Direct inhibition of the longevity-promoting factor SKN-1 by insulin-like signaling in C. elegans.

Insulin/IGF-1-like signaling (IIS) is central to growth and metabolism and has a conserved role in aging. In C. elegans, reductions in IIS increase stress resistance and longevity, effects that require the IIS-inhibited FOXO protein DAF-16. The C. elegans transcription factor SKN-1 also defends against oxidative stress by mobilizing the conserved phase 2 detoxification response. Here we show that IIS not only opposes DAF-16 but also directly inhibits SKN-1 in parallel. The IIS kinases AKT-1, -2, and SGK-1 phosphorylate SKN-1, and reduced IIS leads to constitutive SKN-1 nuclear accumulation in the intestine and SKN-1 target gene activation. SKN-1 contributes to the increased stress tolerance and longevity resulting from reduced IIS and delays aging when expressed transgenically. Furthermore, SKN-1 that is constitutively active increases life span independently of DAF-16. Our findings indicate that the transcription network regulated by SKN-1 promotes longevity and is an important direct target of IIS.

Objective and perceived food environment and household economic resources related to food insecurity in older adults living alone in rural areas.

BACKGROUND: Limited attention has been paid to an association between food environment and household economic resources related to food expenditure in food-insecure seniors. The aim of the study was to investigate the relationship between factors of economic resource, food environment, and food insecurity in single seniors residing in rural areas of South Korea. METHODS: A cross-sectional study was conducted in 170 single senior households aged 65 years or over residing in rural areas. Face-to-face interviews were performed to collect data on demographic characteristics, household economic resources/expenditure, food environmental factors, and food insecurity. RESULTS: Among economic resources, generally limited food expenditures due to housing fees and heating costs during the winter were positively related to food insecurity. Among food environmental factors, food accessibility at community level such as food stores located far from home and inconvenient bus routes was related to food insecurity. The most explainable economic and food environment factors related to food insecurity by stepwise logistic regression analysis were the percentage of total expenditure on housing fee (OR = 1.021, 95% CI: 1.008-1.034), foods purchasing at super supermarket (OR = 0.398, 95% CI: 0.166-0.951), having difficulties in food purchasing due to food stores being located far from home (OR = 14.487, 95% CI: 5.139-40.842) and inconvenient bus routes (OR = 0.083, 95% CI: 0.015-0.460). CONCLUSION: Inadequate community food environment as well as limited household food resources were an important risk factor for food insecurity in Korean single rural seniors. Findings of this study could help us better understand how characteristics of household food resources and community food environment can serve as barriers or facilitators of food security among single older adults residing in rural areas.

Quantitative microleakage analysis of endodontic temporary filling materials using a glucose penetration model.

OBJECTIVE: The purpose of this study was to analyze the sealing ability of different temporary endodontic materials over a 6-week period using a glucose penetration model. MATERIALS AND METHODS: Standardized holes were formed on 48 dentin discs from human premolars. The thicknesses of the specimens were distributed evenly to 2 mm, 3 mm and 4 mm. Prepared dentin specimens were randomly assigned into six groups (n = 7) and the holes in the dentin specimens were filled with two kinds of temporary filling materials as per the manufacturers' instructions as follows: Caviton (GC Corporation, Tokyo, Japan) 2 mm, 3 mm, 4 mm and IRM (Dentsply International Inc., Milford, DE) 2 mm, 3 mm, 4 mm. The remaining specimens were used as positive and negative controls and all specimens underwent thermocycling (1000; 5-55°C). The sealing ability of all samples was evaluated using the leakage model for glucose. The samples were analyzed by a spectrophotometer in quantitative glucose microleakage test over a period of 6 weeks. As a statistical inference, a mixed effect analysis was applied to analyze serial measurements over time. RESULTS: The Caviton groups showed less glucose penetration in comparison with the IRM groups. The Caviton 4 mm group demonstrated relatively low glucose leakage over the test period. High glucose leakage was detected throughout the test period in all IRM groups. The glucose leakage level increased after 1 week in the Caviton 2 mm group and after 4 weeks in the Caviton 3 mm and 4 mm groups (p < 0.05). CONCLUSIONS: Caviton had better sealing ability than IRM in the glucose penetration model during 6 weeks. Temporary filling of Caviton to at least 3 mm in thickness is necessary and temporary filling periods should not exceed 4 weeks.

Cytotoxicity of four denture adhesives on human gingival fibroblast cells.

OBJECTIVE: The purpose of this study was to compare the cytotoxicity of four denture adhesives on human gingival fibroblast cells. MATERIALS AND METHODS: Immortalized human gingival fibroblasts were cultured with one of four different denture adhesives, Polident, Protefix, Staydent or Denfix-A, which was placed in insert dishes (10% w/v concentration) for 48 h. The MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] assay and flow cytometric apoptosis assay were used to evaluate cell viability and apoptosis rates. The fibroblasts were also examined under a scanning electron microscope. RESULTS: The MTT assay showed that all denture adhesives resulted in a significantly lower cell viability compared to the control cells propagated in normal culture medium (p < 0.05), with Staydent demonstrating the lowest cell viability. According to the flow cytometric apoptosis assay, Staydent and Protefix showed significantly higher apoptosis rates than the control group (p < 0.05), whereas Polident and Denfix-A did not demonstrate any significant differences (p > 0.05). Staydent showed the highest apoptosis rate. Scanning electron microscopy showed that the cells of the Staydent group underwent cytoplasmic membrane shrinkage, with cell free areas containing residual fragments of the membrane of dead cells. CONCLUSIONS: The four denture adhesives evaluated in this study imparted cytotoxic effects on human gingival fibroblast cells. Staydent showed the highest toxicity.

Carbohydrate intake interacts with SNP276G>T polymorphism in the adiponectin gene to affect fasting blood glucose, HbA1C, and HDL cholesterol in Korean patients with type 2 diabetes.

BACKGROUND/OBJECTIVE: The SNP276G>T polymorphism in the adiponectin gene has been reported to be associated with type 2 diabetes and impaired glucose tolerance. The objective of this study was to examine whether SNP276G>T polymorphism influences the blood glucose levels in relation to dietary carbohydrate intake. SUBJECTS/METHODS: In an ongoing, prospective study, 673 patients with type 2 diabetes (339 men and 334 women, aged 40-85 years) were recruited from one of two diabetes clinics in Seoul, Korea. The levels of carbohydrate intake were categorized as <55%, 55%-65%, and >65% of total energy intake. RESULTS: Significant gene-nutrient interactions between SNP276G>T polymorphism and the level of carbohydrate intake were found, which modulated plasma fasting blood glucose (p=0.0277), HbA1C (p=0.0407), and high-density lipoprotein (HDL) cholesterol (p=0.0134) concentrations. The G allele was associated with higher fasting blood glucose only in subjects consuming a low-carbohydrate diet (<55% of energy). However, when carbohydrate intake was intermediate (55%-65%), carriers of the T allele had greater fasting blood glucose and HbA1C concentrations. When carbohydrate intake was high (>65%), carriers of the T allele had greater HDL cholesterol concentrations. This interaction was significant even when carbohydrate intake was considered a continuous variable (p=0.0200 for fasting blood glucose, p=0.0408 for HbA1C, and p=0.0254 for HDL cholesterol), suggesting a strong dose-response relation. CONCLUSIONS: Our data show that the effect of the SNP276G>T polymorphism on plasma fasting blood glucose, HbA1C, and HDL cholesterol concentrations depends on dietary carbohydrate intake.

Relationship between maternal sodium intake and blood lead concentration during pregnancy.

Pb is released from bone stores during pregnancy, which constitutes a period of increased bone resorption. A high Na intake has been found to be negatively associated with Ca and adversely associated with bone metabolism. It is possible that a high Na intake during pregnancy increases the blood Pb concentration; however, no previous study has reported on the relationship between Na intake and blood Pb concentration. We thus have investigated this relationship between Na intake and blood Pb concentrations, and examined whether this relationship differs with Ca intake in pregnant Korean women. Blood Pb concentrations were analysed in 1090 pregnant women at mid-pregnancy. Dietary intakes during mid-pregnancy were estimated by a 24 h recall method covering the use of dietary supplements. Blood Pb concentrations in whole-blood samples were analysed using graphite furnace atomic absorption spectrophotometry. Multiple regression analysis performed after adjustment for covariates revealed that maternal Na intake was positively associated with blood Pb concentration during pregnancy, but only when Ca intake was below the estimated average requirement for pregnant Korean women (P= 0·001). The findings of the present study suggest that blood Pb concentration during pregnancy could be minimised by dietary recommendations that include decreased Na and increased Ca intakes.

Maternal iron intake at mid-pregnancy is associated with reduced fetal growth: results from Mothers and Children's Environmental Health (MOCEH) study.

BACKGROUND: Iron supplementation is a common recommendation for pregnant women to prevent iron deficiency during pregnancy. There is an increasing concern about excessive iron consumption as a general iron prophylaxis by pregnant women without any due consideration about their dietary iron intake or iron status. Our present study investigated the association between total iron intake from diet and supplements and fetal growth in 337 pregnant women at mid-pregnancy in South Korea. METHODS: Iron intake from diet and supplements was examined by a 24-hour recall method. Subjects were divided into three groups based on tertiles of total iron intake levels. Fetal biometry was assessed by ultrasonography at mid-pregnancy. RESULTS: About 99% of the non-supplement users had iron intake below the recommended nutrient intake (RNI) for pregnant women (24 mg), whereas 64.9% of supplement users had iron intake above the upper level (UL) (45 mg). In the babies of mothers in the third tertile of iron intake (>17.04 mg), biparietal diameter, abdominal circumference, and femur length were lower by 0.41 cm (P =0.019), 0.41 cm (P = 0.027), and 0.07 cm (P = 0.051), respectively, than the babies of mothers in the second tertile of iron intake (11.49 ~ 17.04 mg). CONCLUSION: These results suggest that excessive maternal iron intake at mid-pregnancy is associated with reduced fetal growth. Iron supplementation for pregnant women should be individualized according to their iron status. Appropriate diet education is needed for pregnant women so that they can consume adequate amounts of iron from food and supplements.

Does Better Diet Quality Offset the Association between Depression and Metabolic Syndrome?

Several studies have shown that depression increases the risk of metabolic syndrome (MetS), which is often exacerbated by the fact that both exist concurrently. People with depression are more likely to have unhealthy eating habits, which can eventually trigger the development of MetS. This study was to investigate whether diet quality modifies the association between depression and MetS in a total of 13,539 Korean adults aged 19 to 80 from 2014, 2016 and 2018 Korean National Health and Nutrition Examination Surveys. Depression was assessed by the Patient Health Questionnaire-9 (PHQ-9) and subjects were divided into subgroups according to the PHQ-9 scores: normal (<5), mild (5-9), and moderate-to-severe (≥10) groups. Diet quality was measured by the Korean Healthy Eating Index (KHEI). A complex sample multiple logistic regression stratified by tertiles of KHEI scores was used to explore whether diet quality modifies an association between depression severity and metabolic syndrome. Depression severity was positively associated with the risk of MetS (p trend = 0.006) after adjustment for potential confounders. Only the lowest diet quality, moderately-to-severely depressed group, showed a higher risk of MetS (OR: 1.72, 95% CI: 1.24-2.40) compared to the normal group. Our results suggest that healthy diet quality could offset the positive relationship between depression and MetS in the general Korean adult population. Encouraging a healthy diet regime can improve not only physical health but also the mental state of the general public.

Dietary Reference Intakes for Koreans with special consideration to older adults.

BACKGROUND/OBJECTIVES: The Dietary Reference Intakes for Koreans (KDRIs) were revised in 2020. Due to the rapidly aging Korean population, special consideration was given to reclassify the KDRI age group categories of older adults. This article examines the evidence for modifying the current KDRI age group ranges of older adults (65-74 and ≥ 75 yrs). SUBJECTS/METHODS: We first reviewed the domestic and international data on the elderly, following which we received expert opinions on age classification from the KDRI Advisory Committee. Finally, the 6th and 7th (2013-2017) Korea National Health and Nutrition Examination Survey (KNHANES) data were used to analyze the nutritional intake statuses by considering the age of older adults. RESULTS: According to the review results of domestic and international data and the inputs received from the expert advisory committee, the minimum age considered for the elderly was maintained at 65 yrs. However, the KNHANES data was analyzed to review whether there was a need to subdivide the later periods. Examining the differences in nutrient intakes by age group through the interaction effect term of the piecewise linear regression model revealed the interaction effect was maximum in the groups divided by 65 yrs (50-64 and 65-80), as compared to the groups divided by 70 yrs (50-69 and 70-80) and 75 yrs (50-74 and 75-80). The mean adequacy ratio was calculated per 1 yr of age, and a 3-yr (age) moving average analysis was performed to examine the change in the trends of overall nutrient intake. However, it was challenging to secure a scientific basis for subdivision into age groups in older adults from the results obtained. CONCLUSIONS: This study could not find any scientific evidence for modifying the KDRI age groups for older adults.

Development of the Korean Healthy Eating Index for adults, based on the Korea National Health and Nutrition Examination Survey.

BACKGROUND/OBJECTIVES: The objective of this study was to describe the development process of the Korean Healthy Eating Index (KHEI) based on the Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS: The components of KHEI were selected based on Dietary Guidelines for Koreans, domestic and overseas dietary quality indices, and results of the analysis of association with chronic diseases. The standards for scoring of KHEI were selected based on the 2015 Dietary Reference Intakes for Koreans (KDRI). The KHEI scores of Korean adults were calculated using a 1-day 24-h recall data in the 2013-2015 KNHANES. RESULTS: The KHEI included eight adequacy components evaluating the proper intake of recommended foods such as fruit, vegetable, and milk and three moderation components evaluating the consumption of food that limit intake such as sodium and saturated fatty acid. In addition, three balance components assessing the balance of energy intake were included. The KHEI score was defined to range from the minimum of 0 point to the maximum of 100 points. Among Korean adults, the total KHEI score was 63.2 out of 100. Gender and age differences were found in the average of total KHEI scores. Women showed higher score than men (61.7 in men and 64.7 in women, respectively). By age group, 20s and 30s showed the lowest scores with 57.4 and 61.1 respectively, and the scores increased with age by peaking at 67.8 in ages 60-69 and slowed down again in ages 70 or over. CONCLUSIONS: The KHEI can be useful for establishing and assessing national nutritional policies and in epidemiological studies to assess the relationship between overall dietary quality and chronic diseases. KHEI will need to be continuously updated to reflect changes in dietary guidelines and the KDRI.

Relationships of maternal zinc intake from animal foods with fetal growth.

Zn is an essential element for human growth. The nutritional adequacy of dietary Zn depends not only on the total Zn intake, but also on the type of food source (i.e. of plant or animal origin). We investigated the association between maternal dietary Zn intake from animal and plant food sources and fetal growth. A total of 918 pregnant women at 12-28 weeks of gestation were selected from the Mothers and Children's Environmental Health study in Korea. Dietary intakes in mid-pregnancy were estimated by a 24 h recall method, and subsequent birth weight and height were obtained from medical records. Multiple regression analysis showed that maternal Zn intake from animal food sources and their proportions relative to total Zn intake were positively associated with birth weight (P = 0.034 and 0.045, respectively) and height (P = 0.020 and 0.032, respectively). Conversely, the percentage of Zn intake from plant food sources relative to total Zn intake was negatively associated with birth height (P = 0.026) after adjustment for covariates that may affect fetal growth. The molar ratio of phytate:Zn was negatively associated with birth weight (P = 0.037). In conclusion, we found that the absolute amounts of Zn from different food sources (e.g. animal or plant) and their proportions relative to total Zn intake were significantly associated with birth weight and height. A sufficient amount of Zn intake from animal food sources of a relatively higher Zn bioavailability is thus encouraged for women during pregnancy.

Is It What They Eat or How Much They Eat That Matters More in Adults with Food Insecurity in a Wealthy-Country Context?

This study aimed to investigate whether dietary quantity and/or quality differ according to food security levels in the Korean adult population. Dietary adequacy and quality were evaluated by the Korean Dietary Reference Intake and the Korean Healthy Eating Index (KHEI) for adults, respectively, according to three food security levels, i.e., food security, low food security, and very low food security. A total of 7144 Korean adults (aged 19 to 64 years) were selected from cross-sectional data from the 2013-2015 Korean National Health and Nutrition Examination Surveys. The risk of inadequate nutrient intakes of protein (p trend = 0.021) and phosphorus (p trend = 0.002) increased according to food insecurity levels after adjustment for putative risk factors. The total KHEI scores (p < 0.001) as well as scores of having breakfast (p < 0.001) were lowest in the very low food security group. Among KHEI components, adults with food insecurity were less likely to get full scores from intakes of mixed grains (p trend = 0.016), total fruit (p trend = 0.039), fresh fruit (p trend = 0.043), and breakfast (p trend < 0.001). In addition, food-insecure adults were more likely to get zero score from intakes of fresh fruit (p trend = 0.020), milk and dairy products (p trend = 0.049), breakfast (p trend < 0.001), % of energy from sweets and beverages (p trend = 0.002), and total energy (p trend = 0.033). In conclusion, food security levels were associated with how much they ate, as well what they ate, in adults in South Korea. These results implied that the diet adequacy as well as moderation and balance could be carefully treated with food assistance or nutrition intervention once nutritional adequacy has mostly been met. In addition, targeted intervention programs tailored to diverse contexts for improving food insecurity may prevent unintended consequences due to easy access to inexpensive obesogenic foods in adults with food insecurity.

Blood cadmium concentrations of male cigarette smokers are inversely associated with fruit consumption.

Decreased fruit and vegetable consumption, along with elevated blood cadmium concentrations, are frequently observed among cigarette smokers. Few studies have investigated whether the blood cadmium concentrations of cigarette smokers are associated with the consumption of antioxidative nutrients, as well as foods containing high concentrations of antioxidative nutrients and phytochemicals, such as fruits and vegetables. In this study, we aimed to determine where there is any relationship between blood cadmium concentration and the consumption of certain foods and nutrients in adult male smokers. Blood cadmium concentrations in whole blood samples from 546 adult men, whose pregnant wives were registered in the Mothers and Children's Environmental Health Study, were analyzed using the graphite furnace atomic absorption spectrophotometry method. Dietary intakes were assessed using a semiquantitative FFQ. Blood cadmium concentrations were higher in the smokers than in the nonsmokers (P < 0.001). Multiple regression analysis with covariates revealed that blood cadmium concentrations were negatively associated with intakes of fruit (P = 0.001), vitamin C (P = 0.035), and fiber (P = 0.049), but only in the smokers. These results warrant future studies to explore any mechanisms responsible for fruit's beneficial role against elevated blood cadmium concentrations in smokers.

Vegetables, but not pickled vegetables, are negatively associated with the risk of breast cancer.

This study investigated the association between pickled vegetable consumption and the risk of breast cancer using a validated food frequency questionnaire. A total of 358 patients with breast cancer who were matched to 360 healthy controls by age (using a 5-yr age distribution) were recruited from the National Cancer Center in South Korea. After adjusting for nondietary risk factors, total vegetable intake was inversely associated with risk of breast cancer. However, unlike nonpickled vegetables, pickled vegetable intake and its proportion relative to total vegetables were positively associated with the risk of breast cancer, and this association was more profound and consistent when pickled vegetable intake was considered as a proportion relative to total vegetables (odds ratio [OR] = 6.24, 95% confidence interval [CI] = 3.55-10.97; P for trend <0.001 for highest vs. lowest quartiles of intake) than as the absolute consumed amount (OR = 2.47, 95% CI = 1.45-4.21; P for trend = 0.015 for highest vs. lowest quartiles of intake). These results suggest that not only the amount of total vegetable intake but also the amounts of different types of vegetable (i.e., pickled or nonpickled) and their proportions relative to total vegetables are significantly associated with the risk of breast cancer.

Hypoadiponectinemia is strongly associated with metabolic syndrome in Korean type 2 diabetes patients.

OBJECTIVE: To evaluate the relationship between serum adiponectin level, dietary intake, and metabolic syndrome (MetS) in type 2 diabetes mellitus (DM) patients, and to identify factors associated with serum adiponectin level. METHODS: A cross-sectional study was performed using 789 type 2 DM patients (406 men and 383 women) 40-80 years old. Subjects were classified into 3 groups on the basis of serum adiponectin level. General characteristics and anthropometric, hematologic, and dietary data were obtained for each subject. RESULTS: The prevalence of hypoadiponectinemia (<4.0 µg/mL) was 57.4% in men and 32.4% in women. Serum adiponectin level was negatively correlated with body mass index (BMI), waist circumference, body fat percentage, and serum concentrations of insulin and triglyceride, and was positively correlated with high-density lipoprotein (HDL)-cholesterol level. Even though the direct association of nutrient intake with serum adiponectin concentration was not strong, various contributing factors for hypoadiponectinemia were strongly correlated with micronutrient intake, such as calcium, iron, and niacin. Both sexes in the group with the lowest adiponectin concentration had a higher prevalence of MetS and MetS components than corresponding sexes in the group with the highest adiponectin concentration. CONCLUSIONS: Our findings show that hypoadiponectinemia is strongly associated with MetS in type 2 DM patients. Dietary intake may be indirectly associated with adiponectin levels through factors such as BMI, waist circumference, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), triglyceride, HDL-cholesterol, and blood pressure. Therefore, our results suggest that manipulation of the level of adiponectin may prevent MetS and reduce the risk of cardiovascular disease in type 2 DM patients.

Effects of Coffee Intake on Dyslipidemia Risk According to Genetic Variants in the ADORA Gene Family among Korean Adults.

Current evidence on the effects of coffee intake on cardiovascular diseases is not consistent, in part contributed by the genetic variability of the study subjects. While adenosine receptors (ADORAs) are involved in caffeine signaling, it remains unknown how genetic variations at the ADORA loci correlate the coffee intake with cardiovascular diseases. The present study examined the associations of coffee intake with dyslipidemia risk depending on genetic variants in the ADORA gene family. The study involved a population-based cohort of 4898 Korean subjects. Consumption of more than or equal to a cup of coffee per day was associated with lower dyslipidemia risk in females carrying the ADORA2B minor allele rs2779212 (OR: 0.645, 95% CI: 0.506-0.823), but not in those with the major allele. At the ADORA2A locus, male subjects with the minor allele of rs5760423 showed instead an increased risk of dyslipidemia when consuming more than or equal to a cup of coffee per day (OR: 1.352, 95% CI: 1.014-1.802). The effect of coffee intake on dyslipidemia risk differs depending on genetic variants at the ADORA loci in a sex-specific manner. Our study suggests that a dietary guideline for coffee intake in the prevention and management of dyslipidemia ought to consider ADORA-related biomarkers carefully.

Neutral Position Facilitates Nasotracheal Intubation with a GlideScope Video Laryngoscope: A Randomized Controlled Trial.

The optimal head position for GlideScope facilitated nasotracheal intubation has not yet been determined. We compared the neutral and sniffing positions to establish the degree of intubation difficulty. A total of 88 ASA I-II patients requiring nasotracheal intubation for elective dental surgery with normal airways were divided into two groups according to head position, neutral position (group N), and sniffing position (group S). The primary outcome was the degree of intubation difficulty according to the Intubation Difficulty Scale (IDS): Easy (IDS = 0), mildly difficult (IDS = 1 to 4), and moderately to severely difficult (IDS ≥ 5). Eighty-seven patients completed the study and their data were analyzed. The degree of intubation difficulty was significantly different between the two groups (p = 0.004). The frequency of difficult intubation (IDS > 0) was 12 (27.9%) in group N and 28 (63.6%) in group S (difference in proportion, 35.7%; 95% confidence interval [CI], 14.8 to 52.6%; p = 0.001). The neutral position facilitates nasotracheal intubation with GlideScope by aligning the nasotracheal tube and the glottis inlet more accurately than the sniffing position.

Diet quality, physical activity, and their association with metabolic syndrome in Korean adults.

OBJECTIVE: The aim of ths study was to investigate the combined association of overall diet quality and physical activity (PA) on the risk for metabolic syndrome (MetS) in Korean adults. METHODS: This cross-sectional study extracted the data on 1008 adults (384 men and 624 women) 20 to 64 y of age. Dietary quality was assessed using a recommended food score (RFS) modified for a Korean diet. The total PA was summed to obtain a metabolic equivalent task score. Participants were classified according to the recommended levels of PA and RFS. Multiple logistic regression analysis was applied to determine the associations of RFS and PA with the prevalence of MetS after adjustment for potential confounders. RESULTS: About 21% of men and 19% of women were reported to have MetS. Nearly 5% of both sexes reached the recommended level of diet quality and PA. In men, a significantly reduced odds ratio (OR) for MetS (OR, 0.16; 95% confidence interval [CI], 0.09-0.93) and hypertriglyceridemia (OR, 0.25; 95% CI, 0.04-0.99) was found in those with better diet quality, within the strata of high PA. In women, compared with inactive individuals with poor diet quality, the OR for abdominal obesity in those with a better diet quality and who were active was 0.21 (95% CI, 0.05-0.86). CONCLUSIONS: Both diet quality and PA are associated with a lower risk for hypertriglyceridemia in men and abdominal obesity in women. These findings suggest that a sex-specific pattern of association between MetS and lifestyle factors (diet and PA) should be considered in clinical practice.

Fruit and vegetable intakes in relation to behavioral outcomes associated with a nutrition education intervention in preschoolers.

BACKGROUND/OBJECTIVES: Although a lot of effort has been put into increasing fruit and vegetable intakes in preschool children, vegetable intake in this group is still low. This study investigated whether nutrition education focusing on fruit and vegetable intakes can affect preschoolers' fruit and vegetable intakes as well as their behavioral outcomes. SUBJECTS/METHODS: Thirty-five preschoolers (54.3% boys, n = 19) aged 4-6 years residing in Seoul underwent weekly nutrition education intervention (8 sessions) between May and July 2016. Intakes of fruits and vegetables were measured during pre and post-intervention. At snack time, fresh fruit (150 g) and vegetable (120 g) snacks were distributed to each child by teachers. The remaining portions of the snacks were weighed and recorded for each child. Behavioral outcomes were measured by applying Child behavior checklist 1.5-5 and the Diagnostic and statistical manual of mental disorders. RESULTS: During post intervention, vegetable intake increased from 36.15 ± 30.64 g to 48.01 ± 31.23 g (P = 0.010). Among the emotional and behavioral problems measured by parents, levels of total problems (P = 0.001), internalizing (P = 0.004), externalizing (P = 0.003), anxiety and depression (P = 0.001), and aggressive behavior (P = 0.005) decreased. Anxiety (P = 0.026) score, as measured by teachers, also decreased. CONCLUSIONS: Nutrition education of preschoolers regarding the intakes of fruits and vegetables had a positive effect on preschoolers' vegetable intake as well as on their emotional and behavioral outcomes. A long-term, large-scale study with a broader study design is warranted to further investigate the role of fruit and vegetable intake in cognitive development and behavior of preschoolers.

Spatial Disparity in Food Environment and Household Economic Resources Related to Food Insecurity in Rural Korean Households with Older Adults.

Different contextual factors of a household and a community, such as access to resources and transportation, may influence the level of food insecurity. The objective of this study was to identify how food environmental factors and economic resources were related to food insecurity in Korean older adults residing in different contexts of rural areas. Face-to-face interviews with 248 older adults residing in land (n = 149) and mountain (n = 99) rural areas were performed. In both areas, risk of food insecurity was increased for households with limited community food accessibility measured by having difficulties in food purchasing due to food stores far from home. There were discrepancies in factors related to increased risks of food insecurity between households in land and mountain areas. The experience of reducing food expenditure resulting from burden of heating costs during the winter in households in a mountain area whereas the percent proportion of housing fee and household cook's physical disability in households residing in the land area were found to be factors associated with increased risks of food insecurity. For households residing in mountain areas, the risk of food insecurity was decreased when economic resources measured by average monthly income for the last one year was increased and there was farming or home gardening activity. Such spatial disparity might affect household food insecurity in rural areas. In addition, food environmental factors and economic resources may affect household food insecurity differently according to the diverse contexts of rural areas. Better understanding of spatial challenges in food insecurity faced by seniors in a large rural area would help prepare programs or policy change to strengthen and improve their food environments.