Dietary Patterns Independent of Fast Food Are Associated with Obesity among Korean Adults: Korea National Health and Nutrition Examination Survey 2010-2014.

Few studies have examined the multifaceted aspects of fast food consumption and dietary patterns for their effects on obesity. We examined the independent associations of obesity with fast food consumption and dietary pattern in Korean adults using a nationally representative cross-sectional survey. A total of 19,017 adults aged 19-64 years participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2014. Fast food items were removed from diet and then dietary patterns were generated. Multivariate logistic regression analysis was used to examine the odds of overweight/obesity and central obesity according to fast food consumption and dietary patterns. Fast food consumers were about 10% of Korean adults. Both the "White rice and kimchi" pattern and "Meat and alcohol" pattern were associated with low intakes of fiber, calcium, vitamin C, grains, fruit, and milk (p < 0.05). Fast food consumers had higher "Meat and alcohol" and "Grains, fruit, and milk" patterns, and they had a lower "White rice and kimchi" pattern than non-fast food-consumers. Fast food consumers were not associated with overweight/obesity, whereas participants with the "Meat and alcohol" pattern had 14% higher overweight/obesity (95% CI: 1.01, 1.28) and 16% higher central obesity (95% CI: 1.00, 1.34). Fast food consumption was not directly associated with obesity, whereas the "Meat and alcohol" pattern had independent associations with overweight/obesity and central obesity among Korean adults.

Postthyroidectomy obesity in a Korean population: does the extent of surgery matter?

PURPOSE: The purpose of this study was to investigate the prevalence of postthyroidectomy obesity, and the relationship between the extent of thyroidectomy and obesity. METHODS: A survey conducted at an outpatient clinic from June to October 2014 and retrospective charts for patients undergoing thyroidectomy at Konkuk University Medical Centers from June 2009 to December 2013 were reviewed. We compared clinical characteristics and pre- and postoperative obesity-related factors in 227 patients who underwent total thyroidectomy or lobectomy. RESULTS: Patients included 39 males and 188 females with a mean age of 46.0 ± 11.0 years; the mean follow-up period was 23.9 ± 16.7 months, and 90 of the 227 patients showed postthyroidectomy obesity. In effect of operative extent on postoperative obesity, patients who underwent TT (48.2 years) than those who underwent lobectomy (43.4 years). TT group had longer follow-up and the frequency of menopause was higher than in the lobectomy group. No differences in postthyroidectomy obesity, body weight change, or body mass index (BMI), change among 2 groups. The predictors of postthyroidectomy obesity were older age, female, heavy alcohol consumption (P = 0.029), higher preoperative BMI (P < 0.001), larger postoperative weight gain (P = 0.024), and larger BMI change. However, the extent of thyroidectomy did not affect postthyroidectomy obesity. Preoperative BMI (P < 0.001) and heavy alcohol consumption (P = 0.03) were independent factors of postthyroidectomy obesity. CONCLUSION: The extent of thyroidectomy does not affect postthyroidectomy obesity. Preoperative BMI and heavy alcohol consumption are risk factors for postthyroidectomy obesity. Studies are needed to suggest preoperative life style modification to prevent postthyroidectomy obesity.

Association of High-Risk Drinking with Metabolic Syndrome and Its Components in Elderly Korean Men: The Korean National Health and Nutrition Examination Survey 2010-2012.

BACKGROUND: Previous studies have examined the association between alcohol consumption and metabolic syndrome (MetS) in adults, but studies in the elderly are lacking. We examined the relationship between high-risk alcohol consumption and MetS in elderly Korean men using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire from the 2010-2012 Korean National Health and Nutrition Examination Survey. METHODS: Among 25,534 subjects, 2,807 were men >60 years of age; after exclusions, we included 2,088 men in the final analysis. We categorized the study participants into three groups according to AUDIT score: low risk (0-7), intermediate risk (8-14), and high risk (≥15 points). RESULTS: Among the study population, 17.0% of the men were high-risk drinkers, who had the highest mean waist circumference, systolic and diastolic blood pressure (BP), fasting plasma glucose (FPG), and triglyceride (TG) levels. The overall prevalence of MetS was 41.9% in the elderly men, and it was significantly higher in the group with high (48.3%) versus low (31.9%) AUDIT scores. The prevalence of MetS components (elevated BP, high FPG, high TG, and low high-density lipoprotein cholesterol) was associated with a high AUDIT score. The odds ratios (95% confidence interval) of the high-risk group for MetS, elevated BP, and high TG were 1.40 (1.03-1.89), 1.82 (1.28- 2.60), and 1.77 (1.30-2.41) after adjustment for confounding variables. CONCLUSION: AUDIT score was correlated with most MetS components in elderly Korean men.

Potentially Inappropriate Medications by Beers Criteria in Older Outpatients: Prevalence and Risk Factors.

BACKGROUND: Prescription of inappropriate medicine to elderly patients is a major public health care concern. The Beers criteria have been commonly employed as a screening tool to identify the use of potentially inappropriate medications (PIMs). The present study investigated the prevalence of PIM use according to the Beers criteria as well as factors related to PIM use. METHODS: Data obtained from a retrospective survey included 25,810 outpatients aged ≥65 years from a university medical center in Seoul, Korea. PIMs were defined using the Beers criteria. Factors associated with PIM use were evaluated using multiple regression analysis. RESULTS: Of all participants, 7,132 (27.6%) were prescribed at least one PIM. The most commonly prescribed PIMs were alprazolam (11.2%), clonazepam (10.8%), zolpidem (8.7%), quetiapine (8.4%), and hydroxyzine (5.4%). In multivariate logistic regression analysis, having five or more prescription medicines (odds ratio [OR], 11.32; 95% confidence interval [CI], 9.38 to 13.66) and five or more prescribing doctors (OR, 4.40; 95% CI, 3.59 to 5.39) were strongly associated with PIM. In a likelihood ratio test for trend, an increasing number of medications and prescribing doctors were both significantly associated with PIM. CONCLUSION: At a university medical center, the number of medications and the number of prescribing doctors was associated with PIM in older outpatients.

Exertional Rhabdomyolysis after Spinning.

Any strenuous muscular exercise may trigger rhabdomyolysis. We report an episode of clinically manifested exertional rhabdomyolysis due to stationary cycling, commonly known as spinning. Reports of spinning-related rhabdomyolysis are rare in the English literature, and the current case appears to be the first such case reported in South Korea. A previously healthy 21-year-old Asian woman presented with severe thigh pain and reddish-brown urinary discoloration 24-48 hours after attending a spinning class at a local gymnasium. Paired with key laboratory findings, her symptoms were suggestive of rhabdomyolysis. She required hospital admission to sustain renal function through fluid resuscitation therapy and fluid balance monitoring. Because exertional rhabdomyolysis may occur in any unfit but otherwise healthy individual who indulges in stationary cycling, the potential health risks of this activity must be considered.

Predictors of Successful Smoking Cessation after Inpatient Intervention for Stroke Patients.

BACKGROUND: Smoking is a well-known risk factor of cancer, chronic disease, and cerebrovascular disease. Hospital admission is a good time to quit smoking but patients have little opportunity to take part in an intensive smoking cessation intervention. The purpose of this study was to identify the factors of successful smoking cessation among stroke patients who undergo an intensive cessation intervention during the hospitalization period. METHODS: Thirty-nine male smokers who were admitted with stroke were enrolled in the study. They participated in a smoking cessation intervention during hospitalization. Smoking status was followed up by telephone 3 months later. Nicotine dependence, sociodemographic factors, and other clinical characteristics were assessed. RESULTS: After 3 months post-intervention, the number of patients who stopped smoking was 27 (69.2%). In addition, there was no significant difference in nicotine dependence, sociodemographic factors, and clinical characteristics. Only the stages of readiness for smoking cessation were a significant predictor (odds ratio, 18.86; 95% confidence interval, 1.59-223.22). CONCLUSION: This study shows that a patient's willingness to quit is the most significant predictor of stopping smoking after Inpatient cessation Intervention for stroke Patients.

Correlation between Overactive Bladder Syndrome and Obsessive Compulsive Disorder in Women.

BACKGROUND: Overactive bladder syndrome is characterized by urinary urgency, usually accompanied by Frequent urination and nocturia, with or without urgent urinary incontinence. There must be the absence of causative infection or pathological conditions. Overactive bladder syndrome is related to mental disorders, particularly depression and anxiety. However, obsessive-compulsive symptoms are investigated much less frequently. The purpose of the present study was thus to assess obsessive-compulsive symptoms in overactive bladder syndrome patients. METHODS: Fifty-seven women patients with overactive bladder syndrome and fifty-seven women without it (age matched control group) were prospectively enrolled. They completed the overactive bladder syndrome-validated 8-question screener and the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire at the same time they visited the clinic. Patients were compared with controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire and its checking, tidiness, doubting, and fear of contamination components. RESULTS: Patients showed more obsessive traits than controls on the Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score (P=0.006) and on the checking subscale (P=0.001). Odds ratio for the overactive bladder syndrome group's obsessive-compulsive symptoms traits (score≥14) was 5.47 (P=0.001). The Korean version of the Maudsley Obsessional-Compulsive Inventory Questionnaire total score was associated with the overactive bladder syndrome-validated 8-question screener score in patients (P=0.03). CONCLUSION: Obsessive-compulsive symptoms may constitute an important aspect of the psychiatric profile of overactive bladder syndrome patients. The severity of obsessive-compulsive symptoms seems to be related to the degree of the overactive bladder syndrome severity. Clinicians may consider screening women with overactive bladder syndrome for obsessive-compulsive symptoms.

A one-way text messaging intervention for obesity.

INTRODUCTION: Worldwide, there has been a startling increase in the number of people who are obese or overweight. Obesity increases the risk of cardiovascular disease and overall mortality. Mobile phone messaging is an important means of human communication globally. Because the mobile phone can be used anywhere at any time, mobile phone messaging has the potential to manage obesity. We investigated the effectiveness of a one-way text messaging intervention for obesity. METHODS: Participants' body mass index and waist circumference were measured at the beginning of the programme and again after 12 weeks. The text message group received text messages about exercise, dietary intake, and general information about obesity three times a week, while the control group did not receive any text messages from the study. RESULTS: Of the 80 participants, 25 subjects in the text message group and 29 participants in the control group completed the study. After adjusting for baseline body mass index, the body mass index was significantly lower in the text message group than in the control group (27.9 vs. 28.3; p = 0.02). After adjusting for the baseline waist circumference, the difference of waist circumference between the text message group and control group was not significant (93.4 vs. 94.6; p = 0.13). DISCUSSION: The one-way text messaging intervention was a simple and effective way to manage obesity. The one-way text messaging intervention may be a useful method for lifestyle modification in obese subjects.

Validation of the Korean version of the thyroid cancer-specific quality of life questionnaire.

PURPOSE: The increasing incidence of thyroid cancer worldwide has drawn attention to the needs for assessing and managing health-related quality of life (HRQoL) of thyroid cancer survivors. We conducted this study to validate the Korean version of the thyroid cancer-specific quality of life (THYCA-QoL) questionnaire. METHODS: Data obtained from 227 thyroid cancer survivors were analyzed using standard validity and reliability analysis techniques. Reliability was assessed by measuring internal consistency via Cronbach α coefficient, and validity was assessed by determining the Pearson correlation coefficient between the THYCA-QoL questionnaire and the following relevant assessment tools: the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30), the Korean version of Brief Fatigue Inventory (BFI-K), the Korean version of Brief Encounter Psychosocial Instrument (BEPSI-K), Goldberg Short Screening Scale for Anxiety and Depression, and a nine-item Patient Health Questionnaire (PHQ-9). A multitrait scaling analysis was performed to assess each item's convergent and discriminant validity. RESULTS: The reliability of the THYCA-QoL questionnaire was confirmed by Cronbach α coefficients for multiple-item scales which ranged from 0.54 (sensory) to 0.82 (psychological). Except for a single item (sexual interest), the questionnaire's validity was established by significant correlation observed between scales in the THYCA-QoL questionnaire and scales used in other assessment tools. A multitrait scaling analysis confirmed that all scales met the recommended psychometric standards. CONCLUSION: The Korean version of the THYCA-QoL questionnaire is a reliable and valid assessment tool that can be used in combination with the EORTC QLQ-C30 to assess the HRQoL of thyroid cancer survivors in Korea.

Acceptable macronutrient distribution ranges and hypertension.

Acceptable macronutrient distribution ranges (AMDRs) for carbohydrate, fat, and protein have been set by considering epidemiological evidences that suggest consumption within these ranges plays a role in reducing risk of chronic diseases. Little evidence has been presented on the relationship between the intake outside the AMDR for macronutrient and hypertension. Therefore, this study was performed to examine the association between the intake outside the AMDR and hypertension in Korean adults. This study was based on data obtained from the fifth Korean National Health and Nutrition Examination Survey. The AMDR for carbohydrate is 55-70%, for fat is 15-25%, and for protein is 7-20% of the energy intake for adults. The subjects who did not meet the AMDRs for carbohydrate, fat and protein were considered to be the non-AMDR group. The odds ratio of the non-AMDR group was 1.25 (95% CI, 1.02-1.53) in the hypertensive subjects without anti-hypertensive medication and 1.25 (95% CI, 1.06-1.48) in the hypertensive subjects with anti-hypertensive medication after adjustment for age, sex, current smoking, heavy drinking, physical inactivity, obesity, diabetes mellitus, dyslipidemia, total energy intake, high sodium intake, and vitamin D deficiency. The intake outside the AMDR was significantly associated with hypertension in Korean adults. The AMDR might be useful nutritional requirement for dietary management of hypertension. In the future, these findings need to be verified through prospective population-based studies.

Global Prevalence of Physical Frailty by Fried's Criteria in Community-Dwelling Elderly With National Population-Based Surveys.

This study presents a brief review of 6 articles published between 2001 and 2014 that examined the prevalence of frailty as defined by the Fried scale in community-dwelling adults representative of the national population, age 65 years and older.

Non-alcoholic Fatty Liver Disease and Chronic Kidney Disease in Koreans Aged 50 Years or Older.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD) share common pathogenic mechanisms and many risk factors, and both are linked to an increased risk of cardiovascular diseases. The aim of this study was to assess the association between NAFLD and CKD according to the presence of hypertension and diabetes mellitus in Koreans aged 50 years or older. METHODS: A cross-sectional study of 1,706 subjects who received their routine health examination was conducted between May 2008 and April 2010 at Konkuk University medical center. Biochemical tests for liver and abdominal ultrasonography were performed. CKD was defined as either proteinuria or glomerular filtration rate ≤60 mL/min per 1.73 m(2). RESULTS: Among the 1,706 subjects, There were 545 (31.9%) with non-alcoholic fatty liver disease and 424 (24.9%) with chronic kidney disease. In univariate logistic regression analysis, NAFLD was significantly associated with CKD (odds ratio [OR], 1.69; 95% confidence interval [CI], 1.34 to 2.12). In multivariate logistic regression analysis adjusted for age, sex, current smoking, abdominal obesity, aspartate aminotransferases, alanine aminotransferases, γ-glutamyltransferase, hypertension, diabetes mellitus, hypertriglyceridemia, and low high-density lipoprotein cholesterol, NAFLD was associated with CKD (adjusted OR, 1.68; 95% CI, 1.27 to 2.24). This relationship remained significant after classification according to the presence of hypertension or diabetes mellitus. CONCLUSION: NAFLD diagnosed by ultrasonography was significantly associated with CKD in Koreans aged 50 years or older.