• Journal of Preventive Medicine and Public Health
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• v.56 no.1
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• pp.50-58
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• 2023

Objectives: Socioeconomic inequality in metabolic syndrome (MetS) remains poorly understood in Iran. The present study examined the extent of the socioeconomic inequalities in MetS and quantified the contribution of its determinants to explain the observed inequality, with a focus on middle-aged adults in Iran. Methods: This cross-sectional study used data from the Ravansar Non-Communicable Disease cohort study. A sample of 9975 middleaged adults aged 35-65 years was analyzed. MetS was assessed based on the International Diabetes Federation definition. Principal component analysis was used to construct socioeconomic status (SES). The Wagstaff normalized concentration index (CI_n) was employed to measure the magnitude of socioeconomic inequalities in MetS. Decomposition analysis was performed to identify and calculate the contribution of the MetS inequality determinants. Results: The proportion of MetS in the sample was 41.1%. The CI_n of having MetS was 0.043 (95% confidence interval, 0.020 to 0.066), indicating that MetS was more concentrated among individuals with high SES. The main contributors to the observed inequality in MetS were SES (72.0%), residence (rural or urban, 46.9%), and physical activity (31.5%). Conclusions: Our findings indicated a pro-poor inequality in MetS among Iranian middle-aged adults. These results highlight the importance of persuading middle-aged adults to be physically active, particularly those in an urban setting. In addition to targeting physically inactive individuals and those with low levels of education, policy interventions aimed at mitigating socioeconomic inequality in MetS should increase the focus on high-SES individuals and the urban population.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.204-211
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• 2011

Purpose: This study used a nonequivalent control group pre-post test design to analyze how a death preparation education program helps middle-aged adults deal with life and death anxiety. Methods: We studied 83 adults at the age of 40 to 65 years. An experimental group of 38 people participated in the death preparation education, and a control group of 45 people did not. The death preparation program comprising four sections was given for four hours per week, and the program ran for 11 weeks. Data were analyzed by descriptive statistics, t-test, ${\chi}^2$ test, Fisher's exact test, and ANCOVA using SPSS version 17.0. Results: The death anxiety score of the experimental group was significantly lower than that of the control group (P<0.000). The quality of life did not show significant difference between the experimental and control groups (P=0.188). Conclusion: It was confirmed that the death preparation education program is effective in alleviating death anxiety. Although the program was confirmed as a necessity for the middle-aged adults, repeated observations with a wider range of experimental group is needed to collect objective and solid data. Death preparation education for middle-aged adults is expected to be more widely provided, starting from local health facilities.

• Journal of Korean Public Health Nursing
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• v.29 no.3
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• pp.540-550
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• 2015

Purpose: The purpose of this study was to examine a combined influence of obesity and metabolic syndrome on ischemic heart disease in Korean middle aged and older adults. Methods: This study used secondary data from the 2013 Korea National Health and Nutrition Examination Survey. A total of 3,726 adults over age 40 were included. Logistic regression was used for analysis of complex samples. Gender, age, educational level, family income, family history of ischemic heart disease, physical activity, smoking, and heavy alcohol consumption were analyzed as covariates. Results: Ischemic heart disease was more prevalent among adults with metabolic syndrome regardless of obesity (non-obesity: Adjusted Odds Ratio [AOR]: 3.044, 95% Confidence Interval [CI]: 1.163-7.967, overweight: AOR: 2.805, 95% CI: 1.246-6.316, obese: AOR: 3.137, 95% CI: 1.548-6.358) compared to the reference group, defined as adults with non-obesity and non-metabolic syndrome. Odds of ischemic heart disease were not significant in the group with obesity and non-metabolic syndrome compared to the reference group. Conclusion: The results of this study show that the population with metabolic syndrome is an at-risk group for ischemic heart disease. Thus, management of metabolic syndrome is required for prevention of ischemic heart disease.

• Korean Journal of Health Education and Promotion
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• v.31 no.2
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• pp.1-14
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• 2014

Objectives: This study aimed to investigate factors influencing suicidal ideation among Korean adults. Methods: Cross-sectional data from the fifth Korea National Health and Nutritional Examination Survey conducted in 2012 were analyzed in this study. The subjects were categorized into three groups by subjects' age(defined as young adults(20-39), middle-aged adults(40-59), and the elderly(60 or more). Data were analyzed by frequency, Chi-square test and multiple logistic regression using SPSS 18.0. Results: The factors influencing suicidal ideation were different among three age groups. The influencing factors were (1) gender, marital status, household income, perceived stress and depression in the young adult group, (2) household income, perceived health status, perceived stress and depression in the middle-aged group, (3) gender, regular physical activity, smoking, perceived health status, perceived stress and depression in the elderly group. Conclusions: The health education considering the characteristics of each age group should be developed and applied to prevent adults' suicidal ideation because the factors influencing suicidal ideation were revealed differently between the age groups.

• Nutrition Research and Practice
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• v.17 no.2
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• pp.316-329
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• 2023

BACKGROUND/OBJECTIVES: This study investigated the association between dietary quality based on the Korean Healthy Eating Index (KHEI), and the prevalence of chronic conditions among middle-aged individuals (40-60 yrs of age) living alone. MATERIALS/METHODS: The participants were selected (1,517 men and 2,596 women) from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016-2018 and classified into single-person households (SPH) and multi-person households (MPH). Nutrient intake, KHEI, and the prevalence of chronic conditions were compared according to household size. The odds ratios (ORs) of chronic conditions were analyzed according to the tertile levels of KHEI by gender within each household size category. RESULTS: Men in SPH had a significantly lower total KHEI score (P < 0.0001) and a lower prevalence of obesity (OR, 0.576) than those in MPH. For men, the adjusted ORs for obesity, hypertension, and hypertriglyceridemia in the first tertile (T1) of KHEI scores within SPH compared with the third tertile (T3) were 4.625, 3.790, and 4.333, respectively. Moreover, the adjusted OR for hypertriglyceridemia in the T1 group compared to the T3 group within the MPH was 1.556. For women, the adjusted ORs for obesity and hypertriglyceridemia in T1 compared to T3 within the SPH were 3.223 and 7.134, respectively, and 1.573 and 1.373 for obesity and hypertension, respectively, within MPH. CONCLUSIONS: A healthy eating index was associated with a reduced risk of chronic conditions in middle-aged adults. Greater adherence to a healthy eating index could lower the risk of chronic conditions in middle-aged adults living alone.

• Korean Journal of Exercise Nutrition
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• v.25 no.1
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• pp.16-22
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• 2021

[Purpose] Aerobic exercise training (AT) reverses aging-induced deterioration of arterial stiffness via increased arterial nitric oxide (NO) production. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase, was decreased by AT. However, whether AT-induced changes in ADMA levels are related to changes in nitrite/nitrate (NOx) levels remains unclear. Accordingly, we aimed to clarify whether the relationship between plasma ADMA and NOx levels afected the AT-induced reduction of arterial stifness in middle-aged and older adults. [Methods] Thirty-one healthy middle-aged and older male and female subjects (66.4 ± 1.3 years) were randomly divided into two groups: exercise intervention and sedentary controls. Subjects in the training group completed an 8-week AT (60%-70% peak oxygen uptake [${\dot{V}}O_{2peak}$] for 45 min, 3 days/week). [Results] AT signifcantly increased ${\dot{V}}O_{2peak}$ (P < 0.05) and decreased carotid β-stifness (P < 0.01). Moreover, plasma ADMA levels were significantly decreased while plasma NOx levels and NOx/ADMA ratio were significantly increased by AT (P < 0.01). Additionally, no sex diferences in AT-induced changes of circulating ADMA and NOx levels, NOx/ADMA ratio, and carotid β-stifness were observed. Furthermore, the AT-induced increase in circulating ADMA levels was negatively correlated with an increase in circulating NOx levels (r = -0.414, P < 0.05), and the AT-induced increase in NOx/ADMA ratio was negatively correlated with a decrease in carotid β-stifness (r = -0.514, P < 0.01). [Conclusion] These results suggest that the increase in circulating NOx with reduction of ADMA elicited by AT is associated with a decrease in arterial stiffness regardless of sex in middle-aged and older adults.

• Journal of Korean society of Dental Hygiene
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• v.23 no.1
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• pp.43-53
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• 2023

Objectives: We developed an integrated cognitive function improvement program comprising cognitive, emotional, and physical domains, and remotely applied it to middle-aged adults to investigate its effects on oral health, cognitive function, and mental health improvement. Methods: The experimental group underwent the program remotely, using the Zoom platform. A total of 24 participants were recruited and divided into 12 experimental and 12 control groups. The program comprised cognitive, emotional, and physical activities. The sessions lasted 90 min and were performed twice a week for 6 weeks from April to May 2022. Results: Cognitive function, arousal, physical, and mental stress were significantly improved in the experimental group after the intervention than at the baseline (p<0.05). Regarding oral health, tongue plaque decreased 1.34-fold (p<0.01) and saliva increased 1.04-fold (p<0.05) in the experimental group after the intervention than at the baseline. Moreover, the experimental group showed significant improvements in tongue plaque and saliva than the control group (p<0.05 for tongue plaque and p<0.01 for saliva). Regarding mental health, social support significantly increased 11.67-fold (p<0.05) in the experimental group than at the baseline. The experimental group also showed significantly improved social support than the control group (p<0.01). Conclusions: The non-face-to-face integrated cognitive function improvement program for middle-aged adults improved their cognitive function and oral and mental health. Based on these findings, this program may be a useful health program tool for middle-aged individuals.

• Nutrition Research and Practice
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• v.13 no.4
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• pp.316-322
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• 2019

BACKGROUND/OBJECTIVES: The association between dietary patterns and depression has been reported but the results have been inconsistent. This study was conducted to investigate the association between dietary patterns and depression in middle-aged Korean adults. SUBJECTS/METHODS: The participants were selected from a community-based cohort, a subset of the Korean Genome and Epidemiology Study. Depression was assessed using the Korean version of the Beck Depression Inventory (BDI) and those with a BDI score ${\geq}16$ were defined as having depression. The subjects' food intakes over the year preceding the survey were estimated by using a validated semi-quantitative food frequency questionnaire. Dietary patterns were identified by using factor analysis. Multiple logistic regression was used to assess the association of dietary pattern with depression. RESULTS: Among 3,388 participants, 448 (13.2%) were identified as having depression. We identified two major dietary patterns: 'Healthy' dietary pattern was characterized by high intakes of vegetables, soybeans, mushroom, seaweeds, white fish, shellfish and fruits and a low intake of white rice. 'Unhealthy' dietary pattern was characterized by high intakes of white rice, meats, ramen, noodles, bread and coffee and a low intake of rice with other grains. Compared with subjects in the lowest quartiles, those in the highest quartiles of the healthy dietary pattern had a significantly lower odds ratio (OR = 0.59, 95% CI: 0.42-0.82, P for trend = 0.0037) after adjusting for potential confounders. In contrast, the unhealthy dietary pattern was negatively associated with depression (OR = 1.65, 95% CI: 1.19-2.28, P for trend = 0.0021). CONCLUSION: This results suggest that a healthy dietary pattern (rich in vegetables, soybeans, mushroom, seaweeds, white fish, shellfish, and fruits) is associated with low risk of depression. Whereas an unhealthy dietary pattern (rich in white rice, meats, ramen, noodles, bread, and coffee) is associated with a high risk of depression in middle-aged Korean adults.

• Nutrition Research and Practice
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• v.16 no.3
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• pp.379-391
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• 2022

BACKGROUND/OBJECTIVES: We investigated the associations between eating away from home (EAFH) and overweight and obesity among Ugandan adults using the 2014 Uganda non-communicable disease risk factor survey. SUBJECTS/METHODS: In total, 3,025 participants aged 18-69 years were included in the analysis. The frequency of EAFH was assessed by asking participants the number of meals eaten per week that were not prepared at a home. EAFH frequency was categorized as; less than once/week, 1-2 times/week, or ≥ 3 times/week. Logistic regression was used to evaluate the associations between overweight, obesity, and EAFH. We also tested whether sex and age modified these associations. RESULTS: Participants that ate away from home ≥ 3 times/week were 2.13 times more likely to be obese than those that ate away from home less than once/week (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.28-3.54). However, when the analysis was stratified by sex, women that ate away from home ≥ 3 times/week were 42% less likely to be overweight than those that ate away from home less than once/week (OR, 0.58; 95% CI, 0.36-0.94). Men that ate away from home ≥ 3 times a week were 3.89 times and 2.23 times more likely to be obese and overweight, respectively, than those that ate away from home less than once/week (obesity: OR, 3.89; 95% CI, 1.50-10.09; overweight: OR, 2.23; 95% CI, 1.42-3.51). Age-stratified analysis showed that among participants aged 31-50 years, those that ate away from home ≥ 3 times a week were 3.53 times more likely to be obese than those that ate away from home less than once/week (OR, 3.53; 95% CI, 1.69-7.37). CONCLUSIONS: Frequent EAFH was positively associated with overweight and obesity among men, and obesity among young/middle-aged adults, but negatively associated with overweight in women. Nutritional interventions for obesity reduction in Uganda should include strategies aimed at reducing the frequency of eating meals prepared away from home, and specifically target men and young/middle-aged adults.

• Journal of the Korean Home Economics Association
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• v.46 no.1
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• pp.103-116
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• 2008

The purpose of this study was to empirically describe the everyday life of middle-aged adults in terms of their time-use activities. From the original '2004 Time dairy' Data, developed by the Korean National Statistical Office (KNOS), 17,684 respondents aged between 35-59 were selected. In order to categorize their activity patterns, work/labour, domestic labour, and spare leisure time were classified according to the action classification system. As a result, four dominant types were found: namely work-leisure, work-oriented, family-oriented, and leisure-oriented activities. Results of multinomial logistic analysis revealed that gender, age, socioeconomic status, job characteristic, and family structure were the major determinants on time-use. Compared with work-leisure, young middle aged women holding a part-time job with less income tended to be involved in a family-centered time use. Dual earners with lower SES status were likely to have work-oriented time schedules. Older men with relatively lower income were more likely to be involved in leisure-oriented activities rather than work-leisure activities. Multitasking behavior was a significant variable in explaining the four different types of time-use. Work-oriented group showed the highest level of time pressure as well as fatigue. Group differences in these measures, however, was not as large as expected.