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.
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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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.
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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 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 Journal of Community Nutrition.2011; 16(5): 580. CrossRef
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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%.
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.