Healthy Korean Adults Research Articles

The Relationship between 10-Year Cardiovascular Risk Calculated Using the Pooled Cohort Equation and the Severity of Non-Alcoholic Fatty Liver Disease.

BackgroundWe investigated the association between the severity of non-alcoholic fatty liver disease (NAFLD) and the estimated 10-year risk of cardiovascular disease (CVD) calculated by Pooled Cohort Equation (PCE) and Framingham risk score (FRS).MethodsA total of 15,913 participants (mean age, 46.3 years) in a health screening program were selected for analysis. The presence and severity of fatty liver was assessed by abdominal ultrasonogram. Subjects who drank alcohol more than three times a week were excluded from the study.ResultsAmong the participants, 57.6% had no NAFLD, 35.4% had grade I, 6.5% had grade II, and 0.5% had grade III NAFLD. Mean estimated 10-year CVD risk was 2.59%, 3.93%, 4.68%, and 5.23% calculated using the PCE (P for trend <0.01) and 4.55%, 6.39%, 7.33%, and 7.13% calculated using FRS, according to NAFLD severity from none to severe (P for trend <0.01). The odds ratio for ≥7.5% estimated CVD risk calculated using the PCE showed a higher correlation with increasing severity of NAFLD even after adjustment for conventional CVD risk factors (1.52, 2.56, 3.35 vs. the no NAFLD group as a reference, P<0.01) compared with calculated risk using FRS (1.65, 1.62, 1.72 vs. no NAFLD group as a reference, P<0.01).ConclusionIn our study of apparently healthy Korean adults, increasing severity of NAFLD showed a higher correlation with estimated 10-year CVD risk when calculated using the PCE than when calculated using FRS.

Waist Circumference as a Marker of Obesity Is More Predictive of Coronary Artery Calcification than Body Mass Index in Apparently Healthy Korean Adults: The Kangbuk Samsung Health Study.

BackgroundWe aimed to assess the risk for coronary artery calcification (CAC) according to groups subdivided by body mass index (BMI) and waist circumference (WC) in apparently healthy Korean adults.MethodsThirty-three thousand four hundred and thirty-two participants (mean age, 42 years) in a health screening program were divided into three groups according to BMI: <23 kg/m2 (normal), 23 to 25 kg/m2 (overweight), and >25 kg/m2 (obese). In addition, the participants were divided into two groups according to WC. Coronary artery calcium score (CACS) was measured with multi-detector computed tomography in all participants. Presence of CAC was defined as CACS >0.ResultsWhen logistic regression analysis was performed with the presence of CAC as the dependent variable, the risk for CAC increased as BMI increased after adjusting for confounding variables (1.102 [95% confidence interval (CI), 1.000 to 1.216]; 1.284 [95% CI, 1.169 to 1.410]; in the overweight and obese groups vs. the normal weight group). When the participants were divided into six groups according to BMI and WC, the subjects with BMI and WC in the obese range showed the highest risk for CAC (1.321 [95% CI, 1.194 to 1.461]) and those with BMI in the overweight range and WC in the obese range showed the second highest risk for CAC (1.235 [95% CI, 1.194 to 1.461]).ConclusionParticipants with obesity defined by both BMI and WC showed the highest risk for CAC. Those with BMIs in the overweight range but with WC in the obese range showed the second highest risk for CAC, suggesting that WC as a marker of obesity is more predictive of CAC than BMI.

Inter-Arm Difference in Brachial Blood Pressure in the General Population of Koreans.

Background and ObjectivesWe investigated the inter-arm difference in blood pressure of the general Korean population to identify associated factors.Subjects and MethodsA total of 806 participants aged 30 to 64 years without history of major cardiovascular disease were analyzed in this cross-sectional study. They participated in the Cardiovascular and Metabolic Disease Etiology Research Center cohort study that began in 2013. Brachial blood pressure was measured simultaneously for both arms using an automated oscillometric device equipped with two cuffs in seated position. After five minutes of rest, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured three times. The average of the three measurements was used for analysis. Multivariate logistic regression models were used to identify factors associated with inter-arm differences in blood pressure.ResultsThe mean inter-arm difference was 3.3 mmHg for SBP and 2.0 mmHg for DBP. Large inter-arm differences (≥10 mmHg) in SBP and in DBP were found in 3.7% and 0.9% of subjects, respectively. A large inter-arm difference in SBP was associated with mean SBP (p=0.002) and C-reactive protein (p=0.014) while a large inter-arm different in DBP was only associated with body mass index (p=0.015). Sex, age, and anti-hypertensive medication use were not associated with differences in inter-arm blood pressure.ConclusionLarge inter-arm difference in blood pressure is only present in a small portion of healthy Korean adults. Our findings suggest that high SBP, chronic inflammation, and obesity may be associated with larger difference in inter-arm blood pressure.

Pharmacokinetics and Tolerability of Single and Multiple Doses of Desvenlafaxine in Healthy Korean Subjects

Background: Racial and ethnic variations in CYP enzyme polymorphisms have been associated with population differences in drug metabolism. This study evaluated the pharmacokinetics of single- and multiple-dose desvenlafaxine in healthy Korean subjects. Methods: This randomized, double-blind, placebo-controlled, study enrolled 38 healthy Korean adults (aged 18 to 55 years). Subjects received single oral doses of placebo or desvenlafaxine (administered as desvenlafaxine succinate) 50, 100, or 200 mg on day 1, followed by 5 days of once daily dosing on days 4 to 8. Blood samples were collected pre-dose and over 72 h post-dose on days 1 and 8. Plasma desvenlafaxine concentrations were measured using a validated high-performance liquid chromatography tandem mass spectrometry and pharmacokinetic parameters were calculated using non-compartmental method. Tolerability was assessed through adverse event reporting. Results: For both single-and multiple-dose desvenlafaxine, peak plasma concentration and area under the concentration-time curve increased approximately linearly with dose. For the 4-fold increase in dose from 50 mg to 200 mg desvenlafaxine, area under the concentration-time curve from time 0 extrapolated to infinite time for singledose and area under the concentration-time curve from time 0-24 h for multiple-dose administration increased 4.3- and 4.1-fold, respectively; peak plasma concentration values increased 4.5- and 4.3-fold, respectively. Mean apparent half-life ranged from 10.75-13.49 h across all doses following single and multiple dose administration. Accumulation ratios for area under the concentration-time curve ranged from 1.478 to 1.669 (peak plasma concentration, 1.488- 1.578). No serious or severe adverse events were reported. Conclusion: The pharmacokinetics of multiple-dose desvenlafaxine 50-200 mg was linear and was able to be predicted from single-dose pharmacokinetics in Korean subjects. Pharmacokinetic parameters were similar to values previously observed in other racial/ethnic populations. There were no new safety findings for desvenlafaxine.

Association between serum fatty acid composition and innate immune markers in healthy adults.

BACKGROUND/OBJECTIVESSupplementation with n-3 polyunsaturated fatty acids (PUFAs) has been shown to generally decrease levels of innate immune markers and inflammatory cytokines, but the specific associations between blood levels of PUFAs and those of innate immune markers have not been investigated. Thus, the present study was conducted to test the hypothesis that innate immune markers as well as cytokines are negatively associated with n-3 PUFAs but positively associated with n-6 PUFAs in healthy adults.MATERIALS/METHODSOne hundred sixty-five healthy Korean adults aged 25-70 years old were included in this cross-sectional study.RESULTSSerum levels of n-3 PUFAs, such as 18:3n3, 20:5n3, 22:5n3, and 22:6n3 were negatively correlated with eosinophil and basophil counts and TNF-α, IFN-γ, IL-4, and IL-10 levels. Multivariate analysis also showed that serum levels of n-3 PUFAs were negatively associated with monocyte, eosinophil, and basophil counts and TNF-α, IFN-γ, IL-4, and IL-12 levels. Additionally, the ratio of 20:4n6 to 20:5n3 was positively correlated with eosinophil counts and associated with TNF-α, IFN-γ, and IL-4 levels. However, NK cell activity was not associated with serum fatty acid composition.CONCLUSIONSInnate immune markers such as eosinophil, monocyte, and basophil counts were inversely associated with serum levels of n-3 PUFAs, but were positively associated with the 20:4n6/20:5n3 ratio in this population.

Clinical characteristics and long-term observation of simple renal cysts in a healthy Korean population.

Although simple renal cysts are common in older patients, little is known concerning their development and natural history. We investigated the characteristics of simple renal cysts and risk factors for their development in healthy Korean adults. The medical records of 10,261 subjects who participated in a multiphase health screening program at our institution in 2002 were reviewed. Logistic regression analysis was used to examine various risk factors for renal cyst formation including sex, age, BMI, serum creatinine, estimated GFR, proteinuria, microscopic hematuria, hypertension, hypercholesterolemia, and diabetes mellitus. In 65 patients and 79 simple renal cysts with annual follow-up for 10 years, sequential changes in size and risk factors related to cyst growth rate were analyzed. The prevalence of simple renal cysts was 5.43 %. Age (p < 0.001), BMI (p < 0.001), proteinuria (p = 0.011), microscopic hematuria (p < 0.001), estimated GFR (p < 0.001), and hypertension (p < 0.001) had a significant influence on the occurrence of simple renal cysts. The average growth rates of simple renal cysts over the 10-year follow-up period were 1.43 mm (6.5 %) per year. Age <50 years was the only significant predictor of growth rates of renal cysts in the multivariate analysis (β = 2.37; 95 % CI 0.52, 4.22; p = 0.013). Age, BMI, renal dysfunction, proteinuria, microscopic hematuria, and hypertension were found to be risk factors for the presence of simple renal cysts. Simple renal cysts in younger patients (<50 years) tend to have a more rapid increase in size, but generally do not progress to aggressive disease.

Abdominal Adipose Tissue was Associated with Glomerular Hyperfiltration among Non- Diabetic and Normotensive Adults with a Normal Body Mass Index.

Glomerular hyperfiltration is recognized as an early marker of progressive kidney dysfunction in the obese population. This study aimed to identify the relationship between glomerular hyperfiltration and body fat distribution measured by computed tomography (CT) in healthy Korean adults. The study population included individuals aged 20–64 years who went a routine health check-up including an abdominal CT scan. We selected 4,378 individuals without diabetes and hypertension. Glomerular filtration rate was estimated using the CKD-EPI equation, and glomerular hyperfiltration was defined as the highest quintile of glomerular filtration rate. Abdominal adipose tissue areas were measured at the level of the umbilicus using a 16-detector CT scanner, and the cross-sectional area was calculated using Rapidia 2.8 CT software. The prevalence of glomerular hyperfiltration increased significantly according to the subcutaneous adipose tissue area in men (OR = 1.74 (1.16–2.61), P for trend 0.016, for the comparisons of lowest vs. highest quartile) and visceral adipose tissue area in women (OR = 2.34 (1.46–3.75), P for trend < 0.001) in multivariate analysis. After stratification by body mass index (normal < 23 kg/m2, overweight ≥ 23 kg/m2), male subjects with greater subcutaneous adipose tissue, even those in the normal BMI group, had a higher prevalence of glomerular hyperfiltration (OR = 2.11 (1.17–3.80), P for trend = 0.009). Among women, the significance of visceral adipose tissue area on glomerular hyperfiltration resulted from the normal BMI group (OR = 2.14 (1.31–3.49), P for trend = 0.002). After menopause, the odds ratio of the association of glomerular hyperfiltration with subcutaneous abdominal adipose tissue increased (OR = 2.96 (1.21–7.25), P for trend = 0.013). Subcutaneous adipose tissue areas and visceral adipose tissue areas are positively associated with glomerular hyperfiltration in healthy Korean adult men and women, respectively. In post-menopausal women, visceral adipose tissue area shows significant positive association with glomerular hyperfiltration as in men.

What is the most appropriate lipid profile ratio predictor for insulin resistance in each sex? A cross-sectional study in Korean populations (The Fifth Korea National Health and Nutrition Examination Survey).

BackgroundInsulin resistance (IR) reduces reactivity of the target organ to blood insulin. Researchers have attempted to evaluate IR using various serum lipid concentration ratios. We aimed to determine the most strongly IR-predictive lipid profile ratios for each sex by studying associations between lipid concentration ratios and IR using data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1) 2010.MethodsOverall, 8958 individuals participated in health interview and examination surveys. Among them, 1910 individuals who completed physical examinations and 8-h fasting blood tests and were older than 20 years of age were enrolled (929 men and 981 women). The lipid-ratio-related study outcomes were the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (LDL-C/HDL-C), triglyceride (TG)/HDL-C, and non-HDL-C (LDL-C + TG/5)/HDL-C ratios. We divided subjects into 4 groups according to lipid profile ratio quartiles for a comparison of homeostasis model assessment (HOMA)-IR values. Regression analyses were performed after adjusting for the confounding factors of age, body mass index, and diabetes mellitus history.ResultsHOMA-IR values tended to increase significantly along with LDL-C/HDL-C, TG/HDL-C, and non-HDL-C/HDL-C ratios in both sexes. In men, multiple linear regression analyses showed that after adjusting for confounding factors, a significant positive association remained only with the LDL-C/HDL-C ratio (p = 0.0238, R2 = 0.3605, root mean squared error [MSE] =0.3512). In women, multiple linear regression analyses showed that after adjusting for confounding factors, significant positive associations remained with the LDL-C/HDL-C (p < 0.0001, R-square = 0.2329, root MSE = 0.3776), TG/HDL-C (p = 0.0001, R2 = 0.2373, root MSE = 0.3766), and non-HDL-C/HDL-C ratios (p < 0.0001, R2 = 0.2456, root MSE = 0.3745).ConclusionThe LDL-C/HDL-C ratio in men and LDL-C/HDL-C, TG/HDL-C, and non-HDL-C/HDL-C ratios in women might be clinically significant predictors of IR in healthy Korean adults. However, additional large-scale studies are required to confirm these findings.

Safety and immunogenicity of a single intramuscular dose of a tetanus-diphtheria toxoid (Td) vaccine (BR-TD-1001) in healthy Korean adult subjects

BR-TD-1001 was developed as a booster for the immunity maintenance of diphtheria and tetanus. The aim of this study was to evaluate the safety and immunogenicity of BR-TD-1001 (test vaccine) in comparison with placebo and an active comparator in healthy Korean adults. A randomized, double-blind, placebo-controlled, active comparator, phase I clinical trial was conducted. Fifty subjects were randomly assigned to one of 3 treatment groups in a ratio of 2:2:1, and were administered a single intramuscular dose of test vaccine, active comparator, or placebo, respectively. All subjects were monitored for 4 weeks after injection. The antibody titers of the patients 2 and 4 weeks after vaccination were compared with the baseline. The frequencies of all adverse events including adverse drug reactions in the test group were not statistically different from those of the other treatment groups (P = 0.4974, 0.3061). No serious adverse event occurred, and no subject was withdrawn from the study for safety. The seroprotection rates against both tetanus and diphtheria at 4 weeks after vaccination were over 0.95. For anti-tetanus antibody, the geometric mean titer in the test group was significantly higher than those of the other groups (P = 0.0364, 0.0033). The geometric mean titer of anti-diphtheria antibody in the test group was significantly higher than the value of the placebo (P = 0.0347) while it was not for the value of the active comparator (P = 0.8484). In conclusion, BR-TD-1001 was safe, well-tolerated, and showed sufficient immunogenicity as a booster for diphtheria and tetanus.

Abdominal Adipose Tissue was Associated with Glomerular Hyperfiltration among Non- Diabetic and Normotensive Adults with a Normal Body Mass Index

Glomerular hyperfiltration is recognized as an early marker of progressive kidney dysfunction in the obese population. This study aimed to identify the relationship between glomerular hyperfiltration and body fat distribution measured by computed tomography (CT) in healthy Korean adults. The study population included individuals aged 20-64 years who went a routine health check-up including an abdominal CT scan. We selected 4,378 individuals without diabetes and hypertension. Glomerular filtration rate was estimated using the CKD-EPI equation, and glomerular hyperfiltration was defined as the highest quintile of glomerular filtration rate. Abdominal adipose tissue areas were measured at the level of the umbilicus using a 16-detector CT scanner, and the cross-sectional area was calculated using Rapidia 2.8 CT software. The prevalence of glomerular hyperfiltration increased significantly according to the subcutaneous adipose tissue area in men (OR = 1.74 (1.16-2.61), P for trend 0.016, for the comparisons of lowest vs. highest quartile) and visceral adipose tissue area in women (OR = 2.34 (1.46-3.75), P for trend < 0.001) in multivariate analysis. After stratification by body mass index (normal < 23 kg/m2, overweight ≥ 23 kg/m2), male subjects with greater subcutaneous adipose tissue, even those in the normal BMI group, had a higher prevalence of glomerular hyperfiltration (OR = 2.11 (1.17-3.80), P for trend = 0.009). Among women, the significance of visceral adipose tissue area on glomerular hyperfiltration resulted from the normal BMI group (OR = 2.14 (1.31-3.49), P for trend = 0.002). After menopause, the odds ratio of the association of glomerular hyperfiltration with subcutaneous abdominal adipose tissue increased (OR = 2.96 (1.21-7.25), P for trend = 0.013). Subcutaneous adipose tissue areas and visceral adipose tissue areas are positively associated with glomerular hyperfiltration in healthy Korean adult men and women, respectively. In post-menopausal women, visceral adipose tissue area shows significant positive association with glomerular hyperfiltration as in men.

Increased association of coronary artery calcification in apparently healthy Korean adults with hypertriglyceridemic waist phenotype: The Kangbuk Samsung Health Study

BackgroundHypertriglyceridemic waist phenotype is a simple screening parameter to identify people at increased risk for cardiovascular disease. We evaluated whether hypertriglyceridemic waist (HTGW) phenotype increases the risk for coronary artery calcification (CAC) in apparently healthy Korean adults. MethodsA total of 32,186 participants (mean age 41.3, 80.2% men) in a health screening program, in whom the coronary artery calcium score (CACS) was measured, were analyzed. Subjects were divided into four groups: 1) normal waist circumference (WC)–normal triglyceride (TG) (NWNT), 2) normal WC–high TG (NWHT), 3) enlarged WC–normal TG (EWNT), and 4) enlarged WC–high TG (EWHT). Enlarged WC was defined as WC ≥90cm for men and ≥85cm for women; high serum TG was defined as TG ≥150mg/dL. The presence of CAC was defined by CACS >0, and CACS was analyzed in a logarithmized form of CACS plus 1 {ln(CACS+1)}. ResultsA total of 14.9% of the participants had CAC. The EWHT group showed the highest mean value for ln(CACS+1) among the four groups. The EWHT group showed the highest odds ratio for CAC, with NWHT group the second, and with EWNT group the third compared with the NWNT group after adjusting for confounding variables (1.579, 1.302, and 1.266 vs. NWNT). ConclusionsThe EWHT group showed the highest association for CAC, suggesting this HTGW phenotype as a useful marker for the detection of subjects with high cardiometabolic risk in healthy Korean adults.

Genetic Influence on Left Ventricular Structure and Function: A Korean Twin and Family Study

Genetic factors have been suggested to be one of the determinants of the variation of left ventricular (LV) structure and function. However, the heritability range of LV structure varies across studies and the influence of genetics on LV function is not well established, especially in Asian populations. Study subjects were 1,642 healthy Korean adults from 426 families, consisting of 298 pairs of monozygotic twins, 62 pairs of dizygotic twins, one set of triplets, 567 siblings, and 354 parents. LV structure and function were measured by M-mode and 2D echocardiography, and conventional and tissue Doppler imaging (TDI). Pairwise intra-class correlations for various familial relationships and heritability were estimated for LV structure and function. The heritability of LV mass, LV ejection fraction (LVEF), left atrial volume index, the ratio between early and late diastolic velocity of mitral inflow (E/A ratio), and the ratio between early diastolic velocity of mitral inflow and early diastolic mitral annular velocities (E/Ea ratio) was 0.44, 0.27, 0.44, 0.25, and 0.33, respectively. Bivariate genetic analysis showed that LV structural and functional traits had significant genetic correlations with cardiovascular risk factors. Additive genetic correlation (ρG) of LV mass with body mass index, systolic blood pressure, and high density lipoprotein cholesterol were 0.49, 0.42, and -0.15 respectively. LVEF (ρG = 0.33) and left atrial volume index (ρG = 0.24) also had a significant genetic correlation with systolic blood pressure. These findings support the theory that genetic factors have significant influence on these traits and necessitate further work to identify the specific genes involved.

Chromium intake and its relationship with blood glucose in healthy Korean adults

Chromium (Cr) is the most abundant element in the Earth's crust and widely distributed throughout the food supply. Previous research has demonstrated the beneficial effects of Cr on circulating glucose and insulin; however, the dietary intake level of Cr in the self‐selected diet and its relationship with blood glucose have not been investigated because of the lack of a database on Cr content in commonly consumed foods. Thus, the purpose of this study was to assess Cr intake and investigate its relationship with blood glucose in healthy adults. A total of 51 adults aged 20‐28 years participated in this study and their Cr intakes were estimated by using the recently established database. Fasting blood glucose levels of the subjects were analyzed as well. Daily energy intakes of men and women were 1733.41 kcal and 1571.42 kcal, respectively, and daily Cr intakes were 66.38 ug and 52.34 ug, respectively, without significant difference. The subjects were supplied Cr mainly from cereals (20.04 ug/day), followed by vegetables (8.36 ug/day), beverages (6.00 ug/day), and fish and shellfishes (5.24 ug/day). Fasting blood glucose showed significant correlations with Cr intake from cereals in men (r = ‐0.4995, p &lt; 0.05), total Cr intake in men (r = ‐0.4366, p &lt; 0.05), and Cr intake from fish and shellfishes in women (r = 0.4248, p &lt; 0.05), respectively. These results show that higher Cr intake from diet may be associated with lower blood glucose levels in healthy Korean adults.

Silicon intake and its relationship with bone mineral density in healthy Korean adults

Silicon (Si) is the most abundant element next to oxygen and has been reported to play an important role in bone and connective tissue formation. However, the relationship between dietary Si intake in self‐selected diet and bone mineral density has not been well established. The purpose of this study was to evaluate Si intake and investigate its relationship with bone mineral density in healthy adults using the data from Korea National Health and Nutrition Examination Survey (2010‐2011). A total of 8,698 adults aged 19 to 64 years (male 3,693, female 5,005) were participated in this study. Daily Si intake of the total subjects was 30.87 mg (male vs. female; 35.20 mg/d vs. 26.52 mg/d, p&lt;0.0001), and 15.12 mg per 1,000 kcal (male vs. female; 14.62 mg/1,000 kcal vs. 15.82 mg/1,000 kcal, p&lt;0.0001). The bone mineral density of lumbar spine of the total subjects increased with increment of Si density of the diet (Q1 vs. Q4; 0.907 g/cm2 vs. 0.937 g/cm2) after adjusting age (p&lt;0.0001). The similar results were found in the male and female subjects (p&lt;0.0001, respectively). These results may represent that higher Si intake from the diet is associated with bone health promotion. “This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011‐0010880)”

Optimal Interval for Repeated Gastric Cancer Screening in Normal-Risk Healthy Korean Adults: A Retrospective Cohort Study.

PurposeThis retrospective cohort study was conducted to estimate the optimal interval for gastric cancer screening in Korean adults with initial negative screening results.Materials and MethodsThis study consisted of voluntary Korean screenees aged 40 to 69 years who underwent subsequent screening gastroscopies after testing negative in the baseline screening performed between January 2007 and December 2011. A new case was defined as the presence of gastric cancer cells in biopsy specimens obtained upon gastroscopy. The follow-up periods were calculated during the months between the date of baseline screening gastroscopy and positive findings upon subsequent screenings, stratified by sex and age group. The mean sojourn time (MST) for determining the screening interval was estimated using the prevalence/incidence ratio.ResultsOf the 293,520 voluntary screenees for the gastric cancer screening program, 91,850 (31.29%) underwent subsequent screening gastroscopies between January 2007 and December 2011. The MSTs in men and women were 21.67 months (95% confidence intervals [CI], 17.64 to 26.88 months) and 15.14 months (95% CI, 9.44 to 25.85 months), respectively.ConclusionThese findings suggest that the optimal interval for subsequent gastric screening in both men and women is 24 months, supporting the 2-year interval recommended by the nationwide gastric cancer screening program.

Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data

Purpose: The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. Results: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. Conclusion: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

The Relationships among Quality of Life and Stress, Health-related Habits and Food Intake in Korean Healthy Adults Based on 2013 Korea National Health and Nutrition Examination Survey

【Objectives: This study investigated the socioeconomic factors that affect quality of life (QL) in healthy adults and to study the relationship between QL and health-related habits and food intake. Methods: Subjects consisted of 1,154 healthy adults without any known disease, aged 19 to 65 years from the 2013 Korean National Health and Nutrition Examination Survey data. We used SPSS statistical program version 20.0 for data analysis. Results: The average age and QL score of the study population were 36.7 years and 0.99 points, respectively. Males had a significantly higher QL score than the females (p】

Analysis of six elements (Ca, Mg, Fe, Zn, Cu, and Mn) in several wild vegetables and evaluation of their intakes based on Korea National Health and Nutrition Examination Survey 2010-2011.

Wild vegetables, those edible among naturally grown vegetables, have been reported to contain many bioactive substances, dietary fibers, vitamins, and minerals. The purpose of this study is to examine the six elements of the wild vegetables frequently consumed by Koreans and assess the element intakes through them. Contents of six kinds of elements (Ca, Mg, Fe, Zn, Cu, and Mn) in 11 wild vegetables were analyzed by inductively coupled plasma optical emission spectroscopy. Using these analysis data, the 6-element intakes from the wild vegetables were evaluated in healthy Korean adults aged 19-64 years from the Korea National Health and Nutrition Examination Survey (2010-2011). Sedum and shepherd's purse contained over 100 mg of Ca in 100 g of their edible portion. The Mg content per 100 g of the 11 wild vegetables ranged from 12.1 mg to 43.4 mg. The wild vegetable with the highest mineral content per 100 g was sedum for Ca, spinach for Mg, shepherd's purse for Fe, spinach for Zn, bracken for Cu, and fragrant edible wild aster for Mn. The element intakes from the 11 wild vegetables compared with dietary reference intakes in the healthy Koreans were 1.0 % for Ca, 2.1 % for Mg, 5.3 % for Fe, 1.4 % for Zn, 0.3 % for Cu, and 1.8 % for Mn. Considering the low intake ratio (1.2 %) of the wild vegetable to total food intake, wild vegetables may contribute to some element intakes. Our results show the nutritional value of the wild vegetables in the aspect of mineral nutrition; however, further research is needed to evaluate the bioavailability of various elements in wild vegetables.

Composition of Dietary Macronutrient Intake Is Not Associated with Prevalence of Coronary Artery Calcification in Healthy Korean Adults

Background and Aims: There is little information supporting the relationships between macronutrients and pre-clinical atherosclerosis. The aim of this study was to identify whether dietary macronutrient content is related with CAC. Methods: 10,793 healthy Korean adults in a cohort were enrolled. Subjects were divided into CAC (CAC score >0) or non-CAC group (CAC score = 0). Intake of energy, carbohydrate (CHO), protein and fat were obtained using food frequency questionnaire (FFQ). Macronutrient composition was expressed as the ratio of energy from each macronutrient to total energy. Subjects were classified into three groups according to tertiles of intake for each macronutrient. To investigate the association between macronutrient intake and CAC, multiple regression analysis was conducted according to tertile groups of each macronutrient. Results: The prevalence of CAC significantly differed among tertile groups of CHO and fat intake in men (p < 0.001, p < 0.01) and women (p < 0.05, p < 0.01). However, multiple logistic regression analysis revealed that the odds ratios (ORs) for CAC were not significantly different among tertile groups of each macronutrient intake after adjustment in men (CHO: OR = 0.965 [95% CI = 0.826-1.129]; protein: OR = 1.029 [95% CI = 0.881-1.201]; fat: OR = 1.015 [95% CI = 0.868-1.188]) and women (CHO: OR = 1.158 [95% CI = 0.550-2.438]; protein: OR = 1.261 [95% CI = 0.629-2.528]; fat: OR = 0.625 [95% CI = 0.286-1.365]). Conclusions: The prevalence of CAC may not be associated with composition of dietary macronutrient intake in in healthy Korean adults. © 2014 S. Karger AG, Basel

A fruit, milk and whole grain dietary pattern is positively associated with bone mineral density in Korean healthy adults.

Osteoporosis is a major health problem that will grow in burden with ageing of the global population. Modifiable risk factors for osteoporosis, including diet, have significant implications for disease prevention. We examined associations between dietary patterns and bone mineral density (BMD) in a Korean adult population. In total, 1828 individuals from the Healthy Twin Cohort were included as subjects. Information on general characteristics, lifestyles and health status was obtained through a health examination, and BMD was assessed using DEXA. Dietary intake was assessed using a 3-day food record, and dietary patterns were examined by factor analysis. Associations between dietary patterns and BMD were examined using mixed linear regression, adjusting for family and twin structure as well as other potential risk factors for bone health. Four dietary patterns were identified (Rice and kimchi; eggs, meat and flour; Fruit, milk and whole grains; and Fast food and soda). The 'Fruit, milk and whole grains' pattern was associated with a reduced risk of having low BMD in men (odds ratio (OR)=0.38; 95% confidence interval (CI)=0.22-0.67) and women (OR=0.45; 95% CI=0.28-0.72) and was positively associated with BMD at multiple sites. The 'rice and kimchi' pattern had a positive association with only whole-arm BMD in men and women. Our results suggest that a dietary pattern with high intake of dairy products, fruits and whole grains may contribute positively to bone health in a Korean adult population, and dietary pattern-based strategies could have potential in promoting bone health.