• Journal of Nutrition and Health
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• v.55 no.1
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• pp.155-173
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• 2022

Purpose: This study was undertaken to update the Nutrition Quotient for Elderly (NQ-E), which reflects dietary quality and behavior among Korean older adults. Methods: The first 29 items of the measurable food behavior checklist were obtained from a previous NQ-E checklist, recent literature reviews, and national nutrition policies and recommendations. One-hundred subjects (50 men and 50 women) aged ≥ 65 years living in the Seoul Metropolitan Area, including Gyeonggi Province, completed a pilot survey from March to April 2021. Based on the results of the pilot study, we conducted factor analysis and frequency analysis to determine whether the items of the survey were properly organized and whether the distribution of answers for each evaluation item was properly distributed. As a result, we reduced the number of items on the food behavior checklist and used 23 items for the national survey. Nationwide, 1,000 subjects (472 men and 528 women) aged > 65 years, completed the checklist survey, which was applied using a face-to-face survey method from May to August 2021. The construct validity of the NQ-E 2021 was assessed using confirmatory factor analysis, LISREL. Results: Seventeen food behavior checklist items were selected for the final NQ-E 2021. Checklist items addressed three factors: balance (8 items), moderation (2 items), and practice (7 items). Standardized path coefficients were used as the weights of items to determine nutrition quotients. NQ-E and three-factor scores were calculated according to the weights of questionnaire items. Conclusion: The updated NQ-E 2021 produced by structural equation modelling provides a suitable tool for assessing the dietary quality and behavior of Korean older adults.

• Journal of Nutrition and Health
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• v.57 no.1
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• pp.1-15
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• 2024

Purpose: This study aimed to develop a comprehensive tool for assessing dietary guideline adherence among older Korean adults, focusing on the domains of food and nutrient intake, eating habits, and dietary culture. Methods: Candidate items were selected through a literature search and expert advice. The degree of adherence to dietary guidelines was then evaluated through a face-to-face survey conducted on 800 elderly individuals across five nationwide regions. The items for dietary guideline adherence evaluation tool were selected through exploratory factor analysis of the candidate items in each of the three areas of the dietary guidelines, and construct validity was verified by performing confirmatory factor analysis. Using the path coefficient of the structural equation model, weights were assigned to each area and item to calculate the dietary guideline adherence score. A rating system for the evaluation tool was established based on national survey results. Results: A total of twenty-eight items were selected for evaluating dietary guideline adherence among the elderly. Thirteen items related to food intake, seven to eating habits, and eight to dietary culture. The average score for dietary guideline adherence was 56.9 points, with 49.8 points in the food intake area, 63.2 points in the eating habits area, and 58.6 points in the dietary culture area. Statistically significant correlations were found between dietary guideline adherence scores and food literacy (r = 0.679) and nutrition quotient scores (r = 0.750). Conclusion: The developed evaluation tool for dietary guideline adherence among Korean older adults can be used as a simple and effective instrument for comprehensively assessing their food and nutrient intake, dietary habits, and dietary culture.

• Journal of The Korean Society of Inherited Metabolic disease
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• v.16 no.1
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• pp.34-41
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• 2016

Adult-onset type II citrullinemia (CTLN2) is characterized by episodes of neurologic symptoms associated with hyperammonemia leading to disorientation, irritability, seizures, and coma. CTLN2 is distinct from classical citrullinemia, which is caused by a mutation of the argininosuccinic acid synthetase (ASS) gene. The serum citrulline level is elevated, while the activity of ASS in liver tissue is decreased. CTLN2 is known to have a poor prognosis if the proper treatment is not taken. We reported a female aged 37 years who developed recurrent attacks of altered consciousness, aberrant behavior, and vomiting. We initially suspected the patient had CTLN2 because of the signs of hyperammonemic encephalopathy, such as altered mentality, memory disturbance, and aberrant behaviors provoked by exercise-induced stress and excessive intravenous amino acid administration. Through her peculiar diet preferences and laboratory findings that included hyperammonemia and citrullinemia, we diagnosed the patient as CTLN2, and SLC25A13 sequencing revealed known compound heterozygous mutations (IVS11+1G>A, c.674C> A). Her parents were heterozygous carriers, and we identified that her older sister had the same mutations. The older sister had not experienced any episodes of hyperammonemia, but she had peculiar diet preferences. The patient and her sister have been well with conservative management. When considering the clinical course of CTLN2, it was meaningful that the older sister could be diagnosed early in an asymptomatic period and that preemptive treatment was employed. Through this case, CTLN2 should be considered in adults who present symptoms of hyperammonemic encephalopathy without a definite etiology. Because of its rare incidence and similar clinical features, CTLN2 is frequently misdiagnosed as hepatic encephalopathy, and it shows a poor prognosis due to the lack of early diagnosis and proper treatment. A high-carbohydrate diet, which is usually used to treat other urea cycle defects, can also exaggerate the clinical course of CTLN2, so proper metabolic screening tests and genetic studies should be performed.

• 한국노년학
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• v.36 no.4
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• pp.1003-1024
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• 2016

The human rights of older people have gotten more attention recently in South Korea, a country that is in transition to a super-aged society. This study aimed to systematically review studies on elder abuse and related factors among community-dwelling older adults in South Korea over twenty years (1994-2016). We searched major databases (Riss, DBpia, KISS, KMbase, and PubMed) and identified published studies relevant to the topic. Based on inclusion and exclusion criteria related to study quality, a total of 31 studies were selected for this review. We examined types, measurements, and risk factors of elder abuse as well as study designs in the selected studies, guided by Johannesen's theoretical framework on elder abuse. All of the reviewed studies on elder abuse in Korea were cross-sectional studies, most of which focused on older people living in urban areas, using a non-random sampling method. All of the studies focused on certain types of elder abuse only. Some adopted elder-abuse instruments that were not validated, and others used self-developed instruments without psychometric tests. As for the risk factors of elder abuse in South Korea, the physical and mental health of the victims and aggressors impacted the risk of elder abuse, but general sociodemographic factors such as age, sex, and education were less likely to be related to the risk. In addition, decreasing caregiver burden and building elder-friendly communities are important for the prevention of elder abuse. Needed are further empirical studies on elder abuse with a theoretical framework that gives consideration to the unique sociocultural contexts of Korea. It is also recommended to develop instruments to measure elder abuse reflecting the sociocultural contexts of Korea, and to examine the multi-dimensional risk factors of elder abuse.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.9
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• pp.5660-5667
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• 2014

The aim of this study was to assess the association of metabolic syndrome, metabolic syndrome score (MSS) and pulse pressure (PP) in Korean adults. The study subjects were Korean adults 20 years or older (n=5,889) who participated in the Korea National Health and Nutrition Examination Survey 2012. After adjusting for factors, such as year and gender and BMI, the mean PP increased with increasing MSS (MSS 0, $41.30{\pm}0.34mmHg$ and MSS 1, $42.16{\pm}0.31mmHg$ and MSS 2, $44.73{\pm}0.34mmHg$ and MSS, 3, $46.46{\pm}0.42mmHg$ and MSS 4, $48.62{\pm}0.58mmHg$ and MSS 5, $53.50{\pm}1.05mmHg$), and the mean PP for metabolic syndrome($47.25{\pm}0.34mmHg$) increased in comparison to Non-Metabolic syndrome ($42.77{\pm}0.19mmHg$). When logistic regression analysis was performed, the odds ratio (OR) of Hyper-PP (61> PP) for MSS 0 was 4.49 in MSS 1 (95% confidence interval[CI], 2.68-7.57) and 8.01 in MSS 2 (95% CI, 4.77-13.47) and 11.37 in MSS 3 (95% CI, 6.67-19.35) and 19.69 in MSS 4 (95% CI, 11.20-34.60) and 34.07 in MSS 5 (95% CI, 17.44-66.52), metabolic syndrome was associated with an increased Hyper-PP(OR 4.6, 95% CI, 2.0-10.4). Conclusion. These results suggest that an increase in MSS or metabolic syndrome might increase the pulse pressure.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7978-7989
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• 2015

Dyslipidemia is a major risk factor for cardio-cerebrovascular disease. Although the prevalence among Korean adults is very high, its management is known to be poor. The aim of this study was to access the prevalence, awareness, treatment, and control rates of dyslipidemia according to treatment guideline rather than diagnostic criteria. The risk factors for cardio-cerebrovascular disease were evaluated to apply the appropriate risk-based threshold of the lipid treatment targets according to risk category. Analysis was done using nationally representative data (n = 16,263) collected from adults aged 20 years and older participating the Korea National Health and Nutrition Examination Survey (KNHANS) 2010-2012. The age-standardized prevalence rate of dyslipidemia according to treatment criteria was 34.1%. Of these prevalent cases, however, only 19.2% were aware; 9.5% treated; and 8.7% controlled. The age-standardized control rate among treated persons was 47.5%. Men had a significantly higher prevalence than women (39.7% vs. 28.8%), but a significantly lower rate of awareness, treatment, and control (16.0% vs. 22.3%, 7.7% vs. 11.3%, and 6.1% vs. 11.2%, respectively). As the higher risk category, the prevalence rate was higher but the control rate was lower. The prevalence of patients with diabetes was 82.5% when applying the treatment criteria (LDL-cholesterol level of ${\geq}100mg/dL$ and triglyceride level of ${\geq}200mg/dL$). However, only 11.9 % of these were controlled, whose LDL-cholesterol and triglycerides were lower than the treatment goals. Our findings suggest that effective strategies are required to decrease the gap between the prevalence of dyslipidemia and the following treatment. It would be worthwhile to strengthen the follow-up management of patients with dyslipidemia in the National Health Screening Program, especially in the high risk group of cardio-cerebrovascular disease.

• Journal of Nutrition and Health
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• v.52 no.2
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• pp.227-241
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• 2019

Purpose: This study examined the relationship between caffeine intake and metabolic syndrome in Korean adults using the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey data (KNHANES). Methods: The caffeine database (DB) developed by Food and Drug Safety Assessment Agency in 2014 was used to estimate the caffeine consumption. The food and beverage consumption of the 24 hr recall data of 2013 ~ 2016 KNHANES were matched to items in the caffeine DB and the daily caffeine intakes of the individuals were calculated. The sample was limited to non-pregnant healthy adults aged 19 years and older, who were not taking any medication for disease treatment. Results: The average daily caffeine intake was 41.97 mg, and the daily intake of caffeine of 97% of the participants was from coffee, teas, soft drinks, and other beverages. Multivariate analysis showed that the caffeine intake did not affect metabolic syndrome, hypertension, low HDL-cholesterol, and abdominal obesity. Diabetes and hypertriglyceridemia, however, were 0.76 (95% CI: 0.63 ~ 0.93), and 0.87 (95% CI: 0.77 ~ 0.98) in third quintile (Q3), and 0.66 (95% CI: 0.53 ~ 0.82) and 0.83 (95% CI: 0.73 ~ 0.94) in fourth quintile (Q4) compared to Q1, respectively. Therefore, caffeine intake of 3.66 ~ 45.81 mg per day is related to a lower risk of diabetes and hypertriglyceridemia. Conclusion: The study showed that adequate caffeine intake (approximately 45 mg) was associated with a lower prevalence of diabetes and hypertriglyceridemia. Therefore, it can be used as a guideline for the adequate level of caffeine intake for maintaining health.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.11
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• pp.403-410
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• 2018

This study is to look at the risk of chronic diseases in adults and oral health behaviors affecting periodontitis by gender. This study selected 3,071 males aged 35 to 65, 4,273 females, and 7,344 people as the final subjects of the study using the sixth original data from the National Health and Nutrition Survey. In this study, subjective oral health classified under 'bad' presented 1.69 times(p<0.001) the risk of Periodontitis for males and 1.50 times(p<0.001) for females. There was a 2.01 times(p<0.001) of a risk of periodontitis for male and 1.40 times(p=0.001) of a risk for females. Smokers have a 1.68 times(p<0.001) of a risk for males and 2.07 times(p<0.001) of a risk for females, thus a higher risk for periodontitis for females. The risk of periodontitis was 1.44 times(p<0.001) of a risk for males and 1.30 times(p<0.05) for females when compared in normal hypertension. Obesity was at a rate of 1.199 times(p<0.05) as much for males in the non-military group, 1.202 times(p<0.05) that of females for periodontitis and putting females slightly more at risk. For diabetes, males were at risk of 1.28(p<0.05) whereas it being 1.53 times(p<0.05) for females, compared the average health female. In total, Males were found to be at the greatest risk of periodontitis, while women were at the highest risk for smoking. All parameters except smoking and diabetes show a higher risk of periodontitis for females. As males are more likely to have a higher risk of periodontitis than females, they are considered to be more interested in oral health care and need systematic oral health education and policies to prevent oral diseases.

• Journal of Nutrition and Health
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• v.51 no.6
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• pp.556-566
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• 2018

Purpose: This study was designed to determine the relationship between health behaviors and high levels of low-density lipoprotein-cholesterol (LDL-cholesterol) according to cardiovascular risk factors among Korean adults. Methods: This cross-sectional study was based on the sixth Korea national health and nutrition examination survey (KNHANES VI). Participants were 13,841 adults aged 19 years and older. Cardiovascular risk factors were stroke, myocardial infarction or angina, diabetes mellitus, smoking, hypertension, aging, high density lipoprotein-cholesterol (HDL-cholesterol) under 40 mg/dL and HDL-cholesterol over 60 mg/dL. Cardiovascular risk groups were classified as very high risk (stroke, myocardial infarction or angina), high risk (diabetes mellitus), moderate risk (over 2 risk factors), and low risk (below 1 risk factor). The prevalence of high LDL-cholesterol was calculated using the LDL-cholesterol target level according to cardiovascular risk group. Results: The prevalence of high LDL-cholesterol was 25.5% in males and 21.7% in females. Complex sample cross tabulation demonstrated that the high LDL-cholesterol and normal groups differed significantly according to age, education, body mass index, percentage of energy from carbohydrate, fat, saturated fat and n-6 in males and females. These two groups were also significantly different according to smoking in males and the percentage of energy from n-3 in females. Complex sample multiple logistic regression analysis adjusted for multiple confounding factors demonstrated that the probability of high LDL-cholesterol was significantly associated with current smoking (OR: 1.66, 95% CI: 1.40-1.99), obesity (OR: 1.95, 95% CI: 1.64-2.31) in males, and current smoking (OR: 1.73, 95% CI: 1.19-2.52), obesity (OR: 1.63, 95% CI: 1.39-1.90), percentage of energy from n-3 (quartile 1 vs. quartile 2; OR: 0.77, 95% CI: 0.62-0.96; quartile 1 vs. quartile 3; OR: 0.73, 95% CI: 0.56-0.94; quartile 1 vs. quartile 4: OR: 0.67, 95% CI: 0.51-0.87) in females. Conclusion: This study reveals the impact of smoking, obesity, energy percentage of nutrient intake on LDL-cholesterol.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.6
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• pp.1008-1013
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• 2011

Osteoporosis is the leading underlying cause of fractures, particularly in postmenopausal women, due to the loss of estrogen-mediated suppression of bone resorption. More than 50% of adults 50 years of age or older are estimated to have osteoporosis. Osteoclast which is main target for treatment of osteoporosis is originated from hematopoietic cell line. Aloe has been widely used in worldwide country as a coadjuvant medicine. Extracts of the leaves of Aloe have been used in condition to improve dermatologic problem such as seborrheic dermatitis, aphthous stomatitis, xerosis, lichen planus and has been known to exert anti-inflammatory, anti-oxidant and anti-tumor effects. However, despite the popularity of aloe as a plant food supplements, the evaluation of its efficacy as a possible therapeutic option for osteoporosis remains scarce. Thus, we evaluated the effect of Aloe on receptor activator of nuclear factor-${\kappa}B$ ligand (RANKL)-induced osteoclast differentiation. Here we found that Aloe significantly inhibited osteoclast differentiation induced by RANKL. Aloe suppressed the activation of p38 pathway and $NF{\kappa}B$ in bone marrow macrophages (BMMs) treated with RANKL. Also, Aloe significantly inhibited the mRNA expression of c-Fos, tartrate-resistant acid phosphatase (TRAP), osteoclast-associated receptor (OSCAR), nuclear factor of activated T cells (NFAT)c1 and cathepsin K in BMMs treated with RANKL. Particularly, Aloe greatly inhibited the protein expression of c-fos and NFATc1. Taken together, our results suggested that Aloe may be useful tool for treatment of osteoporosis by inhibition of osteoclast differentiation.