Comparison between 24-hour diet recall and 24-hour urine collection for estimating sodium and potassium intakes and their ratio among Korean adults.

BACKGROUND/OBJECTIVES: This study aimed to compare 24-h diet recall (DR) and 24-h urine collection (UC) for estimating sodium and potassium intakes and their ratio (Na/K), identifying factors associated with sodium and potassium intakes and Na/K, and identifying those who were likely to underestimate sodium and potassium intakes by DR. SUBJECTS/METHODS: A total of 640 healthy adults aged 19-69 yrs completed a questionnaire survey, salty taste assessment, anthropometric measurement, two 24-h DRs, and two 24-h UCs. RESULTS: The mean sodium and potassium intakes and Na/K were 3,755 mg/d, 2,737 mg/d, and 1.45 according to DR, and 4,145 mg/d, 2,812 mg/d, and 1.57 according to UC, with percentage differences of -9.4%, -2.7%, and -7.6% in the values between the two methods, respectively. Men, older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who were found to be salty in the salty taste assessment consumed significantly more sodium; older adults, the heavy- activity group, and obese individuals consumed more potassium; and men, younger adults, smokers, and obese individuals had a significantly higher Na/K, according to UC. Compared with UC, DR was more likely to underestimate sodium intake in older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who consumed eating-out/delivery food at least once a day, and potassium intake in older adults, the heavy-activity group, and obese individuals. CONCLUSIONS: The mean sodium and potassium intakes and Na/K estimated by DR were comparable to those measured by UC. However, the association of sodium and potassium intakes with sociodemographic and health-related factors showed inconsistent results when estimated by DR and UC. Factors influencing the underestimation of sodium intake by DR compared to UC should be further investigated.

Development and application of the sodium index to estimate and assess sodium intake for Korean adults.

BACKGROUND/OBJECTIVES: The purpose of this study was to develop a sodium index, which is a tool for estimating and assessing sodium intake easily and quickly, to assist in the prevention of various diseases induced by excess sodium intake in Korean adults. SUBJECTS/METHODS: The 24-h urine collection and dietary behavior surveys were performed on 640 healthy people in 4 regions of South Korea, and an equation for the estimation of 24-h sodium intake was developed. The validity and reliability of the equation were verified with 200 adults. The sodium index was developed by converting the estimated sodium intake using the equation. Finally, the sodium intake status of 1,600 adults was assessed using the sodium index. RESULTS: The equation included sex, age, body mass index, eating habit and dietary behaviors related to sodium intake. In validity test of the equation, the mean bias between sodium intake using 24-h urine analysis and using the equation from the Bland-Altman plots was -1.5 mg/day. The sensitivity and specificity of the equation for estimation of sodium intake were 80.5% and 64.4%, respectively. In the reliability test of the equation, there was no significant difference between the first and second sodium intakes calculated using the equations, and Spearman's correlation coefficient between the 2 sodium intakes was 0.98. Sodium intake can be assessed as 'very moderate' for 75-100 on the sodium index, 'moderate' for 100-150, 'careful' for less than 75 or 150-200, and 'severe' for 250 or more. When sodium intake was assessed using the sodium index in 1,600 subjects, 54.3% and 24.3% of the subjects were assessed to be in the 'careful' and 'severe' categories, respectively. CONCLUSIONS: Using a simple questionnaire, the sodium index can be used to monitor and assess sodium intake status, assisting in nutrition education and counseling in a large population.

Beneficial Effects of a Specially Designed Home Meal Replacement on Cardiometabolic Parameters in Individuals with Obesity: Preliminary Results of a Randomized Controlled Clinical Trial.

We aimed to investigate if a home meal replacement (HMR), designed with a low ω-6/ω-3 fatty acid ratio, improves cardiometabolic parameters, including metabolic syndrome (MetS) in obese individuals. We conducted a monocentric, controlled, randomized crossover trial. The HMR contains higher protein and fat content, lower carbohydrate content, and a lower ω6FA/ω3FA ratio than the regular diet. Sixty-four participants were randomized into two groups and switched to the other group following a 4-week intervention. While subjects in the HMR group were provided three HMRs daily, those in the control group were requested to maintain their regular dietary pattern. We conducted paired t-tests, repeated measures analysis of variance, and McNemar tests before and after the intervention. Body mass index (BMI) and weight were lower in the HMR group after adjusting for age, sex, and total energy intake and significantly changed in the between-group differences. The waist circumference, systolic blood pressure, triglycerides, triglyceride-glucose index, and triglyceride to high-density lipoprotein cholesterol ratio were reduced in the HMR group (all p < 0.05). The percentage of subjects with MetS significantly decreased from 39.1% at baseline to 28.1% post-intervention (p = 0.035). Using the HMR for 4 weeks reduced the BMI, weight, and MetS prevalence in individuals with obesity. This trial was registered at clinicaltrials.gov (NCT04552574).

Nutrient intakes from supplement and factors associated with supplement use among breast cancer survivors: A cross-sectional study.

OBJECTIVE: We investigated the contribution of supplement use to total nutrient intake, the prevalence of inadequate nutrient intake and the factors associated with supplement use among breast cancer survivors. METHODS: A total of 701 Korean breast cancer survivors were included. We calculated the contribution of dietary supplements to total nutrient intake and the proportion of the population below the estimated average requirements (EARs) or exceeding the tolerable upper intake levels (ULs). Stepwise logistic regression was used to identify factors associated with dietary supplement use. RESULTS: A total of 66.5% of the survivors used dietary supplements, with multivitamins and minerals being the most commonly consumed ones. The per cent contribution of supplement to the total intake was the highest for vitamin C. 28.2%-55.4% of the non-users consumed below the EAR of riboflavin, folate and calcium; 6.1%, 4.9% and 6.5% of the supplement users consumed above the UL of vitamins A and C, and iron, respectively. Supplement users had higher education levels or longer survival time. CONCLUSION: 66.5% of Korean breast cancer survivors used dietary supplements. A higher education level or prolonged survival time was associated with higher use of dietary supplements.

Association between the Frequency of Dining Out and the Risk of Obesity, Diabetes Mellitus, and Dyslipidemia among Korean Adults.

This study aimed to clarify the association between the frequency of dining out and the risk of obesity, diabetes mellitus, and dyslipidemia among Korean adults. This cross-sectional study surveyed 640 participants aged 20-69 years in Korea. Daily intake of energy, fat, protein, and cholesterol significantly increased as the frequency of dining out increased (P < .001). Energy derived from carbohydrates significantly decreased with the frequency of dining out, while that derived from fat and protein increased (P < .001). Among participants who rarely dined out, the fully adjusted odds ratios (ORs) for hyperglycemia were significantly lower at 0.35 (95% CI, 0.16-0.76). Decreased risk of being hyperglycemia among participants who rarely dined out suggests that the frequency of dining out can be related to diabetes risk.

Impact of a school-based culinary nutrition education program on vegetable consumption behavior, intention, and personal factors among Korean second-graders.

BACKGROUND/OBJECTIVES: Veggiecation was developed to improve children's vegetable consumption through classroom lecture and cooking activities. In this study, we explored potential determinants of vegetable consumption behavior and intention, and examined the impact of Veggiecation on vegetable consumption behavior, intention and personal factors among Korean children. MATERIALS/METHODS: The 4-week Veggiecation program was implemented for second-graders in South Korea (35 children in the intervention group, 36 in the control group). We identified personal and environmental factors influencing vegetable consumption behavior and intention using multiple regression analyses. Consumption behavior, intention and, personal factors such as preference, attitude, and self-efficacy were compared between the groups before and after the intervention. RESULTS: Children's vegetable consumption behavior was significantly correlated with personal, social-, and physical-environmental factors as well as intention. Among the variables, preference was the most influential factor on intention, and attitude and intention had great influence on the behavior. After the program, children in the intervention group demonstrated significant improvements in vegetable consumption, intention, attitude, preference, and self-efficacy compared with children in the control group. CONCLUSION: Veggiecation, a school-based culinary nutrition education program, improved vegetable consumption and intention, as well as preference, attitude, and self-efficacy, in second-graders. Veggiecation has great potential, as a global program, to increase children's vegetable consumption. This program can be expanded through various channels, such as after-school programs or camps, to provide a positive impact for children.

Dietary vitamin D intake and vitamin D related genetic polymorphisms are not associated with gastric cancer in a hospital-based case-control study in Korea.

There have been few studies on the association between vitamin D levels and gastric cancer in Asian populations, but no studies have been performed on the interactions between vitamin D intake and polymorphisms in the vitamin D pathway. The effects of vitamin D intake, vitamin D related genetic polymorphisms, and their association with the incidence of gastric cancer were investigated in a hospital case-control study, including 715 pairs of newly diagnosed gastric cancer patients and controls matched for age and sex. Correlations between vitamin D intake and plasma vitamin D concentrations were also assessed in a subset of subjects. No statistically significant difference was observed in the dietary intake of vitamin D between the patients and controls, nor were there any evident associations between vitamin D intake and risk of gastric cancer in multivariate analyses. Vitamin D intake significantly correlated with the circulating 25-hydroxyvitamin D levels, but not with the active form of the vitamin, 1,25-dihydroxyvitamin D. There were no statistically significant interactions between vitamin D intake, and VDR or TXNIP polymorphisms. This study suggests that dietary vitamin D intake is not associated with gastric cancer risk, and the genetic polymorphisms of vitamin D-related genes do not modulate the effect of vitamin D with respect to gastric carcinogenesis.

Awareness, knowledge, and use of folic acid among non-pregnant Korean women of childbearing age.

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to reduce the risk of neural tube defects. The purposes of this study were to investigate the awareness, knowledge, and use of folic acid supplements along with their associated factors among non-pregnant Korean women of childbearing age. SUBJECTS/METHODS: From August 2012 to March 2013, 704 women aged 19-45 years completed a self-administered questionnaire regarding their awareness, knowledge, and use of folic acid as well as questions to identify risk of inadequate folate intake. RESULTS: Approximately 67% of women reported that they had heard of folic acid, and 23.7% had knowledge of both the role of folic acid in preventing birth defects and appropriate time for taking folic acid supplements to prevent birth defects. However, only 9.4% of women took folic acid supplements at the time of the survey. Women aged 19-24 years, unmarried women, and women who had never been pregnant were less likely to be aware and knowledgeable of folic acid or take folic acid supplements. In addition, women at high risk of inadequate folate intake were less likely to take folic acid supplements. In a multivariate analysis, women aged 19-24 years, women with a high school diploma or lower education level, and unmarried women were less likely to be aware and have knowledge of folic acid. The percentage of women taking folic acid supplements was significantly higher among knowledgeable women than among unknowledgeable women. CONCLUSIONS: These results support our hypothesis that women with knowledge of folic acid are more likely to take folic acid supplements. Therefore, educational programs or campaigns to improve knowledge regarding the importance of folic acid and to promote consumption of folic acid supplements as well as folate-rich foods are needed to target young, less educated, and unmarried women.

Estimation model for habitual 24-hour urinary-sodium excretion using simple questionnaires from normotensive Koreans.

This study was conducted to develop an equation for estimation of 24-h urinary-sodium excretion that can serve as an alternative to 24-h dietary recall and 24-h urine collection for normotensive Korean adults. In total, data on 640 healthy Korean adults aged 19 to 69 years from 4 regions of the country were collected as a training set. In order to externally validate the equation developed from that training set, 200 subjects were recruited independently as a validation set. Due to heterogeneity by gender, we constructed a gender-specific equation for estimation of 24-h urinary-sodium excretion by using a multivariable linear regression model and assessed the performance of the developed equation in validation set. The best model consisted of age, body weight, dietary behavior ('eating salty food', 'Kimchi consumption', 'Korean soup or stew consumption', 'soy sauce or red pepper paste consumption'), and smoking status in men, and age, body weight, dietary behavior ('salt preference', 'eating salty food', 'checking sodium content for processed foods', 'nut consumption'), and smoking status in women, respectively. When this model was tested in the external validation set, the mean bias between the measured and estimated 24-h urinary-sodium excretion from Bland-Altman plots was -1.92 (95% CI: -113, 110) mmol/d for men and -1.51 (95% CI: -90.6, 87.6) mmol/d for women. The cut-points of sodium intake calculated based on the equations were ≥4,000 mg/d for men and ≥3,500 mg/d for women, with 89.8 and 76.6% sensitivity and 29.3 and 64.2% specificity, respectively. In this study, a habitual 24-hour urinary-sodium-excretion-estimation model of normotensive Korean adults based on anthropometric and lifestyle factors was developed and showed feasibility for an asymptomatic population.

Dietary supplement use among cancer survivors and the general population: a nation-wide cross-sectional study.

BACKGROUND: Use of dietary supplements among cancer survivors is common and controversial, but information on the amount of nutrients from supplements among cancer survivors is limited. We examined the amount of nutrients and their contribution to total nutrient intake from supplements and compared these data between cancer survivors and cancer-free individuals. We also identified factors associated with supplement use among cancer survivors. METHODS: We identified 400 cancer survivors and 10,387 cancer-free individuals, aged ≥ 19 years, from the fifth Korea National Health and Nutrition Examination Survey (KNHANES) V-1, 2 (2010, 2011). We calculated the amount of nutrients consumed from foods and supplements, the percent contributions of supplement nutrients to total nutrient intakes and cancer survivors' nutrient intakes relative to the Estimated Average Requirements (EARs) and the Tolerable Upper Intake Levels (ULs). We examined factors associated with supplement use among cancer survivors. RESULTS: We found that 33.3% of cancer survivors and 22.1% of cancer-free individuals reported the use of dietary supplements. Compared to cancer-free individuals, cancer survivors had higher intakes of riboflavin, folate, and iron from foods (p < 0.05 for each), and higher intakes of calcium (p = 0.05) and vitamin C (p = 0.01) from foods and supplements. The similar pattern was observed for the percent contributions to total nutrient intake. Cancer survivors had higher proportion of participants below EARs than cancer-free individuals for thiamin and niacin (p < 0.05 for each). The proportions of cancer survivors below the EARs were 61.2% for calcium, 49.1% for riboflavin, and 43.5% for folate and the proportions of cancer survivors above the ULs were 3.3% for iron, and 2.3% for vitamin A. For female cancer survivors, education above an elementary school level, moderate physical activity, low vegetable intake, and high circulating vitamin D levels were associated with supplement use. For male cancer survivors, living in an urban area, no consumption of alcohol, and lower energy intake, were associated with supplement use. CONCLUSIONS: Korean cancer survivors have higher rate of dietary supplement use and higher contribution from supplements to total nutrient intake than cancer-free individuals. Demographic and lifestyle factors were associated with supplement use among cancer survivors.

Association between 24-h urinary sodium excretion and obesity in Korean adults: A multicenter study.

OBJECTIVE: The aim of this study was to explore the association between sodium intake, as assessed by 24-h urinary sodium excretion, and various obesity parameters among South Korean adults. The associations of 24-h urinary sodium excretion and sodium intake calculated from the dietary questionnaire with obesity parameters also were compared. METHODS: This multicenter, cross-sectional study analyzed data of 640 healthy adults from eight provinces in South Korea. Obesity was assessed by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Mean 24-h urinary sodium excretion was calculated from repeatedly collected 24-h urine samples. Participants' dietary intake was assessed by 24-h dietary recall interview on the days before 24-h urine collection. RESULTS: In both sexes, the means of all anthropometric measurements tended to increase proportionally with 24-h urinary sodium excretion quartiles, regardless of adjustment. Men in the highest quartile (Q4) of 24-h urinary sodium excretion had increased odds of obesity (as assessed by BMI, WC, WHR, and WHtR) compared with men in the three lower quartiles (Q1-Q3) of 24-h urinary sodium excretion. Women in Q4 of 24-h urinary sodium excretion exhibited a higher chance of general obesity and abdominal obesity. Sodium intake calculated from the dietary questionnaire was not significantly associated with obesity in either sex. CONCLUSIONS: In Korean adults, there was a positive association between higher sodium intake as assessed by 24-h urinary sodium excretion and obesity independent of energy intake.

Preconceptional use of folic acid and knowledge about folic acid among low-income pregnant women in Korea.

BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea. SUBJECTS/METHODS: A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers. RESULTS: Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%). CONCLUSIONS: Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.

Additive interactions between PRKAA1 polymorphisms and Helicobacter pylori CagA infection associated with gastric cancer risk in Koreans.

Although several studies reported genetic polymorphisms in protein kinase AMP-activated alpha 1 catalytic subunit (PRKAA1) and their associations with gastric cancer risk, few have evaluated associations between Helicobacter pylori infection and PRKAA1 gene-environment interactions. Here, we evaluated the effects of interactions between H. pylori infection and PRKAA1 polymorphisms on gastric cancer risk in Koreans. In this hospital-based case-control study, PRKAA1 genotypes were analyzed and H. pylori infection and CagA status were examined using a serologic method in 846 pairs of gastric cancer patients and controls matched for age and sex. H. pylori seropositivity was associated with a 1.43-fold [95% confidence interval: 1.12-1.81] increase in the risk of gastric cancer, and CagA low-positive titers during H. pylori infection increased the risk by 1.85-fold (95% confidence interval, 1.38-2.48). Significant positive interaction between the PRKAA1 rs13361707 genotype and H. pylori infection was verified on an additive scale [relative excess risk due to interaction, 0.55; 95% confidence interval, 0.05-1.04; P = 0.030], and the gene-environment interaction between PRKAA1 rs13361707 and CagA status was also statistically significant (relative excess risk due to interaction, 0.50; 95% confidence interval, 0.30-0.70; P < 0.001). Our results indicated that H. pylori infection, CagA status, and PRKAA1 polymorphisms were risk factors for gastric cancer in Koreans, and that the combination of two of these factors rather than their independent effects synergistically increased the risk.

Daily Copper and Manganese Intakes and Their Relation to Blood Pressure in Normotensive Adults.

Although it has been proposed that trace minerals have anti-oxidative functions and are related to the control of blood pressure, only a limited number of studies directly address the issue. Thus, the purpose of our study was to assess the intake of copper and manganese, which are trace minerals, and to clarify their relation to blood pressure. In a cross-sectional study, the blood pressure of 640 normotensive adults, from 19 to 69 year-old (320 males and 320 females), was measured, and its correlation with the intake of copper and manganese was assessed using a 24-hour dietary recall method. The average value of the blood pressure was 126.4/80.2 mmHg for the males and 117.8/75.8 mmHg for the females. The daily copper intake was 1.3 mg/day for the males and 1.2 mg/day for the females. For manganese, the daily intake was 4.2 mg/day for the males and 4.1 mg/day for the females. Although the copper intake of all subjects showed a positive correlation with the systolic and diastolic blood pressures, there was no significant correlation when the potential confounding factors were adjusted. The manganese intake of the male subjects had a significantly negative correlation with the systolic blood pressure after adjusting for gender, age, body mass index, and energy intake. In conclusion, the daily manganese intake of the normotensitve adults showed a significantly negative correlation with the systolic blood pressure indicating a possibility of a positive effect of manganese on blood pressure.

Associations of Breastfeeding Knowledge, Attitude and Interest with Breastfeeding Duration: A Cross-sectional Web-based Study.

PURPOSE: Maternal knowledge, positive attitudes and interest toward breastfeeding may improve the sustainability of breastfeeding. This study examined the associations of knowledge, attitudes, and interest toward breastfeeding with the duration of breastfeeding in Korean mothers who used the internet. METHODS: We conducted a cross-sectional study of 604 Korean mothers who breastfed their babies. Mothers were recruited through the internet and their knowledge, attitudes and interest toward breastfeeding were assessed using a web-based self-administered questionnaire. Geometric means and odds ratio (OR) with 95% confidence intervals were calculated. RESULTS: Higher knowledge, attitudes, and interest toward breastfeeding were associated with longer duration of breastfeeding in Korean mothers. In particular, mothers who had optimal breastfeeding duration were more likely to be aware of the easiness of breast milk stimulation and breastfeeding, the development of attachment between mother and child, and pleasure from breastfeeding compared to those mothers with shorter duration. The association with optimal breastfeeding duration was more pronounced among mothers who graduated from high school for total attitude scores and total interest scores, compared to mothers who graduated from college or above. CONCLUSION: The results of this study suggest that it is important to improve maternal knowledge, attitudes, and interest toward breastfeeding in Korean mothers who use the internet as a source of knowledge. Also, the study results imply that the development of strategies to target mothers with relatively low education levels may improve breastfeeding rates.

Breastfeeding Initiation and Continuation by Employment Status among Korean Women.

PURPOSE: The objective of this study was to examine the factors associated with initiation and continuation of breastfeeding among Korean women in relation to their employment status. METHODS: Data were collected using a web-based self-administered questionnaire from 1,031 Korean mothers living in Seoul with babies younger than 24 months. Demographic characteristics, education on breastfeeding, rooming in, breastfeeding during hospital stay, and breastfeeding knowledge were examined. Multivariate logistic regression analyses were performed to identify factors associated with initiation and continuation at 1, 6 and 12 months according to mothers' employment status. RESULTS: Breastfeeding initiation rates were similar regardless of mothers' employment status. Continuation rates decreased for both groups of mothers, but were significantly lower among employed mothers at all duration points. Unemployed mothers who were able to keep their babies in the same room during the hospital stay were more likely to initiate breastfeeding. The factor that was consistently associated with breastfeeding continuation for all duration points among unemployed mothers was whether the mother breastfed during the hospital stay. Higher knowledge scores and having an infant with atopic dermatitis were also associated with breastfeeding continuation at 6 months and 12 months, respectively for unemployed mothers, and receiving education on breastfeeding was associated with 12-month continuation for employed mothers. CONCLUSION: These results emphasize the significant roles of hospitals for breastfeeding initiation and continuation, with rooming-in, initial breastfeeding practice and education during hospital stay as important practices. In addition, for working mothers to continue their breastfeeding, significant support from the workplace is crucial.

Risk of gastric cancer is associated with PRKAA1 gene polymorphisms in Koreans.

AIM: To evaluate the association between genetic polymorphisms of the gene encoding AMP-activated protein kinase (PRKAA1) and the risk of gastric cancer. METHODS: The study subjects consisted of 477 age- and sex-matched case-control pairs. Genotyping was performed for 5 tag single nucleotide polymorphisms (SNPs): rs13361707, rs154268, rs3805486, rs6882903, and rs10074991. Associations between gastric cancer and putative risk factors (including the SNPs) were analyzed with multivariate conditional logistic regression models, after adjusting for potential confounding factors. Multiple testing corrections were implemented following methodology for controlling the false discovery rate. Gene-based association tests were performed by using the versatile gene-based association study (VEGAS) method. RESULTS: In the dominant model, SNPs rs13361707 [odds ratio (OR) = 1.51, 95%CI: 1.07-2.11)], rs154268 (OR = 1.65, 95%CI: 1.22-2.22), rs6882903 (OR = 1.48, 95%CI: 1.09-2.00), and rs10074991 (OR = 1.53, 95%CI: 1.09-2.16) were significantly associated with an increased risk of gastric cancer. In the recessive model, SNPs rs154268 (OR = 1.66, 95%CI: 1.22-2.26), rs3805486 (OR = 0.63, 95%CI: 0.46-0.85), and rs10074991 (OR = 1.47, 95%CI: 1.15-1.88) were significant risk or protective factors for gastric cancer. In the codominant model, the ORs of each of the 5 SNPs were statistically significant. All SNPs in the model showed a dose-response relationship between the minor allele frequency and the risk of gastric cancer. Most notably, subjects with a homozygous minor allele in SNP rs10074991 showed 2.15 times the risk of gastric cancer as subjects without a minor allele. The PRKAA1 gene showed a significant gene-based association with gastric cancer in the VEGAS test. CONCLUSION: All 5 tested tag SNPs of the PRKAA1 gene (rs13361707, rs154268, rs3805486, rs6882903, and rs10074991) were significantly associated with gastric cancer.

ITGA1 polymorphisms and haplotypes are associated with gastric cancer risk in a Korean population.

AIM: To evaluate the association between the genetic polymorphisms and haplotypes of the ITGA1 gene and the risk of gastric cancer. METHODS: The study subjects were 477 age- and sex-matched case-control pairs. Genotyping was performed for 15 single nucleotide polymorphisms (SNPs) in ITGA1. The associations between gastric cancer and these SNPs and haplotypes were analyzed with multivariate conditional logistic regression models. Multiple testing corrections were carried out following methodology for controlling the false discovery rate. Gene-based association tests were performed using the versatile gene-based association study (VEGAS) method. RESULTS: In the codominant model, the ORs for SNPs rs2432143 (1.517; 95%CI: 1.144-2.011) and rs2447867 (1.258; 95%CI: 1.051-1.505) were statistically significant. In the dominant model, polymorphisms of rs1862610 and rs2447867 were found to be significant risk factors, with ORs of 1.337 (95%CI: 1.029-1.737) and 1.412 (95%CI: 1.061-1.881), respectively. In the recessive model, only the rs2432143 polymorphism was significant (OR = 1.559, 95%CI: 1.150-2.114). The C-C type of ITGA1 haplotype block 2 was a significant protective factor against gastric cancer in the both codominant model (OR = 0.602, 95%CI: 0.212-0.709, P = 0.021) and the dominant model (OR = 0.653, 95%CI: 0.483-0.884). The ITGA1 gene showed a significant gene-based association with gastric cancer in the VEGAS test. In the dominant model, the A-T type of ITGA1 haplotype block 2 was a significant risk factor (OR = 1.341, 95%CI: 1.034-1.741). SNP rs2447867 might be related to the severity of gastric epithelial injury due to inflammation and, thus, to the risk of developing gastric cancer. CONCLUSION: ITGA1 gene SNPs rs1862610, rs24321 43, and rs2447867 and the ITGA1 haplotype block that includes SNPs rs1862610 and rs2432143 were significantly associated with gastric cancer.

Determinants of neural tube defect (NTD)-protective circulating concentrations of folate in women of child-bearing age in the US post-folic acid fortification era.

We evaluated folate status of child-bearing age women diagnosed with abnormal pap smear in the US post-folic acid (FA) fortification era and assessed the determinants of NTD-protective and supra-physiologic (SP) concentrations of folate. The distribution of 843 women according to NTD-protective concentrations of RBC folate, plasma folate and SP concentrations of plasma folate were tested in relation to demographic and life-style factors. Logistic regression models specified NTD-protective concentrations of RBC and plasma folate or SP concentrations of plasma folate as dependent variables and demographic and life-style factors as independent predictors of interest. More than 82% reached NTD-protective concentrations of RBC and plasma folate and ~30% reached SP concentrations of plasma folate. FA supplement use was associated with having SP concentrations of plasma folate rather than NTD-protective concentrations of folate. African American (AA) women and smokers were significantly less likely to achieve NTD-protective concentrations of RBC and plasma folate. A large majority of women reached NTD-protective concentrations of folate with the current level of FA fortification without using supplementary FA. Therefore, the remaining disparities in AA women and in smokers should be addressed by targeted individual improvements in folate intake.

Dietary aflatoxin B1 intake, genetic polymorphisms of CYP1A2, CYP2E1, EPHX1, GSTM1, and GSTT1, and gastric cancer risk in Korean.

PURPOSE: We investigated the effects of aflatoxin B1 (AFB1) intake, genetic polymorphisms of AFB1 metabolic enzymes, and interactions between the polymorphisms and intake of AFB1 with regard to the risk of gastric cancer in Korean. METHODS: The participants in the study included 477 gastric cancer patients and 477 age- and sex-matched control subjects. Direct interviews and a structured questionnaire were used to determine the level of exposure to AFB1, and the GoldenGate assay and multiplex polymerase chain reaction were used for genotypic analyses of the cytochrome P450 1A2 (CYP1A2), cytochrome P450 1E1, epoxide hydrolase 1, and glutathione S-transferase genes. RESULTS: The probable daily intake of AFB1 was significantly higher among gastric cancer patients than among control subjects (cases vs. controls: 1.91 ± 0.87 vs. 1.65 ± 0.72 ng/kg bw/day, p < 0.0001), and increased AFB1 intake was significantly associated with an elevated risk of gastric cancer (odds ratio 1.94; 95 % confidence interval 1.43-2.63). However, genetic polymorphisms of AFB1 metabolic enzymes were not associated with gastric cancer, with the exception of CYP1A2. Moreover, there was no interaction between AFB1 intake and the genotypes of metabolic enzymes that affect gastric cancer risk. CONCLUSIONS: Our results suggest that dietary AFB1 exposure might be associated with a risk of gastric cancer. However, the effect of AFB1 on gastric carcinogenesis may not be modulated by genetic polymorphisms of AFB1 metabolic enzymes.