The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis.

BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2; 95% confidence interval [CI], 1.59-2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2; 95% CI, 1.13-1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2; 95% CI, 0.1-1.51; P < 0.05; I2 = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

Minor alleles in the FTO SNPs contributed to the increased risk of obesity among Korean adults: meta-analysis from nationwide big data-based studies.

BACKGROUND/OBJECTIVES: Many studies have revealed an association between fat mass and the obesity-related gene (FTO) and obesity. On the other hand, no meta-analysis was conducted with data from only Koreans. Therefore, this study performed a meta-analysis using Korean data to provide evidence for the association between FTO single nucleotide polymorphisms (SNPs) and the risk of obesity among Korean adults. SUBJECT/METHODS: Meta-analysis was finally conducted with data extracted from seven datasets of four studies performed on Korean adults after the screening passed. Five kinds of FTO SNPs (rs9939609, rs7193144, rs9940128, rs8050136, and rs9926289) were included, and the relationship between FTO SNPs and body mass index (BMI) was investigated using linear regression with an additive model adjusted for covariants, such as age, sex, and area. RESULTS: The minor alleles of FTO SNPs were associated with increased BMI (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.21-1.42). In sub-group analysis, FTO rs9939609 T>A was significantly associated with BMI (OR, 1.23; 95% CI, 1.06-1.42). The other FTO SNPs together were significantly associated with BMI (OR, 1.37; 95% CI, 1.25-1.49). The publication bias was not observed based on Egger's test. CONCLUSIONS: This meta-analysis showed that minor alleles in the FTO SNPs were significantly associated with an increased BMI among Korean adults. This meta-analysis is the first to demonstrate that minor alleles in the FTO SNPs contribute significantly to the increased risk of obesity among Korean adults using data from a Korean population.

Effects of Ginger Intake on Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Randomized Clinical Trials.

Nausea and vomiting are the most common side effects of chemotherapy. They must be managed because they can increase the risk of malnutrition in patients, which can adversely affect treatment. The objective of this study was to evaluate the effect of ginger supplementation as an adjuvant treatment for alleviating chemo We checked. therapy-induced nausea and vomiting (CINV). This study searched for randomized controlled trials (RCTs) related to ginger supplement intake for CINV in three electronic databases (i.e., Medline (PubMed), Embase, and Web of Science). The search period ranged from each database's first date of service to 5 November 2021. Two investigators independently performed abstract screenings, full-text screenings, data extraction, and risk of bias analyses (ROB). The Cochrane ROB tool was used for the assessment of ROB. This study systematically reviewed 23 RCTs. The effects of ginger supplementation were compared to those of placebo or antiemetic agents. This study conducted a meta-analysis after classifying the effects of ginger supplementation on acute and delayed CINV into subgroups due to the clinical heterogeneity between these RCTs. The results showed that the incidence of acute nausea (p = 0.53), the incidence of delayed nausea (p = 0.31), the incidence of acute vomiting (p = 0.09), and the incidence of delayed vomiting (p = 0.89) were not significantly different between the ginger supplement intake group and the control group. However, it was found that the ginger supplement intake group, which took not more than 1 g of ginger supplementation per day for above four days, had significantly less acute vomiting than the control group (OR 0.30; 95% CI 0.12 to 0.79; p = 0.02; I2 = 36%). Ginger supplementation may reduce the incidence of acute chemotherapy-induced vomiting. However, this study could not confirm the effects of ginger supplementation on the incidence of chemotherapy-induced nausea and delayed vomiting. Therefore, it will be necessary to conduct additional studies with sufficient sample sizes using high-quality RCTs to evaluate the effects of ginger supplementations based on the results of this study.

Critical ionic transport across an oxygen-vacancy ordering transition.

Phase transition points can be used to critically reduce the ionic migration activation energy, which is important for realizing high-performance electrolytes at low temperatures. Here, we demonstrate a route toward low-temperature thermionic conduction in solids, by exploiting the critically lowered activation energy associated with oxygen transport in Ca-substituted bismuth ferrite (Bi1-xCaxFeO3-δ) films. Our demonstration relies on the finding that a compositional phase transition occurs by varying Ca doping ratio across xCa ≃ 0.45 between two structural phases with oxygen-vacancy channel ordering along <100> or <110> crystal axis, respectively. Regardless of the atomic-scale irregularity in defect distribution at the doping ratio, the activation energy is largely suppressed to 0.43 eV, compared with ~0.9 eV measured in otherwise rigid phases. From first-principles calculations, we propose that the effective short-range attraction between two positively charged oxygen vacancies sharing lattice deformation not only forms the defect orders but also suppresses the activation energy through concerted hopping.

Effects of garlic intake on cancer: a systematic review of randomized clinical trials and cohort studies.

BACKGROUND/OBJECTIVES: Due to the rapid increase of global cancer incidence and mortality and a high level of interest in cancer prevention, a systematic review of garlic intake and cancer risk is needed. SUBJECTS/METHODS: We implemented a systematic review to examine the effects of varying levels of garlic intake on cancer. We conducted comprehensive literature searches in three electronic databases (MEDLINE, Embase, and Web of Science) for studies published between database inception and July or September of 2018. Two investigators independently screened abstracts and full-texts, extracted data, and assessed risk of bias (RoB). A total of one medium-quality randomized controlled trial (RCT) and 13 cohort studies graded as high RoB were included. RESULTS: The 1-year follow-up results from a RCT showed that a significant decrease in the number and size of colorectal adenomas among participants with colorectal adenomas who received high-dose aged garlic extract (AGE) compared with those who received low-dose AGE (P < 0.05). The results of prospective observational studies provided inconsistent associations of colorectal cancer risk with garlic supplements and garlic intake as food. CONCLUSIONS: In summary, the AGE was effective in reducing the number and magnitude of colorectal adenomas in one RCT, but there were inconsistent associations between garlic intake and colorectal cancer in cohort studies. Therefore, we could not draw a firm conclusion regarding the effects of garlic on cancer, because the current strength of evidence is inadequate due to a lack of number of high-quality RCTs.

Prevalence and correlates of highly caffeinated beverage consumption among Korean adolescents.

OBJECTIVE: The purposes of this study were to (1) examine the multi-year prevalence of highly caffeinated beverage (HCB) consumption, (2) identify sex differences in the prevalence, and (3) investigate relationships between HCB consumption and behavioral characteristics in a nationally representative sample of Korean adolescents. METHODS: Data from the Korea Youth Risk Behavior Web-based Survey (2014-2017) were analyzed. RESULTS: HCB consumption was higher in 2017 than 2014 (23.9% vs. 12.0%), and higher among boys than girls (17.2% vs. 13.1%). HCB drinkers were more likely to (1) be boys, (2) be overweight or obese, (3) use alcohol and tobacco, (4) consume soda at least once per week, (5) consume sweetened beverages at least once per week, (6) have seriously considered suicide during the past 12 months, and (7) have attempted suicide during the past 12 months (p<0.05 for all). CONCLUSION: Effective programs to curb HCB consumption among Korean adolescents need to be established.

Trends in sodium intake and major contributing food groups and dishes in Korea: the Korea National Health and Nutrition Examination Survey 2013-2017.

BACKGROUND/OBJECTIVES: Excess intake of dietary sodium, either directly or indirectly, increases the risk of several diseases, including cardio-cerebral vascular diseases such as stroke and hypertension. Excessive sodium intake and increased prevalence of hypertension have emerged as major issues worldwide. Therefore, the present study evaluated the recent trends in dietary sodium intake and the food sources of sodium intake in the Korean population using the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2017) data. SUBJECTS/METHODS: This study used the one-day 24-h recall dietary intake survey data from the 2013-2017 KNHANES to determine the average daily sodium intake by sex and age and the main dishes and food groups contributing to the dietary sodium intake. RESULTS: The mean sodium intake range was 3,477.2-3,889.6 mg/day during 2013-2017. The major food groups contributing to sodium intake were seasonings (1,597.5-1,870.5 mg/day), vegetables (680.4-756.7 mg/day), and cereal and grains (573.2-609.4 mg/day). Noodles and dumplings (536.7-573.2 mg/day), kimchi (487.3-539.6 mg/day), and soups (367.6-428.9 mg/day) were the top three dish groups that contributed to the sodium intake. In these dishes, the major sources of sodium intake were ramyeon (age groups 10-18 and 19-29 yrs), baechukimchi (age groups 40-49 and 50-59 yrs) and doenjang-kuk (age groups 60-69 and ≥ 70 yrs), respectively. CONCLUSIONS: In summary, reducing the consumption of soups and kimchi is an effective way to reduce sodium intake. Personalized nutrition education on dietary sodium intake management is required because of the different food sources contributing to the sodium intake according to the subjects' age.

Sex differences in weight perception and weight gain among Black college students in the USA.

OBJECTIVE: The aims of this study were to examine the prevalence of overweight/obesity and to explore sex differences in body weight perceptions and correlates of weight gain among Black students at 2 historically Black colleges and universities (HBCUs) in the USA. METHODS: Participants completed a paper-based survey, and their height and weight were measured (67% completion rate). RESULTS: The overweight and obesity rates were 33.8% and 26.9%, respectively. More females than males accurately assessed their weight (p < 0.05). Body weight underestimation was associated with male sex, excellent/very good perceived overall health, and not being informed by a doctor of having overweight or obesity (p < 0.01). Higher odds of ≥5% weight gain were related to female sex, living on campus, and not being informed by a doctor of having overweight or obesity (p < 0.05). CONCLUSION: Given the high overweight and obesity rates among Black students, HBCUs in the USA should develop intervention strategies for the prevention and management of overweight and obesity. College health educators at HBCUs need to provide regular check-ups or health screenings that help male students perceive their weight accurately and prevent weight underestimation. It is important for HBCUs to monitor and address weight gain among Black students as early as possible.

Regional disparities in healthy eating and nutritional status in South Korea: Korea National Health and Nutrition Examination Survey 2017.

BACKGROUND/OBJECTIVES: Concerns about regional disparities in heathy eating and nutritional status among South Korean adults are increasing. This study aims to identify the magnitude of regional disparities in diet and nutritional status among Korean adults who completed the 2017 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The participants were a nationally representative sample of Korean adults aged 19 years and older from the 2017 KNHANES (n = 6,126). We employed the svy commands in STATA to accommodate the complex survey design. The relative concentration index (RCI), absolute concentration index (ACI) and index of disparity were used to measure regional nutritional inequalities. RESULTS: Overweight and obese adults were more prevalent among the poor than among the rich in urban areas (RCI = -0.041; P < 0.05), while overweight and obese adults were more prevalent among the rich than among the poor in rural areas of South Korea (RCI = 0.084; P < 0.05). Economic inequality in fruit and vegetable intake ≥ 500 g per day was greater in rural areas than in urban areas in both relative size (RCI = 0.228 vs. 0.091, difference in equality = 0.137; P < 0.05) and absolute size (ACI = 0.055 vs. 0.023, difference in equality = 0.032; P < 0.05). CONCLUSIONS: This study provides useful information identifying opposite directions in the relative concentration curves between urban and rural areas. Adult overweight/obesity was more prevalent among the poor in urban areas, while adult overweight/obesity was more prevalent among the rich in rural areas. Public health nutrition systems should be implemented to identify nutritional inequalities that should be targeted across regions in South Korea.

Effects of Capsicum annuum supplementation on the components of metabolic syndrome: a systematic review and meta-analysis.

Metabolic syndrome (MetS) has increasingly gained importance as the main risk factor for cardiovascular diseases and type II diabetes mellitus. Various natural compounds derived from plants are associated with beneficial effects on the incidence and progression of MetS. This study aimed to evaluate the effects of Capsicum annuum on factors related to MetS by assessing randomized controlled trials (written in English). We searched the online databases of PubMed, Embase, Google scholar, and Cochrane Library up to April 2020. 'Patient/Population, Intervention, Comparison and Outcomes' format was used to determine whether intervention with C. annuum supplementation compared with placebo supplementation had any effect on the components of MetS among participants. We considered standardized mean differences (SMD) with 95% confidence intervals (CI) as effect size measures using random-effects model. Analysis of the included 11 studies (n = 609) showed that C. annuum supplementation had significant effect on low density lipoprotein-cholesterol [SMD = - 0.39; 95% CI - 0.72, - 0.07; P = 0.02; prediction interval, - 1.28 to 0.50] and marginally significant effect on body weight [SMD = - 0.19; 95% CI - 0.40, 0.03; P = 0.09]. However, larger and well-designed clinical trials are needed to investigate the effects of C. annuum on MetS.

Harnessing the topotactic transition in oxide heterostructures for fast and high-efficiency electrochromic applications.

Mobile oxygen vacancies offer a substantial potential to broaden the range of optical functionalities of complex transition metal oxides due to their high mobility and the interplay with correlated electrons. Here, we report a large electro-absorptive optical variation induced by a topotactic transition via oxygen vacancy fluidic motion in calcium ferrite with large-scale uniformity. The coloration efficiency reaches ~80 cm2 C-1, which means that a 300-nm-thick layer blocks 99% of transmitted visible light by the electrical switching. By tracking the color propagation, oxygen vacancy mobility can be estimated to be 10-8 cm2 s-1 V-1 near 300°C, which is a giant value attained due to the mosaic pseudomonoclinic film stabilized on LaAlO3 substrate. First-principles calculations reveal that the defect density modulation associated with hole charge injection causes a prominent change in electron correlation, resulting in the light absorption modulation. Our findings will pave the pathway for practical topotactic electrochromic applications.

Sex and Racial/Ethnic Differences in Suicidal Consideration and Suicide Attempts among US College Students, 2011-2015.

Objectives: In this study, we examined sex and racial/ethnic differences in the prevalence and predictors of suicide consideration and attempts among US college students. Methods: We used multivariable logistic regression to investigate suicide consideration and attempts by sex and race/ethnicity among students (N = 319,342) who completed the American College Health Association-National College Health Assessment from fall 2011 to spring 2015. Results: Overall, the prevalence of suicide consideration and attempts was higher in spring 2015 than fall 2011 (p < .05). Men had higher odds of suicide consideration and attempts than women (p < .001). Blacks, Hispanics, and Asians had higher odds of suicide consideration and attempts compared with Whites (p < .001). Weight-related problems (unhealthy weight, body weight overestimation, and lack of physical activity), sleep problems (insufficient sleep and sleep difficulties), and lower levels of academic performance were associated with both suicide consideration and attempts (p < .05). Conclusions: Our findings indicate a need for sex- and race/ethnicity-specific suicide prevention strategies for college students, specifically men and racial/ethnic minority groups. Furthermore, appropriate weight and sleep management could be considered to help prevent suicide among US college students.

Sex and racial/ethnic differences in sleep quality and its relationship with body weight status among US college students.

Objective: To examine sex and racial/ethnic differences in sleep quality and the association between sleep quality and body weight status among US college students. Participants: A nationally representative sample (N = 324,767) of college students from 2011 to 2015. Methods: A secondary data analysis of cross-sectional data. Results: Women showed poorer sleep quality (nights per week getting enough sleep to feel rested) than men (4.00 versus 4.34 days; p < .001). In both men and women, compared with non-Hispanic whites, racial/ethnic minorities showed lower sleep quality (p < .001). Compared with normal weight participants, overweight participants had poorer sleep quality (p = .007) among men, and both overweight (p = .004) and obese participants (p < .001) had lower sleep quality among women. Conclusions: Understanding sex and racial/ethnic sleep differences and the association between sleep and body weight status is important for colleges to promote college students' healthy sleep.

The Effects of Irvingia gabonensis Seed Extract Supplementation on Anthropometric and Cardiovascular Outcomes: A Systematic Review and Meta-Analysis.

Background: It has been hypothesized that Irvingia gabonensis can promote weight loss by increasing fatty acid breakdown and inhibiting fatty acid synthesis.Objective: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of Irvingia gabonensis seed extract supplementation on weight-related health outcomes.Methods: Literature searches were conducted in 4 databases from January 2018 to identify randomized controlled trials (RCTs) investigating the effects of Irvingia gabonensis seed extract supplementation on anthropometric measures and cardiovascular biomarkers. Two investigators independently performed abstract screenings, full-text screenings, data extraction, and risk of bias (ROB) assessments. Random effects meta-analyses were performed when 3 or more RCTs reported the same outcome.Results: Five RCTs met the eligibility criteria for this systematic review. Four of the 5 RCTs were rated as having a high ROB, and only one RCT was rated as having a low ROB. Random-effects meta-analysis of the 5 RCTs showed that a significant decrease in body weight, body fat, and waist circumference was observed in relation to Irvingia gabonensis seed extract supplementation. However, the only one low-ROB trial did not have significantly different outcomes. Meta-analysis also showed beneficial effects of Irvingia gabonensis seed extract supplementation on total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides. Only the low-ROB trial showed a trend of increasing HDL-cholesterol levels (net percent change = 11.61%; 95% confidence interval (CI: -6.12%, 29.34%) and decreasing triglyceride levels (net percent change = -29%; 95% CI: -76%, 19%). The reported adverse events were minor in these 5 RCTs.Conclusions: Overall efficacy of Irvingia gabonensis seed extract supplementation on weight loss seems positive but is limited due to poor methodological quality and the insufficient reporting of the clinical trials. Further high quality RCTs are needed to determine the effectiveness of Irvingia gabonensis seed extract supplement on the weight-related health outcomes.

Role of milk and dairy intake in cognitive function in older adults: a systematic review and meta-analysis.

BACKGROUND: As aging populations increase across the globe, research on lifestyle factors that prevent cognitive decline and dementia is urgently needed. Therefore, a systematic review was conducted to examine the effects of varying levels of milk intake alone or in combination with other dairy products on the outcomes of cognitive function and disorders in adults. METHODS: A comprehensive search was conducted across 3 databases (PUBMED, CINAHL, and EMBASE) from their inception through October 2017. Prospective cohort studies and randomized controlled trials (RCTs) that enrolled adults were included. Studies with follow-up durations of less than 4 weeks and studies including schizophrenic patients were excluded. Two independent investigators conducted abstract and full-text screenings, data extractions, and risk-of-bias (ROB) assessments using validated tools. Studies were synthesized qualitatively using a strength of evidence (SoE) rating tool. A random-effects model for meta-analysis was conducted when at least 3 unique studies reported sufficient quantitative data for the same outcome. RESULTS: A total of 1 RCT and 7 cohort studies were included. One medium-quality small RCT (n = 38 participants) showed that only spatial working memory was marginally better in the high dairy diet group compared to the low dairy diet group. Two of the 7 cohort studies were rated as having a high ROB, and only 1 cohort study was rated as having a low ROB. There were large methodological and clinical heterogeneities, such as the methods used to assess milk or dairy intake and the characteristics of the study populations. It was impossible to conduct a dose-response meta-analysis because the studies utilized different categories of exposures (e.g., different frequencies of milk consumption or the amount of dairy intake). Thus, the overall SoE was rated as insufficient regarding the associations between milk intake and cognitive decline, dementia, and Alzheimer's disease outcomes. Our meta-analysis of 3 cohort studies showed no significant association between milk intake and cognitive decline outcome (pooled adjusted risk ratio = 1.21; 95% CI: 0.81, 1.82; for highest vs. lowest intake) with large statistical heterogeneity (I2 = 64.1%). CONCLUSIONS: The existing evidence (mostly observational) is too poor to draw a firm conclusion regarding the effect of milk or dairy intake on the risk of cognitive decline or disorders in adults.

Racial/ethnic differences in body weight perception among U.S. college students.

OBJECTIVE: To examine racial/ethnic differences in weight perception by sex among U.S. college students. PARTICIPANTS: a national sample (N = 70,267) of college students selected from 2- and 4-year postsecondary institutions (N = 62) during the Fall semester from 2011 to 2014. METHODS: This is a secondary data analysis using 4 years of American College Health Association-National College Health Assessment IIb data. Sex-stratified multinomial logistic regression was performed to investigate racial/ethnic differences in body weight perception. RESULTS: Compared with non-Hispanic whites, non-Hispanic black men and women were more likely to underestimate their body weight (p < .01). Asian men and women were more likely to overestimate their body weight than non-Hispanic whites (p < .001). CONCLUSIONS: Weight-related interventions should take into account racial/ethnic differences in body weight perception.

Body-related Perspectives and Weight Control Methods of Korean-Chinese Nursing School Students in Yanbian, China: A Pilot Study.

OBJECTIVES: This study aimed at identifying the current nutrition knowledge, body-related perspectives, and weight control behaviors of Korean-Chinese college students. METHODS: We conducted a pilot study by employing a healthy weight education program targeting Korean-Chinese nursing school students at the Yanbian University of Science and Technology in Yanbian, China. RESULTS: This pilot study included 40 participants (38 women and 2 men; mean age, 20.5 years). The current weight status of the participants was as follows: 7.9% underweight, 78.9% normal weight, 7.9% overweight, and 5.3% obese. However, nearly two-thirds of the participants were dissatisfied with their current body size (43.6% a little dissatisfied; 20.5% very dissatisfied). Fifty percent of the participants perceived their current body size as being either slightly fat (35.0%) or very fat (15.0%). The following unhealthy weight control methods were commonly used among the 24 participants who practiced weight control: (1) laxatives or diuretics (91.7%), (2) saunas or spas (87.5%), and (3) a one-food diet (79.2%). In addition, the nutrition knowledge of the participants increased by 24 points from 117 points (pretest) to 141 points (posttest) through the healthy weight education program. CONCLUSION: The findings of this study indicate an urgent need to educate Korean-Chinese college students on healthy weight control methods and body-related perspectives.

Barriers, Attitudes, and Dietary Behaviors Regarding Sodium Reduction in the Elderly Korean-Chinese Population in Yanbian, China.

OBJECTIVES: This research investigated the barriers, attitudes, and dietary behaviors related to sodium reduction among the elderly Korean-Chinese population in Yanbian, China. METHODS: We conducted this pilot study using both descriptive research and a focus group interview at the elderly community center in Yanbian. RESULTS: In total, 21 elderly Korean-Chinese (average age, 71 years) were examined. The findings showed that the top three barriers to sodium reduction were 1) the difficulties associated with having meals with others, 2) a preference for liquid based-dishes, and 3) the lack of taste in low-sodium dishes. Although the participants strongly believed that a reduced-sodium diet would improve their health, they were poorly aware of the amount of sodium in various foods and dishes. In particular, the focus group interviews with eight participants (mean age, 67 years) revealed that salt-preserved foods (e.g., Korean pickled cabbage called 'kimchi' and soybean paste) were frequently consumed as part of their food culture, and that very salty dishes were served at restaurants, both of which lead to a high sodium intake. CONCLUSION: This study provides useful preliminary data to help design a nutrition intervention program for sodium reduction that targets the elderly Korean-Chinese population in China.

Sleep duration's association with diet, physical activity, mental status, and weight among Korean high school students.

BACKGROUND AND OBJECTIVES: Sleep deprivation is a critical public health problem, especially in Korean adolescents. This study aimed to identify the association between sleep duration and dietary behaviors, physical activity, mental status, and nutritional status among high school students in South Korea. METHODS AND STUDY DESIGN: Based on the data collected from the 2014 Korea Youth Risk Behavior Web-based Survey, 31,407 high school students who met the inclusion criteria were selected and the association between sleep duration and selected health risk factors was identified using multivariable logistic regression models. RESULTS: The average daily sleep duration was 5.7 hours, and the mean BMI was 21.3 kg/m2. Participants with shorter durations of sleep (<7 hours versus >=7 hours of sleep) were more likely to feel sad or hopeless (adjusted OR, 1.09; 95% CI, 1.00-1.18), have suicidal ideation (adjusted OR, 1.13; 95% CI, 1.01-1.27), and feel much or very much stressed (adjusted OR, 1.82; 95% CI, 1.66-2.00). Moreover, shorter sleep was associated with less frequent muscle-strengthening exercises, >=3 times per week (adjusted OR, 0.86; 95% CI, 0.78-0.94), and more frequent cracker consumption, >=3 times per week (adjusted OR, 1.24; 95% CI, 1.13-1.35). CONCLUSIONS: High school students in South Korea suffer from extreme sleep deprivation; only 16% of the students were found to have >=7 hours of sleep during weekdays. Sleep education should be provided to students to improve their physical and mental health.

Development of a Food Safety and Nutrition Education Program for Adolescents by Applying Social Cognitive Theory.

OBJECTIVES: The purpose of this study was to develop an educational model regarding food safety and nutrition. In particular, we aimed to develop educational materials, such as middle- and high-school textbooks, a teacher's guidebook, and school posters, by applying social cognitive theory. METHODS: To develop a food safety and nutrition education program, we took into account diverse factors influencing an individual's behavior, such as personal, behavioral, and environmental factors, based on social cognitive theory. We also conducted a pilot study of the educational materials targeting middle-school students (n = 26), high-school students (n = 24), and dietitians (n = 13) regarding comprehension level, content, design, and quality by employing the 5-point Likert scale in May 2016. RESULTS: The food safety and nutrition education program covered six themes: (1) caffeine; (2) food additives; (3) foodborne illness; (4) nutrition and meal planning; (5) obesity and eating disorders; and (6) nutrition labeling. Each class activity was created to improve self-efficacy by setting one's own goal and to increase self-control by monitoring one's dietary intake. We also considered environmental factors by creating school posters and leaflets to educate teachers and parents. The overall evaluation score for the textbook was 4.0 points among middle- and high-school students, and 4.5 points among dietitians. CONCLUSION: This study provides a useful program model that could serve as a guide to develop educational materials for nutrition-related subjects in the curriculum. This program model was created to increase awareness of nutrition problems and self-efficacy. This program also helped to improve nutrition management skills and to promote a healthy eating environment in middle- and high-school students.