• Journal of Nutrition and Health
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• v.42 no.3
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• pp.234-245
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• 2009

Nutritional assessment for the elderly can identify health status and morbidity. However, development of Nutritional Risk Index (NRI) remains limited for elderly because of difficulties in understanding physiological mechanism of elderly. This study was performed to analyze and develop Nutritional Risk Index for Korean elderly Women (Geriatric Nutritional Risk Index, GNRI). Based on literature review, factors for NRI were identified and indices were assessed by a cross-sectional survey. The survey involved Korean elderly women (${\geq}$60, n = 94) in Gwangju area, and sociodemographics, lifestyle characteristics, health conditions, dietary intakes based on 24h- recall, anthropometric measures (wt, ht, BMI, waist, hip, WHR, body protein, body fat, abdominal fat, and triceps skinfold thickness), and clinical biochemistry parameters (systolic blood pressure, diastolic blood pressure, cholesterol, HDL-cholesterol, triglyceride, total protein, albumin, prealbumin, hemoglobin, hematocrit, fasting blood glucose, HbAlc, ferritin, Zn, Ca, Na, K, Vit E, Vit $B_{12}$, folate, C-reactive protein) were examined relation to nutritional risk index. Based on literature review and data analyses, three NRIs were categorized (NRI I, NRI II, NRI III) and used for further analysis. NRI I was related to having metabolic syndrome, NRI II was related to serum albumin and body weight, and NRI III was related to food habit and health concerns. Abdominal fat (%) of elderly was correlated with each NRIs. NRI II was correlated with nutritional deficiency and higher tendency of inflammatory response, and NRI III was correlated with nutritional status which tend to be lower on aging (protein, folate, Vit $B_{12}$). NRI can serve as a useful tools in assessing health risk and nutritional status. Some modification of items in NRI and validity study are need to apply to Korean elderly.

• Korean Journal of Community Nutrition
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• v.29 no.3
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• pp.189-198
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• 2024

Objectives: The sodium index is an index that converts the estimated sodium intake calculated using a verified and reliable sodium estimation formula. This study aimed to determine the relationship between the sodium index and obesity indicators and the potential impact of excessive sodium consumption on obesity. Methods: Obesity indicators, such as body mass index (BMI), body fat percentage, waist-to-hip ratio (WHR), and visceral fat levels, were analyzed in 120 university students (60 men and 60 women). The sodium index was calculated by indexing the estimated sodium intake according to age, sex, BMI, salt-eating habits, and salt-eating behaviors. The relationship between sodium index and obesity indicators was analyzed using multiple logistic regression. Results: The estimated sodium intake was 3,907.1 mg, with 76.7% of the participants categorized under the "careful" level of sodium index and 10.8% under the "moderate" level. As the sodium index increased, the BMI, body fat percentage, WHR, and visceral fat levels significantly increased. All obesity indicators significantly increased in patients with a "severe" sodium index than in those with a "moderate" sodium index. In addition, a strong positive correlation was identified between obesity indicators and sodium index. When the "severe" sodium index was compared with the "moderate" sodium index, the risk of obesity based on body fat percentage increased by 2.181 times (95% confidence interval [CI], 1.526-3.118), while the risk of obesity based on visceral fat level increased by 4.073 times (95% CI, 2.097-7.911). Conclusions: Our findings suggest a correlation between excessive sodium intake and obesity. Moreover, the sodium index can be used to determine sodium intake.

• Clinical Nutrition Research
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• v.12 no.3
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• pp.199-217
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• 2023

People with higher genetic predisposition to obesity are more susceptible to cardiovascular diseases (CVDs) and healthy plant-based foods may be associated with reduced risks of obesity and other metabolic markers. We investigated whether healthy plant-foods-rich dietary patterns might have inverse associations with cardiometabolic risk factors in participants at genetically elevated risk of obesity. For this cross-sectional study, 377 obese and overweight women were chosen from health centers in Tehran, Iran. We calculated a healthy plant-based diet index (h-PDI) in which healthy plant foods received positive scores, and unhealthy plant and animal foods received reversed scores. A genetic risk score (GRS) was developed based on 3 polymorphisms. The interaction between GRS and h-PDI on cardiometabolic traits was analyzed using a generalized linear model (GLM). We found significant interactions between GRS and h-PDI on body mass index (BMI) (p = 0.02), body fat mass (p = 0.04), and waist circumference (p = 0.056). There were significant gene-diet interactions for healthful plant-derived diets and BMI-GRS on high-sensitivity C-reactive protein (p = 0.03), aspartate aminotransferase (p = 0.04), alanine transaminase (p = 0.05), insulin (p = 0.04), and plasminogen activator inhibitor 1 (p = 0.002). Adherence to h-PDI was more strongly related to decreased levels of the aforementioned markers among participants in the second or top tertile of GRS than those with low GRS. These results highlight that following a plant-based dietary pattern considering genetics appears to be a protective factor against the risks of cardiometabolic abnormalities.

• Journal of the Korean Dietetic Association
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• v.11 no.3
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• pp.365-374
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• 2005

This study was conducted to compare the validity of obese index among body mass index(BMI), waist to hip ratio(WHR), and waist circumference(WC) and to determine which is the best in relation to cardiovascular risk factors of middle aged Korean(40-64yr).Data from the 1998 Korean Health and Nutrition Survey were used(N=3380). Anthropometric indices and cardiovascular risk factors were measured. Chi-square test, analysis of variance following duncan's multiple range test, partial correlation analysis, and Receiver Operator characteristic(ROC) curves were used in the analysis. There was a significant increasing trend in WHR, systolic blood pressure(SBP), high density lipoprotein cholesterol(HDL), and fasting blood sugar(FBS) with age categories of male and in BMI, WC, WHR, diastolic blood pressure(DBP), SBP, total cholesterol(TC), low density lipoprotein cholesterol(LDL), triglycerol(TG), and FBS with those of female. Specially female had the characteristics of upper body fat and systolic blood pressure risk(p<0.05). Proportions of subjects with lifestyle factors related to cardiovascular risk in overweight or upper body fat group were higher than that of normal group. Higher proportions of subjects were practiced exercise in upper body fat group of male than in other groups. Among 7 cardiovascular risk factors in partial correlation analysis, BMI had the highest correlation coefficient in 6 risk factors in male, whereas WC in 4 risk factors in female. Mean of each obese index according to cardiovascular risk groups except smoker was higher than that of normal(p<0.05). These trends were shown in upper body fat group and female. In ROC analysis of 12 risk factors and health conditions, the largest area under curve among obese indices for risk factors were BMI in male and WHR in female. The optimal cutoff values of each index(BMI: WHR: WC) for one or more cardiovascular risk factors were 23.13: 0.89: 85.35 in male and 23.57: 0.84: 78.35 in female. The results showed that cardiovascular risk factors were prevalent in middle aged Koreans within normal limits of obese indices like another Asians. For the identification of cardiovascular risk factors of middle aged Koreans, BMI for men and WHR for women are appropriate indices. But it is recommended that BMI, WHR, and WC, all three indices should be considered, when using these indices.

• Journal of Nutrition and Health
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• v.42 no.7
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• pp.622-630
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• 2009

The purpose of this study was to establish an association between glycemic index (GI), glycemic load (GL), dietary carbohydrates and diabetes with the context of the current population dietary practice in Korea. The subjects of 3,389 adults (male 1,430, female 1,959) were divided into normal (serum fasting glucose < 100 mg/dL), impaired glucose tolerance (100 ${\leq}$ serum fasting glucose < 126 mg/dL), diabetes (serum fasting glucose > 126 mg/dL) by serum fasting glucose. Anthropometric and hematologic factors, and nutrient intakes, dietary glycemic index (DGI), dietary glycemic load (DGL) were assessed. Multiple logistic regression model was used to determine the odds ratios (ORs) and 95% confidence intervals for relationship of DGI, DGL, carbohydrates intakes, and diabetes. DGI and DGL were not significantly correlated with impaired glucose tolerance and diabetes. However, the risk of impaired glucose tolerance and diabetes showed a tendency to increase as increase of DGI after multivariate adjustment (age, education, income, region area, diabetes family history, smoking, drinking, exercise, energy intake) in male. The risk of impaired glucose tolerance and diabetes showed a tendency to increase in the DGI 71.1-74.8 after multivariate adjustment in female. DGL was inversely related to impaired glucose tolerance and diabetes in male. In female, however, DGL was positively related to impaired glucose tolerance and diabetes. In particular, the risk of diabetes increased positively in level of DGL 260.5, and remained after multivariate adjustment (Q5 vs Q1：2.38, 0.87-6.48). When percent energy intakes from carbohydrates were more than 70%, the risk of impaired glucose tolerance and diabetes increased in both male and female. In particular, when percent energy intakes from carbohydrates were more than 69.9%, the risk of diabetes increased positively in male (Q4 vs Q1：2.34, 1.16-4.17). In conclusion, above 70% energy intakes from carbohydrates appeared to be a risk factor of diabetes. It seemed that the meal with high GI and GL value must be avoided it. And also, the macronutrients of the meal must be properly balanced. In particular, it may be said that it is a preventive way for treatment of the diabetes to avoid eating carbohydrates of much quantity.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2747-2751
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• 2013

In this study we assessed the dietary phytochemical index in relation to the risk of breast cancer in women. This case-control study was conducted on 100 incident breast cancer cases and 175 healthy controls. Data regarding socio-demographic factors, medical history, medications, and anthropometric measurements were collected. Dietary data were obtained using a validated food frequency questionnaire and a energy-adjusted dietary phytochemical index (PI) was calculated. The odds ratios of breast cancer were assessed across energyadjusted PI quartile categories. The mean age of participants was $46.2{\pm}8.9$ and $45.9{\pm}9.4$ years in cases and controls, respectively. The mean PI across quartile categories was $13.9{\pm}2.6$, $21.1{\pm}1.8$, $26.7{\pm}2.1$, $41.6{\pm}10.2$ in the first, second, third and fourth quartiles, respectively. After adjustment for all potential confounders, the risk of breast cancer in the forth quartile of dietary PI was significantly decreased (OR=0.08, 95%CI=0.01-0.84). Higher intake of phytochemical-rich foods is associated with lower risk of breast cancer.

• Journal of Community Nutrition
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• v.5 no.3
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• pp.160-172
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• 2003

This study was performed to investigate the dietary characteristics and related factors of the elderly female living alone. The subjects were 70 single living elderly female residing in Bucheon city and receiving benefits from the government based social welfare programs. Seventy nine percent of the subjects had self reported monthly income less than 200,000 (won) and forty one percent of the subjects were paying more than 100,000 (won) for food expense. The number of side dishes for a meal was two or three (35.71 ％) or one or two (31.40％)； fifty seven percent of the subjects ate reheated left-over for lunch and 70.0％ for dinner. The proportion of the single living elderly at high nutrition risk ($\geq$ 6 as evaluated with Nutrition Risk Index Score) was 77.1 ％. Cereals and their products contributed most to the macronutrients like energy, protein and carbohydrates and vitamin B. In contrast vegetables and their products contributed most to the fiber, minerals (Ca and Fe) and vitamins (vitamin A, vitamin B and vitamin C). The mean total score of depression was 8.59${\pm}$2.69 (full score: 12) meaning that the extent of depression was serious.

• Nutritional Sciences
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• v.6 no.4
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• pp.232-238
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• 2003

Cardiovascular disease (CVD) is one of the most common causes of death in elderly Koreans, and HDL-cholesterol is known to have a pivotal role in protecting against CVD. This study was undertaken to study the relationships between plasma HDL-cholesterol levels and dietary, anthropometric, and biochemical factors in elderly Koreans. The 102 subjects, who were over 60 years old, were classified into two groups based on their plasma HDL-cholesterol levels: a risk group with plasma HDL-cholesterol < 40mg/dl in men or HDL-cholesterol < 50mg/d1 in women, and a control group with higher HDL-cholesterol levels. The subjects' mean intakes of energy, calcium, zinc, vitamin A, vitamin $B_2$, vitamin E, and folate did not meet the Korean RDA for elderly people. Vitamin $B_2$ and folate intakes were significantly lower (p<0.l) in the risk group compared to the control group. The consumption of seaweed was significantly lower (p<0.05), and fish intake was 33% lower, in the risk group compared to the control group. Subjects in the risk group showed a higher BMI, waist/hip ratio, triceps skinfold thickness, and % body fat, compared to control subjects. Plasma triglyceride levels and values of the atherogenic index were significantly higher (p<0.00l) in risk group subjects. Significant negative correlations between HDL-cholesterol level and plasma triglyceride level (r= 0.37), and values of the atherogenic index (r=-0.74), were found. In summary, subjects with low levels of HDL-cholesterol were found to have relatively low intakes of vitamin B$_2$, folate, and seaweed, and higher levels of the CVD risk factors: body fat, plasma TG, and AI. These results suggest that plasma HDL-cholesterol levels can be modified by dietary, anthropometric, and hematological means.

• Journal of Nutrition and Health
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• v.36 no.1
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• pp.40-48
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• 2003

This study was conducted to investigate the relationship between alcohol consumption, physical activity and breast cancer risk in Korean women. Newly histologically identified cases (N = 108) were selected at Hanyang and Soonchunhyang University Hospitals in Seoul, from January 1998 to August 1999. Hospital-based controls (n = 121) were the patients who visited at the same hospital in the department of plastic surgery, general surgery and opthalmology. Subjects were asked informations on demographic, reproductive, and history of breast feeding as well as physical activity, exercise habit, alcohol consumption by individual interview. Odds ratio (OR) and 95% Confidence Intervals (CI) were calculated by using unconditional logistic regression after adjusted for confounding factors. Among postmenopausal women, the risk of breast cancer increased with increasing alcohol drinking: relative risk for the highest group ( $\geq$ 150 g per week) compared with the lowest group (never drinking) was 2.05 (CI=1.74-3.79). Association of exercise and high physical activity for breast cancer appeared to be limited to women with high physical index among postmenopausal women. We observed decreasing risk of breast cancer with increasing physical activity index among postmenopausal women (OR=0.49,95% CI=0.56-0.92). Results of this study support a protective effects of physical activity during adulthood for breast cancer. (Korean J Nutrition 36(1): 40-48, 2003)

• Nutrition Research and Practice
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• v.6 no.1
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• pp.78-85
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• 2012

Whether the $FTO$ polymorphisms interact with environmental factors has not yet been evaluated in associations with metabolic syndrome (MS) risk. The present study investigated the association of the $FTO$ rs9939609 genotypes, body mass index (BMI), and lifestyle-related factors including smoking, alcohol drinking, physical activity, and diet with MS incidence. A population-based prospective cohort study comprised 3,504 male and female Koreans aged 40 to 69 years. At the beginning of the study, all individuals were free of MS and known cardiovascular disease. Incident cases of MS were identified by biennial health examinations during a follow-up period from April 17, 2003 to April 15, 2009. Pooled logistic regression analysis was applied to obtain relative odds (RO) of MS with its 95% confidence interval (CI). After controlling for potential MS risk factors, we observed no association between the rs9939609 genotypes and MS incidence. In analysis stratified by BMI, however, carriers with the $FTO$ risk allele whose BMI is $29kg/m^2$ or greater showed an approximately 6-fold higher RO (95% CI: 3.82 to 9.30) compared with non-carriers with BMI less than $25kg/m^2$. In particular, the association between the rs9939609 variants and MS risk was significantly modified by high BMI (P-value for interaction < 0.05). Such significant interaction appeared in associations with central obesity and high blood pressure among the MS components. Because carriers of the $FTO$ risk alleles who had BMI of $29kg/m^2$ or greater are considered a high risk population, we suggest that they may need intensive weight loss regimens to prevent MS development.