Association between the Frequency of Dining Out and the Risk of Obesity, Diabetes Mellitus, and Dyslipidemia among Korean Adults.

This study aimed to clarify the association between the frequency of dining out and the risk of obesity, diabetes mellitus, and dyslipidemia among Korean adults. This cross-sectional study surveyed 640 participants aged 20-69 years in Korea. Daily intake of energy, fat, protein, and cholesterol significantly increased as the frequency of dining out increased (P < .001). Energy derived from carbohydrates significantly decreased with the frequency of dining out, while that derived from fat and protein increased (P < .001). Among participants who rarely dined out, the fully adjusted odds ratios (ORs) for hyperglycemia were significantly lower at 0.35 (95% CI, 0.16-0.76). Decreased risk of being hyperglycemia among participants who rarely dined out suggests that the frequency of dining out can be related to diabetes risk.

Estimation model for habitual 24-hour urinary-sodium excretion using simple questionnaires from normotensive Koreans.

This study was conducted to develop an equation for estimation of 24-h urinary-sodium excretion that can serve as an alternative to 24-h dietary recall and 24-h urine collection for normotensive Korean adults. In total, data on 640 healthy Korean adults aged 19 to 69 years from 4 regions of the country were collected as a training set. In order to externally validate the equation developed from that training set, 200 subjects were recruited independently as a validation set. Due to heterogeneity by gender, we constructed a gender-specific equation for estimation of 24-h urinary-sodium excretion by using a multivariable linear regression model and assessed the performance of the developed equation in validation set. The best model consisted of age, body weight, dietary behavior ('eating salty food', 'Kimchi consumption', 'Korean soup or stew consumption', 'soy sauce or red pepper paste consumption'), and smoking status in men, and age, body weight, dietary behavior ('salt preference', 'eating salty food', 'checking sodium content for processed foods', 'nut consumption'), and smoking status in women, respectively. When this model was tested in the external validation set, the mean bias between the measured and estimated 24-h urinary-sodium excretion from Bland-Altman plots was -1.92 (95% CI: -113, 110) mmol/d for men and -1.51 (95% CI: -90.6, 87.6) mmol/d for women. The cut-points of sodium intake calculated based on the equations were ≥4,000 mg/d for men and ≥3,500 mg/d for women, with 89.8 and 76.6% sensitivity and 29.3 and 64.2% specificity, respectively. In this study, a habitual 24-hour urinary-sodium-excretion-estimation model of normotensive Korean adults based on anthropometric and lifestyle factors was developed and showed feasibility for an asymptomatic population.

International hospital accreditation and clinical nutrition service in acute care hospitals in South Korea: results of a nationwide cross-sectional survey.

BACKGROUND AND OBJECTIVES: Beginning in 2007, 29 hospitals in South Korea have received accreditation from Joint Commission International (JCI). The present study aimed to identify differences in clinical nutrition service provisions between JCI accredited acute care hospitals and non-accredited acute care hospitals. A survey questionnaire was sent to all 43 acute care hospitals in South Korea. METHODS: A total of 35 sets of clinical nutrition service surveys, 234 sets of clinical dietitian job satisfaction surveys, and five-day daily work logs from 129 clinical dietitians were received. We used Fisher's exact test and independent t-test to analyze differences between acute care hospitals based on JCI accreditation. STUDY DESIGN: Nationwide cross-sectional survey. RESULTS: JCI accredited acute care hospitals (N=8) showed a higher, but not significantly higher, nutritional intervention rate of 12.7% among malnourished patients, compared with 7.0% in non-JCI accredited acute care hospitals (N=27). Analysis of work hours of clinical dietitians indicated time spent on direct care was higher (p<0.05), while time spent on outpatient care was lower (p<0.05) among JCI accredited acute care hospitals relative to non-JCI accredited acute care hospitals. CONCLUSIONS: Accreditation from JCI has a positive influence in the advancement of not only the hospital services, but also clinical nutrition services.

Association between 24-h urinary sodium excretion and obesity in Korean adults: A multicenter study.

OBJECTIVE: The aim of this study was to explore the association between sodium intake, as assessed by 24-h urinary sodium excretion, and various obesity parameters among South Korean adults. The associations of 24-h urinary sodium excretion and sodium intake calculated from the dietary questionnaire with obesity parameters also were compared. METHODS: This multicenter, cross-sectional study analyzed data of 640 healthy adults from eight provinces in South Korea. Obesity was assessed by body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Mean 24-h urinary sodium excretion was calculated from repeatedly collected 24-h urine samples. Participants' dietary intake was assessed by 24-h dietary recall interview on the days before 24-h urine collection. RESULTS: In both sexes, the means of all anthropometric measurements tended to increase proportionally with 24-h urinary sodium excretion quartiles, regardless of adjustment. Men in the highest quartile (Q4) of 24-h urinary sodium excretion had increased odds of obesity (as assessed by BMI, WC, WHR, and WHtR) compared with men in the three lower quartiles (Q1-Q3) of 24-h urinary sodium excretion. Women in Q4 of 24-h urinary sodium excretion exhibited a higher chance of general obesity and abdominal obesity. Sodium intake calculated from the dietary questionnaire was not significantly associated with obesity in either sex. CONCLUSIONS: In Korean adults, there was a positive association between higher sodium intake as assessed by 24-h urinary sodium excretion and obesity independent of energy intake.

Daily Copper and Manganese Intakes and Their Relation to Blood Pressure in Normotensive Adults.

Although it has been proposed that trace minerals have anti-oxidative functions and are related to the control of blood pressure, only a limited number of studies directly address the issue. Thus, the purpose of our study was to assess the intake of copper and manganese, which are trace minerals, and to clarify their relation to blood pressure. In a cross-sectional study, the blood pressure of 640 normotensive adults, from 19 to 69 year-old (320 males and 320 females), was measured, and its correlation with the intake of copper and manganese was assessed using a 24-hour dietary recall method. The average value of the blood pressure was 126.4/80.2 mmHg for the males and 117.8/75.8 mmHg for the females. The daily copper intake was 1.3 mg/day for the males and 1.2 mg/day for the females. For manganese, the daily intake was 4.2 mg/day for the males and 4.1 mg/day for the females. Although the copper intake of all subjects showed a positive correlation with the systolic and diastolic blood pressures, there was no significant correlation when the potential confounding factors were adjusted. The manganese intake of the male subjects had a significantly negative correlation with the systolic blood pressure after adjusting for gender, age, body mass index, and energy intake. In conclusion, the daily manganese intake of the normotensitve adults showed a significantly negative correlation with the systolic blood pressure indicating a possibility of a positive effect of manganese on blood pressure.

Maternal and grandmaternal obesity and environmental factors as determinants of daughter's obesity.

Obesity may be the consequence of various environmental or genetic factors, which may be highly correlated with each other. We aimed to examine whether grandmaternal and maternal obesity and environmental risk factors are related to obesity in daughters. Daughters (n = 182) recruited from female students, their mothers (n = 147) and their grandmothers (n = 67) were included in this study. Multivariable logistic regression was used to analyze the association between the daughter's obesity and maternal, grandmaternal, and environmental factors. Maternal heights of 161-175cm (OD: 8.48, 95% CI: 3.61-19.93) and 156-160 cm (2.37, 1.14-4.91) showed positive associations with a higher height of daughter, compared to those of 149-155 cm. Mothers receiving a university or a higher education had a significant OR (3.82, 1.27-11.50) for a higher height of daughter compared to those having a low education (elementary school). Mother having the heaviest weight at current time (59-80 kg, 3.78, 1.73-8.28) and the heaviest weight at 20 years of age (51-65 kg, 3.17, 1.53-6.55) had significant associations with a higher height of daughters, compared to those having the lightest weight at the same times. There was no association between the height, weight, and BMI of daughters and the characteristics and education of her grandmothers. In conclusion, although genetic factors appear to influence the daughter's height more than environmental factors, the daughter's weight appears to be more strongly associated with individual factors than the genetic factors.

Analysis of the Prevalence and Risk Factors of Malnutrition among Hospitalized Patients in Busan.

This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.

Improvement of diabetic complication by hydrangea dulcis folium in streptozotocin-induced diabetic rats.

The improvement of diabetic complications such as lipid lowering and anti-oxidative potential of Hydrangea Dulcis Folium (HDF) was studied in streptozotocin-induced diabetic rats. Male Sprague-Dawley rats were divided into 3 groups after induction of streptozotocin (STZ)-diabetes: normal control; diabetic control; diabetic-HDF supplement (hot water extract 40 g/kg diet); and fed experimental diets for 3 weeks. Serum glucose and insulin concentrations, serum lipid profile, intraperitoneal glucose tolerance test, and liver cytosolic antioxidant enzyme levels were measured. The HDF supplement significantly decreased serum glucose concentration, increased insulin level, and improved glucose homeostasis in diabetic control rats. The total cholesterol and triglyceride concentrations in the serum and liver were markedly reduced by HDF treatment in STZ-diabetic rats. Moreover, low density lipoprotein (LDL)-, VLDL-, and high density lipoprotein (HDL)-cholesterol levels were ameliorated in HDF supplemented diabetic rats. Decreased fecal excretions of cholesterol, triglyceride, and bile acid in diabetic rats were significantly increased by HDF consumption. HDF supplement reversed the effects of the oxidative stress system of liver in diabetic rats. Lipid peroxidation of diabetic rats, assessed by thiobarbituric acid reactive substance (TBARS), as well as superoxide dismutase (SOD) activities were significantly increased, and glutathione contents were decreased in diabetic rats. HDF supplement reverted these parameters to near normal value. Our data suggest that HDF supplement could be used to improve the glucose and lipid metabolism as well as to reduce the imbalance between the generation of reactive oxygen species (ROS) and the scavenging enzyme activity in preventing diabetic complications.

Korean adolescents' perceptions of nutrition and health towards fast foods in Busan area.

Adolescents in Busan area were asked in a survey about their perception and attitudes towards fast food. Most respondents answered that they consume fast food once a month because it is fast, easily accessible and tasty. Although they perceived fast food as unhealthy and less nutritious, they were less aware of its effect on their health and nutritional status. The more knowledgeable respondents were about nutrition and health the less likely they were to choose fast food over other meals. However, respondents who had little or no knowledge about the nutritional factors of fast food accounted for 43.1%. As to their source of dietary information, students relied on themselves (31.0%), parents (20.5%) and friends (19.9%). The medium through which students got the most nutrition and health information was television (66.8%), followed by the Internet (36.7%) and magazines (29.7%). This study will enable educators to plan more effective strategies for improving the dietary knowledge of the adolescent population.