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Purpose@#This study examined the factors affecting sugar intake in adults based on social cognitive theory. @*Methods@#An online survey regarding the intake frequency of sugar-source food, factors related to sugar intake based on social cognitive theory, perceptions of sugar intake, and health-related factors was conducted in October 2019 with 1,022 adults (502 men and 520 women) aged 19–49 years. The intake frequency of sugar-source food was divided into tertiles using percentiles based on the daily frequency. @*Results@#The daily intake frequency of sugar-source foods was 4 times, with beverages (1.87 times/day) and sweetened coffee (0.81 times/day) being the highest among the food groups and types, respectively. The group with a high intake frequency of sugar-source food had a high negative outcome expectation for reducing sugar intake, and was in a home and social environment with easy access to sweet food. Women in this group showed low self-efficacy and poor behavioral capability in reducing sugar intake. Self-control had the lowest average score among the factors of social cognitive theory (2.56/5 points), followed by nutrition knowledge related to sugar (5.42/10 points). As a result of regression analysis, the social cognitive factor affecting the intake frequency of sugar-sourced foods was found to be home environment for both men and women. On the other hand, factors contributing to reducing sugar intake were positive outcome expectations for men and behavioral skills for women. @*Conclusion@#Dietary education and nutritional interventions for adults, including changes in the home environment with easy access to sweet foods, can reduce sugar intake and raise positive expectations for reduced sugar intake.
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Objectives@#The sodium index is an index that converts the estimated sodium intake calculated using a verified and reliable sodium estimation formula. This study aimed to determine the relationship between the sodium index and obesity indicators and the potential impact of excessive sodium consumption on obesity. @*Methods@#Obesity indicators, such as body mass index (BMI), body fat percentage, waist-tohip ratio (WHR), and visceral fat levels, were analyzed in 120 university students (60 men and 60 women). The sodium index was calculated by indexing the estimated sodium intake according to age, sex, BMI, salt-eating habits, and salt-eating behaviors. The relationship between sodium index and obesity indicators was analyzed using multiple logistic regression. @*Results@#The estimated sodium intake was 3,907.1 mg, with 76.7% of the participants categorized under the “careful” level of sodium index and 10.8% under the “moderate” level. As the sodium index increased, the BMI, body fat percentage, WHR, and visceral fat levels significantly increased. All obesity indicators significantly increased in patients with a “severe” sodium index than in those with a “moderate” sodium index. In addition, a strong positive correlation was identified between obesity indicators and sodium index. When the “severe” sodium index was compared with the “moderate” sodium index, the risk of obesity based on body fat percentage increased by 2.181 times (95% confidence interval [CI], 1.526–3.118), while the risk of obesity based on visceral fat level increased by 4.073 times (95% CI, 2.097–7.911). @*Conclusions@#Our findings suggest a correlation between excessive sodium intake and obesity. Moreover, the sodium index can be used to determine sodium intake.
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Objectives@# This study aimed to investigate the correlation between adolescents’ dietary safety management competency, value recognition, efficacy, and competency of convergence using the dietary area (CUDA). @*Methods@# Data were collected from 480 middle and high school students in Daegu, Gyeongbuk and Seoul, Gyeonggi using a self-administered five-point Likert scale questionnaire from May to July 2021. A questionnaire was used to investigate dietary safety management competency, awareness of convergence, recognition of the benefits, efficacy, and competency of CUDA. @*Results@# We conducted factor, reliability, correlation, and regression analyses using SPSS 25. The average scores for each factor were: dietary significance (3.68); dietary safety management knowledge (3.34); food selection and cooking (3.72); nutrition management (3.38); weight management (3.28); risk dietary management (3.13); CUDA interest (2.98); convergence necessity (3.50); benefits in specialized areas (3.31); benefits in everyday life (3.48); efficacy of science and technology convergence (3.35); convergence efficacy with humanities, social science, and arts (3.31); and CUDA competency (3.41). The score for interest in CUDA was lower than that for the recognition of CUDA benefits. Significant positive correlations were observed between all factors except between risk dietary management and both nutrition and weight management (P < 0.01). Interest in CUDA and recognition of the need for convergence exhibited a positive and significant effect on all factors of the perception of CUDA benefits and efficacy. The subgroup factors of dietary safety management competency and the recognition of CUDA had a positive effect on the CUDA competency (P < 0.001, R 2 = 0.58). @*Conclusions@# Strengthening dietary safety management competency and increasing the awareness of CUDA can enhance adolescents’ convergence competency. Therefore, CUDA and targeted education must be actively promoted among adolescents.
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Background@#Smoking can reduce taste sensitivity, the ability to sense various tastes, and diet quality and can increase the incidence of diseases such as hypertension. This study aimed to analyze the association between the smoking amount, subjective salt preference, and salt-related eating behaviors. @*Methods@#Data of more than 16 million individuals from the Korean Community Health Survey were used. Forest plots were drawn to compare the cumulative odds ratios of salt taste preference and salt-related eating behaviors, adjusted for sex, age, body mass index, education level, household income, marital status, and drinking status at various smoking levels. @*Results@#Subjective salt preference and salt-related eating behaviors increased with smoking amount; the adjusted odds ratios (AORs) for smoking >20 cigarettes were higher than those for smoking <20 cigarettes. For daily smokers, the AOR was 1.27 (95% confidence interval [CI], 1.22–1.31) for 1–5 cigarettes per day and 1.68 (95% CI, 1.65–1.71) for 16–20 cigarettes per day (P<0.001). Smokers were more likely to have more frequent salt-related eating behaviors than nonsmokers. @*Conclusion@#The subjective salt preference of smokers was higher than that of nonsmokers. Additionally, smokers used salt or soy sauce and dipped fried food in soy sauce more frequently than nonsmokers, which was also related to smoking amount.
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Objectives@#The goal of this study was to help prevent and control the spread of coronavirus disease 2019 (COVID-19) by identifying transmission routes and risk factors in livestock slaughtering and processing facilities (SPFs) and establishing an optimal intervention strategy for outbreaks. @*Methods@#This case series study was a demographic analysis of patients with confirmed COVID-19 associated with 5 SPFs in Korea between January and June 2021. Additionally, in a retrospective cohort study, the association between COVID-19 infection and risk factors was analyzed for SPFs at which outbreaks occurred. @*Results@#The COVID-19 attack rates were 11.2%, 24.5%, and 6.8% at 3 poultry SPFs (PSPFs) and 15.5% and 25.2% at 2 mammal SPFs (MSPFs). Regarding spatial risk factors, the COVID-19 risk levels were 12.1-, 5.2-, and 5.0-fold higher in the refrigeration/ freezing, by-product processing, and carcass cutting areas, respectively, than in the office area. The risk of COVID-19 infection was 2.1 times higher among employees of subcontractors than among employees of contractors. The COVID-19 risk levels were 5.3- and 3.0-fold higher in foreign workers than in native Korean workers in the PSPFs and MSPFs, respectively. @*Conclusion@#As the COVID-19 pandemic continues, a detailed policy for infectious disease prevention and control intervention is needed, without interrupting economic activities. Thus, we propose an ideal intervention plan to prevent COVID-19 through disinfection and preemptive testing and to block its transmission through effective contact management during outbreaks at SPFs.
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The purpose of this study was to investigate the association between daily beverage intake and obesity in young adults. This cross-sectional study was conducted with 256 adults in their 20s and 30s. Obesity was evaluated by anthropometric measurement of body mass index (BMI), waist to hip ratio and waist to height ratio. In addition, the daily intake of milk, caffeinated beverages, sweetened beverages, and alcoholic beverages was investigated using the dietary record and 24-h recall methods. Based on the BMI, men and women were classified into underweight, normal, overweight and obese. Among men, 38.3% were found to be normal, 28.1% were overweight and 31.3% obese. Among women, 11.7% were underweight, 73.4% were normal, and 10.2% were overweight, which was significantly different from men. In women, the BMI of the milk consumers was significantly lower than the non-consumers. Also, the obesity indices of caffeinated beverage consumers were significantly lower than the non-consumers. An analysis of the correlation between beverage intake and the obesity index showed that the intake of caffeinated beverages among women had a significant negative correlation with the obesity index, and intake of alcoholic beverages had a significant positive correlation with waist to height ratio. This study suggests that intake of milk and caffeinated beverage may have a positive effect on obesity, whereas the intake of alcoholic beverages may have a negative effect, especially in young adult women.
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Objectives@# The purpose of this study was to analyze high-sugar food consumption habits frequency among elementary school students, and their correlations with eating habits and sweet taste assessment. @*Methods@# The participants of the study were 164 elementary school students in Daegu, in the fifth or sixth grade, along with their parents. A questionnaire investigated eating habits, high-sugar food consumption habits and frequency, and sweet taste assessment. @*Results@# The average eating habits score for elementary school students was determined to be 71.7 out of 100. Students with higher eating habits scores had lower high-sugar food consumption habits and frequency compared to those with lower eating habits scores. Sweet taste assessment revealed that students who preferred less sweetness chose a 5% sugar concentration, those with a preference for normal sweetness chose a 10% sugar concentration, and those who preferred sweeter tastes chose a 20% sugar concentration. Sweet taste assessment showed that students who tended to prefer less sweetness had the highest eating habits scores and the lowest scores for high-sugar food consumption habits and frequency.In addition, eating habits scores were found to be negatively correlated with high-sugar food consumption habits, high-sugar food consumption frequency, and sweet taste assessment. The sweet taste assessment was positively correlated with high-sugar food consumption habits and frequency. @*Conclusions@# Our results indicate that students with good eating habits had more desirable overall sugar intake habits, and when the preference for sweetness was high, the frequency of high-sugar food consumption was also high. Our study highlights the importance of educating elementary school students and their parents about the harmful effects of excessive sugar consumption, as well as the benefits of adopting healthy eating habits and creating supportive environments.
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BACKGROUND/OBJECTIVES@#This study aimed to compare 24-h diet recall (DR) and 24-h urine collection (UC) for estimating sodium and potassium intakes and their ratio (Na/K), identifying factors associated with sodium and potassium intakes and Na/K, and identifying those who were likely to underestimate sodium and potassium intakes by DR. @*SUBJECTS/METHODS@#A total of 640 healthy adults aged 19–69 yrs completed a questionnaire survey, salty taste assessment, anthropometric measurement, two 24-h DRs, and two 24-h UCs. @*RESULTS@#The mean sodium and potassium intakes and Na/K were 3,755 mg/d, 2,737 mg/d, and 1.45 according to DR, and 4,145 mg/d, 2,812 mg/d, and 1.57 according to UC, with percentage differences of −9.4%, −2.7%, and −7.6% in the values between the two methods, respectively.Men, older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who were found to be salty in the salty taste assessment consumed significantly more sodium; older adults, the heavy- activity group, and obese individuals consumed more potassium; and men, younger adults, smokers, and obese individuals had a significantly higher Na/K, according to UC. Compared with UC, DR was more likely to underestimate sodium intake in older adults, smokers, obese individuals, those who consumed all the liquid in the soup, and those who consumed eating-out/delivery food at least once a day, and potassium intake in older adults, the heavy-activity group, and obese individuals. @*CONCLUSIONS@#The mean sodium and potassium intakes and Na/K estimated by DR were comparable to those measured by UC. However, the association of sodium and potassium intakes with sociodemographic and health-related factors showed inconsistent results when estimated by DR and UC. Factors influencing the underestimation of sodium intake by DR compared to UC should be further investigated.
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BACKGROUND/OBJECTIVES@#Excessive sodium intake, cigarette smoking, and alcohol consumption are risk factors for a wide range of diseases. This study aimed to determine whether smokers and drinkers are more likely to enjoy their food with more salt, and whether the combination of smoking and drinking is associated with salty taste preferences. @*SUBJECTS/METHODS@#This study analyzed the data of over 16 million Koreans from two four-year Korean Community Health Survey cycles (i.e., 2010 to 2013 and 2014 to 2017). The respondents’ preferences for salty foods (i.e., their salt intake levels, whether they added salt or soy sauce to foods served on the table, and whether they dipped fried foods in salt or soy sauce), and the odds ratio (OR) of their preference were examined among smokers and drinkers when adjusted for sex, age, body mass index, educational level, household income, marital status, and cigarette smoking or alcohol consumption status. @*RESULTS@#Cigarette smoking and alcohol consumption were correlated with the consumption of salty food. Based on the adjusted model, cigarette smokers and alcohol drinkers preferred adding salt or soy sauce or dipping fried foods in soybean more than non-smokers and nondrinkers. In addition, people who smoked and consumed alcohol reported a more significant stacking effect regarding the salty taste preference. @*CONCLUSION@#This large population-based study found that both cigarette smoking and alcohol consumption were correlated with salty taste preferences, which may cause excessive sodium intake.
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Purpose@#Obesity can lead to several chronic diseases. With a continuous increase in the obesity rates, sustainable healthy weight management among growing adolescents has become essential. This study was conducted to examine the relationship between obesityrelated factors and creative convergence ability. This could form the basis for convergence education for the sustainable healthy weight management of adolescents. @*Methods@#Data were collected from 430 adolescents in Daegu, Gyeongbuk, and Gyeonggi regions using a self-administered 5-Likert questionnaire from November to December 2020. @*Results@#The average score of the male students was higher than that of the female students in terms of healthy weight management convergence awareness, creativity, convergence thinking ability, self-efficacy, exercise, and dietary diversity. On the other hand, the dietary restraint score and the number of weight loss attempts were higher in the female students. Dietary restraint, disinhibition scores and weight loss attempts were higher in obese adolescents compared to underweight adolescents. It was found that dietary restraint, convergence thinking ability, problem-solving ability, exercise, and dietary diversity factors had a positive effect on healthy weight management convergence awareness. Healthy weight management convergence awareness, exercise, meal amount management, junk food management, weight loss belief, and weight loss trial experience had a positive effect on dietary restraint. Convergence thinking ability, weight loss experience, and obesity factors had a positive effect on dietary disinhibition. @*Conclusion@#The sustainable healthy weight management education of adolescents is based on weight management knowledge and awareness of convergence, and must include gender differences. Thus, the problem-solving ability for healthy weight management can be creatively cultivated to enhance self-efficacy.
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BACKGROUND/OBJECTIVES@#South Korea has been conducting the Sodium Reduction Restaurant Project since 2015 to reduce sodium contents in restaurant menus. The purpose of this study was to analyze changes in the sodium content of menus as determined by the Daegu Sodium Reduction Restaurant Project between 2015 and 2019.MATERIALS/METHODS: Intervention was aimed at reducing the sodium contents of over 10% of menu items in participating restaurants. On-site inspections and evaluations were conducted using a checklist, and reductions in sodium contents were determined by analyzing the salinities and sodium contents of menus after intervention. @*RESULTS@#Post-intervention salinities and sodium contents were significantly lower than baseline values in 2016 (P < 0.001), 2017 (P < 0.001), 2018 (P < 0.001), and 2019 (P < 0.001). However, sodium contents and salinities differences before and after intervention were not significant in 2015. Sodium contents of more than 20% of menu items offered by restaurants that participated in the Sodium Reduction Restaurant Project for 2 yrs starting in 2016 declined by 28.9%. On the other hand, the sodium reduction rate achieved by restaurants that participated for 4 yrs from 2015 reached 55.4%. The percentage of restaurants that participated in the project increased annually, though some failed to be designated as Sodium Reduction Restaurants because they did not meet sodium reduction rate requirements. @*CONCLUSIONS@#Positive correlations were found between duration of participation in the project and sodium reduction and designation rates. Sustainable long-term support at the national level is required to expand the project to other regions.
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Objectives@#The purposes of this study were to compare the degree of sodium reduction practice and estimate sodium intake by salty food preference. @*Methods@#Sodium reduction practices, salty food preferences and estimated sodium intake were surveyed for restaurant owners (n = 80), employees (n = 82) and customers (n = 727) at the restaurants participating in the sodium reduction project in Daegu, Korea. Estimated sodium intake was performed by examining sex, age, body mass index (BMI), salty eating habit and dietary behaviors. @*Results@#The degree of sodium reduction practice was significantly higher in salinity meter use (P < 0.001), low salt seasonings (P < 0.001) and efforts to make the foods as bland as possible overall (P < 0.001) in the restaurants participating in sodium reduction project than in homes (P < 0.001). The degree of sodium reduction practice appeared lower in the high salty food preference group than in the low-preference group in such items as efforts to make the foods as bland as possible overall (P < 0.05) and washing the salty taste and then cooking (P < 0.05). The high-preference group showed high-salt dietary behavior, including eating all the soup until nothing was left (P < 0.05) more than the low-preference group, but low-salt dietary behavior included checking the sodium content in processed foods (P < 0 .0 5) less than the low-preference group. The high-preference group was higher in the soup and stew intake frequency than the low-preference group (P < 0.05) and much lower in nuts (P < 0.05) and fruits (P < 0.05) intake frequency. The high-preference group had a higher salty eating habit (P < 0.05), salty taste assessment (P < 0.05) and estimated sodium intake (P < 0.05) than the low-preference group. @*Conclusions@#The present study showed that the salty food preference was strongly associated with lower sodium reduction practice and higher estimated sodium intake.
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BACKGROUND/OBJECTIVES@#The purpose of this study was to develop a sodium index, which is a tool for estimating and assessing sodium intake easily and quickly, to assist in the prevention of various diseases induced by excess sodium intake in Korean adults. @*SUBJECTS/METHODS@#The 24-h urine collection and dietary behavior surveys were performed on 640 healthy people in 4 regions of South Korea, and an equation for the estimation of 24-h sodium intake was developed. The validity and reliability of the equation were verified with 200 adults. The sodium index was developed by converting the estimated sodium intake using the equation. Finally, the sodium intake status of 1,600 adults was assessed using the sodium index. @*RESULTS@#The equation included sex, age, body mass index, eating habit and dietary behaviors related to sodium intake. In validity test of the equation, the mean bias between sodium intake using 24-h urine analysis and using the equation from the Bland-Altman plots was −1.5 mg/day. The sensitivity and specificity of the equation for estimation of sodium intake were 80.5% and 64.4%, respectively. In the reliability test of the equation, there was no significant difference between the first and second sodium intakes calculated using the equations, and Spearman's correlation coefficient between the 2 sodium intakes was 0.98. Sodium intake can be assessed as ‘very moderate’ for 75–100 on the sodium index, ‘moderate’ for 100–150, ‘careful’ for less than 75 or 150–200, and ‘severe’ for 250 or more. When sodium intake was assessed using the sodium index in 1,600 subjects, 54.3% and 24.3% of the subjects were assessed to be in the ‘careful’ and ‘severe’ categories, respectively. @*CONCLUSIONS@#Using a simple questionnaire, the sodium index can be used to monitor and assess sodium intake status, assisting in nutrition education and counseling in a large population.
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Sodium is a physiologically essential nutrient, but excessive intake is linked to the increased risk of various chronic diseases, particularly cardiovascular. It is, therefore, necessary to accomplish an evidence-based approach and establish the Korean Dietary Reference Intakes (KDRIs) index, to identify both the nutritional adequacy and health effects of sodium. This review presents the rationale for and the process of revising the KDRIs for sodium and, more importantly, establishing the sodium Chronic Disease Risk Reduction Intake (CDRR) level, which is a new specific set of values for chronic disease risk reduction. To establish the 2020 KDRIs for dietary sodium, the committee conducted a systematic literature review of the intake–response relationships between the selected indicators for sodium levels and human chronic diseases. In this review, 43 studies published from January 2014 to December 2018, using databases of PubMed and Web of Science, were finally included for evaluating the risk of bias and strength of evidence (SoE). We determined that SoE of the relationship between dietary sodium and cardiovascular diseases, cerebrovascular disease, and hypertension, was moderate to strong.However, due to insufficient scientific evidence, we were unable to establish the estimated average requirement and the recommended nutrient intake for dietary sodium. Therefore, the adequate intake of sodium for adults was established to be 1,500 mg/day, whereas the CDRR for dietary sodium was established at 2,300 mg/day for adults. Intake goal for dietary sodium established in the 2015 KDRIs instead of the tolerable upper intake level was not presented in the 2020 KDRIs. For the next revision of the KDRIs, there is a requirement to pursue further studies on nutritional adequacy and toxicity of dietary sodium, and their associations with chronic disease endpoint in the Korean population.
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Objectives@#This study investigated an association between sugar-sweetened beverage (SSB) intake and the dietary quality of adults in Deagu, Korea. @*Methods@#A questionnaire survey was conducted in 1,022 adults aged 19 ~ 49 years (502 men and 520 women) in the Deagu area of Korea. Daily intake of SSB was obtained by the food frequency questionnaire, and the dietary quality was assessed using the nutrition quotient (NQ) for Korean adults. Multiple logistic regression analysis was used to estimate the association between dietary quality and daily intake of SSB in adults. @*Results@#Daily intake of SSB was 463.6 mL/d for total subjects, and the highest intakes were sweetened coffees (192.7 mL/d), followed by carbonated drinks (77.1 mL/d).Higher intake of SSB was associated with higher intake frequency of fast food or sweet and greasy bread, processed beverage, ramyon, eating out or delivery food and night snack, and also associated with lower frequency of water, breakfast intake and nutrition label checking in men or women. Men and women who had a higher intake SSB had significantly greater odds for being in the low grade of NQ (P for trend = 0.0006 for men, P for trend = 0.0007 for women), especially in the moderation factor (P for trend < 0.0001 for men and women). @*Conclusions@#This study showed that high SSB intake was significantly associated with low dietary quality among adults. These study results suggest that nutrition education programs and guidelines should be provided to adults for improving their consumption of SSB and related diets.
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Objectives@#The purpose of this study was to evaluate the effect of the sodium and sugar reduction practices of the Samsam foodservice project of Daegu, in comparison with that of general foodservices in Daegu. @*Methods@#A survey was conducted on 80 Samsam foodservice workers and 80 general foodservice workers from Sep. to Oct. 2020. We compared each worker's taste preferences, stage of behavior change and dietary behavior regarding sodium and sugar, and each foodservice's practices regarding sodium and sugar reduction. @*Results@#There was no significant difference between the salty taste and sweet taste preferences between the workers at the Samsam foodservices and those at the general foodservices. The percentage of foodservice workers in action or maintenance stage of behavior change for eating less salty was higher in the Samsam foodservices than in the general foodservices (P < 0.05). In addition, regarding the degree of saltiness and sweetness of meals, the workers at the general foodservices perceived their meals to be saltier (P < 0.001) and sweeter (P < 0.01) than the workers at Samsam foodservices.The workers at Samsam foodservices had fewer salty dietary behaviors compared to the workers at general foodservices (P < 0.01). The sodium reduction practice was significantly higher in the Samsam foodservices than the general foodservices (P < 0.001), especially in “efforts to make the food as bland as possible overall” (P < 0.001), and “serving less soup and stew” (P < 0.001). The sugar reduction practice too was significantly higher in the Samsam foodservices than the general foodservices (P < 0.001). @*Conclusions@#The Samsam foodservices were shown to be better in the practice of sodium and sugar reduction compared to general foodservices. Therefore, it is necessary to provide continuous and practical support and incentives at the national level to expand the sodium and sugar reduction practices in foodservices.
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Objectives@#This study was conducted to identify the awareness and practice of reducing sugar in school meals and the status of nutrition education regarding sugar reduction. @*Methods@#An online survey was conducted on 101 nutrition teachers (dietitians) working at elementary, middle, and high schools in Daegu. @*Results@#School nutrition teachers in Daegu recognized the need for efforts to reduce the sugar intake in the Korean diet, and it was found that elementary nutrition teachers were more aware of the implementation of the sugar reduction policy at the national level than middle and high school nutrition teachers (P = 0.002). Among the policies to reduce sugar intake at the national level, there was a high need for the promotion of self-control and limiting the sales of food with high sugar content in schools and their vicinity. The degree of practice for reducing sugar in school meals was found to be higher in the preparation, purchase, and cooking stage compared to the serving stage (P < 0.05). There was a high need for changing the preferences of the subjects for a sweet taste as a means of reducing the sugar in school meals. Thirty-six percent of nutrition teachers conducted sugar reduction education, and sending out school newsletters was the highest type of nutrition education at 80.6%. @*Conclusions@#To effectively promote reduced sugar intake in school meals, it is necessary to change the preference of the subjects for sweetness and to conduct continuous education that can improve the awareness of people for reducing their sugar intake. For this, it is necessary to set aside time for nutrition education and to prepare an institutional framework for providing this education.
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Purpose@#This study aimed to provide baseline data for establishing a sugar reduction policy at coffee shops by analyzing the factors that affect a coffee shop user's perception and behavioral intention of reducing sugar intake. @*Methods@#An online survey was conducted involving 1,274 Daegu citizens aged 19-49 years, who had visited coffee shops within the last month. @*Results@#When visiting a coffee shop, the purchase of sweet drinks was higher in the younger age group, and the addition of syrup or sugar was higher in the older age group. Of the total respondents, 42.1% were aware that some coffee shops accommodate reduced sugar requests, 57.9% perceived the need to reduce sugar in coffee shop beverages and 22.3% had purchased beverages intending to reduce their sugar intake. In addition, 59.7% knew about sugar nutrition labeling, and 68.8% perceived the need for nutrition labeling for sugar. When purchasing beverages, 35.6% checked the nutrition labeling, and 77.2% purchased alternative drinks when the sugar content was high. Guiding the choice of sweetness levels in coffee shop orders was seen to have the highest effectiveness and intention to reduce sugar intake.Moreover, the perceived need to reduce sugar intake had the most positive effect on the behavioral intention to reduce sugars in coffee shop beverages (β = 0.558, p < 0.001). @*Conclusion@#Although the overall awareness and practice of reducing the sugar intake in coffee shop users were low, the behavioral intention to reduce sugars was positive, and this was most affected by the perception of the need to reduce sugars. Therefore, there is a need for differentiated education and promotion for each age group for recognizing the necessity and outlining methods for reducing sugar intake. Furthermore, coffee shops should reflect customer's sugar reduction needs.
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Objective@#To elucidate whether clinical features and the weighted genetic risk score (wGRS) were associated with the presence of lupus nephritis (LN). @*Methods@#We retrospectively divided patients with systemic lupus erythematosus (SLE, n=1,078) into biopsy-proven LN (n=507) and non-LN groups (non-LN, n=571). Baseline clinical features, serologic markers, and the wGRS were collected. The wGRS was calculated from 112 non-human leukocyte antigen (non-HLA) loci and HLA-DRβ1 amino acid haplotypes for SLE. Associations among clinical features, wGRS, and the presence of LN were identified. @*Results@#In the multivariate analysis, patients with LN were younger at diagnosis (odds ratio [OR]=0.97, p<0.001), had more pleuritis (OR=2.44, p<0.001) and pericarditis (OR=1.62, p=0.029), had a higher detection rate of anti-double stranded deoxyribonucleic acid (anti-dsDNA antibodies, OR=2.22, p<0.001), anti-Smith antibodies (anti-Sm antibodies, OR=1.70, p=0.002), low level of complement (OR=1.37, p=0.043) and absence of antiphospholipid antibodies (aPL antibodies, OR=1.60, p=0.002), and had higher wGRS (OR=1.16, p=0.012). Mediation analysis suggested that anti-Sm antibodies and low complement could be mediators in the relationship between high wGRS and the presence of LN. @*Conclusion@#Onset age, pleuritis, pericarditis, several serologic markers, and wGRS were associated with the presence of LN. Anti-Sm antibodies and low complement appeared to mediate the indirect relationship between wGRS and the presence of LN.
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Rheumatoid arthritis (RA) is a chronic inflammatory disease in which the abnormal immune system causes arthritis. We reviewed previous studies about the mortality and causes of death in Korean patients with RA. Also, we discussed the association between comorbidities and mortality in Korean patients with RA. In Korea, a few epidemiologic studies reporting mortality rates in patients with RA have been conducted using large databases. According to these data sources, the estimated mortality rate of Korean patients with RA from 1.29% to 1.65%. Despite substantial improvements in RA management, the mortality rate of patients with RA remains higher than that of the general population. Also, the most common cause of death was malignancy, and respiratory disease and cardiovascular disease followed. The malignancy-specific mortality rate of patient with RA was not higher than that of the general population; however, several causes of death, such as respiratory disease and infections, were associated with a higher mortality rate among patients with RA than among the general population. Therefore, to increase the survival rate of patients with RA, attention should be paid to the management of comorbidities as well as to the RA itself.