physical activity for healthy weight' were significantly associated with the decreased risk of MetS in both males and in females. Especially, the risk of MetS was significantly lower in the subjects that responded the practice of all items of Korean Dietary Guidelines. Significantly negative associations with MetS were also found in the responding for practice of 'limiting consumption of alcoholic beverages' in males, and taking dietary supplements in females. Skipping breakfast was positively associated with the risk of MetS. In conclusion, dietary behaviors such as having breakfast, practice of dietary guidelines, and food consumption in moderation could modify the prevalence of MetS, and our findings could be useful for establishing guidelines for preventing MetS.

Association between ESR1 rs1884051 polymorphism and dietary total energy and plant protein intake on obesity in Korean men

ESR1 has been listed in the Human Obesity Gene Map as candidate gene associated with obesity. Thus, in this study, we investigated the effect of the ESR1 rs1884051 polymorphism on obesity-related variables, together with their modulations by dietary intake in Korean men. The obesity-related variables and dietary intake of 3,039 Korean men aged 40-59 years from KoGES database were analyzed. Body weight (P = 0.007), BMI (P = 0.003), waist-hip ratio (= 0.011), fat body mass (P = 0.010), and body fat percentage (P = 0.040) were significantly lower in subjects with the minor T allele of ESR1 rs1884051 than in subjects carrying the C allele. Moreover, the rs1884051 T allele was associated with a decreased risk of obesity prevalence (P = 0.040). Among the subjects whose total energy intake was below the median, carrier of the minor T allele of ESR1 rs1884051 had a lower BMI (P = 0.003) when compared with subjects carrying the C allele. In addition, among subjects whose plant protein intake was above the median, carrier of the minor T allele of ESR1 rs1884051 had a lower BMI (P = 0.044) compared with subjects carrying the C allele. Our findings demonstrate that there is a significant association between the ESR1 rs1884051 variant and obesity-related variables and this association can be potentially modified by dietary energy and plant protein intake.