• Nutrition Research and Practice
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• v.16 no.6
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• pp.755-764
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• 2022

BACKGROUND/OBJECTIVES: Cardiovascular diseases (CVDs) are the leading cause of death in Koreans, and eating habits, including diet quality, are among the etiologies of these diseases. Recently, various studies on regional health disparities have been conducted. However, there are limited studies on their relationship with nutritional factors. This study aimed to identify the magnitude of regional disparities in diet quality and prevalence of CVD in Korean adults. SUBJECTS/METHODS: This study included 17,646 participants aged ≥ 20 years from the 7^th (2013-2016) Korean National Health and Nutrition Examination Survey. Participants were classified into four groups based on their residential areas: City 1, City 2, City 3, and non-city. Demographic characteristics, health-related factors, body mass index (BMI), metabolic syndrome index, diet quality, and CVD prevalence were evaluated. RESULTS: In terms of demographic characteristics, age (P < 0.001), marital status (P < 0.001), educational level (P < 0.001), and income (P < 0.001) were lower in the non-city category. Health-related factors such as monthly drinking rate (P < 0.01) and mental stress (P < 0.05) were the highest in City 1 and lowest in the non-city group. Conversely, the current smoking rate (P < 0.05), BMI (P < 0.05), and prevalence of metabolic syndrome (P < 0.001) were the highest in the non-city group (P < 0.05). The non-city group also had the highest prevalence of CVDs (35.6%). This group had the lowest diet quality index (68.36 ± 0.22, P < 0.01), caused by low intake of fruit and calcium, a lack of sodium moderation, and an overall imbalance in the macronutrient and fatty acid ratio. When the diet quality index was increased by 1, the odds ratio for the prevalence of CVDs was reduced by 0.991 (P < 0.001), but this was not the case in all regions. CONCLUSIONS: This study provides useful information and data in identifying and resolving the regional health disparities related to CVD prevalence and implementation of public health nutrition systems.

• Journal of the Korean Dietetic Association
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• v.11 no.3
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• pp.365-374
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• 2005

This study was conducted to compare the validity of obese index among body mass index(BMI), waist to hip ratio(WHR), and waist circumference(WC) and to determine which is the best in relation to cardiovascular risk factors of middle aged Korean(40-64yr).Data from the 1998 Korean Health and Nutrition Survey were used(N=3380). Anthropometric indices and cardiovascular risk factors were measured. Chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator characteristic(ROC) curves were used in the analysis. There was a significant increasing trend in WHR, systolic blood pressure(SBP), high density lipoprotein cholesterol(HDL), and fasting blood sugar(FBS) with age categories of male and in BMI, WC, WHR, diastolic blood pressure(DBP), SBP, total cholesterol(TC), low density lipoprotein cholesterol(LDL), triglycerol(TG), and FBS with those of female. Specially female had the characteristics of upper body fat and systolic blood pressure risk(p<0.05). Proportions of subjects with lifestyle factors related to cardiovascular risk in overweight or upper body fat group were higher than that of normal group. Higher proportions of subjects were practiced exercise in upper body fat group of male than in other groups. Among 7 cardiovascular risk factors in partial correlation analysis, BMI had the highest correlation coefficient in 6 risk factors in male, whereas WC in 4 risk factors in female. Mean of each obese index according to cardiovascular risk groups except smoker was higher than that of normal(p<0.05). These trends were shown in upper body fat group and female. In ROC analysis of 12 risk factors and health conditions, the largest area under curve among obese indices for risk factors were BMI in male and WHR in female. The optimal cutoff values of each index(BMI: WHR: WC) for one or more cardiovascular risk factors were 23.13: 0.89: 85.35 in male and 23.57: 0.84: 78.35 in female. The results showed that cardiovascular risk factors were prevalent in middle aged Koreans within normal limits of obese indices like another Asians. For the identification of cardiovascular risk factors of middle aged Koreans, BMI for men and WHR for women are appropriate indices. But it is recommended that BMI, WHR, and WC, all three indices should be considered, when using these indices.

• Journal of Preventive Medicine and Public Health
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• v.44 no.5
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• pp.218-225
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• 2011

Objectives: This study investigated the relationship between the blood mercury concentration and cardiovascular risk factors in elderly Korean individuals living in coastal areas. Methods: The sample consisted of 477 adults (164 males, 313 females) aged 40 to 65 years who visited a Busan health promotion center from June to September in 2009. The relationship between blood mercury concentration and cardiovascular risk factors including metabolic syndrome, cholesterol profiles, blood pressure, body mass index (BMI), waist circumference and waist-to-hip ratio (WHR), was investigated. Variables related to blood mercury concentration were further evaluated using multiple regression analysis. Results: The blood mercury concentration of the study population was 7.99 (range, 7.60 to 8.40) ${\mu}g$/L. In males, the blood mercury concentration was 9.74 (8.92 to 10.63) ${\mu}g$/L, which was significantly higher than that in females (7.21, [6.80 to 7.64] ${\mu}g$/L). The blood mercury concentration of the study population was related to several cardiovascular risk factors including low-density lipoprotein (LDL) cholesterol (p=0.044), high-density lipoprotein (HDL) cholesterol (p=0.034), BMI (p = 0.006), waist circumference (p = 0.031), and WHR (p < 0.001). In males, the blood mercury concentration was significantly correlated with WHR in the multiple regression analysis. Conclusions: In males, the blood mercury concentration was related to waist-to-hip ratio, which is a central obesity index and cardiovascular risk factor. Our finding suggests that cardiovascular disease risk in males was increased by mercury exposure via an obesity-related mechanism.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.109-119
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• 2006

Objectives: A number of studies in economically developed countries have shown occurrence of stroke and cardiovascular disease to be inversely related to socioeconomic class. The purpose of this study is to investigate socioeconomic differentials in stroke and cardiovascular disease mortality in Korea. Methods: Two data from two sources, registry data from National Health Insurance Corporation and death certification data from National Statistics Office, were used to calculate mortality rate for five socioeconomic classes. Poisson regression analysis was used to calculate relative indices of inequality as a measure of mortality differentials between socioeconomic classes. Results: For males, graded socioeconomic differentials in mortality were observed with higher mortality rates related to lower socioeconomic class for intracerebral hemorrhage, cerebral infarct, hypertension, ischemic heart disease, myocardial infarct, and arrhythmia. The relative index of inequality for stroke and cardiovascular disease was 1.61(95% CI=1.54-1.68). For females, these differentials were observed for arrhythmia and intracerebral hemorrhage. The relative index of inequality was 1.06(95% CI=1.02-1.11). Conclusions: This socioeconomic differential in mortality, consistent with the results of other studies performed in economically developed countries suggest that Socioeconomic class can influence mortality regardless of the developmental stage of the country.

• Journal of Preventive Medicine and Public Health
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• v.46 no.6
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• pp.319-328
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• 2013

Objectives: This study estimated the association of cardiovascular health behaviors with the risk of all-cause and cardiovascular disease (CVD) mortality in middle-aged men in Korea. Methods: In total, 12 538 men aged 40 to 59 years were enrolled in 1993 and followed up through 2011. Cardiovascular health metrics defined the following lifestyle behaviors proposed by the American Heart Association: smoking, physical activity, body mass index, diet habit score, total cholesterol, blood pressure, and fasting blood glucose. The cardiovascular health metrics score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior. A Cox proportional hazards regression model was used to estimate the hazard ratio of cardiovascular health behavior. Population attributable risks (PARs) were calculated from the significant cardiovascular health metrics. Results: There were 1054 total and 171 CVD deaths over 230 690 person-years of follow-up. The prevalence of meeting all 7 cardiovascular health metrics was 0.67%. Current smoking, elevated blood pressure, and high fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 35.2% (95% confidence interval [CI], 21.7 to 47.4) and 52.8% (95% CI, 22.0 to 74.0) for all-cause and CVD mortality, respectively. The adjusted hazard ratios of the groups with a 6-7 vs. 0-2 cardiovascular health metrics score were 0.42 (95% CI, 0.31 to 0.59) for all-cause mortality and 0.10 (95% CI, 0.03 to 0.29) for CVD mortality. Conclusions: Among cardiovascular health behaviors, not smoking, normal blood pressure, and recommended fasting blood glucose levels were associated with reduced risks of all-cause and CVD mortality. Meeting a greater number of cardiovascular health metrics was associated with a lower risk of all-cause and CVD mortality.

• Korean Journal of Health Education and Promotion
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• v.2 no.1
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• pp.63-78
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• 2000

This survey provides, at a participation rate of 70％, 4,790 examinees. The purpose of this study is to study the association of the failed rest after work with 34 diseases including cardiovascular diseases. The index of the failed rest after work was composed of 4 questions about "thinking of work for several hours", "feeling exhausted", feeling unsatisfied or depressed", and "needing to go to bed early for next day′s work". Estimation of correlation among 4 variables, factor analysis, and ANCOVA adjusted for sex, age and job were carried out. A self-rating questionnaire of one′s own disease history and the "London School of Hygiene Cardiovascular Questionnaire" were used in order to discriminate each morbid group from the opposite group. Brief explanations of the result are as follows: 1) Every variable of failed rest after work shows significant difference between the morbid group and the no morbid group for possible infarction; for angina pectoris in the total, and men. 2) Among 4 variables ′exhaustion′ best discriminates the infarction group from the no infarction group, and the angina group from the no angina group. 3) The factor of failed rest after work is a significant factor that distinguishes the infarction group from the no infarction group, and the angina pectoris group from the no angina group. Therefore, stress management through health education and promotion such as behavioral modification can be used to reduce cardiovascular diseases and stress as perceived by an individual.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.3
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• pp.127-139
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• 2019

Purpose : The lipid profile is a major predictive index for cardiovascular disease, but there have only been a few studies conducted on the relationship between lipid ratio and cardiovascular disease risk factors in the Korean population. To address this research gap, we investigated the association between three lipid ratios and cardiovascular disease risk factors among Korean adults. Methods : This study used data from the seventh Korea National Health and Nutrition Examination Survey conducted in 2016. Lipid ratios included triglyceride (TG)/high density lipoprotein cholesterol (HDL), total cholesterol (TC)/HDL, and low density lipoprotein cholesterol (LDL)/HDL. Cardiovascular risk factors included in this research were: systolic blood pressure $(SBP){\geq}140$, diastolic blood pressure $(DBP){\geq}90$, fasting blood sugar $(FBS){\geq}126$, $HbA1c{\geq}6.5$, body mass index $(BMI){\geq}25$, waist circumference (WC) $men{\geq}90$, $women{\geq}85$, and metabolic syndrome (MetS). A complex samples logistic regression test was performed to analyze the association between lipid ratios and cardiovascular disease risk factors. Results : 1) TG/HDL ratio had statistically significant relationships with DBP, FBS, HbA1c, BMI, WC and MetS. 2) TC/HDL ratio was correlated to SBP, DBP, FBS, BMI, WC, and MetS. 3) LDL/HDL ratio had association with BMI, WC, and MetS. Conclusion : We identified significant association between lipid ratios and cardiovascular disease risk factors. The three lipid ratios were particularly strongly associated with BMI, WC, and MetS.

• Biomedical Science Letters
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• v.23 no.4
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• pp.321-326
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• 2017

Tomatoes are rich in nutrients and have many beneficial advantages on human health. Four cherry tomato supplementation diets (CTSDs) were prepared from the juice and cake of fresh and processed (heat-treated) cherry tomatoes. Rats were fed CTSDs for 28 days and the changes in health indices in the serum were analyzed. CTSDs significantly decreased (P < 0.05) food efficiency ratio compared with the control. CTSD feeding significantly increased (P < 0.05) the high-density lipoprotein cholesterol level compared with the control, which resulted in a significant (P < 0.05) decrease in coronary artery risk index and atherogenic index. Furthermore, CTSD feeding increased serum serotonin level. These results indicate that CTSD shows antihyperlipidemic effect.

• Journal of Korean Biological Nursing Science
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• v.21 no.2
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• pp.123-132
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• 2019

Purpose: The purpose of this study was to identify influencing factors of metabolic index and cardiovascular risk factors, on depressive and non-depressive groups, in vulnerable diabetic elderly women. Methods: Participants were 137 vulnerable diabetic elderly women, using health centers in D city. Data were collected through interviews September though December 2017. The metabolic index was measured using National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III), and cardiovascular risk factors were measured using Framingham Risk Score (FRS). Depressive and non-depressive groups were divided by the score of Geriartric Depress Scale Short Korea Version (GDSSF). Collected data were analyzed using a x2 test, independent t-test, and binary logistic regression, with the SPSS/WIN 25.0 program. Results: Vulnerable diabetic elderly women, did not exercise in the depressive groups, and had higher triglyceride (TG), total cholesterol (TC) and larger waists, than in the non-depressive group. Results show that lack of exercise (OR= 6.30), is the highest risk factor, influencing the depressive symptom in vulnerable diabetic elderly women. Conclusion: These results suggest that to reduce depressive symptom levels among vulnerable diabetic elderly women, nursing interventions are needed to increase exercise and decrease TG, TC, and waist size, particularly in improving exercise of vulnerable diabetic elderly women.

• Clinical and Experimental Pediatrics
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• v.57 no.2
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• pp.79-84
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• 2014

Purpose: Overweight can be defined by the body mass index (BMI) and is likely associated with an increased cardiovascular disease risk. However, waist circumference (WC), a central adiposity index, may be a better indicator of cardiovascular disease risk. Studies comparing the effects of BMI and WC on cardiovascular risk factors, such as high blood pressure (BP), are rare in adolescents. Methods: We analyzed the correlations of BMI and WC with BP in 3,363 Korean adolescents (aged 10-19 years), using data from the Korean National Health and Nutrition Examination Surveys (2009-2011). Results: Systolic BP (SBP) in both sexes and diastolic BP (DBP) in boys were higher in the high BMI (>85th percentile) and high WC (>90th percentile) groups. High BMI and high WC were positively correlated with high SBP (>90th percentile) in both sexes, and high DBP (>90th percentile), in boys. BMI maintained its positive associations with SBP, DBP, high SBP, and high DBP in the normal weight ($BMI{\leq}85th$ percentile) and overweight (BMI>85th percentile) groups in both boys and girls, as well as in all subjects of both sexes, even after adjustment for WC. However, WC did not correlate with SBP, DBP, high SBP, or high DBP after adjustment for BMI in any group in either sex. Conclusion: In Korean adolescents, BMI correlated better with BP and high BP levels than WC. Further, BMI was positively associated with BP and high BP in the normal weight group as well as in the overweight group.