Korean Journal of Community Nutrition

Original Articles

[English]
Food and Nutrient Intake Level by the Risk of Osteoporosis and Cardiovascular Disease in Postmenopausal Women: The use of the 5th Korean National Health and Nutrition Examination Surveys (2010–2011): Hyobin Kim, Heysook Kim, Oran Kwon, Heejung Park; Korean J Community Nutr 2019;24(2):152-162. Published online April 30, 2019; DOI: https://doi.org/10.5720/kjcn.2019.24.2.152

OBJECTIVES
The purpose of this study was to investigate the food, nutrient intake, and diet quality of postmenopausal women at high risk of osteoporosis (OP) and cardiovascular disease (CVD) compared with those of control subjects.
METHODS
A total of 1,131 post-menopausal women aged over 45 years, who took the 2010â€“2011 Korean National Health and Nutrition Examination Survey (KNHANES), were included for analysis. These participants were classified into the following groups: the OP group, with a risk of OP (n=135); the CVD group, with a risk of CVD (n=373); the OP+CVD group, with a risk of OP and CVD concurrently (n=218); and the control group (n=405) according to bone mineral density (BMD) and CVD risk. Anthropometric measurements, blood profiles, dietary intake, and dietary quality indices were measured and compared among the four groups.
RESULTS
Waist circumference, total body fat percentage, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and LDL-cholesterol were higher, and HDL-cholesterol and BMD were lower in the OP+CVD group than in the control group. In the food frequency questionnaire, the OP+CVD group had significantly higher frequencies of grain (except for multi-grain) and lower frequencies of fruit and dairy product. The frequency of consumption of red meat, processed meat, and carbonated beverages was higher in OP+CVD group. In nutrient density analysis, proteins and vitamin B2 levels were significantly lower in the OP+CVD group than in the control group. The nutritional quality index (INQ) values of calcium were in the order of 0.63, 0.58, 0.56, and 0.55 in each group, and it was urgent to improve the dietary intake for calcium in postmenopausal women. In addition, vitamin B2 was inadequately consumed by all groups.
CONCLUSIONS
These results suggest that it is necessary to increase the intake of vitamin B2 and calcium and decrease the frequency of intake of red meat, processed meat, and carbonated beverages in postmenopausal women with the risk of OP and CVD.

Citations

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Arterial stiffness index, physical activity and food and nutrient intake: cross-sectional study in adults aged 40 years and older
Eun-A Kim, Yun-Mi Kim, Eun-Kyung Kim
Korean Journal of Community Nutrition.2024; 29(2): 81. CrossRef
Comparison of the Nutrient Intake and Health Status of Elderly Koreans According to their BMI Status: Focus on the Underweight Elderly Population
You-Sin Lee, Yoonna Lee
Korean Journal of Community Nutrition.2022; 27(5): 422. CrossRef
Association between frailty and dietary intake amongst the Korean elderly: based on the 2018 Korean National Health and Nutrition Examination Survey
Suhyeon Yang, Won Jang, Yangha Kim
Journal of Nutrition and Health.2021; 54(6): 631. CrossRef
Cardiorespiratory Fitness is Inversely Associated with Risk of Low Bone Mineral Density in Older Korean Men
Inhwan Lee, Jeonghyeon Kim, Hyunsik Kang
International Journal of Environmental Research and Public Health.2020; 17(21): 7907. CrossRef
Research Trend of Nutrition through Analysis of Articles Published in 'Korean Journal of Community Nutrition'
Jin Suk Jo, Kyoung Sin Lee, Ki Nam Kim
Korean Journal of Community Nutrition.2011; 16(2): 278. CrossRef

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[English]
Sarcopenia and Sarcopenic Obesity and Their Association with Cardiovascular Disease Risk in Postmenopausal Women: Results for the 2008-2011 Korea National Health and Nutrition Examination Survey: Misung Kim, Cheongmin Sohn; Korean J Community Nutr 2016;21(4):378-385. Published online August 31, 2016; DOI: https://doi.org/10.5720/kjcn.2016.21.4.378

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OBJECTIVES
This study was conducted to investigate the association between sarcopenia and sarcopenic obesity and cardiovascular disease risk in Korean postmenopausal women.
METHODS
We analyzed data of 2,019 postmenopausal women aged 50-64 years who participated in the Korea National Health and Nutrition Examination Survey in 2008-2011 and were free of cardiovascular disease history. Blood pressure, height, and weight were measured. We analyzed the serum concentrations of glucose, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglyceride levels. Waist circumference was used to measure obesity. Appendicular skeletal muscle mass was measured by dual-energy X-ray absorptiometry. Sarcopenia was defined as the appendicular skeletal muscle mass/body weight<1 standard deviation below the gender-specific means for healthy young adults. The estimated 10-year risk of cardiovascular disease risk was calculated by Pooled Cohort Equation. Subjects were classified as non-sarcopenia, sarcopenia, or sarcopenic obesity based on status of waist circumference and appendicular skeletal muscle mass.
RESULTS
The prevalence of sarcopenia and sarcopenic obesity was 16.3% (n=317) and 18.3% (n=369), respectively. The 10-year risk of cardiovascular disease risk in the sarcopenic obesity group was higher (3.82 Â± 0.22%) than the normal group (2.73 Â± 0.09%) and sarcopenia group (3.17 Â± 0.22%) (p < 0.000). The odd ratios (ORs) for the â‰¥7.5% 10-year risk of cardiovascular disease risk were significantly higher in the sarcopenic obesity group (OR 3.609, 95% CI: 2.030-6.417) compared to the sarcopenia group (OR 2.799, 95% CI: 1.463-5.352) (p for trend < 0.000) after adjusting for independent variables (i.e., exercise, period of menopausal, alcohol use disorders identification test (AUDIT) score, income, education level, calorie intake, %fat intake and hormonal replacement therapy).
CONCLUSIONS
Sarcopenia and sarcopenic obesity appear to be associated with higher risk factors predicting the 10-year risks of cardiovascular disease risk in postmenopausal women. These findings imply that maintaining normal weight and muscle mass may be important for cardiovascular disease risk prevention in postmenopausal women.

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Kahyun Kim, Dukyoo Jung
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 18. CrossRef
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Jeong-Min Ji, Hyun-Min Koh, Ji-Yong Jang, Jin-Sook Moon, Hye-Rang Bak, Hye-Jin Jang, An-Na Lee, Nak-Gyeong Ko
Korean Journal of Family Practice.2022; 12(5): 311. CrossRef
Risk Factors for Sarcopenia, Sarcopenic Obesity, and Sarcopenia Without Obesity in Older Adults
Seo-hyun Kim, Chung-hwi Yi, Jin-seok Lim
Physical Therapy Korea.2021; 28(3): 177. CrossRef
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Yoon J Park, Young M Lee
Asia-Pacific Journal of Oncology Nursing.2021; 8(6): 679. CrossRef

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[English]
Vitamin D intake, Outdoor Activity Time and Serum 25-OH Vitamin D Concentrations of Korean Postmenopausal Women by Season and by Age: Jin Sook Yoon, Min Kyoung Song; Korean J Community Nutr 2015;20(2):120-128. Published online April 30, 2015; DOI: https://doi.org/10.5720/kjcn.2015.20.2.120

Abstract PDF PubReader

OBJECTIVES
The purpose of this study was to examine the relative impact of seasonal differences and age on dietary vitamin D intakes, outdoor activity time and serum vitamin D status among Korean postmenopausal women.
METHODS
A cross-sectional study was conducted with 164 free-living postmenopausal women (mean age=55.4 years) in Daegu, Korea. Dietary intake, daily physical activity patterns and fasting blood samples were collected during summer and winter. We compared the results from 75 women during summer and 89 women during winter. Dietary intake of vitamin D was assessed by 24-hour recall method. Daily outdoor activity time was derived from physical activity diary.
RESULTS
The average dietary intake of vitamin D of the participants was 3.7 microg during summer, 3.3 microg during winter, showing no significant difference between the two seasons. The average time spent on outdoor activities was not significantly different between summer (=35.1 +/- 75.0 min/d) and winter (=48.5 +/- 76.8 min/d). The average serum 25-(OH) vitamin D concentrations of participants was 17.5 +/- 7.5 ng/mL in the summer and 13.4 +/- 4.3 ng/mL in the winter, showing no significant differences by season. Dietary intake of vitamin D was not related to age. When total subjects were divided into two groups by age, the average serum 25-(OH) vitamin D concentration was significantly higher in older group (p=0.047) and time spent on outdoor activities was also (p=0.018) significantly higher in the older group.
CONCLUSIONS
In order to improve the current vitamin D status of Korean postmenopausal women, nutrition education programs should focus more on adequate intake of vitamin D, while maintaining enough outdoor activities over the season.

Citations

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Vitamin D intake and bone mineral density in Korean adults: analysis of the 2009–2011 Korea National Health and Nutrition Examination Survey
Hyejin You, Hye Ran Shin, SuJin Song, Sun Yung Ly
Nutrition Research and Practice.2022; 16(6): 775. CrossRef
Differences in serum ferritin and vitamin D levels of Korean women with obesity and severe obesity
Nan Hui Kang, Ji Sook Park, Hongchan Lee, Jung-Eun Yim
Journal of Nutrition and Health.2020; 53(4): 381. CrossRef
Cardiorespiratory Fitness is Inversely Associated with Risk of Low Bone Mineral Density in Older Korean Men
Inhwan Lee, Jeonghyeon Kim, Hyunsik Kang
International Journal of Environmental Research and Public Health.2020; 17(21): 7907. CrossRef
Association between vitamin D deficiency and anemia among Korean adolescent girls and young women
Haeun Jang, Seonghee Park, Kyong Park
Journal of Nutrition and Health.2019; 52(6): 552. 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

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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

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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.

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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
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The Factors Influencing the Bone Mineral Density in Korean Adult Men : Based on Korea National Health and Nutrition Examination Survey 2010~2011 Data
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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
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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
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Problems with Bone Health and the Influencing Factors of Bone Mineral Density in Women across the Life Cycle
Nami Chun, Hyunju Chae
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A Study on the Correlation between Menopausal Rating Scale and Bone Mineral Density for Menopausal Osteoporosis Patients※
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Kwang-Hyun Jho, Soon-Nam Choi, Nam-Yong Chung
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[English]
Nutritional Status, Quality of Diet and Quality of Life in Postmenopausal Women with Mild Climacteric Symptoms Based on Food Group Intake Patterns: Okhwa Lee, Jinkyung Kim, Hansongyi Lee, Ryowon Choue; Korean J Community Nutr 2012;17(1):69-80. Published online February 29, 2012; DOI: https://doi.org/10.5720/kjcn.2012.17.1.69

Abstract PDF PubReader

This study was conducted to examine the nutritional status, quality of diet and quality of life in postmenopausal women with mild climacteric symptoms based on their food group intake patterns. The data for nutritional status were obtained using 3-day records. Quality of diet was assessed by INQ, NAR, MAR, DDS, DVS, DQI-I. Climacteric symptoms were analyzed by the questionnaire of Kupperman's index and MENoL. The subjects were classified into the five groups, GMVDF, GMVdF, GMVDf, GMVdf, GmVDF according to their food group intake patterns. Analysis of nutrient intakes showed that the GMVDF group took significantly higher levels of kcal, carbohydrate, protein, fat, vitamin A, thiamin, riboflavin, folate, vitamin C, vitamin E, calcium, phosphorous, sodium, iron, zinc and fiber than GMVdf group did (p < 0.05). INQ of Ca and Fe appeared to be higher in GMVDF than in GMVdf groups (p < 0.05). Analysis of NARs showed that missing milk groups took lower riboflavin, Ca and P than other groups did as the same result with MAR (p < 0.05). Analysis of DDS and DQI showed that GMVdf group had the lowest quality of diet (p < 0.05); however, no difference was found on DVS. The GMVdf group showed the worst climacteric symptoms compared with those of the other groups (p < 0.05). However, we couldn't observe any differences in menopause-specific quality of life among the groups. In conclusion, it would be beneficial to meet all five food groups to increase the quality of diet and to reduce the climacteric symptoms in postmenopausal women.

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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
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Korean Journal of Community Nutrition.2017; 22(4): 307. CrossRef
Evaluation of Anthropometric Characteristics, Bone Density, Food Intake Frequency, Nutrient Intakes, and Diet Quality of Preand Postmenopausal Women : Based on 2008∼2011 Korean National Health and Nutrition Examination Survey
Soon Nam Choi, Kwang Hyun Jho, Nam Yong Chung
Journal of the East Asian Society of Dietary Life.2017; 27(5): 500. CrossRef
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Evidence-Based Complementary and Alternative Medicine.2014;[Epub] CrossRef
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[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]
Factors Affecting Bone Mineral Density in Korean Women by Menopause: Hye Bok Na; Korean J Community Nutr 2004;9(1):73-80. Published online February 29, 2004

Abstract PDF: Bone mineral density (BMD) focus one's attention on prevention effects of osteoporosis. This study was conducted to investigate BMD (lumbar spin:L2 - L4, femur neck:FN, femur trochanter:TR, femur ward's triangle:WT, wrist) and look into the factors that affect BMD by menopause in 89 nonsmoking healthy Korean women (40 - 60 yr). Anthropometric index and body composition, nutrient intakes, osteocalcin and total protein, albumin, total cholesterol, triacylglycerol and calcium in serum were determined. Body fat mass, diastolic blood pressure and serum cholesterol concentration of postmenopausal women were significantly higher than those of premenopausal women. FN, TR, WT, wrist BMD of postmenopausal women were not different from those of premenopausal women. However L2 - L4 BMD of postmenopausal women was lower than that of premenopausal women. Significant positive correlations were found between L2 - L4, FN, TR, WT and weight (r = 0.44, r = 0.64, r = 0.58, r = 0.57) and significant positive correlations were found between FN, TR, WT and BMI (r = 0.54, r = 0.45, r = 0.54) of premenopausal women. Whereas significant positive correlation was only found between TR BMD and weight, BMI (r = 0.38, r = 0.29) of postmenopausal women. FN BMD and WC (waist circumstance) of premenopausal women were found significant positive correlation (r = 0.35) whereas L2 - L4 BMD and WC of postmenopausal women was found significant negative correlation (r = -0.31). In premenopausal women, differences of bone BMD were not shown by exercise and alcohol drinking, but in postmenopausal women, significant difference of FN BMD was shown by exercise and alcohol drinking. These results suggested that by menopause, effects of weight, BMI, WC, exercise and alcohol drinking on bone BMD were different. Therefore, by menopause, we should consider the different ways to increase the bone BMD according to different factors.

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[English]
Some Factors Affecting Bone Mineral Status of Postmenopausal Women: Se In Oh, Hang Shin Lee, Mee Sook Lee, Cho Il Kim, In Soon Kwon, Sang Chul Park; Korean J Community Nutr 2002;7(1):121-129. Published online February 28, 2002

Abstract PDF: Osteoporosis, the typical metabolic bone disease of the elderly, is characterized by a reduction in bone mineral density (BMD) and increased fracture risk. Genetic and environmental factors are known to play a key role in bone metabolism, and diet is also considered to be one of the important factors. The purpose of the present study was to investigate the relationship among the factors affecting BMD, including stature, body weight, age, time period since onset of menopause, and biochemical markers of bone turnover in postmenopausal women. Seventy-eight postmenopausal women who visited health promotion center for health examinations volunteered to participate in this study and they were divided into two groups according to the time period since onset of menopause : women with a time period since onset of menopause of less than 5 years (Group 1) and women with a time period since onset of menopause of 5 years or more (Group 2). The demographic characteristics and dietary intake were surveyed using a questionnaire. BMDs of the lumbar spine and femoral neck of subjects were measured by dual energy X-ray absorptiometry. Serum levels of 25-hydroxy-vitamin D and parathyroid hormone (PTH), known to be indicators of bone related hormone status, were anlyzed. Serum samples were measured for calcium, phosphorus, alkaline phosphatase, and osteocalcin as bone formation indicators, and urine was analysed for deoxypyridinoline, creatinine, calcium, and sodium as bone resorption indicators. The results are as follow : The mean BMDs of the lumbar spin and femoral neck were 1.02+/-0.02 g/cm2 and 0.81 +/-0.02 g/cm2, respectively, and the BMD level of Group 2 was significantly lower than tat of Group 1 (p<0.01, p<0.05, respectively). The mean daily intake of energy was 1838 +/- 55 kcal. When nutrient intake was compared with the recommended dietary allowances (RDA) of the subjects, only calcium, vitamin A and riboflavin intake showed means lower than the RDA. The nutrient intake did not show any significant differences between Group 1 and 2 Serum and urine levels of biochemical markers of bone turnover did not show any significant differences between Group 1 and 2, and all were within the normal range. However, the PTH and deoxypyridinoline levels showed a tendency to be higher, and the osteocalcin level to be lower in Group 2 than in Group 1. Although age and years after menopause (YAM) showed negative correlations with lumbar spine bone mineral density (LBMD) (r= -0.38, p<0.001, and r= -0.26, p<0.05, respectively), no correlation was found with femoral neck bone mineral density (NBMD). While height, body weight and body mass index (BMI) showed a positive correlation with LBMD (r= 0.32, p<0.001, r= 0.38, p<0.001, r= 0.22, p= 0.05, respectively), only body weight and BMI showed a positive correlation with NBMD (r= 0.30, p<0.01, and r= 0.27, p<0.05, respectivley). There was no significant corealtion between BMDs and the nutrient intake of subjects, except in the case of carbohydrates (r= 0.22, p<0.05). Also, serum and urine levels of bone turnover markers showed no significant correlation with nutrient intake. On the other hand, serum osteocalcin had a positive correlation with vitamin C intake (r= 0.22, p= 0.05), and urine deoxypyridinolin showed a negative correlation with niacin intake (r= -0.22, p= 0.05). Urinary na was negatively correlated with protein intake(r= -0.23, p= 0.05). The results suggested that it is difficult to prevent the decrease in bone mass among postmenopausal women eating the usual Korean diet. However, the BMDs of the lumbar spine and femoral neck were positively related to body weight ad BMI in postmenopausal women. Therefore, this study confirmed that one of the most effective ways to minimize bone loss in postmenopausal women would be to maintain an adequate body weight with balanced nutrient intake and activity in the pre-and postmenopausal periods.

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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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