Association between diet quality and type of meal companion: the 2013-2015 Korea National Health and Nutrition Examination Survey (KNHANES).

BACKGROUND/OBJECTIVES: A meal companion is an important social determinant of eating behaviors and is related to what and how much a person will eat within the social context. This study examined the difference in diet quality according to the type of dining companion. SUBJECTS/METHODS: This study included 15,074 adults (6,180 men and 8,894 women, ≥ 19 years) who participated in the 6th (2013-2015) Korea National Health and Nutrition Examination Survey. Korean Healthy Eating Index (KHEI) scores were calculated using the food frequency questionnaire data. Survey multivariate linear regression analysis was used to assess the association of dining companions (ordinary type, eating with family members, eating alone, and eating with others) and the total and component scores of KHEI. RESULTS: People who exclusively ate with someone other than family or exclusively ate alone had lower total KHEI scores in both men (57.23 ± 0.67, 58.56 ± 0.73 vs. 62.71 ± 0.26) and women (57.6 3±0.97, 63.89±0.58 vs. 65.79±0.22) compared to people with the ordinary type (all P < 0.05). Both men and women who ate exclusively with someone other than family had lower KHEI component scores for breakfast, whole grains, and fruit, excluding juice, compared to the ordinary type and family eating group. Compared to the eating alone group, the component scores for breakfast and whole grains were lower in the eating with others group. CONCLUSION: The diet quality differed according to the meal companion type. People who always ate with someone other than family members and men who ate alone showed lower diet quality scores than the ordinary type. More research will be needed to improve their adherence to dietary recommendations.

Progranulin and Breast Cancer Mortality: 13-Year Follow-Up of a Cohort Study.

Background: We have reported that serum progranulin (PGRN) levels are clinically significant in predicting recurrence in patients with HR-positive breast cancer. The aim of the present study was to examine whether PGRN levels might be associated with breast cancer mortality. Methods: This was a cohort study of 695 newly diagnosed breast cancer patients who underwent curative surgery between 2001 and 2004. The relationship between breast cancer mortality and pre-operative serum PGRN levels in these patients with a median follow-up of 12.7 years was evaluated until May 2020. Results: A total of 118 (17%) deaths were identified in the cohort. According to the HR status, (10, 15, and 20)-year overall survival (OS) rates were (91.4, 81.1, and 75.9) % for HR-positive patients, and (76.5, 74.2, and 69.8) % for HR-negative patients, respectively (p = 0.003). Higher levels of PGRN were significantly associated with poor OS in the HR-positive group (p for trend = 0.001). In particular, hazard ratios for PGRN quartiles suggested a dose-response relationship, with the highest quartile having the worst OS in the HR-positive group (highest vs lowest: 15-year OS, (68.3 vs 90.0) %; 20-year OS, (62.3 vs 84.8) %, even after adjusting for age, tumor stage, and metabolic confounders. Conclusion: Pre-operative serum PGRN levels had clinical significance for predicting cancer mortality in breast cancer patients independent of tumor stage and metabolic parameters, especially in HR-positive tumors.

Effect of an Integrative Mobile Health Intervention in Patients With Hypertension and Diabetes: Crossover Study.

BACKGROUND: Obesity, hypertension, and type 2 diabetes mellitus (T2DM) are worldwide epidemics that inflict burdens on both public health and health care costs. Self-management plays an important role in the proper management of these 3 chronic diseases, and in this context, mobile health (mHealth) can be a cost-effective self-management tool. OBJECTIVE: The aim of this pilot study is to evaluate the effects of an integrative mHealth approach for obesity, hypertension, and T2DM on body fat, blood pressure, and blood glucose levels and demonstrate the clinical outcomes. The participants were patients aged 40 to 70 years who were treated for T2DM (hemoglobin A1c [HbA1c] above 6.0%) without insulin or hypertension and obesity, controlled with pharmacotherapy. METHODS: This pilot study was performed using a controlled, randomized, 3-month, 2-period crossover design. A total of 37 participants were recruited from 2 university hospitals in South Korea. Integrative mHealth comprised 4 parts: self-measuring home devices for monitoring blood glucose and blood pressure; 2 smartphone apps, where one gathered lifestyle data, giving them feedback with health information, and the other provided drug information and reminders of the medication schedule; unmanned kiosks for official measurement of blood pressure and body composition; and web-based access to participants' health information. RESULTS: Data from the 32 participants were analyzed. Their mean HbA1c level was 7.5% (SD 0.8, ranging from 6.1% to 9.4%). Approximately 38% (12/32) of the participants had hypertension. BMIs of all participants except 1 were >23 kg/m2. The input rates of food intake and exercise to the smartphone app were very low (24.9% and 5.3%, respectively). On the contrary, the input rate of medicine intake was high (84.0%). Moreover, there was no significant difference in the input rate of taking medicine irrespective of whether the mHealth period was before or after the conventional treatment period (80.3% and 87.3%, respectively; P=.06). Among the 3 input functions of food intake, exercise, and medicine intake in smartphone apps, the input of medicine intake was a more helpful, easier to use, and better-designed function than the others. There were no significant differences in changes in body weight (-0.519 kg vs 0 kg), BMI (-0.133 kg/m2 vs -0.167 kg/m2), body composition (body fat -0.255% vs 0.172%), blood pressure (systolic -0.226 mm Hg vs -2.839 mm Hg), and HbA1c (-0.269% vs -0.009%) between the integrative mHealth and conventional treatment groups. However, in proportion to the elevation in the input rate of taking medicine, body fat mass (P=.04) and HbA1c (P=.03) were lower in the integrative mHealth group. CONCLUSIONS: Although smartphone apps can influence body fat and blood glucose levels, they have failed to show clinical improvement. A higher input rate of taking medicine was related to significantly lower body fat mass and HbA1c levels.

Effects of Short-term Mobile Application Use on Weight Reduction for Patients with Type 2 Diabetes.

BACKGROUND: The increasing prevalence of type 2 diabetes mellitus (T2DM) has led to a significant health burden. Technological advancements have highlighted the benefits of digital therapeutics for chronic diseases. In this study, we aimed to investigate the effects of a mobile application on weight reduction in patients with T2DM. METHODS: A total of 48 patients with T2DM was included in this single-center, randomized, controlled trial. In addition to conventional treatment, participants in the intervention group used a mobile application-based self-management system for diet, exercise, and medication adherence. The primary outcome of this study was weight change after 3 months of intervention, and secondary outcomes were metabolic parameters. RESULTS: After 12 weeks, no significant differences in body weight change were observed between the intervention and control groups (P=0.229). However, a significant difference was found in waist circumference (WC) between the two groups, wherein the control group showed an increase in WC (from 95.00±8.89 cm to 95.76±9.72 cm), while the intervention group showed a reduction (from 91.93±6.25 cm to 90.75±6.01 cm) with a significant time by group interaction (P=0.016). Additionally, participants with good compliance exhibited a more evident reduction in WC (P=0.037). However, no significant differences were found in other metabolic parameters between the two groups. CONCLUSION: Lifestyle modification using short-term mobile applications effectively reduced WC, especially in patients with good adherence to the application. However, weight reduction was not achieved.

Relationship between psychological distress and the adherence to the Korean healthy eating index (KHEI): the Korea National Health and Nutrition Examination Survey (KNHANES) 2013 and 2015.

BACKGROUND/OBJECTIVES: This study examined the association of depressive symptoms, stress perception, and suicidal ideation with overall dietary quality using the newly developed Korean healthy eating index (KHEI). SUBJECTS/METHODS: This study included 9,607 adults (3,939 men and 5,668 women, ≥ 19 years) who participated in the 6th Korea National Health and Nutrition Examination Survey 2013 and 2015. The KHEI scores were calculated using the food frequency questionnaire data. Survey logistic regression analyses were performed to analyze the association between psychiatric distress and dietary quality. RESULTS: The percentage of subjects with experience of depressive mood, higher stress perception, and suicidal ideation was 8.2%, 25.0%, and 3.7% in men and 15.4%, 27.3%, and 6.0% in women, respectively. The mean KHEI score was 61.5 ± 0.29 in men and 64.8 ± 0.24 in women (P < 0.001). The present study found a difference in the adherence to specific dietary components of the KHEI between sexes. Men experiencing depressive symptoms were less likely to eat meat, fish, eggs, and beans, while depressed women showed lower vegetable intake. Both men and women with suicidal ideation showed a lower intake of vegetables. The men with stress had a lower breakfast eating score than those without stress (7.21 vs. 6.77, P = 0.016). The multivariate-adjusted odds ratios for depressive symptoms, stress perception, and the suicidal idea in women with the highest quartile of KHEI scores compared to the lowest quartile was 0.69 (95% confidence interval, 0.51-0.92), 0.73 (0.58-0.82), and 0.52 (0.33-0.82), respectively and significant dose-response associations were observed (P for trends < 0.05 for all). On the other hand, these associations were not observed in men after adjusting for the confounding variables (P for trends > 0.05 for all). CONCLUSIONS: Poor adherence to dietary recommendations is associated with psychological distress, especially in women.

Non-contact home-adapted device estimates sleep stages in middle-aged men: A preliminary study.

BACKGROUND: Sleep monitoring is essential to maintain a healthy life, especially for the elderly who want to age well. Among various forms of sleep devices, the non-wearable and home-adapted device might be preferred because it can be easily used. OBJECTIVE: In this study, we evaluated the performance of a non-contact home-adapted device compared to polysomnography (PSG), a gold standard method. METHODS: As a preliminary study, eight subjects were recorded over fourteen nights through PSG. The non-contact home-adapted device comprised a microwave sensor, passive infrared sensor, and smartphone application. Through the device, heart rate, respiratory rate, and body movement were collected and used to estimate sleep stages. Sleep structure was labeled in four classes: wake, REM, light, and deep sleep, and were classified using a weighted k-nearest neighbor algorithm. RESULTS: The device correctly estimated sleep structures with an overall epoch-by-epoch accuracy of 98.65% ± 0.05% based on leave-one-out cross-validation. The device showed significantly positive correlations with PSG in sleep indices including total sleep time, sleep efficiency, and wake after sleep onset. CONCLUSIONS: Our findings demonstrate a good performance of this non-contact and home-adapted device and suggest its suitability for sleep monitoring.

Impact of Discrepancies in General and Abdominal Obesity on Major Adverse Cardiac Events.

Background Body mass index and waist circumference (WC) are commonly used metrics that reflect general obesity and abdominal obesity. However, the impact of general and abdominal obesity discrepancies on the risk for major adverse cardiac events (MACE) is less explored. Methods and Results The study population was derived from the Korean National Health Insurance Service-Health Screening Cohort. Among 315 982 participants aged 40 years or older who underwent health examinations between 2008 and 2009, body mass index and WC were used to determine the obesity status. The participants were followed from January 1, 2010 for MACE until December 31, 2015. Cox proportional hazards models were used to evaluate the association of obesity and the risk of MACE. Compared with men who were not obese, those with abdominal obesity without general obesity (adjusted hazard ratio (aHR) 1.29, 95% CI 1.16-1.43), and general and abdominal obesity (aHR 1.20, 95% CI 1.12-1.29) had elevated risk of MACE, while those with general obesity without abdominal obesity (aHR 1.06, 95% CI 0.98-1.16) did not. Similarly, women with abdominal obesity without general obesity (aHR 1.13, 95% CI 1.03-1.24) and those with general and abdominal obesity (aHR 1.15, 95% CI 1.06-1.25) had increased risk of MACE, while those with general obesity without abdominal obesity (aHR 1.07, 95% CI 0.88-1.30) did not. Conclusions Abdominal obesity without general obesity was associated with an elevated risk of major cardiovascular outcomes while general obesity without abdominal obesity did not. Concurrent determination of body mass index and WC may be beneficial for the accurate determination of future cardiovascular risk.

Circulating adipokines and risk of obesity related cancers: A systematic review and meta-analysis.

BACKGROUND: Obesity can influence on carcinogenesis through alterations in adipokines and subsequent inflammatory changes. This meta-analysis was aimed to comprehensively assess the association between circulating adipokines and risk of obesity-related cancers. METHODS: Pubmed and Embase were searched up to October 2017 for observational studies investigating the relationship between adipokines and cancers. Pooled odds ratio and the corresponding 95% confidence interval was estimated through the meta-analysis using a random-effects model. Findings A total of 93 observational studies (adiponectin = 60, high molecular weight adiponectin = 9, leptin = 39, IL-6 = 16, TNF-α = 10, and resistin = 17) were included. Adiponectin was significantly associated with decreased risk of cancer (pooled OR 0.70, 95% CI 0.60-0.80; I2 = 71.9%; Pheterogeneity <0.01). Leptin was significantly associated with increased risk of cancer (1.26, 1.05-1.51; I2 = 65.7%; Pheterogeneity <0.01). For each 5 µg/ml increase in adiponectin and 5 ng/ml increase in leptin, the pooled OR was 0.88 (0.83-0.93; I2 = 80.2%; Pheterogeneity <0.01) and 1.05 (1.01-1.09; I2 = 67.9%; Pheterogeneity<0.01)), respectively. There was nonlinear dose-response association (Pnonlinearity for adiponectin = 0.01; Pnonlinearity for leptin = 0.003).IL-6 (1.09, 0.94-1.25), TNF- α (1.65, 0.99-2.74), and resistin (1.28, 0.78-2.11) was not associated with risk of cancer. By cancer site and type, highest category of adiponectin was associated with decreased risk of breast (OR 0.74, 0.60-0.91), colorectal (0.74, 0.60-0.91), and endometrial cancer (0.49, 0.34-0.72). Higher leptin was associated with increased risk of endometrial (1.88, 1.24-2.87) and kidney cancer (2.07, 1.51-2.83). CONCLUSION: Our study suggests that adiponectin and leptin may play a role in the etiology of cancer.

Waist Circumference and All-Cause Mortality Independent of Body Mass Index in Korean Population from the National Health Insurance Health Checkup 2009⁻2015.

BACKGROUND: Waist circumference (WC) is an index of abdominal obesity and associated with co-morbidities and mortality. Higher WC is positively associated with increased mortality; therefore, we examined the relationship between WC and mortality in Korean populations with the interaction of body mass index (BMI) and WC for mortality. METHODS: A total of 23,263,878 subjects (men = 11,813,850 and women = 11,450,028) who were older than 20 years and underwent the National Health Insurance Service health checkup were included. WC was divided into six categories by 5 cm increments and level 3 (85⁻90 cm in men and 80⁻85 cm in women) was referenced. Multivariable Cox proportional hazard models were used to obtain the hazard ratios (HRs) and 95% confidence intervals for all-cause mortality according to the six levels of WC. RESULTS: WC in 5 cm increments showed a positively increased all-cause mortality after adjusting for all covariates including BMI. Men showed higher HRs for mortality than women as WC increased, and the HRs were higher in the lower WC levels, but lower in the higher WC levels among the subjects aged 65⁻85 years than subjects aged 40⁻65 years. Even in subjects with normal weight and overweight, increased WC (levels 4, 5, and 6) showed increased HRs for mortality (HRs = 1.156, 1.412, and 1.614 in normal BMI and 1.145, 1.401, and 1.909 in overweight, respectively). CONCLUSION: There was a linear association between WC and all-cause mortality across all BMI categories even in the subjects with normal or overweight BMI. Physicians should check WC routinely even in the subjects with normal weight or overweight.

Efficacy and safety of Panax ginseng berry extract on glycemic control: A 12-wk randomized, double-blind, and placebo-controlled clinical trial.

BACKGROUND: Antihyperglycemic effects of Panax ginseng berry have never been explored in humans. The aims of this study were to assess the efficacy and safety of a 12-wk treatment with ginseng berry extract in participants with a fasting glucose level between 100 mg/dL and 140 mg/dL. METHODS: This study was a 12-wk, randomized, double-blind, placebo-controlled clinical trial. A total of 72 participants were randomly allocated to two groups of either ginseng berry extract or placebo, and 63 participants completed the study. The parameters related to glucose metabolism were assessed. RESULTS: Although the present study failed to show significant antihyperglycemic effects of ginseng berry extract on the parameters related to blood glucose and lipid metabolism in the total study population, it demonstrated that ginseng berry extract could significantly decrease serum concentration of fasting glucose by 3.7% (p = 0.035), postprandial glucose at 60 min during 75 g oral glucose tolerance test by 10.7% (p = 0.006), and the area under the curve for glucose by 7.7% (p = 0.024) in those with fasting glucose level of 110 mg/dL or higher, while the placebo group did not exhibit a statistically significant decrease. Safety profiles were not different between the two groups. CONCLUSION: The present study suggests that ginseng berry extract has the potential to improve glucose metabolism in human, especially in those with fasting glucose level of 110 mg/dL or higher. For a more meaningful benefit, further research in people with higher blood glucose levels is required.

Change in Weight and Body Mass Index Associated With All-Cause Mortality in Korea: A Nationwide Longitudinal Study.

Context: Many studies have reported conflicting evidence on the association between weight change and mortality. Objective: We investigated the association between weight change and subsequent all-cause mortality, using a large-scale, population-based cohort from the National Health Insurance System health checkup data between 2005 and 2015. Methods: A total of 11,524,763 subjects older than age 20 years were included. Weight was measured every 2 years and weight change over 4 years was divided into eight categories, from weight loss ≥15% to weight gain ≥20%, for every 5% of weight change. The hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality were analyzed using multivariable Cox proportional hazard models compared with the stable weight group (weight change <5%) after adjusting for age, sex, smoking, drinking, exercise, diabetes mellitus, hypertension, dyslipidemia, cancer, and income. Results: Weight loss was associated with increased mortality rates compared with weight gain; the group with weight loss ≥15% had the highest HR for all-cause mortality (HR, 2.598; 95% CI, 2.537 to 2.659). The HR for all-cause mortality in the ≥20% weight gain group was 1.784 (95% CI, 1.695 to 1.877). Across all body mass index (BMI) categories, weight loss ≥15% was associated with increased mortality rates and the highest mortality rates were found in the BMI ≥30 kg/m2 group (HR, 3.469; 95% CI, 2.236 to 5.381). Conclusions: Weight change over 4 years showed a reverse J-shaped all-cause mortality curve, independent of BMI status. Weight loss was associated with a greater risk of mortality than was weight gain.

Recent Shift of Body Mass Index Distribution in Korea: a Population-based Korea National Health Insurance Database, 2002-2013.

We investigated trends of obesity prevalence among adult Koreans. Data from 110,280,952 participants who underwent medical examination provided by the National Health Insurance System from 2002-2013 were analyzed. The prevalence of moderate obesity (body mass index [BMI] 25.0-29.9 kg/m²) was slightly increased from 2002 (30.7%) through 2010 (33.1%) and reached a plateau since 2010 among men but continuously decreased from 22.5% in 2002 to 20.9% in 2013 among women. However, severe obesity (BMI ≥ 30.0 kg/m²) was rapidly increased and the prevalence in 2013 (4.2%) was almost doubled the prevalence in 2002 (2.5%). We observed a steep rise of severe obesity as well as potentially right shifting of the obese category.

Data Analytic Process of a Nationwide Population-Based Study on Obesity Using the National Health Information Database Presented by the National Health Insurance Service 2006-2015.

BACKGROUND: In Korea, the prevalence of obesity has steadily increased, and the socioeconomic burden of obesity has increased along with it. In 2015, the National Health Insurance Service (NHIS) signed a memorandum of understanding with the Korean Society for the Study of Obesity (KSSO), providing limited open access to its databases so that the status of obesity and obesity management could be investigated. METHODS: Using NHIS databases, we analyzed nationwide population-based studies for obesity using the definition of obesity (body mass index ≥25 kg/m2) in subjects over the age of 20. Age and sex standardization were used for all data. RESULTS: The KSSO released the 'Obesity Fact Sheet 2016' using the 2006-2015 NHIS Health Checkup database. The prevalence of obesity steadily increased from 28.7% in 2006 to 32.4% in 2015, and the prevalence of abdominal obesity also steadily increased from 18.4% in 2009 to 20.8% in 2015. The prevalence of class II obesity steadily increased from 2006 to 2015, such that the total prevalence was 4.8% in 2015 (5.6% in men and 4.0% in women). The highest prevalence of obesity was found in Jeju Island, while the lowest prevalence was found in Daegu City. The highest prevalence of abdominal obesity was also found in Jeju Island, while the lowest prevalence was found in Gwangju City. CONCLUSION: Based on the Obesity Fact Sheet 2016, a strategy for reducing the prevalence of obesity is needed, especially in Korean men.

Correlations between obesity indices and cardiometabolic risk factors in obese subgroups in women with severe obesity: A multicenter, cross-sectional study.

BACKGROUND: To investigate associations between degrees of obesity using correlations between obesity indices and cardiometabolic risk factors in women. METHODS: BMI, waist circumference (WC), fasting insulin, fasting glucose, lipids, and visceral adipose tissue (VAT) area using computed tomographic images were measured in 113 women with obesity. Correlations between obesity indices and cardiometabolic risk factors were analyzed in subgroups defined using sequential obesity indices. RESULTS: Mean BMI and WC were 29.6kg/m2 and 92.8cm. BMI showed significant correlations with all five cardiometabolic risk factors until the BMI cut-off point reached 29kg/m2, but when it exceeded 30kg/m2, correlations no longer existed. WC was significantly correlated with all five cardiometabolic risk factors up to a value of 85cm, but when WC exceeded 90cm, correlations no longer existed. CONCLUSIONS: Our cross-sectional study suggest that significant correlations between obesity indices and cardiometabolic risk factors may disappear, when obesity cut-off points exceed certain limits in women.

Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: Comparisons of representative nationwide sample data.

BACKGROUNDS: Variation among ethnic groups in the association between obesity and insulin resistance (IR)/diabetes has been suggested, but studies reported inconsistent results. We evaluated ethnic differences in the association between obesity and insulin resistance (IR)/diabetes. METHODS: We conducted a cross-sectional analysis using Korea (n=18,845) and the USA (n=4657) National Health and Nutrition Examination Survey(NHANES) 2007-2010. We performed statistical comparisons of AUC-ROC (area under the curve in a receiver operating characteristic curve) values for body mass index (BMI), waist circumference (WC) and homeostasis model assessment of insulin resistance (HOMA-IR) to predict IR or diabetes among different ethnic groups. RESULTS: AUC-ROC values for BMI and WC for predicting IR were highest in Whites (0.8324 and 0.8468) and lowest in Koreans (0.7422 and 0.7367). Whites showed the highest AUC-ROC values for BMI (0.6869) and WC (0.7421) for predicting diabetes, while the AUC-ROC for HOMA-IR was highest in Koreans (0.8861). Linear regression showed significant interactions between ethnicity and the main effects (all P<0.0001). Increases in BMI were associated with a larger increase in HOMA-IR in Whites (ß=0.0719) and WC in Hispanics (ß=0.0324), while BMI was associated with a larger increase in fasting glucose in Koreans (ß=0.8279) and WC in Blacks (ß=0.4037). In addition, the slope for fasting glucose with increasing HOMA-IR was steeper in Koreans (ß=16.5952, P<0.001) than in other groups. CONCLUSION: The ability of BMI and WC to predict IR and diabetes was highest in Whites, while the ability of HOMA-IR to predict diabetes was highest in Koreans.

Plasma clusterin (ApoJ) levels are associated with adiposity and systemic inflammation.

Obesity and insulin resistance are hallmarks of the metabolic syndrome, which is associated with low-grade chronic inflammation. Clusterin/apolipoprotein J is an abundant plasma chaperone protein that has recently been suggested as a potential biomarker that reflects the inflammatory process in Alzheimer's disease. In the present study, we investigated anthropometric and clinical factors affecting the plasma levels of clusterin in healthy Korean subjects. We measured fasting plasma clusterin levels in healthy Korean adults (111 men and 93 women) using ELISA kit. We analyzed the relationship between plasma clusterin concentrations and anthropometric and clinical parameters. Fasting plasma clusterin concentrations were higher in overweight and obese subjects than in lean subjects. Correlation analysis revealed that the plasma clusterin levels were positively associated with indices of obesity such as body mass index (BMI), waist circumference and waist-hip ratio and markers of systemic inflammation such as high sensitivity C-reactive protein (hsCRP), uric acid, ferritin and retinol binding protein-4. Multiple linear regression analysis showed that sex, BMI and hsCRP were independent determinants of plasma clusterin levels. Furthermore, plasma clusterin levels showed an upward trend with increasing numbers of metabolic syndrome components. These findings suggest that fasting plasma clusterin levels correlate with the parameters of adiposity and systemic inflammation in healthy adults. Therefore, the circulating clusterin level may be a surrogate marker for obesity-associated systemic inflammation.

Weight misperception and its association with dieting methods and eating behaviors in South Korean adolescents.

BACKGROUND/OBJECTIVES: There is little information on the association between weight misperception and eating behavior in Korean adolescents. Therefore, we investigated the association of food intake habits and dieting method and disturbed eating behavior (DEB) in relation to weight misperception. SUBJECTS/METHODS: Data was collected by using a nationwide online panel survey from 6,943 adolescents enrolled in middle/high school. DEB was measured with the Eating Attitudes Test (EAT-26) and those who scored ≥ 20 on the EAT-26 were considered to have eating disorder. Logistic regressions were conducted to examine the association between weight misperception based on self-reported weight status and dieting method and eating behaviors. RESULTS: The proportion of weight underestimation was 23.5% and that of overestimation was 24.0%. Weight overestimating girls were more likely to engage in various unhealthy dieting practices (OR = 1.69 for fasting; OR = 1.88 for laxative or diuretic use; OR = 2.05 for self-induced vomiting after meals; P < 0.05). Moreover, there was a strong association between overestimation and undesirable eating behaviors, especially among girls, e.g.: having breakfast (OR = 0.85), high consumption of fast foods (OR = 1.28) and regular sodas (OR = 1.39), but not among boys. In both genders, weight overestimation appears to be a major risk factor for DEB (OR = 1.34 for boys and OR = 1.41 for girls; P < 0.05). CONCLUSIONS: [corrected] Weight overestimation is associated with unhealthy weight control practices and eating behaviors. We particularly found a significant association between weight overestimation and DEB among nationwide Korean adolescents.

The unique response of renin and aldosterone to dietary sodium intervention in sodium sensitivity.

INTRODUCTION: Sodium sensitivity (SS) is a phenomenon in which significant changes in blood pressure (BP) are observed based on sodium intake. The renin-angiotensin-aldosterone system plays a critical role in sodium handling and hypertension. We identified the specific responses of renin and aldosterone based on dietary sodium intake and revealed the relationship between these hormonal changes and dietary sodium intake in patients with SS. MATERIALS AND METHODS: In total, 61 subjects were available to analyze full data including plasma renin activity (PRA) and aldosterone. Participants were given a low-sodium DASH diet (LSD) for 7 days and a high-sodium DASH diet (HSD) for the following 7 days. RESULTS: SS was found in five (14.71%) in normotensives, and 14 (51.85%) in hypertensives. In sodium-resistant (SR) subjects, both PRA and aldosterone decreased significantly after consuming HSD. Moreover, a significant correlation was observed between PRA and aldosterone in SR subjects. In contrast, only hypertensive subjects showed a marked fall in PRA after consuming HSD (1.299 ± 0.904 vs. 0.593 ± 0.479) among SS subjects. CONCLUSIONS: This study demonstrated the different responses of renin and aldosterone in SS and SR subjects based on dietary sodium intake whether or not they had hypertension.

Optimal waist circumference cutoff values for the diagnosis of abdominal obesity in korean adults.

Abdominal obesity is associated closely with insulin resistance, diabetes, and cardiovascular disease. Waist circumference (WC) is a useful surrogate marker commonly used for abdominal adiposity. The determination of WC cutoff levels is important in the prevention and treatment of obesity, type 2 diabetes, and related cardiovascular diseases. Recent epidemiological evidence suggested that appropriate optimal cutoffs for Koreans ranged over 80 to 89.8 cm in males and 76.1 to 86.5 cm in females. We analyzed the data from two large cohorts using receiver operating characteristic curve analysis with the incidences of diabetes, hypertension, dyslipidemia, cerebrovascular disease, myocardial infarct, angina, coronary artery disease, and multiple metabolic risk factors as outcome variables. Optimal WC cutoff points for Koreans were 85 cm in males and 80 cm in females. However, considering the prevalence of abdominal obesity and the health costs for its prevention and management, 90 cm in males and 85 cm in females are probably more appropriate thresholds for abdominal obesity. These values may be modified once better research is performed through prospective studies using representative populations, common health outcomes, and proper analytical approaches.