Korean Journal of Community Nutrition

Original Articles

[English]
The Factors Influencing the Bone Mineral Density in Korean Adult Men : Based on Korea National Health and Nutrition Examination Survey 2010~2011 Data: Hye Sang Lee; Korean J Community Nutr 2017;22(2):136-144. Published online April 30, 2017; DOI: https://doi.org/10.5720/kjcn.2017.22.2.136

OBJECTIVES
The purpose of this study was to determine which factors influence the bone mineral density (BMD) of total femur (TF), femoral neck (FN) and lumbar spine (LS) of the adult men by analyzing nationally representative Korean survey data.
METHODS
This study was conducted based on the data of 1,770 men aged 19-64 years from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V), 2010~2011. The BMD was analyzed by various factors (general characteristics, anthropometric data, health habits, chronic diseases, nutrient intake status). SPSS statistics for complex samples was used to analyze the data.
RESULTS
We observed that the BMD decreased significantly with aging. The BMD in each of the second lowest quartile of waist circumference (in TF & FN) and body mass index (in TF & LS) was lower than the respective BMD in the highest quartile group. The BMD in FN was higher in the group who reported the weight training. The BMD in LS was lower in hypercholesterolemia group than in the normal group. The BMD in TF, FN and LS was lower in hypertriglyceridemia group and in diabetes group than in the normal group. The BMD in TF, FN and LS was higher in the group with < Estimated Average Requirement iron intake. But there was no evidence to suggest that the BMD was related with educational level, income level, smoking, alcohol intake, anemia and nutrient intake status (except for iron).
CONCLUSIONS
This study suggested that aging, waist circumference, body mass index, weight training, hypercholesterolemia, hypertriglycemia, diabetes were site-specifically associated with the BMD in TF, FN and LS in the adult men. These bone site-specific factors need to be considered for the prevention of osteoporosis.

Citations

Citations to this article as recorded by

Significant association factors of bone mineral density in Taiwan adults
Tzyy-Ling Chuang, Mei-Hua Chuang, Chun-Hung Lin, Shih-Chin Chou, Yuh-Feng Wang
Tzu Chi Medical Journal.2020; 32(4): 367. CrossRef
Bone Mineral Density as a Predictor of Atherogenic Indexes of Cardiovascular Disease, Especially in Nonobese Adults
Tzyy-Ling Chuang, Jiunn-Wen Lin, Yuh-Feng Wang
Disease Markers.2019; 2019: 1. CrossRef
Developing Customized Phantom for Korean Bone Density Using 3D Printing
Junho Lee, Kwan-Yong Choi, Jae-Ho Choi
Journal of Radiological Science and Technology.2019; 42(3): 223. CrossRef

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[English]
Relationship between Bone Mineral Density and Bone Metabolic Biochemical Markers and Diet Quality Index-International(DQI-I) in Postmenopausal Obese Women: Yeonah Jeong, Misung Kim, Saeron Shin, Ahreum Han, Geomsuk Seo, Cheongmin Sohn; Korean J Community Nutr 2016;21(3):284-292. Published online June 30, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.3.284

Abstract PDF PubReader: OBJECTIVES
This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density.
METHODS
The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than 25 kg/m2 and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed.
RESULTS
Normal weight women were 56.03 Â± 3.76 years old and obese women were 58.09 Â± 5.13 years old and there was no significant difference in age between the two groups. The T-score of bone mineral density was 0.03 Â± 1.06 in normal weight women and -0.60 Â± 1.47 in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women (6.09 Â± 3.37 ng/mL) compared to obese women in (9.01 Â± 4.99 ng/mL) (p<0.05). The total score of diet quality index-international was 70.41Â±9.34 in normal weight women and 64.93 Â± 7.82 in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (Î²=-0.048, p<0.05), triglyceride (Î²=-0.005, p<0.05) and HDL-cholesterol (Î²=0.034, p<0.01), moderation of DQI-I (Î²=-0.231, p<0.05) affected T-score significantly.
CONCLUSIONS
The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.

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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

Citations to this article as recorded by

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.

Citations

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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]
Factors Associated with Bone Mineral Density in Korean Postmenopausal Women Aged 50 Years and Above: Using 2008-2010 Korean National Health and Nutrition Examination Survey: Son Ok Mun, Jihye Kim, Yoon Jung Yang; Korean J Community Nutr 2013;18(2):177-186. Published online April 30, 2013; DOI: https://doi.org/10.5720/kjcn.2013.18.2.177

Abstract PDF PubReader

The purpose of this study was to investigate factors associated with Bone Mineral Density (BMD) in Korean postmenopausal women. The data from 2008-2010 Korean National Health and Nutrition Examination Survey (KNHANES) were used for data analysis. Subjects were 2,701 postmenopausal women aged > or = 50 years. BMDs at whole body, total femur, femoral neck, and lumbar spine were measured by Dual-energy X-ray absorptiometry (DXA). Dietary data from 24-hour dietary recall and a food frequency questionnaire containing 63 food items were used. The proportions of osteopenia at total femur, femoral neck, and lumbar spine were 37.4%, 54.5%, and 45.4%, respectively. The proportions of osteoporosis at total femur, femoral neck, and lumbar spine were 6.2%, 25.6%, and 34.3%, respectively. Age, anthropometric index including height, weight, and Body Mass Index (BMI), parathyroid hormone, and physical activity were related to BMD, but the relationships were site specific. Total femur BMD was explained by age, weight, parathyroid hormone and intakes of carbohydrate and fruits. Femoral neck BMD was related to age, weight, parathyroid hormone and intakes of riboflavin and fruits. Lumbar spine BMD was associated with age, weight, milk and dairy products, calcium intake, and exercise. These results indicated that adequate intakes of milk and dairy products, fruits, carbohydrate, calcium, riboflavin and exercise as well as weight maintenance might play an important role in maintaining optimum bone health in Korean postmenopausal women.

Citations

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Estimation of Bone Mineral Density in the Femoral Neck and Lumbar Spine using Texture Analysis of Chest and Pelvis Computed Tomography Hounsfield Unit
Young-Kyung Min, Dong-Ha Lee, Jae-Heung Yoo, Man-Jun Park, Jung-Wook Huh, MinWoo Kim
Current Medical Imaging Reviews.2023;[Epub] CrossRef
Milk Consumption and Bone Mineral Density in Adults: Using Data from the Korea National Health and Nutrition Examination Survey 2008–2011
Ji Soo Kim, Seung-Won Oh, Jiwoo Kim
Korean Journal of Family Medicine.2021; 42(4): 327. 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
Nutrient Intake in Postmenopausal Rheumatoid Arthritis Women with Osteoporosis: Results from the Korean National Health and Nutrition Examination Survey
Yeon Soo Baik, Jee Won Park, Jihye Kim, Won Gyoung Kim, Sohee Oh, Sung-il Cho, Yeong Wook Song, Kichul Shin
Journal of Rheumatic Diseases.2017; 24(1): 35. CrossRef
Association between Hemoglobin Level and Bone Mineral Density in Korean Adults
Yun Hwan Oh, Ji Hyun Moon, Belong Cho
Journal of Bone Metabolism.2017; 24(3): 161. CrossRef
Association of serum vitamin D with osteosarcopenic obesity: Korea National Health and Nutrition Examination Survey 2008–2010
Jinhee Kim, Yunhwan Lee, Seunghee Kye, Yoon‐Sok Chung, Okhee Lee
Journal of Cachexia, Sarcopenia and Muscle.2017; 8(2): 259. CrossRef
The Factors Influencing the Bone Mineral Density in Korean Adult Men : Based on Korea National Health and Nutrition Examination Survey 2010~2011 Data
Hye-Sang Lee
Korean Journal of Community Nutrition.2017; 22(2): 136. 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
Bone mineral density and nutritional state according to milk consumption in Korean postmenopausal women who drink coffee: Using the 2008~2009 Korea National Health and Nutrition Examination Survey
Sun-Hyoung Ryu, Yoon Suk Suh
Journal of Nutrition and Health.2016; 49(5): 347. CrossRef
Sex- and age group-specific associations between intakes of dairy foods and pulses and bone health in Koreans aged 50 years and older: Based on 2008~2011 Korea National Health and Nutrition Examination Survey
Hyun-Bi Seo, Young-Sun Choi
Journal of Nutrition and Health.2016; 49(3): 165. CrossRef
Nutrition Diagnostic Analysis for Nutrition Care Process Model in Adults of a Health Screening & Promotion Center
Hye Seung Lee, Ji Ho Chang, Hyeon Jeong Lee, So Jeong Park, Eun Hee Kang
Korean Journal of Community Nutrition.2015; 20(1): 61. CrossRef
Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle
Nami Chun, Hyunju Chae
Korean Journal of Women Health Nursing.2015; 21(1): 43. CrossRef
A Study on the Correlation between Menopausal Rating Scale and Bone Mineral Density for Menopausal Osteoporosis Patients※
Kyu In Kwak, Jae Hui Kang, Yun Joo Kim, Hyun Lee
The Acupuncture.2014; 31(3): 25. 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

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[English]
A Study on Dietary Mineral Intakes, Urinary Mineral Excretions, and Bone Mineral Density in Korean Postmenopausal Women: Jee Young Yeon, Chung Ja Sung; Korean J Community Nutr 2011;16(5):569-579. Published online October 31, 2011; DOI: https://doi.org/10.5720/kjcn.2011.16.5.569

Abstract PDF PubReader

The purpose of this study was to determine the urinary Ca, P, Mg, Zn, Cu, and Mn levels and bone mineral density (BMD) in sixty-two postmenopausal women. The study was conducted through anthropometric checkup, 24-hour recall, 24-hour urine and bone mineral density using DEXA. Average age, height, weight and body fat of the subjects were respectively 65.39 years, 150.19 cm, 58.03 kg and 37.22%. The average spine and femoral neck BMD of subjects were -2.19, -3.13. The mean intakes of Ca, P and Mg were 524.7 mg, 993.10 mg, and 254.6 mg and those of Zn, Cu and Mn were 8.6 mg, 1.5 mg, and 3.5 mg. The average 24-hour urinary excretion of Ca (UCa), P (UP) and Mg (UMg) were 161.07 mg, 673.68 mg, and 99.87 mg. The average 24-hour urinary excretion of Zn (UZn), Cu (UCu) and Mn (UMn) were 366.50 microg, 22.57 microg, and 1.55 microg. Ca intake showed significantly positive correlations with urinary UCa (p < 0.05), UMg (p < 0.01) and spine BMD (p < 0.05). P intake showed significantly positive correlations with UCa (p < 0.05), UMg (p < 0.05) and UZn (p < 0.05). Mg intake showed significantly positive correlations with UZn (p < 0.05) and Mn intake showed significantly positive correlations with UCa (p < 0.05). Multiple regression analysis indicates that Ca intake and UMg is the most important factor to increase spine BMD. On the other hand, UCa is the most important factor to decrease spine BMD. Higher femoral neck BMD was related to UP, while lower femoral neck BMD was related to UCa. In conclusion, Dietary intake of Ca showed positive effect of spine BMD, while excessive P intake showed negative effect on BMD due to increases in UCa, UMg and UZn. Further studies are required to investigate the relationship between bone metabolism and mineral excretion.

Citations

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Magnesium intake and dietary sources among Koreans: findings from the Korea National Health and Nutrition Examination Survey 2016–2019
Jee-Seon Shim, Ki Nam Kim, Jung-Sug Lee, Mi Ock Yoon, Hyun Sook Lee
Nutrition Research and Practice.2023; 17(1): 48. CrossRef
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
Daily Intake of Magnesium and its Relation to Urinary Excretion in Korean Healthy Adults Consuming Self-Selected Diets
Mi-Kyeong Choi, Connie M. Weaver
Biological Trace Element Research.2017; 176(1): 105. 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
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
The Association between Changes in Food and Nutrient Intakes and Changes in Bone Metabolic Indicators in Postmenopausal Women with Osteopenia after a 12-week Intervention of Nutrition Education and Aerobic Exercise
Seo-Jin Kim, Suh-Jung Kang, Yoon Jung Park, Ji-Yun Hwang
Korean Journal of Community Nutrition.2013; 18(3): 213. CrossRef
Factors Related to Calceneal Broadband Ultrasound Attenuation, Anthropometric Indexes and Nutrient Intakes among Elementary School Children in Chungnam
Ye-Jung Kim, Yoon Jeong Choi, Hee-Seon Kim
Korean Journal of Community Nutrition.2013; 18(4): 312. CrossRef
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 Journal of Community Nutrition.2013; 18(3): 269. CrossRef
Dietary factors affecting bone mineral density in Korean rural postmenopausal women
Jeong Sook Choe, Eun Mi Ahn, Sung Ok Kwon, Young Hee Park, Jinyoung Lee
Korean Journal of Nutrition.2012; 45(5): 470. CrossRef
Evaluation of Dietary Zinc, Copper, Manganese and Selenium Intake in Female University Students
Yun-Jung Bae, Mi-Hyun Kim, Jee-Young Yeon
Korean Journal of Community Nutrition.2012; 17(2): 146. CrossRef

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[English]
Study of Bone Mineral Density, Body Composition and Dietary Habits of 20~30 Years Women: Jae Ok Koo, Hong Seok Ahn, Sook Young Yoo; Korean J Community Nutr 2008;13(4):489-498. Published online August 31, 2008

Abstract PDF: This study was carried out to identify bone mineral density (BMD), body composition, lifestyle and dietary habits of young women by physical measurement and questionnaires. The study subjects, 190 young women living in Seoul, were divided into three age groups: 20 ~ 24 years (93), 25 ~ 29 years (44) and 30 ~ 39 years (53). There was no significant difference in mean body muscle mass, protein, mineral, body fat and BMI among the three age groups. The rate of low weight (18%) in 20 years group was higher that of the 30 years (11.3%). The mean BMD and T-score were 0.44 g/cm2 and -0.66. BMD and T-score of the forearm bone were significantly higher in the 30 ~ 39 years group. But BMD and T-score of calcanues were not significantly different among the three age groups. The rate of normal, osteopenia and osteoporosis subjects by BMD were 60.5%, 38.4%, 1.1%, respectively. The rate of osteopenia in 20 ~ 24 years group was significantly higher than the other age groups. The rate of meal irregularity was significantly higher in 20 ~ 24 years group. The rate of women who walk and are exposed to sunlight more than 1hr per day were significantly higher in 20~24 years group than the others. However, the score of food behaviors is significantly higher (bad) in 20 ~ 24 years group than the others. The relationship between BMD and frequency of food intake showed significant differences in beans, broom, seaweed and rice wine. In conclusion, the risk rate of BMD was very high, 40% of the subjects, and the risk rate of BMD was higher in 20 years group than 30 years group, and the rate of low weight in 20 years group was higher than in 30 years group. The food habits and behaviors were not healthy enough. Therefore, nutrition education is needed for bone health.

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[English]
Dietary and Non-dietary Factors Related to Bone Mineral Density in Female College Students: Ji Hye Lim, Hyun Sook Bae, Seung Min Lee, Hong Seok Ahn; Korean J Community Nutr 2008;13(3):418-425. Published online June 30, 2008

Abstract PDF: The purpose of this study was to investigate correlations between bone mineral density (BMD) and dietary and nondietary factors in female college students. The BMD of the subjects (n = 38) was measured using DEXA (Dual Energy X-ray Absorptiometry) at lumbar spine and three femoral sites including femoral neck, ward's triangle, and femoral trochanter. Three-day 24-hour dietary recall data were collected from each subject to assess consumption levels of nutrients and food groups. The mean (+/- SD) values of age, age of menarche, height, weight, body mass index (BMI), waist-to-hip ratio (WHR), fat mass, and % body fat of the subjects were 21.34 (+/- 1.73) years, 13.1 (+/- 1.2) years, 161.3 (+/- 5.0) cm, 53.7 (+/- 7.2) kg, 20.6 (+/- 2.6) kg/m2, 0.80 (+/- 0.04), 15.4 (+/- 4.4) kg, and 28.2 (+/- 4.7), respectively. The BMD values of lumbar spine, femoral neck, ward's triangle, and femoral trochanter as T-value were 1.150 +/- 0.13 g/cm2, 0.932 +/- 0.11 g/cm2, 0.850 +/- 0.13 g/cm2, and 0.721 +/- 0.10 g/cm2, respectively. The daily mean energy intake of the subjects was 1660.6 kcal. The intake levels of carbohydrate, calcium, iron, vitamin C, and folic acid were lower than the KDRIs, while those of fat, phosphorus, sodium, vitamin A, and vitamin B6 were higher than the KDRIs. Significantly negative correlation were detected between consumption of fat and oils and the BMD of all sites measured (p < 0.05). Potato and starch intake was negatively correlated to the BMD of femoral neck and word's triangle (p < 0.05). The intake of cereals was found to be negatively correlated to the BMD of ward's triangle (p < 0.05). There was also negative correlation of intake of soybeans and products with the BMD of lumbar spine (p < 0.05). Weight and muscle mass were positively correlated to the BMD of both lumbar spine and femurs (p < 0.01). Significantly positive correlations between BMI, and fat mass and the BMD of lumbar spine were observed (p < 0.001). Additionally fat mass was positively correlated to the BMD of femoral neck. WHR and % body fat were positively correlated to the BMD of lumbar spine (p < 0.05). Negative correlation was found between a serum calcium level and the BMD of femoral neck (p < 0.05). In summary non-dietary factors generally showed significant correlations with the BMD of lumbar spine, while several dietary factors showed significant correlations with the BMD of femurs.

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[English]
Comparative Analysis of Food Habits and Bone Density Risk Factors between Normal and Risk Women Living in the Seoul Area: Myung Suk Kim, Jae Ok Koo; Korean J Community Nutr 2008;13(1):125-133. Published online February 29, 2008

Abstract PDF: This study was carried out to compare bone density risk factors affecting women's BMD, and to examine the relationship age, lifestyle and dietary habits for bone health by physical measurement and questionnaires. The subjects of this study were 194 women living in the Seoul area. When the subjects were divided into normal and risk groups, BMD, height, weight, BMI, total body water, soft lean mass, fat free mass, protein, mineral, body-fat of normal group were much higher than those of the risk group. The breakfast eating rate of the normal group was much higher than that of the risk group, walking time was significantly longer and exercise was more (p < 0.05). The normal group had more frequent intakes of tunas, squid, radishes, the green parts of radish, cucumbers, carrots and Iucchinis, tomatoes, and grapes than the risk group (p < 0.01 or p < 0.05). In conclusion, breakfast eating, exercise, intakes of some foods such as anchovies, radishes, carrots, zucchinis and tomatoes were significantly important factor to prevent bone density risk.

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[English]
Analysis of Factors Affecting Bone Mineral Density with Different Age among Adult Women in Seoul Area: Myung Suk Kim, Jae ok Koo; Korean J Community Nutr 2007;12(5):559-568. Published online October 31, 2007

Abstract PDF: Weight control diets induce reducing women' bone mineral density (BMD) that has a close relationship to risk in osteoporosis. This study was carried out to identify bone density risk factors affecting women's BMD, and to examine the relationship age, lifestyle and dietary habits for bone health by physical measurement and questionnaies. The subjects of this study were 194 women living on the Seoul area. When the subjects were divided into 4 age groups, BMI was the highest in the 50 years group (24.8) and the lowest in the 20 years group (21.63). Average T-score, which is BMD of forearm bone and calcaneus was the highest in the 40 years (.0.07) and the lowest in the 20 years (.0.59). The rate of eating breakfast was shown significantly higher in the 50 years group than that in the younger group. The frequencies of eating out, fried food intakes, and alcohol drinks were shown significantly different by age (p < 0.01). In conclusion, the risk rate of BMD was high in the 20syears and 50 years groups. It may due to the 20s' weight-control diet. Breakfast eating, exercise, intakes of anchovies, radishes, carrots, zucchinis and tomatoes were significantly important factors to prevent bone density risk.

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[English]
The Association of Dietary Patterns with Bone Mineral Density in Middle-aged Women: A Cohort of Korean Genome Epidemiology Study: Seon Joo Park, Younjhin Ahn, Hyo Mi Kim, Seong Eun Joo, Kyung Soo Oh, Chan Park; Korean J Community Nutr 2007;12(3):352-360. Published online June 30, 2007

Abstract PDF: Several nutrients are known to affect bone mineral density (BMD). However, these nutrients are combined with food intake and dietary patterns and little is known about the association of dietary patterns and BMD. The objective of this study was to investigate the association of dietary patterns with BMD in Korea Genome Epidemiology Study subjects. Among 2,884 women (40-69 yr) recruited at baseline study (2001), 861 subjects with BMD measurements at baseline and a 4-year follow up study (2005) completed the semi-quantitative food frequency questionnaire. BMD was measured by the Quantitative Ultrasound method. One hundred three food items were combined into 17 food groups and 4 dietary patterns were identified by factor analysis. Cluster analysis using factor score classified each subject into one of three dietary pattern groups named 'Rice and kimchi eating' (n = 617), 'Contented eating' (n = 124), and 'Healthy and light eating' (n = 120). The 'Healthy and light eating' group, characterized by higher intake of fruit, vegetables, fish, milk and dairy products, and younger age, more exercise, higher education, and higher income than other groups. The tibia BMD of the 'Healthy and light eating' group was higher than the other groups after adjusting for the age. After the adjustment for the age BMI and exercise, the 'Healthy and light eating' group showed significantly lower odds of tibia osteopenia/osteoporosis risk compared to the 'Rice and kimchi eating' group both at the baseline [OR(95% CI) : 0.50(0.30-0.84)] and follow-up [OR(95% CI) : 0.59(0.36-0.97)] examinations. The dietary pattern with low calorie and high intakes of fruit, vegetables, fish, milk and dairy products may have beneficial effects on BMD in middle-aged women.

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Randomized Controlled Trial

[English]
The Effect of 6 Month Alphacalcidol Treatment or Nutrition Education on the Nutrient Intakes, Bone Mineral Density and Bone Markers in Continuous Ambulatory Peritoneal Dialysis Patients: Sook Mee Son, Jin Kyung Park; Korean J Community Nutr 2006;11(6):793-807. Published online December 31, 2006

Abstract PDF: This study was performed to estimate the effect of alphacalcidol supplementation or nutrition education on the nutrient intakes, bone mineral density and bone markers in continuous ambulatory peritoneal dialysis (CAPD) patients. The 90 CAPD subjects were randomly assigned to 3 groups (alphacalcidol group: AG, nutrition education group: NG, and control group: CG). Alphacalcidol supplementation(0.5 microgram/day) was carried out for 8 months. Nutrition counseling was performed according to the patient's individual question for the first 6 months and scheduled nutrition education with individual counseling was carried out for the last 2 months. In baseline data, there were no significant differences in age, sex, family number, education years and monthly income except the NG showed significantly less duration of CAPD (p <0.05) compared to other two groups. After intervention all three groups showed tendency of lower intakes. NG revealed less decrease in protein, especially in animal protein, calcium from Ca-P binder, dietary calcium, dietary iron and niacin. NG showed significantly more increase in dry weight (p <0.05) and AG in waist circumference (p <0.001) after intervention. The groups did not show significant differences in the changes of biochemical indices related to bone metabolism. NG revealed more increase in trochanter BMD (p <0.05) compared to other two groups. It seems that nutrition education is more effective in preventing deterioration or improving the bone and general nutrition status.

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Original Articles

[English]
Association of Calcium Intake and Bone Mineral Density by Vitamin D Receptor Genotype among Elderly Women Living in Rural a Area: Ji Sun Kim, Hee Seon Kim; Korean J Community Nutr 2006;11(4):534-540. Published online August 31, 2006

Abstract PDF: Recent studies have shown that environmental, biochemical, nutritional or genetic factors affect bone mineral density (BMD). The purpose of the present study was to investigate the effect of vitamin D receptor (VDR) gentotype and nutritional status on BMD of elderly women living in a rural area. Three hundred thirty five elderly women over 65 years in Asan participated the study. Data for demographic and nutrient intakes were obtained by survey with a two day 24 hr recall method. BMD was measured by broadband ultrasound attenuation (BUA) using quantitative ultrasound (QUS). VDR genotypes of the subjects analyzed with Bsm I restriction enzyme were bb (92%), Bb (7%) and BB (1%). No differences were found between genotypes bb and Bb/BB in age, menopausal age, body mass index and body fat. BUA of bb genotype was higher (62.5 +/- 15.6 dB/MHz) than Bb/BB genotype (56.1 +/- 17.6 dB/MHz) by Student's t-tests. Correlation analyses showed strong negative correlation of BMD and age, but positive correlation with BMI, energy and calcium intake. When subgroup analyses were conducted after stratification by the median calcium intake level (412.9 mg/d), the above median calcium intake group showed significant difference in BUA by VDR genotype while the lower median calcium intake group did not show significant difference. The current study confirmed interaction of calcium intake and VDR genotype in association with BMD. Further nutritional intervention will be needed to improve calcium status of the elderly women living in rural areas.

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[English]
Relation among Dietary Habits, Nutrient Intakes and Bone Mineral Density in Korean Normal and Obese Elementary Students: Yun Jung Bae, Eun Yeong Kim, Hye Kyung Cho, Mi Hyun Kim, Mi Kyeong Choi, Mi Kyung Sung, Chung Ja Sung; Korean J Community Nutr 2006;11(1):14-24. Published online February 28, 2006

Abstract PDF: The purpose of this study was to investigate the relation between bone mineral density and nutrient intake among normal and obese elementary students. Each subject was assigned to one of such as normal (n = 69) and obese groups (n = 94) according to their obesity indices. And they were asked for general characteristics, dietary habits and nutrient intakes using questionnaires and 24-hr recall method. They measured the sound of speed (SOS) of calcaneus using quantitative ultrasound. The averages age of the subjects were 10.6 years in normal and 10.7 years in obese group. The averages weight (p < 0.001) and obesity index (p < 0.001) of the normal group were significantly lower than those of the obese group. In dietary habits, the obese group in boys was the higher skipped breakfast than normal group (p < 0.01). The plant calcium intake of obesity in girls was lower than those of normal group (p < 0.05). The SOS in the calcaneus was 1697.6 m/s in the obese group and 1763.7 m/s in the normal group (p < 0.01). The SOS in the calcaneus was negatively correlated to weight (p < 0.01), obesity index (p < 0.001) and percent of body fat (p < 0.01). Also the SOS in the calcaneus was positively correlated plant calcium intake (p < 0.05). In conclusion, the excessive increase of weight and percent of body fat in elementary students appeared to have negative impact to bone health. And based on these results, further studies on the effects on bone mineral density of obese and nutrient intakes in needed for proper bone health.

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[English]
The Study on Nutritional Status, Bone Mineral Density and Plasma Mineral Concentrations of Smoking Male Adults: Chung Ja Sung, Yun Jung Bae; Korean J Community Nutr 2005;10(1):91-100. Published online February 28, 2005

Abstract PDF: This study was conducted to investigate the effects of smoking on nutrition intake, bone mineral density and blood mineral status. The subjects were composed of two groups: 100 smokers and 100 non-smokers was used along with a questionnaire. Anthropometric measurements, dietary intakes using 24-hours recall method were compared. At twenty subjects from each group were selected, bone mineral density were measured by quantitative ultrasound and plasma mineral levels were analyzed by ICP spectrometer. The average ages of smokers and non-smokers were 23.9 and 22.8 years old, respectively. The height, weight and BMI of the smokers were no significant difference. The average numbers of smoked cigarettes were 11.8/d and the average packyear was 3.1 in the smokers. About 97% of the smokers drank alcoholic beverages, while 85% of the non-smokers did. The smokers tended to eat less meals and dinner meal, but drink coffee more often compared to the non-smokers. The mean daily energy intake and CPF energy intake ratio were 2184. 9 kcal and 57.2 : 13.7 : 26.4 in the smokers and 2262.6 kcal and 55.8 : 13.1 : 28.6 in the non-smokers. The smokers consumed significantly lower intake of beta-carotene. There were no significant differences in bone mineral density of BUA, SOS and QUI. There were no significant differences in plasma levels of Ca, Mg, Fe and Zn. However, plasma Cu level of the smokers was significantly higher than that of the non-smokers. In conclusion, the smokers of this study showed a more undesirable dietary intake in the light of their low beta-carotene and high alcoholic beverages, and coffee. The plasma Cu level of the smokers was higher than that of the non-smokers, showing that Cu is involved in smoking. Therefore, it could be suggested that more systematic research be conducted with respect to Cu and smoking and that increased nutrition education and guidelines for smokers are required.

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[English]
The Effect of Breast Feeding on Growth Development, Bone Mineral Density of Carpus, and Nutrient Intakes in Preschool Children: Mi Kyeong Choi, Seung Yeon Lee; Korean J Community Nutr 2005;10(1):3-11. Published online February 28, 2005

Abstract PDF: The purpose of this study was to examine the long term effects of breast feeding on growth, bone development and nutrient intakes in preschool children. Subjects were 62 preschool children. Anthropometric characteristics and bone mineral density of carpus were measured using DEXA. The questionnaire was composed of health status, life style, dietary behaviors, and dietary intakes and was completed by the children's mothers. The average age of the boys was 62.4 months and that of the girls was 62.1 months. Average birth height and weight of the subjects was 50.9 cm and 3.4 kg for boys and 50.3 cm and 3.3 kg for girls, respectively. The average height, weight, % body fat, and obesity index were 111.7 cm, 19.6 kg, 15.0%, -2.1% in boys and 109.4 cm, 18.7 kg, 17.5%, 0.2% in girls, respectively. Forty children were fed colostrum, 21 were fed breast milk, 29 were fed formula, and 12 were fed mixed milk. There was no significant difference in growth status between children who were fed colostrum and those who were not. Children who had mixed feedings were significantly taller than those who did not (p < 0.001), and children who had colostrum had significantly higher bone mineral density than those who did not (0.25 +/- 0.04 g/ cm2 vs. 0.23 +/-0.04 g/cm2, p < 0.05). However, the different feeding methods did not show any difference in bone mineral density. Except vitamin B6, folic acid and vitamin E, vitamin, mineral and calorie intakes did not meet the Korean RDAs. Calcium intake was especially lower than recommendations by as much as 62% and 70% in boys and girls, respectively. There was no significant difference in nutrient intakes between children who had colostrum and those who did not. However, children who were formula consumed significantly more animal fat than those who did not (p < 0.05). Neonatal feeding and breast or formula feeding seems to associate with height, bone mineral density and animal fat intakes in preschool children, based on the results of this study. A longitudinal study is needed to clarify this relationship.

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[English]
The Study of Pytoestrogen Intake and Bone Mineral Density of Vegetarian and Nonvegetarian Postmenopausal Women: Mi Hyun Kim, Mi Kyeong Choi, Chung Ja Sung; Korean J Community Nutr 2004;9(1):66-72. Published online February 29, 2004

Abstract PDF: There is some evidence that phytostrogen plays an important role in bone metabolism in postmenopausal women. In this study, we investigated the phytoestrogen intake levels and the relation between dietary phytoestrogens intake and bone mineral density of vegetarian (n = 77) and omnivore postmenopausal women (n = 122). Vegetarian women, all of them were seven day adventists, who had been on vegetarian diet (almost lacto-ovo vegetarians;a few vegans) over 20 yrs. The average age of vegetarians and omnivores were 62.3 yrs and 60.2 yrs, respectively and, there was no significant difference. However, body weight (p < 0.001), body mass index (p < 0.001) of vegetarians were significantly lower than those of omnivores. The mean daily energy intake of vegetarians and omnivores were 1386.1 kcal (76.3% of RDA) and 1424.5 kcal (76.9% of RDA), respectively. The mean calcium intake of vegetarians (456.7 mg, 66.3 % of RDA) was not significantly different from that of omnivores (453.5 mg, 65.2 % of RDA). The mean daily isoflavones (daidzein + genistein) intake of vegetarians and omnivore were 33.9 mg and 23.9 mg, respectively. The vegetarians consumed significantly greater quantities of isoflavones (p < 0.05) and lignans precursor (p < 0.05). In the vegetarians, intake of isoflavones was significantly positively correlated with BMD of femoral neck, after adjusted for age and BMI. Also lignan precursor intake of vegetarians was significantly positively correlated with BMD of spine, after adjusted for age and BMI. In conclusion, in omnivore post menopausal women, intake of phytoestrogen such as isoflavones and lignans was little low, and it is not clear that positive association with bone mineral density. But in vegetarian postmenopausal women, phytoestrogen intakes be important factors related to bone mineral density.

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[English]
Factors Affecting Bone Mineral Status of Premenopausal Women: Se In Oh, Hang Shin Lee, Mee Sook Lee, Cho Il Kim, In Soon Kwon, Sang Chul Park; Korean J Community Nutr 2003;8(6):927-937. Published online December 31, 2003

Abstract PDF: This study was conducted to investigate dietary and other factors affecting bone mineral density (BMD) in Korean premenopausal women. Seventy-eight premenopausal women who visited the Health Promotion Center for health examinations volunteered to participate in this study. They were divided into two groups according to their bone status as shown by their T-scores: a non-osteoporotic group and a osteoporotic group. The results are as follows: The mean BMDs of the lumbar spine and femoral neck were 1.21 +/- 0.02 g/cm2 and 0.97 +/- 0.04 g/cm2, respectively. The BMD levels of the osteoporotic group were significantly lower than those of the non-osteoporotic group (p < 0.001, respectively). The heights of the women in the osteoporotic group were significantly lower than those of the non-osteoporotic group (p < 0.01) however, their body weights did not show any significant differences although they tended to be lower. The mean daily intake of energy was 1720 +/- 52 kcal. When the nutrient intake was compared with the Korean recommended dietary allowances (RDA), calcium, Fe, vitamin A and riboflavin intakes were lower than the RDA. Their was no significant difference in the nutrient intake of the non-osteoporotic group and osteoporotic group except for the intakes of protein, fat and niacin. Their was no significant difference between the non-osteoporotic group and the osteoporotic group and all were within the normal range. However, the serum alkaline phosphatase level of the osteoporotic group was significantly higher than that of the non-osteoporotic group (p < 0.001). Height measurements showed positive correlations with lumbar spine bone mineral density (LBMD, r = 0.332, p < 0.01) however there was no correlation with femoral neck bone mineral density (NBMD). Age, age at menarche, body weight, body mass index (BMI) and obesity showed no correlation with BMD. The BMD of the lumbar spine was significantly and positively related to the intake of niacin and vitamin C (r = 0.236, p < 0.05; r = 0.274, p < 0.05). Serum levels of calcium and phosphorus showed negative correlations with LBMD (r = -0.698, p = 0.0001; r = -0.503, p = 0.0001, respectively). The results suggested that the BMD of the lumbar spine was positively related to the intake of niacin and vitamin C in premenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss would be have a higher intake of niacin and vitamin C rich foods and engaging habitually in physical activity may have a beneficial effect on BMD in the premenopausal period.

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[English]
A Study of Nutrient Intake and Serum Levels of Osteocalcin, Ca, P, and Mg and Their Correlation to Bone Mineral Density in Korean Postmenopausal Women Residing in Rural Areas: Chung Ja Sung, Yun Hee Choi, Mi Hyun Kim, Sun Hae Choi, Kyung Ok Cho; Korean J Community Nutr 2002;7(1):111-120. Published online February 28, 2002

Abstract PDF: Postmenopausal women lose more bone mass than men as a result of estrogen deprivation. The resultant low bone mineral density (BMD) is a major risk factor in the development of osteoporosis. Calcium, phosphorus and magnesium are main components of bone. The purpose of this study is to investigate nutrient intake and serum osteocalcin, Ca, P and Mg and their correlation to bone mineral density in Korean postmenopausal women residing in rural areas. We conducted 24 hour dietary recalls, anthropometric measurements and blood analysis on 60 postmenopausal women. The BMD of the lumbar spine (L2-->L4) and the femoral neck were measured by dual energy X-ray absorptiometry (DEXA). Subjects were assigned to one of three groups:normal (T-score> -1, n=20), osteopenia (-2.5> T-score< or = -1, n=23), and osteoporosis ( T-score< or = -2.5, n=17). The mean age, height, weight and BMI were 62.37 yr, 154.36 cm, 55.28 kg and 23.18 kg/m2 respectively. The mean daily energy and protein intakes were 76.35% and 87.41% of RDA for Koreans. The mean intakes of calcium, phosphorus, and magnesium were 463.62 mg (66.23% of RDA), 955.32 mg (136.47% of RDA), 345.87 mg respectively. The mean serum levels of calcium, phosphorus and magnesium were 8.76 mg/dl, 3.80 mg/dl, and 2.10 mg/dl, respectively, and there were no significant differences among the three groups. However, the BMD of the femoral neck showed a significantly negative correlation with serum magnesium (p<0.05). To summarize the results, most nutrient intakes (especially calcium) in postmenopausal women did not reach the RDA values for Koreans. Also, increase of serum magnesium levels may be related to bone loss.

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[English]
A Study on Nutritional Status, Maternal Factors, and Lifestyles according to BMD in Rural Postmenopausal Women: Chung Ja Sung, Sun Hae Choi, Mi Hyun Kim, Yun Hee Choi, Da Hong Lee, Soo Kyung Baek, Hye Kyung Kim, Mi Kyeong Choi; Korean J Community Nutr 2001;6(2):192-204. Published online May 31, 2001

Abstract PDF: Osteoporosis and other related conditions pose a growing public health problem, especially in postmenopausal women. The main purpose of the study was to investigate the correlations among BMD, maternal factors, and life styles, and intake of nutrients in postmenopausal women. One hundred participants in Kyungge-do were divided into three groups according to their BMD measurements measured by DXA. Dietary analysis, anthropometric measurements, and questionares were administered to these women. The percentage of the osteoporosis, osteopenia(Osteopinia), and normal groups were 32%, 48%, and 20% respectively. The average age was significantly the highest in the osteoporosis group. The average age at menopause was 47.2. Osteoporosis group's age at menopause was significantly the lowest. The sleeping hours of the osteoporosis and osteopenia group were significantly longer than the normal group. The intake of vitamin B2 was positively correlated with the BMD of femoral neck. The BMD of these two sites was positively correlated with weight, BMI, waist, and hip size and negatively correlated with the length of the menstrual cycle, duration after menopause, the age at the last delivery, and sleeping hours. Spinal BMD positively correlated with hours of outdoor activity. Therefore, maternal factors, lifestyles, and intake of nutrients contribute to BMD.

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