A Randomized, Double-Blind, Placebo-Controlled, Multi-Centered Clinical Study to Evaluate the Efficacy and Safety of Artemisia annua L. Extract for Improvement of Liver Function

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

A Randomized, Double-Blind, Placebo-Controlled, Multi-Centered Clinical Study to Evaluate the Efficacy and Safety of Artemisia annua L. Extract for Improvement of Liver Function

Non-alcoholic fatty liver disease (NAFLD) has the potential to develop into hepatic steatosis and progress to terminal liver diseases such as cirrhosis and hepatocellular carcinoma. This human clinical study was aimed to demonstrate that SPB-201 (powdered-water extract of Artemisia annua) can improve liver function in subjects with non-alcoholic liver dysfunction at mild to moderate levels. A decrease of 271% in aspartate aminotransferase (AST) level and a significant decrease of 334% in alanine aminotransferase (ALT) level was observed in the test group as compared to the control group at the 4 weeks follow-up. In addition, after 8 weeks, decreases of 199% in AST level and 216% in ALT level were reported in the test group as compared to the control group. These results confirmed that SPB-201 intake significantly enhanced liver function and health. Moreover, the Multidimensional Fatigue Scale score of the test group decreased but that of the control group increased, implicating that SPB-201 also eliminated overall fatigue. No significant adverse events were observed among all subjects during the study. Taken together, our clinical study confirmed the excellent efficacy and safety of SPB-201 in liver function improvement, showing the possibility of SPB-201 as a functional food to restore liver dysfunction and treat liver diseases.

Nutritional Care for the Elderly / 대한소화기학회지

Malnutrition among older people is a common health problem. It is well known that malnutrition is associated with a poor clinical outcome. Especially older individuals in catabolic crisis require comprehensive nutritional management to improve clinical outcome not only recovery of disease itself but also maintain physical and cognitive function. Intensive nutritional therapy in acute care is important since nutritional status is closely related to long-term clinical outcome and quality of life in the older people.

Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study

BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.

Association between intake of antioxidant vitamins and metabolic syndrome risk among Korean adults / 한국영양학회지

PURPOSE: The purpose of this study was to examine the association between intake of antioxidant vitamins and prevalence of metabolic syndrome (MetS) among Korean adults. METHODS: A total of 614 subjects aged 30~60 years were recruited from those who received a medical checkup at a general hospital in South Korea between 2009 and 2012. Presence of MetS was determined based on criteria issued by the NCEP ATP III. Intakes of antioxidant vitamins (vitamin A, retinol, carotenoids, vitamin C, and vitamin E) were estimated by combining 3-day diet records with an antioxidant vitamin database for common Korean foods. We used multiple logistic regression analysis to assess the association between dietary intakes of antioxidant vitamins and MetS. RESULTS: Men in the highest tertile for retinol (OR = 0.40, 95% CI = 0.23~0.71, P for trend = 0.0009), carotenoids (OR = 0.57, 95% CI = 0.32~1.00, P for trend = 0.0470), and vitamin E (OR = 0.52, 95% CI = 0.30~0.92, P for trend = 0.0190) intakes had a lower likelihood of having Mets than those in the lowest tertile. The OR of high fasting blood glucose among men in the highest tertile for vitamin A (µg RE: OR = 0.55, 95% CI = 0.32~0.97, P for trend = 0.0417, µg RAE: OR = 0.52, 95% CI = 0.29~0.92, P for trend = 0.0211), carotenoids (OR = 0.41, 95% CI = 0.23~0.73, P for trend = 0.0036), and vitamin E (OR = 0.47, 95% CI = 0.26~0.82, P for trend = 0.0080) intakes was lower than those in the lowest tertile. In women, subjects in the highest tertile of retinol intakes had a lower prevalence of MetS than those in the lowest tertile group (OR = 0.55, 95% CI = 0.30~0.98). The OR for abdominal obesity was lower among women with the highest vitamin A (µg RE) intakes compared to those in the lowest tertile (OR = 0.51, 95% CI = 0.28~0.93, P for trend = 0.0293). CONCLUSION: These results suggest that dietary intakes of antioxidant vitamins might be associated with reduced risk of having MetS among Korean adults.

Association of total dietary antioxidant capacity with oxidative stress and metabolic markers among patients with metabolic syndrome / 한국영양학회지

PURPOSE: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. METHODS: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual's TAC. RESULTS: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of γ-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of α-tocopherol (p < 0.05) and γ-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. CONCLUSION: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.

The Efficacy and Safety of Cordyceps militaris in Korean Adults Who Have Mild Liver Dysfunction

PURPOSE: The aim of this study is to determine the efficacy and safety of Cordyceps militaris in Korean adults with mild liver dysfunction. C. militaris is a mushroom traditionally used for several clinical purposes in East Asian territory, including China, and has been found to be effective in improving liver function through animal studies. METHODS: The C. militaris group was administered 1.5 g/day of C. militaris (2 capsules per dose, twice per day) and the placebo group was administered the same volume of placebo. Laboratory test (white blood cell, hemoglobin, platelet, aspartate aminotransferase, alanine aminotransferase, gamma glutamyltranspeptidase, lactic dehydrogenase, alkaline phosphatase, total bilirubin, blood urea nitrogen, creatinine), liver computed tomography (CT) were performed, and visual analogue scale score for subjective symptoms and fatigue severity scale were measured. RESULTS: In analysis of the liver CT scan at 8 weeks after administration compared to baseline, the mean ratio of change of Hounsfield unit of 8 segments of liver increased by an average of 21.43%+/-45.11% in the C. militaris group and 9.64%+/-11.41% in the placebo group. Others showed no statistically significant inter-group difference. CONCLUSION: C. militaris extract was used safely as a functional food in patients with mild liver dysfunction, and is expected to protect against progression of fatty liver or cirrhosis caused by suppression of lipid accumulation in hepatocytes.

Erratum: The Palatability of Cereal Based Nutritional Supplements in Cancer Patients

We would like to correct the affiliation for the first author.

The Prevalence of Sarcopenia in Korean Hospitalized Elderly

BACKGROUND: Sarcopenia is a syndrome characterized by the progressive loss of skeletal muscle mass and muscle strength. Although data exist on the prevalence of sarcopenia among the community-dwelling elderly, there is no systematic research on hospitalized elderly patients in Korea, in accordance with the newly developed criteria. METHODS: A cross-sectional study was conducted at the Daejin Medical Center, Bundang Jesaeng Hospital, Korea, from May 2013 to March 2015. In this study, we evaluated the levels of hemoglobin, total cholesterol, serum albumin, serum prealbumin, and serum zinc. Handgrip strength was measured with a hand grip dynamometer (FT-7110). Furthermore, the skeletal muscle mass was measured by bioelectrical impedance analysis (BIA). Sarcopenia was defined by skeletal muscle mass as measured with BIA, according to the Asian Working Group for Sarcopenia. RESULTS: Of the hospitalized elderly subjects, 40 (46.5%) had a definite diagnosis of sarcopenia and 46 (53.5%) had no sarcopenia. The prevalence of sarcopenia of the subjects was higher in males than females (males, 46.9% vs. females, 46.3%). The correlation analysis showed that the score of skeletal muscle index (SMI) was negatively correlated with age; whereas, it was positively correlated with the BMI, body weight, and serum prealbumin level. CONCLUSION: The results of the study showed that sarcopenia was associated with several factors, including age, BMI, serum prealbumin level, among the study subjects. Sarcopenia can be used as a sensitive predictive marker for prognosis of the hospitalized elderly.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged > or = 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Nutritional Status of Korean Hospitalized Patients: A Multi-Center Preliminary Survey

PURPOSE: The purpose of this study is to examine the prevalence of malnutrition in hospitalized patients aged 18 years old or older at the time of admission in Korea. METHODS: This multi-center, preliminary survey included patients over 18 years old who were admitted on a given day from six hospitals in Korea. Nutritional status was assessed using Subjective Global Assessment tool. Data collected included hospital characteristics, patient characteristics, nutrition screening, and nutrition assessment. RESULTS: Among the 99 patients recruited (47 males, 47.5%), 18 (18.2%) and 2 (2.0%) patients were moderately malnourished and severely malnourished, respectively. The mean age of the malnourished group was older than that of the well-nourished group (49.7+/-17.1 vs. 60.5+/-13.6 years old, P-value=0.010). Patients admitted for medical treatment were more malnourished than those admitted for surgical treatment. CONCLUSION: Results of the multi-center preliminary survey showed 20.2% prevalence of malnutrition on admission. A national survey was piloted and will be followed by full implementation.

Measurement of antioxidant capacity using the biological antioxidant potential test and its role as a predictive marker of metabolic syndrome

BACKGROUND/AIMS: Oxidative stress increases the risk of cardiovascular complications of metabolic syndrome (MetS). This study was conducted to examine the difference in antioxidant capacity according to the presence of MetS, and to characterize the association between antioxidant capacity and MetS-related factors. METHODS: We used the biological antioxidant potential (BAP) test to estimate antioxidant capacity. The BAP test has recently been used as an indicator of antioxidant capacity. We measured BAP levels in 45 patients with MetS (mean age, 44.6 +/- 1.1 years) and 47 age- and sex-matched controls (mean age, 42.7 +/- 1.1 years). To evaluate the association between antioxidant capacity and MetS, adiponectin, high-sensitivity C-reactive protein (hs-CRP), interleukin-6, tumor necrosis factor-alpha, and homeostatic model assessment for insulin resistance (HOMA-IR), linear regression and logistic analyses were performed. RESULTS: The mean BAP of the MetS group (1,937.3 +/- 36.5 micromol/L) was significantly lower than that of the non-MetS group (2,101.7 +/- 29.5 micromol/L). Also, the mean BAP was low in persons having low high density lipoprotein and high triglyceride. Reduced antioxidant capacity was significantly associated with adiponectin, HOMA-IR and hs-CRP after adjusting for age and sex. The odds ratios for MetS with BAP, log adiponectin, log HOMA-IR, and log hs-CRP were 0.63 (95% confidence interval [CI], 0.49 to 0.82), 0.22 (0.10 to 0.51), 14.24 (4.35 to 46.58), and 1.93 (1.36 to 2.75), respectively. CONCLUSIONS: Persons with MetS showed reduced antioxidant capacity. We identified relationships between antioxidant capacity measured by BAP test and MetS, as well as MetS-related factors, such as insulin resistance, hs-CRP, and adiponectin.

Nutritional therapy in hospital

Globally, the prevalence of malnutrition in hospitals is high. In Korea, a recent national survey in which 28 general hospitals throughout the country participated showed a 22% prevalence of hospital malnutrition. Malnutrition is associated with adverse outcomes including immune suppression, muscle wasting, delayed wound healing, infectious complications, longer hospital stays, high medical costs, and even increased mortality. Early implementation of nutritional therapy might improve medical outcomes. For early recognition of malnutrition and early nutritional intervention, a qualified nutrition support team (NST) is necessary. In Korea, 110 NSTs were at work as of 2013, mostly affiliated with large high-ranking hospitals. Since the activity of an NST and enteral formula are not reimbursed by the National Health Insurance Corporation, the potential for expansion of NSTs to rather small hospitals remains limited. To improve the quality of care for hospitalized patients and reduce medical expenses nationally, it is time to reform the system for alleviating in-hospital malnutrition.

The Palatability of Cereal Based Nutritional Supplements in Cancer Patients

Recently, it is reported that intervention of oral nutritional supplement improves the nutritional status of cancer patients, and the effectiveness is affected by the sensory preference of cancer patients on the oral nutritional supplement. However, the variety of oral nutritional supplement is extremely limited and the number of patient's benefits from using the products are restricted mostly due to sensory dislikes. The objective of this study was to provide sensory preference score of trial manufactured products with different accessory ingredients to maximize the use of oral nutritional supplements. Cancer patients (n = 30) and age, sex-matched healthy volunteers (n = 30) participated in the sensory assessments (taste, flavor, viscosity, color and overall preference) of three types of oral supplements (cereal base, cereal base+herb and cereal base+fruit) and a control supplement product with scorched cereal flavor, a top seller in current Korean market. Results indicate that the cancer patients' overall preference was significantly higher for the control supplement, and fruit added supplement was preferred over plain cereal and herb added products, although the difference was insignificant. However, there was no significant preference difference for the supplements among the control group for all sensory factors. These results suggest that cancer patients are more sensitive to sensory preferences compared to the control group, and the patients prefer the flavor of cooked cereal which is a staple food in Korea.

Effect of Intravenous High-Dose Selenium Supplementation in Patients with Systemic Inflammatory Response Syndrome: A Pilot Study / 대한내과학회지

BACKGROUND/AIMS: Systemic inflammatory response syndrome (SIRS) can induce occurrence of oxidative stress. Several reports have evaluated selenium supplementation in SIRS patients with encouraging results. Therefore, we evaluated the effect of intravenous high-dose selenium supplementation in patients with SIRS. METHODS: Patients were randomly assigned to one of two groups: the selenium group (800 microg/day of selenoic acid by intravenous bolus injection for 7 days) or the placebo group. Physical and biochemical measurements were used to assay acute phase reactants, severity of illness index and serum selenium concentration. RESULTS: A total of 23 patients classified as mild-to-moderate severity of illness index were enrolled between March 2010 and October 2011. Serum selenium concentration increased in the selenium group after intervention, but there was no significant change in the placebo group. In the selenium group, the white blood cell (WBC) count, serum level of c-reactive protein (CRP), Acute Physiology and Chronic Health Evaluation II (APACHEII) score and Sequential Organ Failure Assessment (SOFA) score improved significantly by days 7 and 14 compared with day 0. In the placebo group, only the serum CRP level at day 14 and APACHE II score at days 7 and 14 improved significantly compared to day 0. CONCLUSIONS: Intravenous supplementation with high-dose selenium improved acute phase reactants and the severity of illness index in patients with SIRS. However, larger prospective clinical trials are required to determine the efficacy of selenium supplementation in SIRS patients.

Breakfast patterns are associated with metabolic syndrome in Korean adults

The Korean diet, including breakfast, is becoming more Western, which could increase the risk of metabolic syndrome. Our aim was to assess whether breakfast patterns are associated with risk for metabolic syndrome in Korean adults. The study subjects (n = 371; 103 men, 268 women) were employees of Jaesang Hospital in Korea and their acquaintances, and all subjects were between 30 and 50 years old. The data collected from each subject included anthropometric measurements, three-day food intake, blood pressure (BP) and blood analyses. The three breakfast patterns identified by factor analysis were "Rice, Kimchi and Vegetables", "Potatoes, Fruits and Nuts" and "Eggs, Breads and Processed meat". The "Rice, Kimchi and Vegetables" pattern scores were positively correlated with systolic (SBP) and diastolic blood pressure (DBP) measurements in men (P < 0.05) and with serum triglyceride (TG) levels in women (P < 0.05). The "Eggs, Breads and Processed meat" pattern scores correlated positively with weight, body mass index (P < 0.05) and serum TGs (P < 0.01) in men. The "Potatoes, Fruits and Nuts" pattern was associated with lower risk of elevated BP (OR 0.49, 95% CI 0.28-0.88) and fasting glucose levels (OR 0.51, 95% CI 0.26-1.00). In contrast, the "Eggs, Breads and Processed meat" pattern was associated with increased risk of elevated TGs (OR 2.06, 95% CI 1.06-3.98). Our results indicate that reducing the consumption of eggs, western grains and processed meat while increasing fruit, nut and vegetable intake for breakfast could have beneficial effects on decreasing metabolic syndrome risk in Korean adults.

Intensive Exercise Reduces the Fear of Additional Falls in Elderly People: Findings from the Korea Falls Prevention Study

BACKGROUND/AIMS: Falls among older people are a major public health problem and may result in fracture, medical complications that require hospitalization, and fear of additional falls. Given the prevalence and impact of the fear of falling again, reducing the incidence of falls is important to prevent additional falls. This study analyzed whether exercise programs decrease the fear of future falls in elderly patients who have fallen previously. METHODS: A randomized controlled study was performed that included 65 elderly community-dwelling subjects who had fallen in the previous year. Subjects were randomized into two groups: an exercise group (EG, n = 36) and a control group (CG, n = 29). The EG participated in three exercise sessions per week for 12 weeks. Muscle strength, balance, agility, flexibility, and muscular endurance were measured at baseline and after 12 weeks. RESULTS: After the 12-week exercise program, the subjects in the EG demonstrated remarkable improvement in their walking speed, balance (p = 0.003), back strength (p = 0.08), lower extremity strength (p = 0.004), and flexibility (p < 0.001). When asked whether they were afraid of falling, more participants in the EG than in the CG responded "not at all" or "a little." CONCLUSIONS: The 12-week exercise program described here reduced the fear of falling (p = 0.02). It also improved the balance, flexibility, and muscle strength of the participants and was associated with improved quality of life.

A Study on the Perception as HANSIK (Korean Food) for the Common Dishes in Korean Adults Residing in Seoul and Metropolitan Area / 대한지역사회영양학회지

This study was conducted to investigate which food items are perceived as HANSIK (Korean food) in Korea. 562 males and females aged 20-70 were surveyed on 512 most frequently consumed dish items from 4th Korean National Health and Nutrition Survey if they perceive it as HANSIK. Dish items in kimchi, namul - sukchae (cooked and seasoned vegetable) and jeotgal (salt-fermented food) category showed high response rate to be perceived as HANSIK. The response rate of twigim (frying foods) as HANSIK was low showing less than 70%. The response rate as HANSIK for foreign origin foods such as ramen and jjajangmyeon (black bean paste noodle) were lower than 25%. In jang . yangnyum (seasoning) category, doenjang (soybean paste) and gochujang (red pepper paste) showed high response rate as HANSIK more than 90%. Females showed a higher response rate as HANSIK than males for most food items except several items of myen . mandu (noodle and dumpling). The younger age group had higher HANSIK perception on many items of recently consumed foods, especially budae-jjigae (spicy sausage stew) (p < 0.001) and jwipo-jorim (braised dried filefish) (p < 0.001), implying that they already accept the common foods as HANSIK regardless of the origin. These results provide an information on the foods perceived as HANSIK among currently consumed common foods in Korea and these results can be utilized for establishment of HANSIK concept reflecting transition of dietary life in Korea.

Skipping breakfast is associated with diet quality and metabolic syndrome risk factors of adults

The aim of the present study was to assess the effects of skipping breakfast on diet quality and metabolic disease risk factors in healthy Korean adults. Subjects included 415 employees (118 men, 297 women; 30-50 years old) of Jaesang Hospital in Korea and their acquaintances. Data collected from each subject included anthropometric measurements, 3-day dietary intake, blood pressure, and blood analyses. The subjects were classified into three groups based on the number of days they skipped breakfast: 'Regular breakfast eater', 'Often breakfast eater', or 'Rare breakfast eater'. Participants in the 'Rare breakfast eater' group consumed less rice, potatoes, kimchi, vegetables, fish and shellfish, milk and dairy products, and sweets than did participants in the other two groups (P for trend < 0.05) and ate more cookies, cakes, and meat for dinner (P for trend < 0.05). Participants in the 'Rare breakfast eater' group consumed less daily energy, fat, dietary fiber, calcium, and potassium than did participants in the other groups (P for trend < 0.05). The percent energy from carbohydrates was lower and fat intake was higher in the 'Rare breakfast eater' group than in the other groups (P for trend < 0.01). When diets were compared using the Acceptable Macronutrient Distribution Range for Koreans, 59.1% of subjects in the 'Rare breakfast eater' group consumed more energy from fat compared with the other two groups (P < 0.005). According to the Estimated Average Requirements for Koreans, intake of selected nutrients was lower in the 'Rare breakfast eater' group than in the other two groups (P < 0.05). The risk of elevated serum triglycerides was decreased in the 'Rare breakfast eater' group (OR, 0.3 [0.1-1.0], P for trend = 0.0232). We conclude that eating breakfast regularly enhances diet quality, but may increase the risk of elevated serum triglycerides.

A Case of Ciliated Hepatic Foregut Cyst Discovered by Chance in Elderly Patient with Cholecystitis and Cholangitis

Ciliated hepatic foregut cyst (CHFC) is a rare disease that originates from the tracheobronchial tree of the foregut. Most patients with CHFC, which is believed to be a non-malignant neoplasm, are clinically asymptomatic. However, there have been some case reports that identify it as changing to malignant in the last decade of the condition. Surgical excision is, therefore, preferred to observation as the treatment of CHFC. However, surgical excision of CHFC in asymptomatic elderly patients is controversial. We experienced a rare case of a 73-year-old female patient who was accidentally diagnosed with CHFC while being diagnosed for cholecystitis and cholangitis. The patient simultaneously underwent laparoscopic cholecystectomy and resection of CHFC, which was finally diagnosed as benign. We report asymptomatic CHFC in elderly patient, focusing our discussion on whether surgical excision of CHFC is necessary for asymptomatic elderly patients. According to a review of case reports, surgical excision of CHFC is not necessary for asymptomatic elderly patients.