• Journal of Korean Academy of Nursing
• /
• v.49 no.6
• /
• pp.748-759
• /
• 2019

Purpose: This study aimed to examine the effect of spouses participating in health coaching on stage of the change, health behaviors, and physiological indicators among male office workers with cardiocerebrovascular disease (CVD) risk factors and compare the findings with trainers who provided health coaching only to workers. Methods: A quasi-experimental pretest-posttest design was used. Convenience sampling was used to recruit participants from a manufacturing research and development company in the city of Gyeonggi province. The health coaching program for the experimental group (n=26) included individual counseling sessions according to workers' stage of change, and provision of customized health information materials on CVD prevention to workers and their spouses for 12 weeks through mobile phone and email. Results: After 12 weeks of intervention, the total score for health behavior, and scores on the sub-areas of exercise and health checkups significantly improved in the experimental group, but there were no significant differences in the scores of stage of the change and physical indicators. The results of a paired t-test showed a significant decrease in the body mass index, abdominal circumference, systolic blood pressure, diastolic blood pressure, total cholesterol and triglyceride values, and a significant increase in the high-density lipoprotein cholesterol value in the experimental group after the intervention. Conclusion: To improve the health of male workers with CVD risk factors in the workplace, sharing health information with their spouses has proven to be more effective than health coaching for only workers. Therefore, it is important to develop strategies to encourage spousal participation when planning workplace health education for changing health-related behaviors.

• Journal of Nutrition and Health
• /
• v.37 no.10
• /
• pp.881-887
• /
• 2004

Elevated plasma homocysteine is an independent risk factor for the development of cardiovascular disease. Exercise is generally believed to reduce the plasma homocysteine levels and therefore, being beneficial for cardiovascular disease (CVD). However, there is a possibility that athletes undergoing strenuous training and competition which increase oxidative stress may suffer from increased plasma homocysteine levels. The purpose of this study was to investigate the influence of endurance training on the plasma concentrations of B vitamins and homocysteine in 23 male adolescent field hockey players. Data collection and blood sampling was performed during the training period and non-training period. Following the training period, significant changes in energy and vitamin B6 intakes were observed in these subjects. Plasma vitamin B2, pyridoxal phosphate (PLP) and homocysteine levels were significantly higher during the training period than non-training period, whereas no difference was observed in plasma folate and vitamin B12 levels. Positive correlation was observed between plasma folate and folic acid intakes. When energy, B vitamin intakes were adjusted there was a significant negative correlation between plasma homocysteine levels and plasma riboflavin, folate and vitamin B12 levels. In conclusion, it is suggested that athletes with oxidative stress by strenuous exercise may need B vitamins since riboflavin, folic acid and vitamin Bl2 were shown to be negatively correlated with plasma homocysteine in athletes during the training period.

• Nutrition Research and Practice
• /
• v.7 no.1
• /
• pp.43-48
• /
• 2013

Quantities as well as distributions of adipose tissue (AT) are significantly related to cardiovascular disease (CVD) risk factors and can be altered with caloric restriction. This study investigated which cross-sectional slice location of AT is most strongly correlated with changes in CVD risk factors after caloric restriction in obese Korean women. Thirty-three obese pre-menopausal Korean women ($32.4{\pm}8.5$ yrs, BMI $27.1{\pm}2.3\;kg/m^2$) participated in a 12 weeks caloric restriction program. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were measured using computed tomography (CT) scans at the sites of L2-L3, L3-L4, and L4-L5. Fasting serum levels of glucose, insulin, triglyceride, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), leptin and homeostasis model assessment-insulin resistance (HOMA-IR) were observed. Pearson's partial correlation coefficients were used to assess the relationship between AT measurement sites and changes in CVD risk factors after calorie restriction. When calories were reduced by 350 kcal/day for 12 weeks, body weight (-2.7%), body fat mass (-8.2%), and waist circumference (-5.8%) all decreased (P < 0.05). In addition, following caloric restriction, serum levels of glucose (-4.6%), TC (-6.2%), LDL-C (-5.3%), leptin (-17.6%) and HOMA-IR (-18.2%) decreased significantly (P < 0.05) as well. Changes in VAT at the level of L3-L4 were significantly greater than those at other abdominal sites, and these changes were correlated with changes in TC (P < 0.05), LDL-C (P < 0.001), SBP (P < 0.001) and HOMA-IR (P < 0.01). These results show that VAT at L3-L4 had a stronger correlation with CVD risk factors than with other AT measurement sites after caloric restriction.

• Nutrition Research and Practice
• /
• v.9 no.5
• /
• pp.496-502
• /
• 2015

BACKGROUND/OBJECTIVES: This study was performed to investigate the association between the dietary intake of fish and shellfish, and omega-3 polyunsaturated fatty acids (PUFAs) and cardiovascular disease (CVD) risk factors in the middle-aged Korean female patients with Type 2 diabetes (T2D). SUBJECTS/METHODS: A cross-sectional analysis was performed with 356 female patients (means age: 55.5 years), who were recruited from the Huh's Diabetes Clinic in Seoul, Korea between 2005 and 2011. The dietary intake was assessed by a validated semi-quantitative food frequency questionnaire and analyzed using the Computer Aided Nutritional Analysis program (CAN-Pro) version 4.0 software. RESULTS: In a multiple regression analysis after the adjustment for confounding factors such as age, BMI, duration of diagnosed T2D, alcohol consumption, fiber intake, sodium intake, and total energy intake, fish and shellfish intake of the subjects was negatively associated with triglyceride and pulse wave velocity (PWV). Omega-3 PUFAs intake was negatively associated with triglyceride, systolic blood pressures, diastolic blood pressures, and PWV. The multiple logistic regression analysis with the covariates showed a significant inverse relationship between the omega-3 PUFAs consumption and prevalence of hypertriglyceridemia [OR (95% CI) for greater than the median compared to less than the median: 0.395 (0.207-0.753)]. CONCLUSIONS: These results suggest that the consumption of fish and shellfish, good sources of omega-3 PUFAs, may reduce the risk factors for CVD in the middle-aged female patients with T2D.

• Journal of Preventive Medicine and Public Health
• /
• v.38 no.3
• /
• pp.366-372
• /
• 2005

Objectives : This study was conducted to assess the distribution of cardiovascular risk factors (serum lipid profiles, BMI, blood pressure, fasting blood sugar) and evaluate the risk profile of CVD by the clustering of the cardiovascular risk factors in school-aged children in the Kyoung-Gi area. Methods : The study sample consists of 208 11 year-old children (51.4% boys, 48.6% girls) who participated in a cross-sectional screening of cardiovascular risk factors. We surveyed their socio-demographic characteristics, measured the anthropometric variables and analyzed the biochemical markers. Results : Of the cardiovascular risk factors, the percentage risk of the BMI, dyslipidememia and hypertension were highest. The prevalence rates of total cholesterol and LDL-cholesterol in girls was higher than in boys. Also, the associations of the BMI, total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, systolic and diastolic blood pressures were highly significant. In addition, the proportion of subjects with 1, 2, 3 and 4 or more risk factors were 29.3, 12.5, 2.9 and 1.9%, respectively; therefore, a total of 97 subjects (46.6%) had at least one more risk factor. Conclusions : From these findings, we concluded that the rates of hypercholesterolemia, cardiovascular risk groups and obesity prevalence of these groups were relatively high. These data provide further evidence that the early intervention for cardiovascular health prevention and promotion in school-aged children is necessary at the population level.

• Journal of muscle and joint health
• /
• v.25 no.1
• /
• pp.50-59
• /
• 2018

Purpose: The purpose of this study was to investigate the relationships among health behavior, wellness condition, and stage of change in health behavior by risk of cardiocerebrovascular diseases (CVD) in male office workers. Methods: A total of 205 male office workers participated in the 2017 National Health Examination at a manufacturing/ R&D business in Seongnam and completed self-reported questionnaires. Results: There were significant differences in health behavior scores by risk of CVD (F=4.78, p=.009) and statistically significant differences in no smoking (F=5.86, p=.003), exercise (F=5.49, p=.005), and health checkup (F=4.39, p=.014). There were statistically significant differences in health behavior (t=-4.14, p<.001) and wellness condition (t=-2.61, p=.010) by the stage of change in health behavior. Health behavior had a weak positive correlation with wellness condition (r=.36, p<.001). Logistic regression analysis showed that, when adjusted for age and employment period, the probability of becoming attention or risk group was 11% lower for quitting smoking (OR 0.89, 95% CI 0.81~0.97, p=.006) and 18% lower for regular exercise (OR 0.82, 95% CI 0.70~0.95, p=.009). Conclusion: The direction of health management at the workplace should be changed to promote the wellness of all workers, not the management of the disease, and a health promotion program should be continued to emphasize health behaviors such as smoking cessation and regular exercise.

• The Journal of Korean Diabetes
• /
• v.19 no.3
• /
• pp.135-139
• /
• 2018

The sodium-glucose cotransporter-2 inhibitor (SGLT2i) is a new anti-hyperglycemic agent that have function to concomitantly inhibit the reabsorption of glucose and sodium in the renal proximal convoluting tubule. Recent two cardiovascular outcome trials showed that a lower risk of cardiovascular events with SGLT2i in people with type 2 diabetes. In addition, prior real-world data demonstrated similar SGLT2i effects, but these studies were limited to the United States and Europe. Thus, the CVD-REAL (Comparative Effectiveness of Cardiovascular Outcomes in New Users of Sodium-Glucose Cotransporter-2 Inhibitors) 2 Study was investigated cardiovascular outcomes in those initiated on SGLT2i versus other glucose-lowering drugs (oGLDs) across 6 countries in the Asia Pacific, the Middle East, and North American regions. In Korea, 336,644 episodes of initiation in SGLT2i or oGLD group between September 2014 and December 2016 were identified in Korea National Health Insurance database after propensity score matching. SGLT2i users was associated with a lower risk of all-cause death (hazard ratio [HR], 0.72; 95% confidence interval [CI], 0.67~0.77), hospitalization for heart failure (HHF) (HR, 0.87; 95% CI, 0.82~0.92), all-cause death or HHF (HR, 0.81; 95% CI, 0.78~0.85), myocardial infarction (HR, 0.81; 95% CI, 0.74~0.89), and stroke (HR, 0.82; 95% CI, 0.78~0.86) compared with oGLD users. In conclusion, initiation of SGLT2i had a lower risk of cardiovascular events in people with type 2 diabetes compared with oGLDs.

• Journal of Nutrition and Health
• /
• v.47 no.4
• /
• pp.236-246
• /
• 2014

Purpose: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. Methods: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). Results: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). Conclusion: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.

• Nutrition Research and Practice
• /
• v.6 no.3
• /
• pp.246-253
• /
• 2012

The Framingham risk score (FRS) has been used to assess the risk of a cardiovascular event and to identify patients for risk factor modifications. Therefore, the purpose of this study was to evaluate the relationship of the FRS with dietary intake and inflammatory biomarkers. We conducted a cross-sectional study of 180 men ($49.2{\pm}10.2$ years) with MS. Serum levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and adiponectin were examined. Participants were asked to complete the food frequency questionnaire (FFQ) using the previous 1 year as a reference point. The absolute cardiovascular disease (CVD) risk percentage over 10 years was calculated to estimate the FRS, which was classified as low risk (< 10%), intermediate risk (10-20%), and high risk (> 20%). Mean intake of polyunsaturated fatty acids was lower in subjects who had > 20% FRS than in subjects who had < 10% FRS ($3.7{\pm}1.9$ g/day vs. $4.7{\pm}1.9$ g/day; P < 0.05). Significant differences in the Index of Nutritional Quality of protein, phosphorus, iron, vitamin A, vitamin $B_1$, niacin, vitamin $B_6$, and vitamin C were observed between the > 20% FRS group and the < 10% FRS group (P < 0.05). IL-6 concentrations were significantly lower in subjects with a < 10% FRS than in subjects who were 10-20% FRS or > 20% FRS ($0.91{\pm}0.26$ vs. $1.48{\pm}033$ vs. $2.72{\pm}0.57$ pg/mL, respectively; P < 0.05). IL-6 and dietary intake of polyunsaturated fatty acids together explained 6.6% of the variation in FRS levels in a stepwise multiple regression model. Our results provide some evidence that dietary intake in the higher CVD risk group was inferior to that in the lower risk group and that dietary fat intake and IL-6 were associated with FRS and MS in Korean men.

• Clinical and Experimental Pediatrics
• /
• v.60 no.11
• /
• pp.359-364
• /
• 2017

Purpose: The risk of cardiovascular disease (CVD) has been shown to be associated with systemic inflammation in obese adults with metabolic syndrome (MetS). The aims of this study were to evaluate the prevalence of MetS and its relation to inflammatory markers in obese Thai children. Methods: A cross-sectional study was conducted. Children with history of endogenous obesity, chronic diseases, drug ingestion, and any acute illness within 2 weeks prior to enrollment were excluded. Their fasting blood glucose (FBG) levels, oral glucose tolerance tests, insulin, lipid profiles, and selected inflammatory markers, including interleukin-6, tumor necrosis factor-alpha, and high-sensitivity C-reactive protein (hs-CRP) levels, were tested. Results: In this study, 58 obese Thai children (female, 20; male, 38) with a mean body mass index z score of $5.1{\pm}2.2$ were enrolled. The prevalence of MetS and prediabetes was 31% and 17.2%, respectively. None of the children had diabetes. FBG levels, 2-hour glucose levels, and lipid profiles were not statistically different between those with and without MetS. However, obese children with MetS had higher insulin levels and homeostasis model assessment of insulin resistance values. Elevated hs-CRP levels were found in 69% of the cases, although it was not statistically different between the 2 groups. Conclusion: We described a substantial prevalence of MetS in Thai obese children. Regardless of MetS status, two-thirds of the obese children had elevated hs-CRP level, indicating subtle ongoing inflammatory process. This chronic inflammation feasibly predisposes them to CVD in the future, even in children without MetS.