• Journal of Preventive Medicine and Public Health
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• v.50 no.6
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• pp.401-410
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• 2017

Objectives: The purpose of this study was to examine the associations of childbirth, breastfeeding, and their interaction with breast cancer (BC) risk reduction, and to evaluate the heterogeneity in the BC risk reduction effects of these factors by menopause, hormone receptor (HR) status, and pathological subtype. Methods: BC patients aged 40+ from the Korean Breast Cancer Registry in 2004-2012 and controls from the Health Examinee cohort participants were included in this study after 1:1 matching (12 889 pairs) by age and enrollment year. BC risk according to childbirth, breast-feeding, and their interaction was calculated in logistic regression models using odds ratios (ORs) and 95% confidence intervals (CIs). Results: BC risk decreased with childbirth (3+ childbirths relative to 1 childbirth: OR, 0.66; 95% CI, 0.56 to 0.78 and OR, 0.80; 95% CI, 0.68 to 0.95 in postmenopausal and premenopausal women, respectively); and the degree of risk reduction by the number of children was heterogeneous according to menopausal status (p-heterogeneity=0.04), HR status (p-heterogeneity<0.001), and pathological subtype (p-heterogeneity<0.001); whereas breastfeeding for 1-12 months showed a heterogeneous association with BC risk according to menopausal status, with risk reduction only in premenopausal women (p-heterogeneity<0.05). The combination of 2 more childbirths and breastfeeding for ${\geq}13$ months had a much stronger BC risk reduction of 49% (OR, 0.51; 95% CI, 0.45 to 0.58). Conclusions: This study suggests that the combination of longer breastfeeding and more childbirths reduces BC risk more strongly, and that women who experience both 2 or more childbirths and breastfeed for ${\geq}13$ months can reduce their BC risk by about 50%.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.2
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• pp.398-404
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• 2017

The aim of this study was to determine the effect of a non-elastic fixation belt on the balance ability and fall prevention in elderly women. Elderly women experience reduced balance ability and an increased risk of falls due to a weakening of the surrounding sacroiliac joint and pelvic muscles during childbirth and menopause. On the other hand, specific studies are still needed. The subjects were allocated randomly to two groups: control (n=20) and experimental (n=20). The experimental group used a non-elastic fixation belt, whereas the control group had no fixation belt. The balance ability and the fall index were measured in all subjects using a balance measurement device, and the low abdominal muscle thickness was determined in the experimental group using ultrasound imaging for the exact application of the non-elastic fixation belt. The following statistical analysis was performed: an independent t-test for the general characteristics of the subjects, $2{\times}2$ analysis of variance with repeated measures for the balance and fall index score, and a paired t-test for the abdominal muscle thickness. The group ${\times}$ time interaction effect showed significant improvement in the General Stability Index (F1,38=47.24, p=0.001), Fourier Harmony Index (F1,38=88.83, p=0.001), Weight Distribution Index (F1,38=50.21, p=0.001), and Fall Index (F1,38=21.59, p=0.001). The thicknesses of the transverse abdominal (p=0.001) and internal oblique (p=0.001) muscles were increased significantly in the experimental group after using the non-elastic fixation belt. Overall, the application of a non-elastic fixation belt could be effective in improving the balance ability and fall prevention in elderly women.

• Journal of Nutrition and Health
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• v.37 no.9
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• pp.786-793
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• 2004

Women with menopause or rats with ovariectomy is associated with increased body weight, body fat and insulin resistance, which are components of metabolic syndrome. Increased prevalence of metabolic syndrome after menopause might be associated with mitochondrial dysfunction, since mitochondrial oxidative and phosphorylation activity is strongly correlated with insulin sensitivity. Although estradiol replacement prevents the metabolic syndrome, harmful effect of estradiol hampers the casual usage to prevent the metabolic syndrome. It has been reported that genistein has a mild estrogenic activity, decreases fat mass in mice and has an antidiabetic role in diabetic rats. Although insulin resistance is closely related to mitochondrial functions, there has not been yet any study in regard to the effect of dietary genistein on mitochondrial function in the insulin resistant female subjects induced by ovariectomy or similar situation. The present study investigated whether the supplementation of genistein in the high fat diet affected the mitochondrial function of high fat fed ovariectomized rats. Female Sprague Dawley rats (8 weeks old) were assigned to the following groups: sham-operated+ high fat diet (S, n=6); sham-operated + high fat diet with 0.1% genistein (S + G, n=7); ovariectomized + high fat diet (OVX, n=8); ovariectomized + high fat diet with 0.1% genistein (OVX+ G, n=8). Ovariectomy significantly increased body weight compared with S group. Genistein consumption in ovariectomized (OVX + G) rats decreased body weight gain compared with OVX rats. Liver weights were increased by ovariectomy. The hepatic mitochondrial protein density expressed as mg per g liver was lower in the OVX group than in the S group. However, OVX + G group showed the increased mitochondrial protein density similar to the level of S group. When mRNA levels of genes related to mitochondria such as peroxisome proliferator-activated receptor ${\gamma}$ coactivator 1 (PGC-1) and cytochrome c oxidase subunit III (COX III) were measured, there were decreases in the mRNA levels of PGC-1 and COX III in S + G, OVX and OVX + G group. The activity of cytochrome c oxidase was not different between groups. We could observe the decrease in succinate dehydrogenase (SDH) activity per g liver in OVX rats. Genistein supplement increased SDH activity. In conclusion, genistein supplementation to the OVX rats enhanced mitochondrial function by increasing mitochondrial protein density and SDH activity. The improvement in mitochondrial function by genistein can contribute to the improvement in metabolic syndrome.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.2
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• pp.89-98
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• 2010

Sex and its tropic hormones influence the lacrimal system, corneal anatomy and disease, aqueous humor dynamics and glaucoma, crystalline lens and cataract, and retinal disease. Dry eye occurs especially frequently during pregnancy, oral contraceptive use, and after menopause, during which androgen levels decrease. Androgen control development, differentiation, and lipid production of sebaceous glands throughout the body, and androgen deficiency also leads to meibomian gland dysfunction and evaporative dry eye. On the other hand, estrogen causes a reduction in size, activity, and lipid production of sebaceous glands. Sex and its tropic hormones also influence the corneal anatomy and disease, and corneal thickening occurred on the second day of the menstrual cycle and around the time of ovulation and appeared to be related to estrogen levels. Fuchs' dystrophy is more commonly seen in postmenopausal women than men and may be linked to hormonal changes that occur with aging. In addition, overexpression of estrogen and progesterone receptors in the conjunctiva of vernal keratoconjunctivitis patients. Serum progesterone levels also may be associated with intraocular pressure especially in pregnant women, and for the women. For women with cataracts, hormone levels were typical of menopause, and there was a significant negative correlation between estradiol and follicular stimulating hormone levels. In addition, serum testosterone levels are associated with the development of diabetic retinopathy. Although the role of sex hormones on the eye is largely unknown, and the results should be interpreted with caution until replicated, the functions of sex hormones in ocular disease remains to be investigated, because they may be involved in structure and function of the ocular components, which are important in the pathogenesis of ocular disease.

• Journal of Nutrition and Health
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• v.51 no.3
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• pp.228-241
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• 2018

Purpose: The health risk of women increases after menopause. This study evaluated the effectiveness of a public health center-based nutrition education program for hypertension in women older than 50 years of age. Methods: The program included 8-week nutrition education and 8-week follow-up with keeping a health diary and nutrition counseling. The program was evaluated three times: before and after the nutrition education, and after the follow-up. The subjects were classified into hypertensives (n = 44) or normotensives (n = 71). Results: The rate of taking antihypertensive drugs in the hypertensive group was 86.4%. The systolic blood pressure decreased in the hypertensive and normotensive groups after nutrition education (p < 0.05). The body weight (p < 0.001), BMI (p < 0.001), waist circumference (p < 0.001), and percent body fat (p < 0.01) were also decreased after nutrition education in both groups. The hypertensive group showed an increase in HDL-cholesterol level (p < 0.001) and decreases in triglycerides (p < 0.01) and LDL-cholesterol (p < 0.05) levels after completion of the program. The normotensive group also displayed significant changes in HDL-cholesterol (p < 0.001) and triglycerides (p < 0.01). The dietary habits and nutrition knowledge on sodium and hypertension were improved in both groups (p < 0.001). The total score of dietary behavior related to the sodium intake was improved in the normotensive group (p < 0.001). The total score of the high sodium dish frequency questionnaire decreased in both groups after nutrition education and completion of the program compared to that before the program. Decreases in the consumption frequencies of noodles, pot stews and stews, Kimchi, and beverages were significant. The total self-efficacy score was increased in both groups by the program (p < 0.001). In particular, the hypertensive group showed improvement in all items. Conclusion: This public health center-based nutrition education program may contribute to the prevention and management of hypertension and chronic diseases in women over 50 years of age.

• The Korean Journal of Rehabilitation Nursing
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• v.7 no.1
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• pp.33-47
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• 2004

The purpose of this study was to investigate weight control practices and cardiovascular risk in middle-aged women. 304 middle-aged women were selected as subjects from thirties to fifthies living at J city in Chung-Buk Do. Data were collected using a questionnaire, anthropometric measurements, BP & total cholesterol level in serum from April 1, to June 30, 2003. The results of this study were as follows: The middle-aged woman's age is average $43.95{\pm}7.09yr$ and mean BMI(body mass index) was $23.54{\pm}3.09\;kg/m^2$. Underweight, normal weight, overweight, obese women were 3.0%, 39.5%, 27.9% and 29.6%respectively. Subjects perceived own as 'Slim' 5.9%, 'ordinary' 45.7%, 'Fat' 48.4%. Their weight perception coincide their own actual body weight but as many as 41.8% of overweight and 9.0% of obese perceived themselves as being 'ordinary'. Middle age women with past weight control experience were 55.6%, and only 35.5% was doing weight control at present. Of these subjects, 71.4% reported wanting to lose weight and the primary reason of weight control was to improve their appearance(39.53%). The most frequently reported weight control behavior was 'exercise' followed 'dieting', but 39.6% reported using 'diet food', 12.4% 'behavior modification', 12.4% 'fasting', and 'diet-drug'(3.6%) or 'smoking'(3.6%). Effective weight control methods were thought regular exercise(97.1%) & dieting (79.3%). And behavior modification(71.4%) or diet camp(60%) were effective, too. An average waist circumference was $79.80{\pm}9.47cm$, waist/hip ratio was $86.63{\pm}6.78$, waist/height ratio was $50.43{\pm}6.10$. In the index of abdominal obesity, 79.7 % of middle-aged women was waist/height ratio over 0.46, 65.3% was waist/hip ratio over 0.85, 28.4% was waist circumference over 85cm. There were significant differences in the degree of abdominal obesity according to age and BMI. In the index of cardiovascualr risk, 10.9% of middle aged women was systolic hypertension over 140mmHg, 18.7% was diastolic hypertension over 90mmHg and 10.6% was hypercholesterolemia over 200mg/dl. There was significant difference in systolic hypertension ratio according to age. There was significant difference in diastolic hypertension ratio according to age and obesity. There were significant differences in hypercholesterolemia accorting to obesity. The abdominal obesity indices and the levels of T-cholesterol in the serum, systolic and diastolic BP increased significantly according to age. T-cholesterol in serum was predicted 2.6% by waist/height ratio. And systolic BP was predicted 15.2% by waist/height, add BMI to 16.8%. Subject's diastolic BP was predicted 12.1% by BMI. Therefore waist/height ratio and BMI were significant factors for the predictors of cardiovascular risk. There was significant correlation between index of obesity and cardiovascular risk. T-cholesterol in serum had correlation with waist/eight ratio(r=0.174) and waist circumference(r=0.48). Systolic BP had correlation with waist/height ratio(r=0.387), and BMI(=0.371). diastolic BP correlation had correlation with BMI(r=0.343) and waist/height ratio(r=0.327). In conclusion, The prevalence of obesity was 29.6% in 304 cases, and increased as age after menopause increased. Middle-aged women's weight perception and actual BMI coincide but some of them did not. Trial to reduce weight was attempted. But most of them did not actually. Undesirable weight control method such as using drugs, fasting, smoking was used by some women. It is important to educate about health weight control methods and raise their awareness of exact body figures. High frequency of abdominal obesity in middle-aged women had correlation with hypertension and hypercholesterolemia. Abdominal index such as waist/height ratio, waist circumference, waist/hip ratio was used. Women's hypertension, hypercholesterolemia significantly related to body mass index and abdominal obesity.

• Nutrition Research and Practice
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• v.8 no.5
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• pp.539-543
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• 2014

BACKGROUND/OBJECTIVES: Soy isoflavones are structurally similar to estrogen and bind to estrogen receptors, suggesting that they exhibit estrogenic activities; therefore, they are referred to as phytoestrogens. Fermentation may affect the bioavailability of isoflavones altering soy isoflavone glycosides in the form of aglycones. Thus, this study investigated the effects of fermented soybeans by Rhizopus oligosporus on bone metabolism in both young rats as a pilot test and in ovariectomized (ovx) old rats as a model of menopause. MATERIALS/METHODS: In the pilot test, a total of 24 seven-week-old female Sprague-Dawley (SD) rats were fed one of three diets for a period of four weeks: casein, unfermented soybean product, or fermented soybean product by R. oligosporus. In the ovx rat model, 20-week-old SD rats weighing 260-290 g underwent either sham-operation (n = 10) or bilateral ovariectomy (n = 30) and were then fed the AIN-93M diet for one week. Thereafter, rats were fed sham-casein, ovx-casein, ovx-soybean, or ovx-fermented soybean diet for five weeks. After decapitation, femoral bones were isolated and preserved in 9% formalin for assessment of bone mineral density (BMD), bone mineral content (BMC), and bone-breaking strength (BBS). RESULTS: Ovx rats showed significantly increased weight gain and decreased uterine wet weight. Of particular interest, ovx rats fed fermented soybeans showed increased uterine wet weights compared to control rats. Fermented soybean diet caused a significant increase in plasma 17-${\beta}$ estradiol concentrations in young rats, and 17-${\beta}$ estradiol levels were enhanced in ovx rats to match those of sham-operated ones. Significantly lower femoral BMD and BMC were observed in ovx rats compared to sham-operated controls, whereas bone areas did not differ statistically among the groups. In addition, BBS tended to be increased in ovx rats fed soybeans and fermented soybeans. CONCLUSIONS: Supplementation of fermented soybeans could have preventive and therapeutic effects against osteoporosis in postmenopausal women.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.4
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• pp.1-20
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• 2023

Objectives: The object of this study was to observe the complex anti-climacterium potentials of Yuklinzu aqueous extracts (YLZ), using bilateral ovariectomy (OVX) female ddY mice similar to women postmenopausal symptoms, as including cardiovascular diseases, obesity, hyperlipidemia, osteoporosis and hepatic steatosis. Methods: In order to evaluate anti-climacterium effects of YLZ, six groups of mice were used; sham control, OVX control, 17β-estradiol, YLZ 500, 250 and 125 mg/kg treated groups. Since 28 days after bilateral OVX surgery, YLZ were administered orally for 84 days, once a day. And then we evaluated anti-climacterium effects divided into five categories; estrogenic effects, anti-obesity, hypolipidemic effects, hepatoprotective effects and anti-osteoporotic effects. The results of YLZ were compared with 17β-estradiol 0.03 ㎍/head/day subcutaneous treated OVX mice. Results: As a result of OVX, obvious changes related to the estrogen-deficient menopausal symptoms - obesity, hyperlipidemia, hepatic steatosis and osteoporosis were displayed in mice. However, these menopausal symptoms induced by OVX were significantly inhibited by 84 days of consecutive treatment of 17β-estradiol, YLZ 500, 250 and 125 mg/kg, respectively. Especially, YLZ showed obvious dose-dependent inhibitory activities on the OVX-induced climacterium changes in mice, and YLZ 500 mg/kg showed comparable inhibitory effects against menopausal symptoms in comparison with those of 17β-estradiol 0.03 ㎍/head/day subcutaneous treatment. Conclusions: The results suggest that oral administration of YLZ 500, 250 and 125 mg/kg has obvious dose-dependent favorable anti-climacterium effects in OVX mice. Especially, YLZ 500 mg/kg showed comparable inhibitory effects against menopausal symptoms in comparison with those of 17β-estradiol 0.03 ㎍/head/day subcutaneous treatment.

• Journal of Nutrition and Health
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• v.52 no.5
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• pp.449-464
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• 2019

Purpose: North Koreans could be at higher risk for their bone health because of previous periods of severe famine and the continuing low availability of food. This study determined the bone mineral density (BMD) status and its relationship with dietary behaviors and nutrient intake of North Korean refugees (NKR) in South Korea (SK). Methods: This cross-sectional study analyzed 110 female NKR from a NORNS cohort of a non-probability sample of adult NKR in Seoul. BMD examined by DEXA was used to divide participants into the normal group (NG) and the non-normal group (NNG) according to the WHO guideline. A self-administered questionnaire included questions on age, the socioeconomic situation in North Korea (NK) and SK, the food security in NK and SK, and the health behaviors, dietary behaviors, and food frequency questionnaire administered in SK. A one-day 24-hr recall was conducted and the results were analyzed by using CanPro. SPSS was used to analyze whether BMD and related dietary behaviors and nutrient intakes differed according to the groups. Results: NG (62.7%) was significantly younger and had a lower abdominal obesity score than NNG (p < 0.001). While 14.5% of NG reported experiencing menopause, all of NNG reported experiencing menopause. The NG more frequently consumed the dairy group of foods (9.6 times a week) than did the NNG (4.8 times a week) after the statistics were adjusted for age (p < 0.007). The NG consumed significantly more animal protein and animal calcium than did the NNG (p = 0.01, p = 0.009, respectively). Calcium intake was low with 49.3% of NG, and 78.0% of the NNG reported consuming calcium lower than the estimated average requirement. Only calcium showed an index of nutrient quality lower than one in both groups. Conclusion: These results showed that NKR women and possibly all North Korean women are at high risk for bone health and they consumed low levels of bone-related nutrients, and this should be considered for the nutrition policy for NKR and North Korea.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.65-85
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• 2001

Osteoporosis is the disease that is the most controversial issue with the aging tendency in 1990. It is an important issue in dealing with the health management for women in middle life. This study is designed to determine the relationships among the level of the knowledge of osteoporosis, the health promoting behaviors and the quality of life. The test has conducted a questionnaire survey of women with osteoporosis. This is a study that focused an interrelation of above issues and its purpose is to gain a foundation of a nursing intervention that can help to improve the qualify of life of an osteoporosis patients. The method of collecting data is collecting a questionnaire survey, individual interviews and records and the collected 123 questionnaire surveys are utilized for an data analysis. Questionnaire surveys are conducted in K and S Universities infirmaries and K general hospital in Seoul and C and J general hospital in near Seoul area from Sep. 27th to Nov. 4th, 2000. The instruments of this study were as follows: Yoon's used the revised and supplemented instrument to test the level of the knowledge of osteoporosis and she referred to the substance of Cassells & Knotz. Lee's revised and supplemented the instrument called Health Promoting Life style Profile that were invented by Walker, Sechrist & Pender and she used it to test the health promoting behaviors with the questionnaires added by this researcher. They are not related to the quality of life but relevant to the patients. Ro's tested the quality of life with the instrument that was invented by herself. The results of this study were as follows. 1. The general characteristics of this study subjects showed that the age of the patients was concentrated from 50 to 59. The periods after menopause was mainly from 6 to 10 years. Subjective symptoms that patients usually complain were musculoskelectal symptoms. 2. The results of measuring the level of the knowledge of osteoporosis, the health promoting behaviors and the quality of life were following. The level of the knowledge was the score 19.83 and it was above middle score out of the score 27 as full marks. In the result of the health promoting behaviors test, the score average was 2.58 with 4 point rating scale and it was about middle score. The quality of life test showed that average score was 2.92 with 5 point rating scale and it indicated that the quality was also around middle score. 3. The statistical test in the activities for promoting health according to the general characteristics of the patients showed that only monthly income has statistically significant difference(F-4.761, p=.004). The same test for the qualify of life indicated that the quality of life was higher from 1 to 5 years after menopause but it was not meaningful statistically. 4. In the correlation among the level of knowledge of osteoporosis, the health promoting behaviors and the qualify of life of the patients, showed a relationship between the health promoting behaviors and the qualify of life. The higher the health promoting behaviors, it was also higher the quality of life. But it was statistically significant with significant positive correlation.