• Journal of Korean Academy of Nursing
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• v.48 no.6
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• pp.692-707
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• 2018

Purpose: We aimed to examine the effects of an integrated physical activity (PA) program developed for physically inactive workers on the theoretical basis of the PRECEDE-PROCEED model. Methods: Participants were 268 workers in three departments of L manufacturing unit in South Korea. The three departments were randomly allocated into integration (n=86) (INT), education (n=94) (ED), and control (n=88) (CT) groups. The INT group received self-regulation, support, and policy-environmental strategies of a 12-week integrated PA program, the ED group received self-regulation strategies only, and the CT group did not receive any strategies. After 12 weeks, process evaluation was conducted by using the measures of self-regulation (autonomous vs. controlled regulation), autonomy support, and resource availability; impact evaluation by using PA measures of sitting time, PA expenditure, and compliance; and outcome evaluation by using the measures of cardiometabolic/musculoskeletal health and presenteeism. Results: Among process measures, autonomous regulation did not differ by group, but significantly decreased in the CT group (p=.006). Among impact measures, PA compliance significantly increased in the INT group compared to the CT group (p=.003). Among outcome measures, the changes in cardiometabolic/musculoskeletal health and presenteeism did not differ by group; however, systolic blood pressure (p=.012) and a presenteeism variable (p=.041) significantly decreased only in the INT group. Conclusion: The integrated PA program may have a significant effect on increases in PA compliance and significant tendencies toward improvements in a part of cardiometabolic health and presenteeism for physically inactive workers. Therefore, occupational health nurses may modify and use it as a workplace PA program.

• Journal of the Korea Convergence Society
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• v.9 no.1
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• pp.233-240
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• 2018

The aim of this study was to investigate the cardiometabolic risk factors (CRF) of community dwelling women based on a combination of body mass index (BMI) and waist circumference (WC). This cross-sectional study was based on 1,447 subjects between 30 and 60 years of age. Subjects were categorized into 4 groups by BMI and WC [group 1, BMI<$25kg/m^2$ and WC<85 cm; group 2, BMI<$25kg/m^2$ and WC>85 cm; group 3, BMI>$25kg/m^2$ and WC<85 cm; and group 4 (BMI>$25kg/m^2$ and WC>85 cm. Logistic regression analyses showed that subjects in group 2 had 1.75 times increased risk of clustering of 2 or more CRFs compared with subjects in group 1 (p<0.001). In conclusion, early detection of people with normal weight but high waist circumference may prevent them from getting worse by implementation of lifestyle intervention, consisting of regular exercise and healthy eating. In addition, further studies on appropriate exercise contents for them should be examined.

• Clinical Nutrition Research
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• v.12 no.4
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• pp.320-335
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• 2023

Literature showed that soluble fiber has beneficial effects on cardiometabolic risk factors and leptin and adiponectin serum levels. Our aim in this meta-analysis was to determine the effect of soluble fiber supplementation on leptin and adiponectin serum levels. A systematic search was conducted using PubMed, Scopus, and ISI Web of Science for eligible trials up to December 2021. A random-effects model was used to pool calculated effect sizes. Our analysis showed that soluble fiber supplementation did not significantly affect adiponectin (standardized mean difference [SMD], -0.49 Hedges's, 95% confidence interval [CI], -1.20, 0.21, p value = 0.167; I² = 95.4, p value < 0.001) and leptin (SMD, -0.8 Hedges's, 95% CI, -1.70, 0.08, p value = 0.076; I² = 94.6, p value < 0.001) concentrations in comparison with placebo. However, in the subgroup, soluble fiber supplementation had a significant improvement in leptin concentration in overweight and obese patients (SMD, -0.22 Hedges's, 95% CI, -0.43, -0.01, p value = 0.048) and a non-significant beneficial effect in adiponectin level in female (SMD, 0.29 Hedges's, 95% CI, -0.13, 0.71, p value = 0.183) and diabetic patients (SMD, 0.32 Hedges's, 95% CI, -0.67, 1.32, p value = 0.526). A non-linear association between soluble fiber dosage and adiponectin (p_{non-linearity} < 0.001) was observed. Soluble fiber supplementation could not change the circulatory leptin and adiponectin levels. However, beneficial effects were seen in overweight and obese leptin, and increases in adiponectin may also be observed in female and diabetic patients. Further studies are needed to confirm this results.

• Journal of Nutrition and Health
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• v.52 no.6
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• pp.540-551
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• 2019

Purpose: Dietary fiber is a component of carbohydrate that is linked closely with the carbohydrate quality, but few studies have investigated the association of high fiber intake with the cardiometabolic risk factors in Koreans. This study examined the association of high fiber and high carbohydrate intake with the cardiometabolic risk factors among Korean adults. Methods: This study included 15,095 adults aged ≥20 years, who participated in the 2013 ~ 2017 KNHANES. The dietary intake was obtained using a 24-h dietary recall method. The associations of high fiber and high carbohydrate intake with metabolic syndrome and dyslipidemia were examined by sex using multiple logistic regression analysis. Results: The median of dietary fiber was 23.6 g/day in men and 20.0 g/day in women. Dietary fiber intake increased gradually as dietary carbohydrate groups increased except for ≥80% of energy from the carbohydrate group. Women in the highest quintile of fiber intake showed a 33% lower risk of metabolic syndrome compared with those in the third quintile. When stratified into low fiber (LF) and high fiber (HF) groups using Adequate Intake of fiber for Koreans, men in the third quartile of carbohydrate intake showed a 44% and 51% higher risk of metabolic syndrome and atherogenic dyslipidemia than in the first quartile, respectively, but only in the LF group. Women in the second quartile of carbohydrate intake showed an 83% higher risk of hypercholesterolemia than in the first quartile in the LF group. On the other hand, as no significant association was observed between the carbohydrate intake and metabolic diseases among the HF groups in both sexes. Conclusion: These findings suggest that a high fiber intake might be associated with a reduced risk of metabolic syndrome and high carbohydrate intake with a low dietary fiber intake might be associated with an increased risk of several metabolic abnormalities among Korean adults. Further prospective studies will be needed to confirm the effects of high fiber and high carbohydrate intake on the cardiometabolic risk factors among Koreans.

• Archives of Obesity and Metabolism
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• v.3 no.1
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• pp.14-26
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• 2024

Ultra-processed foods, falling under group 4 of the Nova classification system, are manufactured from processed food ingredients such as oils, fats, sugars, starch, and protein isolates, containing minimal to no whole food. They commonly incorporate flavorings, colorings, emulsifiers, and various cosmetic additives to enhance their palatability. Ultra-processed foods have become increasingly prevalent in contemporary society owing to their convenience, affordability, extended shelf life, and enhanced taste and aroma through additives. This surge in the consumption of ultra-processed foods has sparked discussions regarding its adverse health effects. Numerous studies have highlighted that an increased intake of ultra-processed foods elevates the risk of metabolic disorders, such as cardiovascular diseases, obesity, and diabetes, along with an increased risk of various cancers. Moreover, its association with an increased mortality risk underscores the importance of recognizing that opting for these foods based solely on taste and convenience is risky. Thus, by recognizing dietary habits as modifiable factors that can prevent health issues, maintaining a balanced diet with diverse nutrient intakes is crucial for overall health. Therefore, raising awareness and understanding of ultra-processed food consumption can significantly contribute to promoting healthy lifestyles.

• Clinical and Experimental Pediatrics
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• v.62 no.7
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• pp.261-268
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• 2019

Purpose: This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. Methods: We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6-18 years who were included in the third to sixth Korea National Health and Nutrition Examination Survey (KNHANES, 2005-2015). Linear regression analyses were used to identify secular changes in WC and WHR by age, sex, and KNHANES waves. A receiver operating characteristic curve analysis was used to determine the optimal WHR cutoff values for abdominal obesity and cardiometabolic risk factors. Results: The mean WC and WHR distributions from 2005 to 2015 showed no significant secular changes between the KNHANES 4 waves (P for trend ${\geq}0.05$ in all ages and both sexes). The mean WCs in the present study were lower than those in the 2007 Korean National Growth Charts. The mean WHR at ages <13 years was statistically higher in the boys than in the girls, but did not significantly differ between the sexes among those aged 13 to 18 years. The optimal WHR cutoff for abdominal obesity was 0.48 (area under the curve, 0.985; 95% confidence interval, 0.985-0.985) in the 13- to 18-year-old adolescents. Conclusion: WC and WHR showed no secular changes over 10 years. The optimal WHR cutoff for abdominal obesity of 0.48 is useful for diagnosing and managing obesity and thus preventing obesity-related cardiometabolic complications in 13- to 18-year-old Korean adolescents.

• Journal of Nutrition and Health
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• v.52 no.4
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• pp.354-368
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• 2019

Purpose: This study evaluated the glycemic response of diets using estimated glycemic load (eGL), which had been developed for mixed meals for Korean adults, and examined its associations with cardiometabolic risk factors among Korean adults. Methods: A total of 4,655 men and 6,760 women aged 19 years and above were included from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey. eGL was calculated by each meal (breakfast, lunch, dinner, and snack) and then summed to give daily total eGL. A multiple logistic regression analysis was used to examine the association. Results: Mean daily total eGL was 112.6 in men and 99.3 in women. Daily total eGL was positively associated with carbohydrate and fiber intakes, but negatively associated with protein and fat intakes in both men and women (p < 0.05 for all). Daily total eGL showed an inverse association with HDL-cholesterol level in both men and women (p = 0.0036 for men and p = 0.0008 for women). Men in the highest quintile of daily total eGL showed a 66% increased risk of hypercholesterolemia (OR, 1.66; 95% CI, 1.10 ~ 2.50; p for trend = 0.0447) compared with those in the lowest quintile. Conclusion: These findings suggest that eGL based on carbohydrate, protein, fat and fiber intakes can reflect glycemic response and therefore can be used as an index for dietary planning, nutrition education and in the food industry.

• Nutrition Research and Practice
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• v.12 no.2
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• pp.173-173
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• 2018

• Journal of Korean Medicine for Obesity Research
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• v.22 no.1
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• pp.77-85
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• 2022

While the Coronavirus disease 2019 (COVID-19) pandemic is gradually turning into an endemic disease, concerns about post COVID-19 conditions (Long COVID) are emerging. Obesity is a major risk factor for severe complications of COVID-19, and COVID-19 has a wide range of effects on obesity and metabolic function. This paper aims to examine the interaction between COVID-19 and obesity, the effects and mechanisms of long COVID on obesity, and the role of Korean medicine on long COVID-related obesity. Obesity may worsen with cardiometabolic damage and psychosocial insecurity during COVID-19 and long COVID-induced neuroinflammation, systemic inflammation, mitochondrial dysfunction, and hypoxia also may aggravate obesity. Korean Medicine treatments, which have been widely used to treat obesity, have the potential to improve obesity in the era of long COVID by intervening in these mechanisms.

• Archives of Obesity and Metabolism
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• v.3 no.1
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• pp.27-34
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• 2024

The prevalence of obesity in children and adolescents is increasing worldwide. Obesity in children and adolescents not only increases the risk of transitioning to obesity in adulthood but also increases the risk of cardiometabolic diseases such as high blood glucose, high blood pressure, dyslipidemia, fatty liver, and hyperinsulinemia during childhood. The goal of treating obesity in children and adolescents is not to focus on weight loss but to help children reach a healthy weight while maintaining normal growth appropriate for their age and sex. To achieve this goal, regular physical activity and exercise, dietary modification, improvement of obesity-prone environmental factors, and behavioral changes are required for a healthy lifestyle. If appropriate weight control is not achieved through lifestyle modifications, pharmacotherapy may be considered for adolescents with severe obesity aged 12 and above. Recent clinical trials have reported the efficacy and safety of pharmacotherapy in severely obese adolescents. Currently, two medications can be prescribed in Korea for patients with obesity aged 12 and above: Orlistat and Liraglutide. However, despite effective weight control through drug treatment, body weight may increase again after treatment discontinuation. Therefore, it is crucial to evaluate adherence to health behaviors during visits and continue to educate on lifestyle modifications, even during pharmacotherapy, to minimize weight regain.