BACKGROUND/OBJECTIVES: Diet quality scores or indices, based on dietary guidelines, are used to summarize dietary intake into a single numeric variable. The aim of this study was to examine the association between the modified diet quality index for Koreans (DQI-K) and mortality among Health Examinees-Gem (HEXA-G) study participants. SUBJECTS/METHODS: The DQI-K was modified from the original diet quality index. A total of 134,547 participants (45,207 men and 89,340 women) from the HEXA-G study (2004 and 2013) were included. The DQI-K is based on eight components: 1) daily protein intake, 2) percent of energy from fat, 3) percent of energy from saturated fat, 4) daily cholesterol intake, 5) daily whole-grain intake, 6) daily fruit intake, 7) daily vegetable intake, and 8) daily sodium intake. The association between all-cause mortality and the DQI-K was examined using Cox proportional hazard regression models. Hazard ratios and confidence intervals were estimated after adjusting for age, gender, income, smoking status, alcohol drinking, body mass index, and total energy intake. RESULTS: The total DQI-K score was calculated by summing the scores of the eight components (range 0-9). In the multivariable adjusted models, with good diet quality (score 0-4) as a reference, poor diet quality (score 5-9) was associated with an increased risk of all-cause mortality (hazard ratios = 1.23, 95% confidence intervals = 1.06-1.43). Moreover, a one-unit increase in DQI-K score resulted in a 6% higher mortality risk. CONCLUSIONS: A poor diet quality DQI-K score was associated with an increased risk of mortality. The DQI-K in the present study may be used to assess the diet quality of Korean adults.
BACKGROUND/OBJECTIVES: Few studies have provided evidence of the association between diet quality and dental caries. This study aimed to examine the association between diet quality and untreated dental caries in a Korean representative population. SUBJECTS/METHODS: The study population included a sample of 13,815 participants, aged ≥ 19 from the Korea National Health and Nutrition Examination Survey during 2013-2015. The explanatory variable was diet quality and the outcome variable was untreated dental caries. Untreated dental caries were defined by the number of decayed teeth recorded according to the criteria established by the World Health Organization. Diet quality was defined by using the Korean Healthy Eating Index (KHEI) through the 24-h recall methods. We assessed the association between diet quality and untreated dental caries while adjusting for age, sex, education, income, smoking status, dental visits, toothbrushing frequencies, obesity, and diabetes mellitus. RESULTS: The mean overall KHEI scores in the untreated dental caries group were significantly lower than those in the group without untreated dental caries. Significant differences were observed in the untreated dental caries group based on the KHEI quartiles (P < 0.001). After adjusting for potential confounders, the quartiles of KHEI scores showed an association with untreated dental caries, demonstrating a dose-effect trend (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.35-1.84 for 1st quartile; OR, 1.38; 95% CI, 1.19-1.59 for 2nd quartile; OR, 1.32; 95% CI, 1.14-1.53 for 3rd quartile; reference quartile highest]). CONCLUSIONS: The findings indicated an inverse association between diet quality and untreated dental caries in Korean adults. Healthcare providers should take into account the significant role of diet quality in preventing and managing oral health.
Objectives: The aim of this study was to compare the nutritional intake and Diet Quality Index-International (DQI-I) of gynecological cancer survivors and normal women. Methods: This study compared the anthropometric indices, dietary behavior, nutritional intake, and DQI-I in women with previous history of breast or uterine cancer [Gynecological cancer survivors group (GCSG, n=126)] and normal women [Normal control group (NCG, n=7,011)] using the 2013~2016 Korea National Health and Nutrition Examination Survey data. Results: Body mass index and waist circumference were lower in the GCSG compared the NCG. The frequency of skipping breakfast and eating out was higher in the NCG compared to GCSG. Energy and fat intake were significantly higher in the NCG than in the GCSG, whereas intake of all minerals and vitamins (excluding thiamine), and dietary fiber intake were higher in GCSG. It was observed that the fatty acid intake of the GCSG was significantly lower than that of the NCG. The diet quality evaluation using DQI-I results showed that GCSG was higher in the "within-group" diet variety and adequacy of vegetable group than the NCG, whereas the intake level of the fruit group was higher in NCG. Besides, protein, calcium, and vitamin C intake were higher in the GCSG than in the NCG. The GCSG showed higher levels of total fat and saturated fat moderation than the NCG, whereas cholesterol moderation showed the opposite results. The results of DQI-I comparison according to the cancer survival years showed that the overall score and scores related to diet adequacy and balance were higher in the below 5-year group, whereas the over 5-year group scored higher in terms of moderation of diet. Conclusions: The results of this study suggest that a chronic disease based management approach is needed in cancer survivors. The study provides important data which can help in the preparation of guidelines for long-term lifestyle and diet management, in these patients.
During last few decades dietary guidelines for the weight management mainly have focused on a low-fat, high carbohydrate diet. Carbohydrate was supposed to be low-dense, highly satiating as well as it affects little on the lipogenesis. Although low-fat diet has significant weight-reducing effect, the loss was modest and usually regained after cessation of the diet. Furthermore, low-fat, modest-carbohydrate diet did not impact on the ever increasing rates of overweight and obesity. Alternative approaches include low-carbohydrate diet, high-carbohydrate diet and low-glycemic index diet. Although none of above mentioned diet have sufficient evidence for standard weight management diet, short-term efficacy and safety are being approved continuously. Low-carbohydrate diet contains less than 45% of carbohydrate in daily energy consumption, it is claimed to have more satiating effect and to improve metabolism. However, low compliance due to the limitation of food choice should be considered on prescribing the diet. High-carbohydrate which contains 90% of carbohydrate in total daily energy consumption, is effective in providing satiety and lowering total calorie intake and cholesterol. On the other hand, nutritional unbalance should be took into account. Low-glycemic index diet is based on the theory that contemporary diet contains significantly less fiber and unrefined carbohydrate, therefore insulin secretion is disturbed. Because low glycemic index food slowly increase blood glucose and insulin level, it induces much satiating effect and may decrease calorie ultimate intake. However, poor standardization of glycemic index is one of the main obstacle for the diet to be applied in the clinic. Meanwhile, high fructose food and beverage should be discouraged because it has little satiating effect and may cause insulin resistance. High fiber food is another recommendation for healthy, lean diet.
This study was performed to assess the nutrient intakes and diet quality of rural middle school students provided with and without the national school lunch program(NSLP). The data on dietary intakes were obtained by using food record method questionnaires which were collected from 340 rural middle school students provided with(n=177) and without (n=163) NSLP. Diet quality was accessed by NAR(nutrient adequacy ration), MAR(mean adequacy ration), and INQ( index of nutritional quality). Total energy intakes of the boys were 2123 kcal with NSLP and 1857 kcal without NSLP. Total energy intakes of the girls were 1913 kcal with NSLP and 1814 kcal without NSLP. Phosphorus, vitamin A, vitamin E, ascorbic acid, thiamin, riboflavin, and niacin intakes were above the RDA in the NSLP group. For those without NLSP, phosphorus, vitamin E, thiamin intakes were above RDA, however, calcium, iron vitamin A, vitamin $B_6$ were less than the RDA. The mean adequacy ration(MAR), an index of dietary quality was 0.69(with) 0.62(without) for males and 0.62(without) for females The indexes of nutritional quality(INQ) were over 1 for most nutrients except calcium, vitamin A, vitamin B$_2$ and zinc. The study showed that total daily energy and nutrient intakes were significantly higher in students provided with than those without school-lunches. Thus, the school-lunch program is recommenced and necessary to improve the nutritional status of middle school students.
The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary therapies have an efficacy almost comparable to that of the KD. In addition, a diet rich in polyunsaturated fatty acids appears to increase the efficacy of diet therapy and reduce the complications of a high-fat diet. Here, we review the systematic information about lower-fat diets and better-quality dietary therapies and the current clinical status of each of these dietary approaches.
This study was performed to evaluate served menu in Korean temples. Among available temples in the nation, 34 temples were carefully selected considering location and the gender characteristics. A five consecutive day menu was collected to analyse by interview between Jan 2004 and Aug 2004. Mean energy content of menu was 1633.8 kcal, with 67.3% of energy supplied by carbohydrate, 14.8% by protein and 17.9% by fat. Beans and bean products were the major contributing dishes for most nutrients. Contents of most nutrients except energy, protein and vitamin B were higher than RDA. Nutrient adequacy ratio (NAR) were 0.9-1.0 and mean adequacy ratio (MAR) was 0.9 for temples. Total number of dishes from menu was 7.3. Dietary variety score (DVS) was 26.4 and buddhist monk temples offered more diverse foods than buddhist nun temples. KDQI (Korean diet Quality Index), overall diet quality index were 0.67 and those of buddhist nun temples were better than those of buddhist monk temples. From the result of this study it was concluded that the temple diet is nutritionally well balanced, rich in dietary fiber and low in cholesterol. So it can be a healthy diet for the modern person. This is the very first study attempting the nationwide investigation of temple diet in Korea. It will be used as fundamental data to improve quality of diet to prevent modern chronic disease.
Objectives: This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults. Methods: Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model. Results: After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level. Conclusions: A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.
Purpose: To examine the levels of physical activity (PA) and diet quality, socio-demographic and clinical correlates, and identify associations with health-related quality of life (HRQOL) among breast cancer survivors. Methods: The study used a cross-sectional study design. A total of 74 breast cancer survivors who had completed their primary cancer therapy were recruited from a comprehensive cancer center in Korea. Measurements used included the International Physical Activity Questionnaire, the Diet Quality Index, and the EORTC QLQ-C30. Results: Only twenty-six women (35.1%) met the American Cancer Society criteria of weekly PA, while most participants (93.2%) displayed good or excellent diet quality. Those less likely to meet the PA criteria were older women, women who had a lower economic level, and women not receiving anti-hormone therapy. However, there was no significant factor associated with diet quality. Women who met the criteria for PA displayed significantly better global QOL than women who did not meet the criteria. No significant differences were found in HRQOL between women who did and did not meet the diet quality criteria. Conclusion: Nurses should be aware of breast cancer survivors who are older and who have a low economic status when assessing and screening the level of PA to improve HRQOL.
This study was performed to assess diet quality in the postmenopausal women. The data of dietary intakes were obtained using food frequency questionnaires which were collected from 151 postmenopausal women in urban area. We evaluated nutrient intake and diet quality. Diet quality was assessed by NAR(nutrient adequacy ratio), FGIP(food group intake pattern), DDS(dietary diversity score), DVS(dietary variety score), FGS(food group score), DQI(diet quality index). Nutrient intakes of the subjects were close to Korean RDA. Nutrient composition of the diet(in percentage of total energy) was 64% carbohydrate, 15% protein, and 19% protein, and 19% total fat, that was close to 65 : 15 : 20. NAR of most nutrients, except vitamin A, E, were higher than 0.75 and MAR was 0.88. NAR and MAR of the subjects in theis study were higher than those of the subjects of rural area in other studies. The subjects who consumed the five food groups were 60.9%. The mean of DDS was 4.5. The subjects who consumed more than 61 dish items during a month were 61.5%. The mean of DVS was 62.4 and it was significantly higher in the elder age group. 67.6% of the subjects were below FGS of 12. The mean of FGS was 10.6 and few subjects consumed serving numbers of each food groups which were recommended for Koreans. 55.0% of the subjects were DQI scores of 0, 1, and 2. The mean of DQI was 2.3 and few subjects followed the five dietary guidelines for Korean.
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