Korean Journal of Community Nutrition

Research Article

[English]
Serum branch chain amino acids and aromatic amino acids ratio and metabolic risks in Koreans with normal-weight or obesity: a cross-sectional study: Ji-Sook Park, Kainat Ahmed, Jung-Eun Yim; Korean J Community Nutr 2024;29(3):212-221. Published online June 30, 2024; DOI: https://doi.org/10.5720/kjcn.2024.29.3.212

Abstract PDF PubReader ePub: Objectives
Metabolic disease is strongly associated with future insulin resistance, and its prevalence is increasing worldwide. Thus, identifying early biomarkers of metabolic-related disease based on serum profiling is useful to control future metabolic disease. Our study aimed to assess the association of serum branched chain amino acids (BCAAs) and aromatic amino acids (AAAs) ratio and metabolic disease according to body mass index (BMI) status among Korean adults.
Methods
This cross-sectional study included 78 adults aged 20–59 years in Korea. We compared serum amino acid (AA) levels between adults with normal-weight and adults with obesity and investigated biomarkers of metabolic disease. We examined serum AA levels, blood profile, and body composition. We also evaluated the association between serum AAs and metabolic-related disease.
Results
The height, weight, BMI, waist circumference, hip circumference, waist-hip-ratio, body fat mass, body fat percent, skeletal muscle mass, systolic blood pressure, and diastolic blood pressure were higher in the group with obesity compared to normal weight group. The group with obesity showed significantly higher levels of BCAA, AAA, and BCAA and AAA ratio. Further, BCAA and AAA ratio were significantly positively correlated with triglyceride, body weight, and skeletal muscle mass. The evaluation of metabolic disease risks revealed an association between the ratios of BCAAs and AAAs, hypertension, and metabolic syndrome.
Conclusions
Our study is showed the associations between BCAA and AAA ratio, obesity, and obesity-related diseases using various analytical approaches. The elevated BCAA and AAA ratio could be early biomarkers for predicting future metabolic diseases in Korean population.

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Original Articles

[English]
The Prevalence of Hypertension and Related Nutritional Risk Factors of Elderly Living in a Rural Area: Mee Sook Lee; Korean J Community Nutr 2015;20(4):291-300. Published online August 31, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.4.291

Abstract PDF PubReader

OBJECTIVES
The prevalence of hypertension in Korean rural elderly was significantly higher than that of the general population. Determining the potential risk factors of hypertension would be useful for managing and improving the treatment and prevention of hypertension in rural areas.
METHODS
We studied 336 elderly individuals 110 males, 226 females) aged between 65 years and 95 years residing in the rural area, S-gun Jeonbuk. Health-related habits, frequency of intake of food groups, nutrient intakes, anthropometric and biochemical measurements were assessed. Subjects were defined as hypertensive if SBP was > or = 140 mmHg or if DBP was > or = 90 mmHg or take an antihypertensive drug.
RESULTS
The rate of prevalence of hypertension in the study group was 51.8% (male 40.0%, female 57.5%). The risk of occurrence of hypertension was higher among females (OR, 1.98), 75 years old or older (OR, 1.62), BMI > or = 25 kg/m2 (OR, 2.84), acceptable range (upper end) of body fat (OR, 2.29) and unhealthy (too high) range of body fat (OR, 3.28), hypertriglyceridemia (OR, 2.17) and hypercholesterolemia (OR, 5.42), low protein intakes (OR, 1.78). However, health related habits, frequencies of intake of food groups and most nutrient intakes except for protein did not show any significant relationship with the occurrence of hypertension.
CONCLUSIONS
To reduce the risk of occurrence of hypertension among elderly individuals in rural areas, it is needed to avoid increase of body fat, 25 or higher BMI (kg/m2) and hyperlipidemia and low intake of proteins.

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Health-related Behavior Affecting Hypertension in the Elderly Using Data from the 8th Korea National Health and Nutrition Examination Survey
Jongsuk LEE
Korean Journal of Clinical Laboratory Science.2024; 56(2): 163. CrossRef

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[English]
Analysis of Bone Mineral Density, Biochemical Index and Nutrient Intakes of 30-70 Years Old Women: Based on 2011 KNHANES: Jae Ok Koo, Myung Sook Kim; Korean J Community Nutr 2014;19(4):328-341. Published online August 31, 2014; DOI: https://doi.org/10.5720/kjcn.2014.19.4.328

Abstract PDF PubReader

OBJECTIVES
This study was carried out to investigate bone mineral density (BMD), blood pressure, age and biochemical index and nutrient intakes, and to analyze the relationship between BMD, blood pressure, biochemical index, nutrient intakes of Korean women.
METHODS
The study subjects were 499 women with a age range of 30-79 years living in Seoul and Kyunggi area who participated in 2011 KNHANES. The study subjects were divided into 5 age groups: 30 years (145), 40 years (110), 50 years (102), 60 years (85) and 70 years (57), and 3 BMD groups: normal 258 (50.4%), osteopenia 163 (32.9%) and osteoporosis 78 (16.7%).
RESULTS
The average waist circumference, BMI and body fat increased with age, but fat free mass decreased with age. Average BMD and T-score was decreased from 0.84, 0.74 g/cm2 in 30 years to 0.05, -1.05 g/cm2 in 70 years. The rates of osteopenia and osteoporosis increased significantly 22% in 30~40 years, 47% in 50 years and 56% in 60~70 years. Systolic blood pressure and cholesterol were significantly increased with age. The rates of hypertension was significantly increased 2.1% in 30 years, 30.4% in 50 years 89.5% in 70 years. Average nutrient intakes such as protein, calcium, iron, vitamin A and C were significantly decreased with age. There were significant negative correlations between age and calcium, systolic blood pressure, triglyceride.
CONCLUSIONS
In this study, we found the risk of osteoporosis and hypertension were significantly increase with over 50 years age. Calcium and protein intake decreased with age. Therefore, in order to prevent osteoporosis and hypertension, adult women need to be educated regarding the importance of protein, calcium and other nutrients in their diet.

Citations

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Association between dietary intake, body measurements, and urinary bone resorption markers in young adults with osteopenia and osteoporosis: a cross-sectional study
Mi-Hyun Kim, Mi-Kyeong Choi
Korean Journal of Community Nutrition.2023; 28(4): 282. CrossRef
Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea
Su-Hyeon Kim, Soo-Kyung Lee, Sin-Gon Kim
Journal of Nutrition and Health.2019; 52(5): 449. CrossRef

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[English]
Association of Bone Mineral Density and Blood Pressure, Calcium Intake among Adult Women in Seoul, Kyunggi Area: Based on 2011 KNHANES: Jae Ok Koo; Korean J Community Nutr 2013;18(3):269-282. Published online June 30, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.3.269

Abstract PDF PubReader

This study was carried out to investigate bone mineral density (BMD), blood pressure, calcium, sodium intake and related biochemical variables, and to analyze the relationship between BMD, and blood pressure, physical characteristics, nutrient intakes of Korean adult women. The study subjects were 30~80years old, 513 women living in Seoul and Kyunggi area who participated in 2011 KNHANES. The study subjects were divided into three BMD groups; normal, n = 259 (50.4%), osteopenia, n = 169 (32.9%), and osteoporosis, n = 85 (16.7%). Average height and weight and fat free mass decreased with a decrease in BMD. Average BMD of normal, osteopenia, osteoporosis were 0.87, 0.79, 0.70 g/cm2, and T-score were 0.42, -0.66, -1.62, respectively. Higher systolic blood pressure, alkaline phosphatase, and triglyceride were significantly associated with a decrease in the BMD. The rates of hypertension were significantly increased from normal to osteoporosis. i.e. 18.5% in normal, 34.3% in osteopenia and 63.5% in osteoporosis. Average nutrientintakes such as protein, fat, calcium, phosphorus, iron, sodium, potassium, vitamin A, vitamin B, vitamin B2, and vitamin C were significantly lower in subjects with lower BMD.n. Average calcium intake of normal, osteopernia and osteoporosis were 528.50, 416.96, 389.56 mg, respectively. There were significant negative correlations between calcium, phosphorus and age, systolic blood pressure, triglyceride. Also, there were negative correlation systolic blood pressure (incomplete sentence). In this study, we found low BMD according to low calcium intake increase the risk of osteoporosis and hypertension rather than sodium intake, also calcium intake decreased with increase age. Therefore, in order to prevent osteoporosis and hypertension, subjects need to be educated regarding the importance of calcium nutrients in diet.

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Developing the Osteoporosis Risk Scorecard Model in Korean Adult Women
Ilsu Park
Journal of Health Informatics and Statistics.2021; 46(1): 44. CrossRef
Dietary behaviors and nutritional status according to the bone mineral density status among adult female North Korean refugees in South Korea
Su-Hyeon Kim, Soo-Kyung Lee, Sin-Gon Kim
Journal of Nutrition and Health.2019; 52(5): 449. CrossRef
Effects of Nutrition Education at a Community Health Center on Overweight and Obese Middle-aged Women in Jeonbuk Area-Focused on Personalized Daily Energy Requirement and Food Exchange Units
Se-Yeon Kim, Sook-Bae Kim
Korean Journal of Community Nutrition.2017; 22(4): 307. CrossRef
Prevalence of Osteopenia/Osteoporosis and Related Risk Factors of Men Aged 50 Years and Older: Korea National Health and Nutrition Examination Survey 2010~2011 Data
Hye-Sang Lee
Journal of the Korean Dietetic Association.2016; 22(2): 106. CrossRef
The Effects of Korean DASH Diet Education with Calcium/Vitamin D Supplements on Nutrient Intakes, Food Consumption, Bone Turnover Markers and Bone Mineral Density among Korean Elderly Women
Haeyoung Lee, Smi Choi-Kwon, Seung-Hye Choi
Korean Journal of Adult Nursing.2015; 27(1): 94. CrossRef
Various Factors Affecting the Bone Mineral Density in Korean Young Adult Women: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011
Kwang-Hyun Jho, Soon-Nam Choi, Nam-Yong Chung
Journal of the Korean Dietetic Association.2014; 20(2): 110. CrossRef
Association of Anthropometric and Biochemical Factors with Bone Mineral Density in Korean Adult Women Data from the Fourth (2008~2009) and Fifth (2010~2011) Korea National Health and Nutrition Examination Surveys (KNHANES IV & V)
Soon-Nam Choi, Kwang-Hyun Jho, Nam-Yong Chung
Journal of the Korean Dietetic Association.2014; 20(3): 157. CrossRef
Analysis of Bone Mineral Density, Biochemical Index and Nutrient Intakes of 30-70 Years Old Women: Based on 2011 KNHANES
Jae Ok Koo, Myung Sook Kim
Korean Journal of Community Nutrition.2014; 19(4): 328. CrossRef
Factors associated with the bone mineral density in Korean adults: Data from the 2010-2011 Korean National Health and Nutrition Examination Survey (KNHANES) V
Kyung Sook Kim
Journal of agricultural medicine and community health.2014; 39(4): 240. CrossRef

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[English]
Development of Nutrition Education Program for Hypertension Based on Health Belief Model, Applying Focus Group Interview: Seoyun Park, Jong Sook Kwon, Cho il Kim, Yoonna Lee, Hye Kyeong Kim; Korean J Community Nutr 2012;17(5):623-636. Published online October 31, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.5.623

Abstract PDF PubReader

Health Belief Model is a socio-psychological theory of decision making to individual health-related behaviors. This study was aimed to develop an effective education program for hypertension based on health belief model. The main factors of health belief model were investigated by focus group interview (FGI) with 23 hypertensive or prehypertensive subjects aged over fifty years. 'Perceived susceptibility' to hypertension was family history, neglect of health care, preference for salty food, broth of soup and stew. Lifelong medication, complications, and medical costs were reported as 'perceived severity' of hypertension. 'Perceived benefits' of hypertension management were decrease of medicinal dose, reduction of medical costs, and healthy eating habits of the family, while 'perceived barriers' were lack of palatability of low salt diet, convenience-oriented dietary habits, and limited choice of foods when eating out. Subjects mentioned TV health programs, public health center programs, and advice from doctors and family as 'cues to action' of hypertension management. These qualitative information provided basis for developing a nutrition education program for hypertension which could be implemented in the public health center. Eight week program was composed of understanding hypertension, risk factor management (eating habits, weight), low salt diet (principles, cooking), advanced management for healthy diet in 2 sessions, and summary. Each session was designed to alert the susceptibility and severity, to emphasize the benefits, and to reduce the barriers by providing dietary monitoring, practical advice, and action tips.

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[English]
Nutrient Intake, Lifestyle Factors and Prevalent Hypertension in Korean Adults: Results from 2007-2008 Korean National Health and Nutrition Examination Survey: Sle Koo, Youngok Kim, Mi Kyung Kim, Jin Sook Yoon, Kyong Park; Korean J Community Nutr 2012;17(3):329-340. Published online June 30, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.3.329

Abstract PDF PubReader

Hypertension is a well-known risk factor for cardiovascular disease. Previous studies have shown that changes in diet and lifestyle factors can prevent the development of hypertension, but the combined effects of these modifiable factors on hypertension are not well established. The objective of this study is to investigate associations of diet and lifestyle factors, evaluated both individually and in combination, with prevalent hypertension among Korean adults. We analyzed data obtained from the 2007-2008 Korean National Health and Nutritional Examination Survey, a nationwide cross-sectional study using a stratified, multistage probability sampling design. The associations of 12 nutrient intakes and lifestyle factors with risk of hypertension were explored using restricted cubic spline regression and logistic regression models among 6,351 adults. Total energy and several nutrients and minerals, including, calcium, vitamin A, vitamin C, and sodium, showed non-linear relationships with the risk of prevalent hypertension. In multivariate logistic regression models, dietary score, obesity and alcohol intake were independently associated with the risk of prevalent hypertension, but smoking and physical activity were not. Overall, participants whose dietary habits and lifestyle factors were all in the low-risk group had 68% lower prevalence of hypertension (OR: 0.32, 95 CI: 0.14-0.74) compared to those who were at least one in the high-risk group of any dietary or lifestyle factors. The result suggests that combined optimal lifestyle habits are strongly associated with lower prevalence of hypertension among Korean adults.

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How Much Intake of Sodium Is Good for Frailty? : The Korean Frailty and Aging Cohort Study (KFACS)
S. Kim, M. Kim, J. Min, J. Yoo, M. Kim, J. Kang, Chang Won Won
The Journal of nutrition, health and aging.2019; 23(6): 503. CrossRef
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Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake
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Journal of the Korean Dietetic Association.2014; 20(2): 99. CrossRef
Excessive Sodium Intake and Related Factors According to Energy Intakes Among Korean Elderly: A Nationwide Cross-Sectional Study
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The relationship of dietary sodium, potassium, fruits, and vegetables intake with blood pressure among Korean adults aged 40 and older
Mi Kyung Kim, Kirang Kim, Min-Ho Shin, Dong Hoon Shin, Young-Hoon Lee, Byung-Yeol Chun, Bo Youl Choi
Nutrition Research and Practice.2014; 8(4): 453. CrossRef
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Jae Ok Koo
Korean Journal of Community Nutrition.2013; 18(3): 269. CrossRef

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[English]
Effects of Nutritional Education Practice Program for Cardiocerebrovascular High-risk Group at the Education Information Center: Hang Me Nam, Seung Hee Woo, Young Ji Cho, Yun Jung Choi, Su Yeon Back, So Yeon Yoon, Jin Young Lee, Jung Jeung Lee, Hye Jin Lee; Korean J Community Nutr 2011;16(5):580-591. Published online October 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.5.580

Abstract PDF PubReader

This research was performed to investigate the effects of NEP (Nutritional Education Practice) program developed by KHyDDI (Korea Hypertension Diabetes Daegu Initiative) for hypertension and diabetes patients. The subjects were 116 patients (hypertension 70, diabetes 46) who had completed basic education program at the education information center and four-session program was implemented for them. Nutrient intake was analyzed and compared before and after the program by 24-hr recall method and evaluate weight, waist circumference, body fat, blood pressure and eating habits in terms of nutrition knowledge, eating behavior, salty taste assessment. The improved results after the program were observed in weight, waist circumference, body fat ratio, blood pressure, slightly salty taste in salty taste assessment, nutrition knowledge, eating behavior, sodium, energy, carbohydrate and protein intake ratio to total energy (p < 0.001). Therefore, this program is effective in the improvement of weight, waist circumference and eating behavior, and the continued management would lead to the prevention of cardio-cerebrovascular diseases in the community.

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Jung Jeung Lee, Hye Jin Lee, Eun Jin Park
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Comparison of the Health Behaviors according to Income and Education Level among Cardio-Cerebrovascular Patients; based on KNHANES data of 2010-2011
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Journal of agricultural medicine and community health.2012; 37(3): 167. CrossRef

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[English]
Dietary and Lifestyle Factors Associated with Hypertension in Korean Adolescents: Based on 2005 Korean National Health and Nutrition Examination Survey: Killye Kim, Sook Mee Son, Hye Kyeong Kim; Korean J Community Nutr 2011;16(4):439-453. Published online August 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.4.439

Abstract PDF PubReader

This study was performed to determine dietary and lifestyle factors associated with hypertension in Korean adolescents. Study subjects were 12~19 years (n = 521) adolescents who participated in the 2005 Korean National Health and Nutrition Examination Survey (KNHANES III). Subjects were divided into the hypertensive group (HG, n = 102) and normotensive group (NG, n = 419) by '2007 Korean children and adolescents growth standard' and the relationships between blood pressure and physical measurement, nutrients intakes, eating behaviors and health related factors were analyzed. HG showed significantly higher levels in weight, waist circumference and BMI than NG. The amount of nutrient intakes was not different between NG and HG. Index of nutritional quality (INQ) for phosphate was higher in HG compared with NG. In both male and female HG, INQ for iron was higher but INQ for vitamin B1 was lower than NG. HG revealed higher consumption frequencies of snack, yoghurt, and ice cream compared with NG. In eating and behavioral factors, 'dinner with family', 'eat proper amount', 'keep Korean traditional diet', alcohol drinking, and mean alcohol intake were significantly different between the two groups. By logistic regression method, risk factors for hypertension revealed in this study were gender (male), age (15~19 years), BMI (> or = 85 percentile), and not keeping Korean traditional diet. These results suggest that education program for hypertension prevention in adolescents should include eating habits improvement and lifestyle modification as well as weight control.

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Jae Ok Koo
Korean Journal of Community Nutrition.2013; 18(3): 269. CrossRef

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[English]
Evaluation of Nutrition Education for Hypertension Patients Aged 50 Years and Over: Eun Hye Moon, Kyung Won Kim; Korean J Community Nutr 2011;16(1):62-74. Published online February 28, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.1.62

Abstract PDF PubReader

This study was designed to implement and evaluate a nutrition education program for hypertensive patients aged between 50 and over. Nutrition education consisted of four sessions and, 35 out of 51 patients completed all education sessions at the public health center. To assess program effectiveness (effectively), data about blood pressure, blood cholesterol, anthropometry, nutrition knowledge, eating behavior and dietary intake were collected before and after nutrition education. Data were analyzed using SAS package (ver. 9.2) and significant difference was evaluated by paired t-test, x2-test and Wilcoxon signed rank test. Blood cholesterol was significantly reduced from 200.7 mg/dL to 188.7 mg/dL after nutrition education, although there were not significant changes in blood pressure or blood triglyceride level. Weight (p < 0.05), % body fat (p < 0.001), BMI (p < 0.05) were significantly reduced, especially in women, after nutrition education. Nutrition knowledge was increased significantly (p < 0.05), and some eating behaviors such as 'having fruits & vegetables for snack' and 'having brown rice, barley rice than white rice' were improved after nutrition education (p < 0.05). Sodium intake was reduced from 3,888.9 mg/day to 3,157.4 mg/day after nutrition education (p < 0.05). Except protein and iron intakes, the nutrient intake of hypertensive patients was much below the recommended level for Koreans. Dietary intakes of most of nutrients were not significantly different between pre-test and post-test. It appeared that nutrition education for the aged hypertensive patients was effective in reducing the percentage of % body fat and BMI, increasing the nutrition knowledge and some dietary behaviors. This nutrition education can be implemented at public health centers or senior centers for hypertensive patients.

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The Effect of Health Coaching Programs on Self-Efficacy, Health Behaviors, and Quality of Life in Hypertensive People Living in Poverty
Sun Ok Eom, Insook Lee
Journal of Korean Academy of Nursing.2017; 47(3): 380. CrossRef
General Characteristics, Self-Efficacy, and Diet Control of Hypertension Patients at a Diabetes Admission Control Center in the Jeollanma-do Area
Su Jeong Yeo, In Woo Shin, Bok Hee Kim
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Dietary Life related to Sodium of Participants in Hypertension and Diabetes Preventive Education at the Public Health Center
Hee-Ok Pak, Chun-Young Sohn, Jung-Hwa Park
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Nutrition knowledge, eating attitudes, nutrition behavior, self-efficacy of childcare center foodservice employees by stages of behavioral change in reducing sodium intake
Yun Ahn, Kyung Won Kim, Kyungmin Kim, Jinwon Pyun, Ikhyun Yeo, Kisun Nam
Journal of Nutrition and Health.2015; 48(5): 429. CrossRef
Sodium Related Recognition, Dietary Attitude and Education Needs of Dietitians Working at Customized Home Visiting Health Service
Yun-Jeong Mo, Sook-Bae Kim
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The Effect of the Telemedicine Service System Application for the Patients with Hypertension at Community Health Practitioner Posts in Gangwon Province
Myung Soon Kwon, Ghee-Young Noh, Jounghwa Choi
Korean Journal of Health Education and Promotion.2014; 31(2): 55. CrossRef
The Effects of Low-sodium Diet Education Program on Dietary Habits, Diet Quality and Obesity Index in Overweight and Obese Middle-aged Women
Soo Bin Jeong, Seoyun Park, Sohyun Ahn, Jin Nam Kim, Hye-Kyeong Kim
Korean Journal of Community Nutrition.2014; 19(6): 513. CrossRef
Development of Nutrition Education Program for Consumers to Reduce Sodium Intake Applying the Social Cognitive Theory: Based on Focus Group Interviews
So-Hyun Ahn, Hye-Kyeong Kim, Kyung Min Kim, Jin-sook Yoon, Jong Sook Kwon
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Effects of nutrition education on nutrition-related knowledge, dietary habits, and nutrient intakes of alcoholic patients
An Na Kim, Hyeon-Sook Lim
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Effects of Dietary Education on Low-sodium Diet Adaptation
Hae Young Kim, Juhyeon Kim
Journal of the Korean Society of Food Culture.2014; 29(2): 212. CrossRef
An Evaluation of the Effectiveness of Nutrition Counseling for Adults with Risk Factors for Dyslipidemia
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Blood Pressure, Sodium Intake and Dietary Behavior Changes by Session Attendance on Salt Reduction Education Program for Pre-hypertensive Adults in a Public Health Center
Eun-Jin Jung, Jong-Sook Kwon, So-Hyun Ahn, Sook Mee Son
Korean Journal of Community Nutrition.2013; 18(6): 626. CrossRef
Effects of a Comprehensive Lifestyle Improvement Program for Middle-aged Women with Cardio-cerebrovascular Disease-related Risk Factors
Mi-Kyoung Park, Jeong-Hee Kim
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The Effect of Sodium Reduction Education Program of a Public Health Center on the Blood Pressure, Blood Biochemical Profile and Sodium Intake of Hypertensive Adults
Eun Jin Jung, Sook Mee Son, Jong-Sook Kwon
Korean Journal of Community Nutrition.2012; 17(6): 752. CrossRef
Development of Nutrition Education Program for Hypertension Based on Health Belief Model, Applying Focus Group Interview
Seoyun Park, Jong-Sook Kwon, Cho-il Kim, Yoonna Lee, Hye-Kyeong Kim
Korean Journal of Community Nutrition.2012; 17(5): 623. CrossRef
Effects of Nutritional Education Practice Program for Cardiocerebrovascular High-risk Group at the Education Information Center
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Korean Journal of Community Nutrition.2011; 16(5): 580. CrossRef

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[English]
Association of Nutritional Status with Obesity by Body Mass Index and Waist Circumference among Hypertensive Elderly Patients: Kyung Hee Seo, Hye Jin Lee, Bu Dol Lim, Yun Jung Choi, Hyunmee Oh, Jin Sook Yoon; Korean J Community Nutr 2009;14(6):831-845. Published online December 31, 2009

Abstract PDF: Hypertension and obesity are important modifiable risk factors for cardiovascular disease, the leading cause of death in Korea. Therefore, we assessed the association between dietary pattern and obesity in hypertensive patients to formulate health promotion strategies for the older population. Dietary information was collected from hypertensive patients visiting community health education and information center by using 24 hour recall method. The 2005 DRIs for Koreans was used to evaluate the dietary adequacy. When subjects were categorized by body mass index (BMI) as normal, overweight and obese, no significant difference in energy intake was found among groups. Dietary intakes of folate, and vitamin C in obese hypertensive patients were significantly lower than in normal weight patients (p < 0.05). When we compare the nutritional status by waist circumferences, dietary intakes of zinc, vitamin A, thiamin, vitamin C and folate were significantly lower in the obese group. Vegetable intake was significantly lower in the obese group according to BMI as well as waist circumference. Energy intake from carbohydrate was significantly higher in obese hypertensive patients (p < 0.05). Obese hypertensive patients had a higher risk of nutritional inadequacy compared to normal weight patients. Our results indicated the need for developing interventions that encourage greater consumption of vegetables while cutting down salt intake with wise selection of staple foods, for obese hypertensive patients.

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[English]
The Effects of a Nutrition Education Program for Hypertensive Female Elderly at the Public Health Center: Kyeong Sook Yim; Korean J Community Nutr 2008;13(5):640-652. Published online October 31, 2008

Abstract PDF: Hypertension is among the most common and important risk factors for stroke, heart attack, and heart failure which is considered to be the leading cause of death in Korea. The prevalence rate of hypertension in Korea is 27.9%, according to the 2006 Korea National Health and Nutrition Survey. Since non-pharmacologic nutrition education is recommended as the first step in the management of hypertension, evaluation of nutrition program is needed to form strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) for reducing the salt intake, at a public health center located in Gyunggi-province. The HNEP was offered for 16 weeks from May to September in 2007. Nutrition education activities included cooking classes, food preparation demonstrations, physical fitness programs, salty taste preference test sessions, games, case-study presentations, planning and evaluation of menus, etc. Forty patients participated fully in the program which had 47 female enrollees. Data about nutrient intake (24-hour recall), nutrition knowledge, food behavior were collected before (baseline) and after the program. Changes after program completion indicated the following: 1) diastolic blood pressure was decreased (p < 0.05), 2) sodium (salt) intake was also decreased (p < 0.01), especially baseline high salt intake group, 3) nutrition knowledge was improved (p<0.001), 4) dietary behaviors for maintaining a low salt diet was improved (p < 0.001), 5) participants preferred cooking class from nutrition education methods. As a conclusion, it appears that a nutrition education program for hypertensive female elderly for reducing the salt intake might effectively decrease blood pressure and salt intake. It also improves nutrition knowledge, dietary behavior, and finally adherence to a recommendable low-sodium diet.

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[English]
Developing Dish-based Food Frequency Questionnaire for the Epidemiology Study of Hypertension Among Korean: Mi Kyung Kim, Young Mi Yun, Youngok Kim; Korean J Community Nutr 2008;13(5):701-712. Published online October 31, 2008

Abstract PDF: The purpose of the present study was aimed to identify dish items applicable in developing dish?based food frequency questionnaire (DFFQ) for a hypertension study of Koreans. The 24-hour recall data of 4,401 subjects aged 20~65 years from the 2001 Korean National Health and Nutrition Examination Survey were used for the analysis. Logistic regression model was used to identify the nutrient related with hypertension. Energy, fiber, sodium, calcium, carotene, vitamin B1 and vitamin C were associated with hypertension. Selection the top 30 dish items for these seven nutrients was performed based on their degree of contribution in supplying nutrients in terms of the cumulative percent contribution (cPC), as well as on their degree of explanation for between?person variation, in terms of the cumulative regression coefficient (cMRC). Rice supplied 43% of total energy consumption. Korean cabbage and radish kimchi were two major sources of sodium and it also covered the 27% of between person variation of sodium intake. Soybean paste soup and single item of orange?colored fruits supplied 43% of total vitamin C intake for Koreans and it covered the almost 79% of between person variation among the Korean population. Korean cabbage kimchi was the major source of fiber, calcium, sodium, carotene, and vitamin C for Koreans. In summary, the top 30 selected dish items supplying the 78% to 89% of the 7 nutrients. Those items also covered the 79% to 94% of between person variation of the 7 nutrients consumption. Therefore, the selected 30 dish items in each categories of nutrient could be applicable in developing dish based food frequency questionnaire for hypertension study.

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[English]
Nutritional Environment Influences Hypertension in the Middle-aged Korean Adults: based on 1998 & 2001 National Health and Nutrition Survey: Hae Jeung Lee, Haeng Shin Lee, Yoonna Lee, Young Ai Jang, Jae Jin Moon, Cho il Kim; Korean J Community Nutr 2007;12(3):272-283. Published online June 30, 2007

Abstract PDF: This study was performed to delineate the relationship between lifestyle and nutritional risk factors associated with hypertension in representative middle-aged Korean population. Hypertension in this study is defined as hypertensive (SBP> or = 140 mmHg or DBP> or = 90 mmHg) adults without recognition of a disease state before a health exam. With data from the 1998 and 2001 National Health and Nutritional Survey, nutrient intakes of 6,112 adults, 40-64 years of age were calculated using food composition database and matched with health examination records by individual ID. After excluding those with extreme intake values, the number of final subjects included in the analysis was 5,200 (male 2,458, female 2,742). Using logistic regression method, socio-demographic data, lifestyle factors, and nutrient intakes were analyzed. Risky factors for hypertension revealed in this study were age, sex, BMI over 23, waist circumference, alcohol intake of more than 16 g (male) or 8 g (female). Regarding nutrient intakes, the intakes of highest quartile for energy (> or = 2363.0 kcal) and protein (> or = 90.2 g) were significantly associated with higher risk of hypertension after adjusting for age, sex, and other socio-demographic factors (OR = 1.312 (1.046-1.711), OR = 1.488(1.194-1.854), respectively)). Although high intakes of sodium (> or = 6604.0 mg) and phosphorus seemed to be risk factors of hypertension also before energy adjustment (OR = 1.278(1.034-1.581), OR = 1.280(1.024 -1.600), respectively), only high intakes of energy and protein remained significant after adjustment. This study revealed that modifying risky lifestyles and dietary patterns, especially high energy intake, high protein intake, and high alcohol drinking, in middle-aged Korean adults could result in a prevalence decrease and/or prevention of hypertension.

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[English]
Moderate Alcohol Consumption Does Not Prevent the Hypertension among Korean: the 2001 Korean National Health and Nutrition Examination Survey: Young Ok Kim; Korean J Community Nutr 2006;11(6):707-713. Published online December 31, 2006

Abstract PDF: The purpose of this study was to test whether moderate alcohol consumption has any positive effect on lowering blood pressure among Koreans. Study subjects were Korean adults 20 years or older (n=5,234) who participated in the 2001 Korean National Health and Nutrition Examination Survey (KNHANES). Analysis of variance and analysis of covariance were used to construct univariate and multivariate models relating alcohol consumption to blood pressure for the analysis. After adjustment for possible covariates, drinkers (regardless of drinking level) had significantly higher systolic and diastolic blood pressure, compared with never-drinker for male subjects. Diastolic and systolic blood pressures were also significantly elevated with the drinking frequency and amount of alcohol intake among male subjects. For the female subjects, only diastolic blood pressure was significantly associated with the alcohol consumption at multivariate model, however, low level alcohol consumption did not show any sign of lowing effects on blood pressure. The result implies that moderate alcohol consumption did not have any positive effect on lowering blood pressure among Koreans for either sex.

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[English]
Dietary Risk Factors Associated with Hypertension in Patients: Sook Mee Son, Gwui Yeop Huh; Korean J Community Nutr 2006;11(5):661-672. Published online October 31, 2006

Abstract PDF: This study was performed to determine the dietary risk factors associated with hypertension. The hypertensive group were composed of 112 hypertensive patients (male 53, female 59) who first visited the hypertension clinic and had been diagnosed as having primary hypertension (SBP > or = 140 mmHg or DBP > or = 90 mmHg). The regular visitors or the subjects on special diets or medical therapies were excluded. The normal group consisted of as subjects (male 41, female 54) matched with age and socioeconomic levels. The subjects having higher intakes (above the 75 percentile) in energy, protein, iron, vitamin A or C showed significantly higher hypertension risk estimated with odds ratio after the covariance factors (age, sex and BMI) were adjusted. More than 2400 mg of sodium (6 g of salt) intake was associated with significantly higher risk of hypertension (odds ratio: 1.773, CI: 1.014 - 3.014 for SBP > or = 140 mmHg; odds ratio: 2.373, CI: 1.359 - 4.215 for DBP > or = 90 mmHg). Hypertensive group showed significantly increased intakes of vegetables and fish and shell fish compared to the normal group. When the vegetable intakes were classified into Kimchi, fresh vegetables and cooked vegetables with seasoning, the hypertensive group was observed as having higher intakes of Kimchi and cooked vegetables with seasoning. The intakes of highest quartile for vegetables (> or = 327 g/day)(odds ratio: 3.164, CI: 1.740 - 5.752), fish and their products (> or = 102 g/day)(odds ratio: 2.756, CI: 1.486 - 5.109), grains(> or = 311 g/day)(odds ratio 2.393, CI: 1.186 - 4.832), meats and their product (> or = 106 g)(odds ratio: 2.210, CI: 1.225 - 3.987) compared to the lower were significantly associated with the higher risk of hypertension estimated with DBP (> or = 90 mmHg) after covariance factors were adjusted. In conclusion, our findings confirm that higher intake of energy or sodium are associated with the increased risk of hypertension. Because increased intake of vegetable or fish was associated with the higher risk of hypertension, in contrast with the finding of western countries, choosing or preparation of vegetables or fish with reduced salt is recommended.

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[English]
Obesity Indices and Plasma Total Antioxidant Status in Hypertensive Elderly Living in Ulsan Area: Jung Hee Kim, Mi Joung Kim, Ho Kyung Kwak; Korean J Community Nutr 2006;11(2):279-288. Published online April 30, 2006

Abstract PDF: The role of free radicals in the progression of many diseases and aging has been given a great attention and total antioxidant status (TAS) has shown to be reduced with aging. The incidence of hypertension has shown to be relatively high in the aged population, and it is known to be associated with increased obesity and oxidative stress. The aim of this study was to examine the obesity indices and the total antioxidant status in hypertensive elderly (64y

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[English]
The Relationship of Nutritional Satus to the Degree of Hypertension in Residents of Kangbuk-gu, Seoul: Eun Jung Son, Hyun Kyung Moon; Korean J Community Nutr 2002;7(3):304-315. Published online June 30, 2002

Abstract PDF: The purpose of this study was to relate the degree of hypertension to nutritional status, in order to prepare basic data for a nutrition program. The study using the WHO standard divided the residents in Kangbuk-gu into a normal group (NG) of 254 adults with systolic blood pressure (SBP) < 130 or diastolic blood pressure (DBP) < 85; a borderline hypertensive group (BG) of 81 adults with 130 < or = SBP < or = 140 or 85 < or = DBP < or = 90; and a hypertensive group (HG) of 143 adults with SBP > 140 or DBP > 90. The mean age of HG was older than the other groups (p < 0.001). The dietary intake was investigated by the 24-hour recall method. The Ca intake as the percentage of the Korean Recommended Dietary Allowances (RDA) for the HG were higher than that of the other groups (p < 0.01). The Nutrient Adequacy Ratio (NAR) of Ca and Vit. A were below 0.75 for all three groups. The Mean Adequacy Ratio (MAR) was above 0.75 (p > 0.05) for all three groups. The Dietary Variety Score (DVS) of the NG was 22.7, and higher than those of the other groups (p > 0.05). The fasting blood sugar (p < 0.001), total cholesterol (p < 0.001), protein (p < 0.001), albumin (p < 0.01), hemoglobin (Hb) (p < 0.001), alkaline phosphatase (ALP) (p < 0.001), and creatinine (p < 0.05) values of the HG were higher than those of the other groups. The Body Mass Index (BMI) and the waist-hip ratio (WHR) of the HG were higher than those of the other groups (p < 0.001). In conclusion, these results showed that there tended to be differences among the three groups. For effective nutritional education and counseling of each group, we should further study the differences and understand their characteristics of each group in order to provide nutritional education for controling and preventing hypertension.

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[English]
The Effect of Nutrition Education Program for Various Chronic Disease in Elderly Visiting Public Health Center: Sook Mee Son, Mun Jung Kim; Korean J Community Nutr 2001;6(4):668-677. Published online October 31, 2001

Abstract PDF: This study conducted to assess the effectiveness of nutrition education program for elderly females with various diseases. Forty subjects(hypertension ; 20, diabetes ; 12, hyperlipidemia ; 8) out of 56 completed the 7 weeks nutrition education program. The nutrition education program was based for healthy food habits and dietary guidelines for each specific disease. It also included practicing individualized menu planning and exercising program. Energy, calcium, iron, vitamin A and ash intakes significantly increased in the hypertension group. total sodium intake did not decrease, however sodium intake per kcal decreased significantly(p<0.05). Elderly with diabetes did not show any changes in dietary intakes. Dietary protein, plant fat, ash, and sodium intakes were significantly elevated(p<0.05), but cholesterol intakes significantly decreased(p<0.05) in the hyperlipidemic group. Elderly with hypertension agreed strongly with changes of food habits such as increasing milk intake, and decreasing Kimchi, soup, pickles and salty food, and table salt intakes after nutrition education. Diabetic elderly showed significantly improved food habit scores in decreasing white rice intake, sugar intake and increasing sea-weed consumption, vegetable consumption and exercise. Hyperlipidemic elderly did not show much improvement in food habit scores except in biochemical indices. However, mean serum glucose and atherogenic index decreased in the diabetic and hyperlipidemic groups after education, respectively.

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[English]
Evaluation of the Effectiveness of a Nutrition Education Program for Hypertensive Patients at the Community Level: Kyeong Sook Yim; Korean J Community Nutr 2000;5(4):654-661. Published online December 31, 2000

Abstract PDF: Hypertension is the major risk factor for cardiovascular disease which is considered the leading cause of death in Korea. Since nonpharmarologic dietary intervention is recommended as the first step in the management of hypertension, evaluation of intervention programs is needed to formulate strategies for improving patients' dietary adherence. This study was designed to evaluate the overall effectiveness of a hypertension nutrition education program (HNEP) at a public health center, by assessing changes in nutrition knowledge, food attitude, self-efficacy, dietary behavior, and nutrient intake after program completion. An HNEP was conducted in Suwon city for 5 months in 1999 by a public health center. The program provided 3 sessions of group education with individual nutrition counseling. Thirty-five patients participated fully in the program out of 62 enrollees. Data about nutrition knowledge, food attitude, self-efficacy, dietary behavior, and intake (24-hour recall) were collected before (baseline) and after the program. Post program results indicate the following : 1) nutrition knowledge and perception of importance of nutrition significantly increased, 2) food attitudes also improved, 3) the self-efficacy for maintaining a low salt diet was increased significantly, whereas self-efficacy for maintaining a low fat diet or dietary guidelines was not improved, 4) frequency of intake of processed food, animal fat, and sweets as well as frequency of dining out were significantly reduced, 5) nutrient intake was not improved after the program, 6) the most serious barrier for participating in the program and practicing diet therapy was lack of time and willingness. In conclusion, it appears that HNEP might improve food attitudes, individual perceptions and self-efficacy for desirable eating behavior, but it might not improve dietary intake. It follows then, that a long term intervention program may need to increase effectiveness of patient dietary adherence.

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[English]
Characteristic of Anthropometric Data and Biochemical Nutritional Status of Hypertensive Patients before Treatment: Sook Mee Son, Gy Yeup Heo; Korean J Community Nutr 2000;5(4):624-632. Published online December 31, 2000

Abstract PDF: Nutrition related factors were investigated in one hundred and two hypertensive patients(Male: 44, female: 58) before they started drug treatment or diet therapy. The mean age of men and women were 49.9 and 53.5, respectively. Among the men, their mean SBP and DBP were 165.8 mmHg/108.4 mmHg. Fifty six point eight percent of men was classified as having in stage 3 hypertension(SBP > or = 180 mmHg, or DBP > or = 110 mmHg) and 45.5% was classified as having low renin hypertension (serum renin<2.5 ng/ml/h). The proportion of overweight or obesity assessed by BMI(> or = 25) or body fat percent( > or = 21%) was 47.7% or 80.9%, respectively. Men showed 19.1% of hypertriglyceridemia(serum TG > or = 200 mg/dl), 42.6% of hypercholesterolemia(serum cholesterol > or = 220 mg/dl), and 17.0% was observed as having serum cholesterol higher than 240 mg/dl. The proportion of men with high risk of cardiovascular disease was 72.3% assessed by atherogenic index(> or = 3.4). The prevalence of drinking was 86.4% including a daily drinking proportion of 15.8%. Among women, their mean SBP and DBP were 162.6 mmHg/104.3 mmHg. Less women(43.1%) were classified as having stage 3 hypertension and more women were observed in low renin hypertension(55.1%). The prevalence of obesity or overweight assessed by BMI( > or = 25) was 31.0% and 76.3% with body At percent(> or =28%). Women revealed 24.1% of hypertriglyceridemia and 36.2% of hypercholesterolemia. The proportion of women who showed high risk of cardiovascular disease(atherogenic index > or = 3.4) was 63.8%. The smoking rate was 8.6% and drinking rate was 43.1%.

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[English]
Distribution and Prevalence Estimation of Cardiovascular Risk Factors through Community Based Health Examination Survey: Soon Young Lee, Youngok Kim, Kun Sik Han, Hae Kyung Kim, Ju Won Park, Yeon Kyung Lee, Seung Soo Shin; Korean J Community Nutr 1999;4(4):521-528. Published online December 31, 1999

Abstract PDF: Cardiovascular disease is very prevalent in Korea, and many risk factors, if properly identified are possibly corrected. However, the study results on prevalence and distribution of risk factors may not be reliable while the risk factors of disease are always issued on health promotion projects conducted recently in a community. The subjects of this study were 854 adults who participated in the health and nutrition survey in a community. They were aged between 20 and 69 and sampled representatively. This study intended to estimate the prevalence and the distribution of risk factors of cardiovascular disease such as hypertention, diabetes mellitus, hypercholesterolemia, and obesity. Systolic blood pressure and diastolic blood pressure levels were estimated at 123.9+/-2.2mgHg(men), 117.9+/-1.7mgHg(women), and 80.4+/-1.5mg(men), 74.9+/-1.1mgHg(women), respectively. Glucose level was estimated at 99.1+/-2.3mg/dl in men, and 95.7+/-1.7mg/dl in women. The estimated level of total cholesterol and HDL-cholesterol were 183.4+/-3.8mg/dl(men), 181.7+/-3.1mg/dl(men), and 122.0+/-4.5mg/dl (women), and body mass index was estimated at 24.0+/-0.4kg/m2 in men and 23.9+/-0.4kg/m2 in men and 23.9+/-0.3kg/m2 in women. The prevalence of hypertension was 20.5% for men, and 14.4% for women. The prevalence of diabetes mellitus was estimated to 6.9% for men, and 6.1% for women. The estimated prevalence of hypercholesterolemia was 3.8%(men), 3.9%(women). The rate of obesity was estimated to 28.5%(men), 28.4% (women), respectively. The levels of blood pressure, glucose, and cholesterol were higher in men than in women in almost all the almost ate groups. The prevalence of hypertension for men is about 20%. It was found that the prevalence of diabetes mellitus for males aged between 40 and 59 was rapidly increased. The risk factor with highest prevalence was obesity, and hypertension and diabetes mellitus were the second and third most prevalent.

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