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Review Article

Exercise, environmental conditions, and diet are integral to athletes’ health and performance. Understanding how these factors interact to influence appetite-regulating hormones is a growing area of interest in sports science. This knowledge facilitates the development of personalized strategies for precisely monitoring and improving dietary intake, enhancing well-being, and improving athletic performance. For this narrative review, databases like “PubMed,” “SportDiscus,” “Scopus,” “ProQuest,” and “Google Scholar” were referred to using Boolean operators (AND, OR) to combine keywords related to exercise, environmental conditions, diet, and appetite-regulating hormones. High-intensity interval training, sprint interval training, resistance exercises, and high-intensity aerobic exercises were found to enhance satiety and suppress appetite by increasing appetite-suppressing hormones while reducing ghrelin levels. Greater exercise intensity prolonged appetite suppression by sustaining elevated levels of satiety hormones. Environmental factors such as high altitude, hypoxia, and extreme heat were associated with increased satiety, reduced appetite, and lower energy intake. Conversely, exposure to cold temperatures and participation in cold water exercises stimulated appetite. Dietary interventions, particularly ketogenic and high-protein diets, promoted satiety by increasing glucagon-like peptide-1 levels and decreasing ghrelin levels. Calorie restriction, especially when meals were infrequent but included breakfast, helped maintain satiety for extended periods by elevating satiety hormones. Integrating personalized exercise routines with dietary strategies while considering environmental adaptations is essential for optimizing appetite regulation, athletic performance, and overall health.
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Original Articles

Background
Interest in healthy aging has grown with the increase in the older population. Nutritional intake is crucial in frailty. Therefore, we aimed to investigate the relationship between frailty and multivitamin and mineral supplements (MVMS), which can easily provide micronutrients.
Methods
The Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2018 to 2019 included 3,395 adults aged ≥65 years. Of these, 1,511 who did not consume dietary supplements (DS, non-DS group) and 415 who took MVMS (MVMS group) were included in the study. We modified Fried’s definition of frailty to fit the KNHANES data. Using multivariate logistic regression, we examined the association between MVMS use and frailty, which varied with satisfaction with total energy intake. Additional subgroup analyses were performed based on age, sex, and income.
Results
MVMS reduced most micronutrient deficiencies compared to obtaining nutrients solely through food. The overall analysis revealed no association between MVMS use and frailty (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.52–1.09). However, a subanalysis revealed that participants with a low income (≤25%) who took MVMS had decreased odds for frailty (OR, 0.55; 95% CI, 0.35–0.88) compared with the non-DS group. Furthermore, a significant association between using MVMS and frailty was confirmed in the group with low income and energy intake below the recommended daily allowance, with a low OR of 0.52 (95% CI, 0.30–0.90).
Conclusion
MVMS use was significantly associated with frailty among the low-income and low-daily energy intake groups.

Citations

Citations to this article as recorded by  
  • Frailty and nutritional inadequacy in older Korean adults: A gender-stratified analysis using National Survey Data
    Subeen Kim, Haerang Lee, Minji Kang, Barry Kweh
    PLOS One.2025; 20(10): e0333620.     CrossRef
  • 6,667 View
  • 82 Download
  • 1 Web of Science
  • 1 Crossref
The Relationship between Diet Quality, Measured by the Recommended Food Score, and Depression, Assessed Using the Patient Health Questionnaire-9: An Observational Study in Korea
Sharon Choi, Jung-Sun Lim, Sujeong Han, Jong Seung Kim, Bumjo Oh
Received August 27, 2024  Accepted October 28, 2024  Published online January 8, 2025  
DOI: https://doi.org/10.4082/kjfm.24.0204    [Epub ahead of print]
Background
Depression is a prevalent mental health disorder that presents substantial public health challenges. Emerging evidence underscores the role of dietary patterns in mitigating depressive symptoms. This study investigated the association between diet quality, assessed using the Recommended Food Score (RFS), and depressive symptoms, evaluated with the Patient Health Questionnaire-9 (PHQ-9), in a sample of Korean adults.
Methods
This cross-sectional study analyzed data from 19,786 participants recruited from a general hospital in Korea, all of whom completed the RFS and PHQ-9 assessments. General characteristics and anthropometric indices were recorded. Statistical analyses included chi-square tests and binary logistic regression to calculate odds ratios (ORs) and 95% confidence intervals for depressive symptoms according to RFS scores, adjusting for potential confounders.
Results
Higher RFS scores were associated with reduced odds of depression in univariate (OR, 0.59; P<0.001) and multivariate (OR, 0.72; P<0.001) analyses. Sociodemographic factors, including older age, higher education, marital status, higher income, professional occupation, and regular exercise, were linked to decreased odds of depression. Conversely, female sex, current smoking, and alcohol consumption were associated with increased odds.
Conclusion
The findings reveal an inverse relationship between diet quality and depressive symptoms among Korean adults, emphasizing the potential of dietary improvements in mental health promotion. Sociodemographic factors significantly influence depression risk. Future studies should adopt longitudinal designs incorporating a wider range of variables to elucidate these complex interactions.
  • 2,283 View
  • 47 Download
Factors for minimum acceptable diet practice among 6–23-month-old children in rural and urban areas of Indonesia
Rika Rachmawati, Rika Rachmalina, Yunita Diana Sari, Tri Wurisastuti, Kencana Sari, Ayunina Rizky Ferdina, Noviati Fuada, Tin Afifah
Korean J Fam Med 2025;46(4):253-261.   Published online June 7, 2024
DOI: https://doi.org/10.4082/kjfm.23.0284
Background
Malnutrition is common among children under 5 years of age in Indonesia, with the rates varying between urban and rural areas. The minimum acceptable diet (MAD) assesses nutrient quality and quantity. This study aimed to identify the potential variables for MAD in 6–23-month-old children in both urban and rural Indonesia.
Methods
We used the data from the 2017 Indonesia Demographic and Health Survey to conduct this nationally representative study. A total of 4,688 children aged 6–23 months were included in the study. MAD was classified using the 2017 World Health Organization global nutrition monitoring framework. The determinants of MAD were analyzed using multiple logistic regression.
Results
Overall, 45% of children aged 6–23 months received the required MAD, with 47.4% receiving the MAD in urban areas and 35.7% in rural areas. Children’s age, fathers’ age, parents’ education level, mothers’ employment, and wealth index were strongly linked to MAD in both rural and urban homes. The factor specifically related to MAD in urban areas was mother living with her husband. For rural households, mothers’ involvement in decisionmaking and a minimum of four antenatal care (ANC) visits significantly increased the likelihood of their children’s MAD status.
Conclusion
MAD status was determined by increased child age, higher parent education, younger father, working mother, and higher wealth index in children aged 6–23 months in both urban and rural settings. Mothers living with a spouse determined the MAD status only in urban areas. More frequent ANC visits and mother participation in household decisions were other factors related to MAD status in rural areas.

Citations

Citations to this article as recorded by  
  • Health behaviors, lifestyle factors, and healthcare challenges in family medicine: a comprehensive review of recent evidence from Asian populations
    Joung Sik Son
    Korean Journal of Family Medicine.2025; 46(4): 215.     CrossRef
  • 3,321 View
  • 93 Download
  • 1 Web of Science
  • 1 Crossref
Barriers, Facilitators of Iron and Folic Acid Supplementation, and Deworming Program among School-Going Adolescents of Deoghar, Jharkhand, India: A Mixed-Methods Study
Bijit Biswas, Anuradha Gautam, G. Jahnavi, Richa, Pratima Gupta, Saurabh Varshney
Korean J Fam Med 2024;45(5):274-282.   Published online February 28, 2024
DOI: https://doi.org/10.4082/kjfm.23.0100
Background
This study aimed to identify barriers and facilitators of iron and folic acid supplementation and deworming programs among school-going adolescents.
Methods
A mixed-method observational study was conducted among adolescents in the 8th to 10th standards and their teachers across four schools in Deoghar, Jharkhand, India, using simple random sampling. The study included a questionnaire on socio-demographics, knowledge (34 items) (α=0.894), attitudes (2 items) (α=0.711) toward iron deficiency anemia, awareness of the Weekly Iron and Folic Acid Supplementation (WIFS) program and deworming (20 items) (α=0.783), and practices related to iron folic acid supplementation (IFS) and deworming, along with qualitative components. Data were analyzed using jamovi.
Results
Compliance rates for IFS and deworming were 27.5% and 67.9%, respectively. The multivariable logistic regression analysis showed that sex, religion, caste, father’s educational status, per capita monthly family income (PCMI), diet type, adequate knowledge, and positive attitude toward anemia influenced IFS compliance. Religion, PCMI, and prior information on the importance of deworming facilitate compliance. Implementation barriers included irregular medication supply and a lack of student awareness.
Conclusion
Periodic evaluation, regular sensitization, and a consistent drug supply are necessary to effectively implement WIFS and deworming programs in the study area.

Citations

Citations to this article as recorded by  
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Health Education and Promotion Interventions to Mitigate Geophagic Practise: A Scoping Review
    Mohora Feida Malebatja, Moreoagae Bertha Randa, Mathildah Mpata Mokgatle, Oluwafemi Omoniyi Oguntibeju
    Public Health Reviews.2025;[Epub]     CrossRef
  • Knowledge of Iron Deficiency Anaemia and Associated Attributes Among School Adolescents in Eastern India: A Cross-Sectional Evaluation
    Bijit Biswas, Anuradha Gautam, G. Jahnavi, Richa Richa, Pratima Gupta, Saurabh Varshney
    Cureus.2025;[Epub]     CrossRef
  • From counsel to consumption: examining sociocultural influences on perinatal nutrition in rural India
    Faiz A. Hashmi, Cristine H. Legare
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Barriers to uptake of treatment for geophagic women of reproductive age in Tshwane district, Gauteng province: A qualitative study using the health belief model
    Mohora Feida Malebatja, Mathildah Mpata Mokgatle, Oluwafemi Omoniyi Oguntibeju
    International Journal of Research in Business and Social Science (2147- 4478).2025; 14(8): 333.     CrossRef
  • 5,465 View
  • 129 Download
  • 4 Web of Science
  • 5 Crossref
Dietary Habits of Newly Diagnosed Patients with Breast Cancer in Korea
Jaehoon Shin, Jiyeon Lee, Yooeun Yoon, Hye Sun Lee, Hyungmi Kim, Yu-Jin Kwon, Ji-Won Lee
Korean J Fam Med 2024;45(3):149-156.   Published online January 23, 2024
DOI: https://doi.org/10.4082/kjfm.23.0117
Background
In patients with breast cancer, a healthy diet can help reduce breast cancer-specific recurrence, mortality, and comorbid chronic disease rates. There have been few studies on dietary habits immediately after breast cancer diagnosis, especially those involving the Asian population. Therefore, this study aimed to compare the nutritional habits of newly diagnosed patients with breast cancer and the general population without cancer in Korea using propensity score (PS) matching.
Methods
We conducted a case-controlled study of 157 patients with breast cancer and 2,363 cancer-free control participants from the Korea National Health and Nutrition Examination Survey. The PS values for the predicted probability of patients with breast cancer and the general population were estimated using logistic regression analysis, including age and body mass index. The dietary patterns were assessed using a 24-hour recall of 1 day and the Food Frequency Questionnaire.
Results
PS matching showed that patients with breast cancer consumed fewer calories and carbohydrates; however, they consumed more protein and fat compared to the general population. Compared to the general population, patients with breast cancer consumed more healthy foods such as fish, seaweed, vegetables, fruit, mixed-grain rice, and nuts; however, they also consumed more soup, stew, and red meat.
Conclusion
Newly diagnosed patients with breast cancer have some healthy dietary habits compared to the general population. However, there is considerable room for improvement in their diet quality. Our results support the need to develop tailored dietary recommendations for patients with breast cancer during the diagnostic and posttreatment periods to improve their diet quality.

Citations

Citations to this article as recorded by  
  • Factors Influencing the Relationship Between Sugar Consumption and Depression Among Women Under Breast Cancer Treatment
    Yu-Chen Liu, Wen-Hung Kuo, Chiao Lo, Chiun-Sheng Huang, Meei-Shyuan Lee, Jen-Ho Chang, Chia-Chen Hsieh, Fei-Hsiu Hsiao
    Behavioral Sciences.2025; 15(7): 940.     CrossRef
  • 5,171 View
  • 79 Download
  • 1 Web of Science
  • 1 Crossref
The Relationship between Dietary Na/K Ratio and Bone Mineral Density in Korean Middle-Aged Women
Seong Su Choi, Yun-A Kim, Hyun Ji Kim, Yoon Jeong Cho, Geon Ho Lee
Korean J Fam Med 2023;44(1):21-27.   Published online January 19, 2023
DOI: https://doi.org/10.4082/kjfm.21.0208
Background
Dietary Na+ or Na+/K+ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na+, K+, and Na+/K+ ratios and BMD in middle-aged Korean women.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1–highest quartile Q4) according to dietary Na+, K+, and Na+/K+ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0.
Results
The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na+ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na+/K+ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD).
Conclusion
A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na+/K+ ratio. Therefore, based on the results of this study, a higher dietary Na+/K+ ratio may be associated with a lower BMD.

Citations

Citations to this article as recorded by  
  • Bioactive Compounds and Health Functions of Plums: Current Status and Future Opportunities
    Ming-Qiang Xu, Samuel Ariyo Okaiyeto, Xiao-Xiao Niu, Qing-Hui Wang, Sriram K. Vidyarthi, Haiou Wang, Li-Zhen Deng, Parag Prakash Sutar, Hong-Wei Xiao
    Food Reviews International.2025; 41(5): 1360.     CrossRef
  • Does Changing the Ratio of Dietary Sodium-to-Potassium Intake Affect Bone Mineral Density?
    Soo Young Kim
    Korean Journal of Family Medicine.2023; 44(1): 1.     CrossRef
  • 5,632 View
  • 110 Download
  • 3 Web of Science
  • 2 Crossref
Dietary Changes Leading to Euglycemic Diabetic Ketoacidosis in Sodium-Glucose Cotransporter-2 Inhibitor Users: A Challenge for Primary Care Physicians?
Manoj Kumar Reddy Somagutta, Utkarsha Uday, Nishat Shama, Narayana Reddy Bathula, Siva Pendyala, Ashwini Mahadevaiah, Greta Mahmutaj, Ngaba Negumadji Ngardig
Korean J Fam Med 2022;43(6):361-366.   Published online November 20, 2022
DOI: https://doi.org/10.4082/kjfm.22.0003
Background
The use of euglycemic diabetic ketoacidosis (EDKA) related to sodium-glucose cotransporter 2 inhibitors (SGLT2i) use in people with diabetes has been increasingly reported. The causes are multifactorial, and dietary changes in SGLT2i users were observed to trigger EDKA. A ketogenic diet or very low-carbohydrate diet (VLCD) enhances body ketosis by breaking down fats into energy sources, causing EDKA. This study aimed to understand the patient specific risk factors and clinical characteristics of this cohort.
Methods
Several databases were carefully analyzed to understand the patients’ symptoms, clinical profile, laboratory results, and safety of dietary changes in SGLT2i’s. Thirteen case reports identifying 14 patients on a ketogenic diet and SGLT2i’s diagnosed with EDKA were reviewed.
Results
Of the 14 patients, 12 (85%) presented with type-2 diabetes mellitus (DM) and 2 (15%) presented with type-1 DM. The duration of treatment with SGLT2i before the onset of EDKA varies from 1 to 365 days. The duration of consuming a ketogenic diet or VLCD before EDKA onset varies from 1 to 90 days, with over 90% of patients hospitalized <4 weeks after starting the diet. At presentation, average blood glucose was 167.50±41.80 mg/dL, pH 7.10±0.10, HCO3 8.1±3.0 mmol/L, potassium 4.2±1.1 mEq/L, anion-gap 23.6±3.5 mmol/L, and the average hemoglobin A1c was 10%±2.4%. The length of hospital stay ranged from 1 to 15 days. None of the patients were reinitiated on SGLT2i’s, and 50% (2/4) of the patients reported were on the ketogenic diet or VLCD upon patient questioning.
Conclusion
Despite the popularity of the ketogenic diet and VLCD for weight loss, their use in diabetics taking SGLT2i’s is associated with EDKA. Physicians should educate patients with diabetes taking SGLT2i’s about the risk of EDKA. In addition, patients should be encouraged to include their physicians in any decision related to significant changes in diet or exercise routines. Further research is needed to address if SGLT2i’s should be permanently discontinued in patients with diabetes on SGLT2i and whether the ketogenic diet developed EDKA.

Citations

Citations to this article as recorded by  
  • A Single Arm Pilot Observational Study to Evaluate the Safety and Feasibility of a Pre‐Operative Very Low Calorie Diet in Severely Obese Patients With Endometrial Cancer
    Chloe Ayres, Hanna Burbidge, Jayna Garratt, Ganendra Raj Mohan, Yee Leung, Stephanie Jeffares, Sanela Bilic, Paul A. Cohen
    Cancer Reports.2025;[Epub]     CrossRef
  • Lifestyle prescriptions for diabetes management in primary care: a narrative review
    Hye Jun Lee, Jung-Ha Kim
    Ewha Medical Journal.2025; 48(4): e55.     CrossRef
  • From Sweet to Sour: SGLT-2-Inhibitor-Induced Euglycemic Diabetic Ketoacidosis
    Andrijana Koceva, Nika Aleksandra Kravos Tramšek
    Journal of Personalized Medicine.2024; 14(7): 665.     CrossRef
  • 5,277 View
  • 90 Download
  • 2 Web of Science
  • 3 Crossref
Background
Previous studies have shown a close relationship between skipping breakfast and nutritional deficiency. However, the impact of regular eating, including lunch and dinner, has not been studied well. We explored the correlation between regularity and frequency of daily meals and nutritional status.
Methods
We analyzed Korea National Health and Nutrition Examination Surveys between 2016 and 2018. A total of 7,725 adults aged 19–49 years were classified into four groups according to the regularity of meal intake: three-meal regular diet (3MRD), two-meal regular diet, one-meal regular diet, and irregular diet (IRD). Food and nutrient intake was assessed using the 24-hour recall method and estimated by a generalized linear model in complex sample weight variables.
Results
In IRD, there were relatively more females who were not married, lived alone, or reported low levels of education. As subjects ate more meals, more people felt thinner and healthier by themselves. Dietary intake of cereal, vegetables, seaweed, and fiber was directly proportional to the number of regular meals as well as essential components such as water, carbohydrates, protein, fat, and micronutrients. Contrarily, alcohol and beverage consumption was inversely proportional to the number of regular meals. Intake level of legumes, fish, fruits, seasonings, milk, oils, sugars, and cholesterol was consistent regardless of meal frequency.
Conclusion
Our findings suggest that 3MRD showed nutrient adequacy and a healthier profile on body weight, body mass index, waist circumference, blood pressure, serum fasting glucose, total cholesterol, and triglyceride.

Citations

Citations to this article as recorded by  
  • Eating patterns in Korean adults, 1998–2018: increased energy contribution of ultra-processed foods in main meals and snacks
    Sukyoung Jung, Jee Young Kim, Sohyun Park
    European Journal of Nutrition.2024; 63(1): 279.     CrossRef
  • Analysis of dietary behavior and intake related to glycemic control in patients with type 2 diabetes aged 30 years or older in Korea: Utilizing the 8th Korea National Health and Nutrition Examination Survey (2019–2021)
    Jin-Ah Seok, Yeon-Kyung Lee
    Nutrition Research and Practice.2024; 18(2): 239.     CrossRef
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • A national cross-sectional study on breakfast skipping-related factors and comparison of nutritional status according to breakfast skipping in older adults based on the 8th Korea National Health and Nutrition Examination Survey (KNHANES, 2020)
    Anna Han, Yean Jung Choi
    The Journal of nutrition, health and aging.2024; 28(9): 100335.     CrossRef
  • The Association between Personality Factors and Metabolic Parameters among Patients with Non-Alcoholic-Fatty Liver Disease and Type 2 Diabetes Mellitus—A Cross-Sectional Study
    Marcin Kosmalski, Rafał Frankowski, Monika Różycka-Kosmalska, Kasper Sipowicz, Tadeusz Pietras, Łukasz Mokros
    Journal of Clinical Medicine.2023; 12(13): 4468.     CrossRef
  • Nutrition fact label (NFL) use is related to meeting the requirements for vitamins and minerals not listed on NFLs: Data from the Korea National Health and Nutritional Examination Survey VIII (2019–2021) for the prepandemic and pandemic periods
    Jung Min Cho, Niravkumar Joshi
    PLOS ONE.2023; 18(12): e0296268.     CrossRef
  • Association between Prediabetes and Meal Patterns Related to Meal Sharing among Korean Young Adults: Eighth Korean National Health and Nutrition Examination Survey, 2019–2020
    Saebom Kim, Sehee Kim, Youngmin Kim, Seonmi Seo, Yu Jin Chung, Sam Cheol Kim
    Korean Journal of Family Practice.2023; 13(3): 179.     CrossRef
  • Meal Frequency, Metabolic Health, and Social Norms
    Young Gyu Cho
    Korean Journal of Family Medicine.2022; 43(5): 275.     CrossRef
  • 7,668 View
  • 122 Download
  • 7 Web of Science
  • 8 Crossref
The Association between the Use of Dietary Supplement and Psychological Status of Cancer Survivors in Korea: A Cross-Sectional Study
Han Rim Lee, Yun-Mi Song, Keun Hye Jeon, In Young Cho
Korean J Fam Med 2021;42(4):317-326.   Published online July 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0184
Background
Dietary supplements (DS) use is known to be common among cancer survivors. However, detailed information on the factors influencing DS use seems insufficient, including cancer-related and psychological factors.
Methods
Study subjects were 1,852 Korean adult cancer survivors recruited from cancer survivor clinic of two university-affiliated hospitals. Data were collected retrospectively through review of medical records and self-administered questionnaires. Psychological factors were assessed using Hospital Anxiety and Depression Scale (HADS) and Fear of Cancer Recurrence Inventory-Short Form. Factors associated the DS use were evaluated by multiple logistic regression analysis after adjusting for covariates.
Results
The prevalence of long-term DS use was 15.7% in overall (17.5% in female and 11.6% in male). Female survivors were 3.14 times (95% confidence interval [CI], 1.89–5.22) more likely to use DS than male. In male cancer survivors, ever-smoking and previous radiotherapy were positively associated with DS use. In females, breast cancer survivors were 0.32 times less likely to use DS compared with stomach cancer survivors, and survivors with family history of cancer were 1.39 times more likely to use DS than those without. After adjusting for sociodemographic, clinical, and lifestyle factors, survivors with anxiety (HADS ≥8) used DS 1.38 times (95% CI, 1.01–1.91) more frequently, compared with those without anxiety.
Conclusion
Diverse factors such as female sex, cancer treatment modality, smoking history, family history and anxiety status were associated with DS use in Korean cancer survivors. Targeted strategies with consideration of these factors are needed for counseling DS use for cancer survivors.

Citations

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  • Exploring men’s cancer journeys in Norway: a comprehensive survey on diet, supplements, and use of complementary and alternative therapies
    Agnete E. Kristoffersen, Kiwumulo Nakandi, Arne Johan Norheim, Mona Bjelland, Jorunn V. Nilsen, Eran Ben-Arye
    BMC Complementary Medicine and Therapies.2025;[Epub]     CrossRef
  • Regulatory systems and scientific evidence for health functional foods in Korea
    Seung-Won Oh
    Journal of the Korean Medical Association.2025; 68(5): 311.     CrossRef
  • Supplement use and its impact on daily life of cancer patients: a cross-sectional study
    Youssef El Toum, Tarek Costa, Elissa El Toum, Tina Haddad, Pascale Salameh, Fady El karak, Marwan Ghosn, Fady Nasr, Georges Chahine, Joseph Kattan, Hampig Raphael Kourie
    Supportive Care in Cancer.2024;[Epub]     CrossRef
  • Factors Associated with Long-Term Dietary Supplement Use among Korean Breast Cancer Survivors: A Cross-Sectional Study
    Seonghye Kim, Yohwan Yeo, Jinyoung Shin, Dong Wook Shin, Belong Cho, Yun-Mi Song
    Nutrients.2023; 15(18): 4087.     CrossRef
  • Addressing Patient Requests to Add Dietary Supplements to Their Cancer Care—A Suggested Approach
    Moshe Frenkel, Meroe B. Morse, Santhosshi Narayanan
    Nutrients.2023; 15(24): 5029.     CrossRef
  • Differences in the Perception of Dietary Supplements between Dietary Supplement/Medicine Users and Non-Users
    Tsuyoshi Chiba, Nanae Tanemura
    Nutrients.2022; 14(19): 4114.     CrossRef
  • The Self-Administered Use of Complementary and Alternative Medicine (CAM) Supplements and Antioxidants in Cancer Therapy and the Critical Role of Nrf-2—A Systematic Review
    Paula Krejbich, Marc Birringer
    Antioxidants.2022; 11(11): 2149.     CrossRef
  • 6,809 View
  • 106 Download
  • 7 Web of Science
  • 7 Crossref
The Relationship between Psychological Factors and Weight Gain
Hye Jin Jang, Byung Sung Kim, Chang Won Won, Sun Young Kim, Myung Weon Seo
Korean J Fam Med 2020;41(6):381-368.   Published online May 14, 2020
DOI: https://doi.org/10.4082/kjfm.19.0049
Background
This study aimed to investigate stress, depression, sleeping time, physical activity, and dietary patterns as factors causing weight gain and investigate which of these factors have a greater effect on weight gain.
Methods
Data were obtained from the seventh Korea National Health and Nutrition Examination Survey, 2016. Among the respondents, 3,163 adults aged 19–64 years were included in the survey, after excluding non-responders and those with diseases that may affect weight change. The t-test and chi-square test were used to analyze the relationship between weight gain and general characteristics. Logistic regression analysis was performed to evaluate weight changes according to stress, depression, sleep time, physical activity, and dietary patterns and evaluate the odds ratios (ORs) for measuring these associations.
Results
Participants in the weight gain group were younger and more likely to be obese than those in the control group. Factors that could cause weight gain among women were stress awareness (OR, 1.271; 95% confidence interval [CI], 1.012–1.597), physical inactivity (OR, 1.250; 95% CI, 1.018–1.535), and skipping breakfast (OR, 1.277; 95% CI, 1.028–1.587). Depression was significantly associated with weight gain among women, but not after adjusting for other variables. There were no significant associations with sleeping time. None of these factors in men were significantly associated with weight gain.
Conclusion
Stress awareness was significantly associated with weight gain among women, while other psychological factors were not significantly associated with weight gain.

Citations

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  • Antioxidant, Antidiabetic and Topical Antiinflammatory Effects of Hibiscus sabdariffa L. Extracts
    Lilia Mouhi, Asma Belkadi, Abdeltif Amrane, Amel Toubane, Hana Guedjali, Lina Chouial
    Journal of Pharmaceutical Innovation.2026;[Epub]     CrossRef
  • Body mass as a result of psychological, lifestyle and genetic determinants. A pilot study involving overweight/obese and normal weight women in their early adulthood
    Małgorzata Obara-Gołębiowska, Katarzyna Eufemia Przybyłowicz, Anna Danielewicz, Tomasz Sawicki, Asif Jan
    PLOS ONE.2024; 19(12): e0314942.     CrossRef
  • Weightism in Asia: A Narrative Review and Implications for Practice
    Shubashini Mathialagan, Poh Li Lau
    Journal of Obesity & Metabolic Syndrome.2024; 33(4): 314.     CrossRef
  • Weight Changes and Unhealthy Weight Control Behaviors Are Associated With Dysmenorrhea in Young Women
    Kyunghee Han, Nam-Kyoo Lim, Hansol Choi, Bo Mi Song, Hyun-Young Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Factors Associated with Breakfast Skipping and Its Attitude among Undergraduate Students of King Khalid University
    Amani Hamad Alhazmi
    King Khalid University Journal of Health Sciences.2023; 8(1): 85.     CrossRef
  • Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index
    Chen Du, Mary Adjepong, Megan Chong Hueh Zan, Min Jung Cho, Jenifer I. Fenton, Pao Ying Hsiao, Laura Keaver, Heesoon Lee, Mary-Jon Ludy, Wan Shen, Winnie Chee Siew Swee, Jyothi Thrivikraman, Felicity Amoah-Agyei, Emilie de Kanter, Wenyan Wang, Robin M. Tu
    Nutrients.2022; 14(5): 1045.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Current status and treatment of obesity in Korea
    Jae-Heon Kang
    Journal of the Korean Medical Association.2022; 65(12): 783.     CrossRef
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    Albertas Skurvydas, Ausra Lisinskiene, Marc Lochbaum, Daiva Majauskiene, Dovile Valanciene, Ruta Dadeliene, Natalja Fatkulina, Asta Sarkauskiene
    International Journal of Environmental Research and Public Health.2021; 18(23): 12809.     CrossRef
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    Alexandra M. Stănilă, Mihaela Oraviţan, Marius L. Matichescu, Cătălin V. Stănilă, Cristiana A. Avram, Bogdan Almăjan-Guţă, Claudiu Avram
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The Effects of Weight Control Behaviors among Korean Obese Adults
Li-Ly Kang, Ha-Nui Kim, Young-Ah Jung, Hwan-Sik Hwang, Hoon-Ki Park, Kye-Yeung Park
Korean J Fam Med 2018;39(4):247-252.   Published online July 5, 2018
DOI: https://doi.org/10.4082/kjfm.17.0021
Background
This study aimed to identify and examine the effects of weight control behaviors correlated with weight loss in obese individuals who attempted to lose weight within the past year.
Methods
In this cross-sectional study, data from 9,461 obese individuals were collected from the fifth and sixth Korean National Health and Nutrition Examination Survey (2010–2014). Three of nine verified methods of weight control suggested in the survey were selected: diet therapy (reduced food intake), exercise therapy (exercise), and medication therapy (prescribed weight loss medications). Participants were divided into one of seven groups (diet therapy alone; exercise therapy alone; drug therapy alone; combined diet and exercise therapy; combined exercise and drug therapy; combined diet and drug therapy; or combined diet, exercise, and drug therapy). Logistic regression analysis was used to determine whether the group that tried to lose weight in the past year had indeed lost weight compared to the group that did not.
Results
The odds ratios for weight loss (≥3 but <6 kg vs. ≥6 but <10 kg) for the combined therapies were 2.05 (95% confidence interval, 1.23–3.41) for combined diet and exercise therapy and 5.43 (1.74–16.92) for combined diet, exercise, and drug therapy.
Conclusion
All levels of weight loss were significantly associated with combined diet and exercise therapy. Weight loss ≥6 kg but <10 kg was significantly associated with combined diet and exercise therapy as well as with combined diet, exercise, and medication therapy among individuals who tried to lose weight in the past year.

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  • Participatory Action for Optimizing Health Literacy and Access to Manage Hypertension: Pre-post Evaluation in a Marginalized Community of India
    Reetu Passi, Manmeet Kaur, Madhu Gupta, Savita Kumari, Rajesh Kumar
    SAGE Open.2025;[Epub]     CrossRef
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    Jung Hur, Ji Young Kang, Young Kyoon Kim, Sook Young Lee, Hwa Young Lee
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The Prevalence of Gallstone Disease Is Significantly Lower in Natives than in Migrants of Jeju Island
Oh-Sung Kwon, Young-Kyu Kim, Kyu Hee Her
Korean J Fam Med 2018;39(3):147-154.   Published online May 18, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.3.147
Background
The eating habits of Jeju Island natives are quite different from those of the mainland people because of geographic isolation. Diet is a main factor affecting gallstone disease. We investigated the prevalence of gallstone disease in both Jeju Island natives and migrants and studied the risk factors affecting gallstone disease in the Jeju Island people.
Methods
A total of 20,763 subjects who underwent medical checkups at the Health Promotion Center of Jeju National University Hospital in Korea from January 2003 to December 2015 were enrolled in the study. Ultrasonography was used to determine the presence of gallbladder stones. Body mass index and biochemical parameters, including liver function test results, lipid profiles, and fasting blood glucose levels, were verified, and data on age, birthplace, and sex were collected from medical records. Univariate and multivariate analyses were performed to identify risk factors affecting gallstone disease.
Results
The prevalence of gallstone disease in the Jeju Island people was 4.0%: Jeju Island natives, 3.8% and migrants, 4.4% (P=0.047). After multivariate logistic regression analysis, the independent risk factors were older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower high-density lipoprotein cholesterol levels.
Conclusion
The prevalence of gallstone disease was significantly lower in natives than in migrants from Jeju Island. Older age, Jeju migrants, higher fasting blood glucose and alanine aminotransferase levels, and lower highdensity lipoprotein cholesterol levels contributed to gallstone disease prevalence in the Jeju Island people.

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  • Liver Function‐Related Indicators and Risk of Gallstone Diseases—A Multicenter Study and a Systematic Review and Meta‐Analysis
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    Seon Mee Park, Hyun Jung Kim, Tae Uk Kang, Heather Swan, Hyeong Sik Ahn
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  • Prevalence and risk factors for gallstone disease: A population‐based cross‐sectional study
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    Oh-Sung Kwon, Young-Kyu Kim, Kyu Hee Her, Hyeon Ju Kim, Seung Duk Lee
    Medicine.2020; 99(26): e20763.     CrossRef
  • The grade of nonalcoholic fatty liver disease is an independent risk factor for gallstone disease
    Young-Kyu Kim, Oh-Sung Kwon, Kyu Hee Her
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Understanding Dieting and Previous Weight Loss Attempts among Overweight and Obese Participants: Insights into My Body Is Fit and Fabulous at Work Program
Tengku Alina Tengku Ismail, Rohana Abdul Jalil, Wan Rosli Wan Ishak, Noor Fadzlina Hamid, Wan Suriati Wan Nik, Hamid Jan Jan Mohamed, Nor Haslina Mohd, Wan Nor Arifin, Wan Mohd Izani Wan Mohamed, Mohd Ismail Ibrahim, Rohaida Ismail, Tengku Fatimatul Tengku Hassim, Tahir Aris, Wan Manan Wan Muda
Korean J Fam Med 2018;39(1):15-22.   Published online January 23, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.1.15
Background

A qualitative study providing an in-depth exploration of people's view and the increasing burden of overweight and obesity is required. This study aimed to explore the understanding of dieting and previous experiences on weight loss attempts among overweight and obese government employees in Kelantan, Malaysia, prior to recruitment into the intervention program.

Methods

Thirteen focus group discussions involving 129 participants from a weight-loss intervention program were conducted within the first 1 month of recruitment. These discussions were moderated by two trained researchers in the Malay language and assisted by an interview guide. They were audio-recorded and transcribed verbatim. A thematic analysis was performed, and codes and themes from each discussion were constructed.

Results

The participants understood dieting with various meanings, including skipping meals and removing rice from daily diets. They applied numerous methods to lose weight and achieved various outcomes. Health and appearance, social support, and compliance with current trends were the factors motivating these participants to lose weight. Their determination to lose weight was limited by lack of self-control and motivation, experiences of unpleasant effects, influence on weight, and environmental and health factors.

Conclusion

Real-life weight loss experiences and perceptions provided relevant insights into current weight loss management strategies. Some of these issues and misunderstandings should be emphasized in weight loss strategies during health promotion.

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    Wonjong Kim, Ahra Jo, Geungyeong Park, Heeyoung Oh, Mirae Jo
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    Mona Mohammed Al-Bisher, Hala Hazam Al-Otaibi
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    Ziaul Hasan Rana, Debra B. Reed, Wilna Oldewage-Theron, Conrad Lyford, Malinda Colwell, John A. Dawson
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    Taniya S. Nagpal, Harry Prapavessis, Christina G. Campbell, Barbra de Vrijer, Isabelle Giroux, Michelle F. Mottola
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Review Article

Is It Possible to Delay or Prevent Age-Related Cognitive Decline?
Jean-Pierre Michel
Korean J Fam Med 2016;37(5):263-266.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.263

Already in the 90s, Khachaturian stated that postponing dementia onset by five years would decrease the prevalence of the late onset dementia by 50%. After two decades of lack of success in dementia drug discovery and development, and knowing that worldwide, currently 36 million patients have been diagnosed with Alzheimer's disease, a number that will double by 2030 and triple by 2050, the World Health Organization and the Alzheimer's Disease International declared that prevention of cognitive decline was a 'public health priority.' Numerous longitudinal studies and meta-analyses were conducted to analyze the risk and protective factors for dementia. Among the 93 identified risk factors, seven major modifiable ones should be considered: low education, sedentary lifestyle, midlife obesity, midlife smoking, hypertension, diabetes, and midlife depression. Three other important modifiable risk factors should also be added to this list: midlife hypercholesterolemia, late life atrial fibrillation, and chronic kidney disease. After their identification, numerous authors attempted to establish dementia risk scores; however, the proposed values were not convincing. Identifying the possible interventions, able to either postpone or delay dementia has been an important challenge. Observational studies focused on a single life-style intervention increased the global optimism concerning these possibilities. However, a recent extensive literature review of the randomized control trials (RCTs) conducted before 2014 yielded negative results. The first results of RCTs of multimodal interventions (Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, Multidomain Alzheimer Prevention Study, and Prediva) brought more optimism. Lastly, interventions targeting compounds of beta amyloid started in 2012 and no results have yet been published.

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    Changzheng Yuan, Elinor Fondell, Alberto Ascherio, Olivia I Okereke, Francine Grodstein, Albert Hofman, Walter C Willett
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    Josef Toman, Blanka Klímová, Martin Vališ
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Original Articles

The Association between Taking Dietary Supplements and Healthy Habits among Korean Adults: Results from the Fifth Korea National Health and Nutritional Examination Survey (2010–2012)
Jin-Wook Kim, So-Hye Lee, Jung-Eun Kim, Kyung-Do Han, Tae-Eung Kwack, Bo-Seon Kim, Jeong-Eun Kim, Eun-Bae Jo, Young-Kyu Park, Kyung-Shik Lee
Korean J Fam Med 2016;37(3):182-187.   Published online May 26, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.3.182
Background

Recently, the number of people interested in health in South Korea has increased, and the rate of dietary supplement use is rising. Researchers have hypothesized that the rate of practicing healthy habits is higher among those who use dietary supplements than those who do not. Therefore, this study aimed to discover the association between taking dietary supplements and practicing various healthy habits in the Korean, adult population.

Methods

The sample included 15,789 adults over 19 years old who participated in the fifth Korea National Health and Nutrition Examination Survey. The user group was defined as those taking dietary supplements for more than 2 weeks during the previous year or once during the past month. Measures for the seven healthy habits were based on those included in the Alameda study and were analyzed accounting for the complex sampling design.

Results

The rate of taking dietary supplements was significantly higher in women, middle aged participants, urban residents, those with a higher income, those with a higher education level, and nonsmokers as well as among women with a moderate subjective health status, women who limited their alcohol content, and women with dyslipidemia. In the adjusted analysis, the rate of performing three of the 'Alameda 7' habits—eating breakfast regularly, restricting snacking, and limiting drinking—was higher in the female dietary supplement user group than in the other groups. Women practiced more healthy habits and had a higher dietary supplement intake rate than men.

Conclusion

We found that taking dietary supplements in Korean adults is highly associated with demographic and social factors. Taking dietary supplements had a relationship with dietary habits, and there was no significant association between dietary supplement and other healthy habits. Thus in the health clinic, we suggest that taking dietary supplements complements a patient's healthy habits, with the exception of dietary habits, for health promotion.

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  • Contribution of fortified foods and dietary supplements to total nutrient intakes and their adequacy in Japanese adults
    Minami Sugimoto, Keiko Asakura, Nana Shinozaki, Kentaro Murakami, Shizuko Masayasu, Satoshi Sasaki
    BMC Nutrition.2024;[Epub]     CrossRef
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    Gülşen Delikanlı Akbay, Erdinç Karakullukçu
    Mediterranean Journal of Nutrition and Metabolism.2024; 17(4): 335.     CrossRef
  • The Reason for Vitamin–Mineral Supplement Intake among Secondary School Adolescents in Malaysia and its Association with Nutritional Status and Dietary Practice
    Azli Baharudin, Fatimah Othman, Syafinaz Mohd Sallehuddin, Suhaila Abd Ghafar, Khairul Hasnan Amali, Norazizah Ibrahim Wong, Ahmad Ali Zainuddin
    Matrix Science Pharma.2023; 7(2): 52.     CrossRef
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    E Lyn Lee, Noni Richards, Jeff Harrison, Joanne Barnes
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  • COVID-19 Pandemisi Sürecinde Yetişkinlerin Besin Destekleri Kullanımlarının İncelenmesi
    Gülperi DEMİR, Beyza KILIÇKALKAN, Muhammed Kazım TAKAK
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  • Vitamin D supplements reduce depressive symptoms and cardiac events in heart failure patients with moderate to severe depressive symptoms
    Eun Kyeung Song, Jia-Rong Wu, Debra K Moser, Seok-Min Kang, Terry A Lennie
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  • Effects of Multivitamin, Multimineral and Phytonutrient Supplementation on Nutrient Status and Biomarkers of Heart Health Risk in a Russian Population: A Randomized, Double Blind, Placebo Controlled Study
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  • Vitamin and Mineral Supplement Use among Korean Adults: Baseline Data from the Trace Element Study of Korean Adults in Yeungnam Area
    Minkyeong Kim, Yujin Lee, Kyong Park
    Nutrients.2018; 10(1): 50.     CrossRef
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    Eun Kyeung Song, Jia-Rong Wu
    Journal of Cardiovascular Nursing.2018; 33(4): 392.     CrossRef
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    Weiyan Gong, Ailing Liu, Yecheng Yao, Yanning Ma, Caicui Ding, Chao Song, Fan Yuan, Yan Zhang, Ganyu Feng, Zheng Chen, Gangqiang Ding
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Vitamin-Mineral Supplement Use Patterns in Elderly Koreans: Data from the 2007–2008 Korean National Health and Nutrition Examination Survey
So Young Park, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Hye Rim Hwang, Dong Wook Jeong, Young Hye Cho, Eun Jung Choi, Yu Hyeon Yi, Young Jin Tak, A Ra Jo, Seung Hoon Lee, Jeong Suk Jeon, Bo Wha Lee
Korean J Fam Med 2016;37(2):123-129.   Published online March 25, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.2.123
Background

Vitamin-mineral supplements are the most popular dietary supplements in Korea. However, few studies have assessed the relationship between vitamin-mineral supplementation and associated factors among the Korean elderly. The purpose of this study was to assess the use of vitamin-mineral supplements among elderly in Korea as well as its association with sociodemographic factors, health-related behaviors, medical conditions, and nutrient intake.

Methods

This study was based on data from the Korean National Health and Nutrition Examination Survey, conducted by the Korean Ministry of Health and Welfare from 2008 to 2009. Data from 3,294 elderly men and women (65 years of age and older) were analyzed. Multivariable-weighted logistic regression model analysis was used to evaluate the association between vitamin-mineral supplement use and sociodemographic factors, health-related habits, and medical conditions.

Results

Vitamin-mineral supplementation was reported by 16.3% of the participants. The most common reason for using dietary supplements was recommendations from friends and acquaintances. Highly educated person, female participants had a greater likelihood of taking vitamin-mineral supplements. In addition, analysis of nutrient intake from food sources alone revealed a lower proportion of vitamin-mineral supplement users with nutrient intakes below the estimated average requirements for vitamin A, vitamin C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus, compared to nonusers. However, vitamin-mineral supplementation was not associated with health-related behaviors or medical conditions.

Conclusion

Highly educated person, elderly Korean women had a greater likelihood of using vitamin-mineral supplements. In addition, nutrient intakes from food sources alone were significantly higher among vitamin-mineral supplement users. Finally, vitamin-mineral supplementation may be an indicator of healthier diet in elderly Koreans.

Citations

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  • Effect of a Single Multi-Vitamin and Mineral Supplement on Nutritional Intake in Korean Elderly: Korean National Health and Nutrition Examination Survey 2018–2020
    Hyoeun Kim, Seung Guk Park
    Nutrients.2023; 15(7): 1561.     CrossRef
  • The Reason for Vitamin–Mineral Supplement Intake among Secondary School Adolescents in Malaysia and its Association with Nutritional Status and Dietary Practice
    Azli Baharudin, Fatimah Othman, Syafinaz Mohd Sallehuddin, Suhaila Abd Ghafar, Khairul Hasnan Amali, Norazizah Ibrahim Wong, Ahmad Ali Zainuddin
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    Wanyue Dong, Zhonghe Sun, Ruhai Bai
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    Manuel Enrique Machado-Duque, Juan Daniel Ayala-Torres, Jorge Enrique Machado-Alba
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    Raymond L. Rodriguez, John G. Albeck, Ameer Y. Taha, Kassandra M. Ori-McKenney, Gregg H. Recanzone, Tyler W. Stradleigh, Bronte C. Hernandez, Feng-Yao Vincent Tang, En-Pei Isabel Chiang, Lillian Cruz-Orengo
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  • Impact of Frequency of Multi-Vitamin/Multi-Mineral Supplement Intake on Nutritional Adequacy and Nutrient Deficiencies in U.S. Adults
    Jeffrey Blumberg, Balz Frei, Victor Fulgoni, Connie Weaver, Steven Zeisel
    Nutrients.2017; 9(8): 849.     CrossRef
  • AVALIAÇÃO DA ROTULAGEM DE SUPLEMENTOS VITAMÍNICOS E/OU MINERAIS
    Andressa Barros Ibiapina, Monalisa de Alencar Lucena, Camila dos Reis Oliveira, Lucas Vaz de Castro Oliveira, Alessandra Braga Ribeiro
    Infarma - Ciências Farmacêuticas.2017; 29(1): 21.     CrossRef
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Dietary Fat Intake and the Risk of Metabolic Syndrome in Korean Adults
Yoo-Jin Um, Seung-Won Oh, Cheol-Min Lee, Hyuk-Tae Kwon, Hee-Kyung Joh, Young-Ju Kim, Hyun-Joo Kim, Sang-Hyun Ahn
Korean J Fam Med 2015;36(5):245-252.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.245
Background

The effect of dietary fat intake on the risk of cardiovascular disease remains unclear. We investigated the association between dietary fat and specific types of fat intake and the risk of metabolic syndrome.

Methods

The study population included 1,662 healthy adults who were 50.2 years of age and had no known hypertension, diabetes, hyperlipidemia, or metabolic syndrome at the initial visit. Dietary intake was obtained from a 1-day food record. During 20.7 months of follow-up, we documented 147 cases of metabolic syndrome confirmed by self-report, anthropometric data, and blood test results. The intakes of total fat, vegetable fat, animal fat, saturated fatty acid (SFA), polyunsaturated fatty acid (PUFA), monounsaturated fatty acid (MUFA), and cholesterol level divided by quintile. Multivariate analyses included age, sex, body mass index, smoking status, alcohol intake, physical activity, total calorie, and protein intake.

Results

Vegetable fat intake was inversely associated with metabolic syndrome risk (odds ratio for the highest vs. the lowest quintile, 0.33; 95% confidence interval, 0.14 to 0.76). Total fat, animal fat, SFA, PUFA, MUFA, and cholesterol intakes showed no association with metabolic syndrome. Vegetable fat intake was inversely associated with the risk of hypertriglyceridemia among the components of metabolic syndrome.

Conclusion

These data support an inverse association between vegetable fat and the risk of metabolic syndrome.

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Association between Nutrition Label Reading and Nutrient Intake in Korean Adults: Korea National Health and Nutritional Examination Survey, 2007-2009 (KNHANES IV)
Min-Gyou Kim, Seung-Won Oh, Na-Rae Han, Dong-Ju Song, Jae-Yean Um, Su-Hyun Bae, Hyuktae Kwon, Cheol-Min Lee, Hee-Kyung Joh, Sung-woo Hong
Korean J Fam Med 2014;35(4):190-198.   Published online July 25, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.4.190
Background

Nutrition labels provide various information on the nutrient contents of food. However, despite the recent increase in the interest in dietary intake and expansion of related policies, studies on the association between nutrition label reading and dietary intake are lacking in Korea.

Methods

This study analyzed the 2007-2009 KNHANES (Korean National Health and Nutrition Examination Survey) data. To examine macronutrients and micronutrients intake according to nutrition label reading, analysis of covariance was used. Multiple logistic regression analysis was also used to examine the association between adherence to dietary reference intake and nutrition label reading.

Results

Nutrition label reading was significantly high among women, youth, and those with high education and high household income. Nutrition label reading was associated with higher intake of calcium and vitamin C in men and the lower intake of calorie, carbohydrates and higher energy ratio of protein in women. Additionally, male nutrition label readers were associated with adherence to dietary reference intake of fiber (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.23 to 3.26) and calcium (OR, 1.26; 95% CI, 1.03 to 1.54). In women, there were no significant differences in the adherence to the dietary reference intake in fat, fiber, sodium, potassium, and calcium according to the nutrition label reading.

Conclusion

In men, nutrition label reading was associated with healthier intake of several micronutrients, although this was not observed in women. Consideration for clearly reporting vulnerable micronutrients in nutrition labels is necessary.

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Factors Related to Body Mass Index and Body Mass Index Change in Korean Children: Preliminary Results from the Obesity and Metabolic Disorders Cohort in Childhood
Hyun Hye Lee, Hyun Ah Park, Jae Heon Kang, Young Gyu Cho, Jin Kyun Park, Ran Lee, Ji Ye Yoon, Ok Hyun Kim
Korean J Fam Med 2012;33(3):134-143.   Published online May 24, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.3.134
Background

This preliminary study is to assess risk factors associated with children's body mass index (BMI) and their changes over a 2-year period based on the analysis of the Obesity and Metabolic Disorders Cohort in Childhood registry.

Methods

A total of 1,504 children comprised of 474 1st graders and 1,030 4th graders were included in the study. Data on physical activity, dietary intake, and socioeconomic status were obtained through self-administered questionnaires, and height and weight were measured annually for 2 years.

Results

In a cross-sectional analysis, BMI of 1st graders was associated with higher parental BMI (both P < 0.001) and frequent snack consumption (P = 0.049). BMI of 4th graders was additionally associated with shorter sleep duration (P = 0.001), lower household income (P = 0.016), higher fat intake (P = 0.017), and frequent meal skipping (P = 0.020). During a 2-year follow-up, BMI increased by 0.8 ± 1.4 kg/m2 in 1st graders and by 1.3 ± 1.4 kg/m2 in 4th graders. In a longitudinal analysis, higher exercise frequency (P = 0.007), shorter sleep duration (P = 0.027), lower household income (P = 0.002), and higher paternal BMI (P = 0.002, 0.043) were significant predictors of BMI changes in the 1st graders whereas only higher maternal BMI (P=0.035), and frequent snack consumption (P = 0.010) were predictors for the 4th graders BMI changes.

Conclusion

Our findings indicate that parental obesity, short sleep duration, low socioeconomic status, and frequent snacking are associated with BMI and BMI changes.

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  • Association between mothers’ working hours and metabolic syndrome in children and adolescents: data from the Korea National Health and Nutrition Examination Survey, 2016–2020
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    Sunyoung Chun, Saerom Lee, Hyo-Jae Son, Hye-Mi Noh, Hye-Young Oh, Han Byul Jang, Hye-Ja Lee, Jae-Heon Kang, Hong-Ji Song, Yu-Jin Paek, Kyung-Hee Park
    Korean Journal of Family Medicine.2015; 36(5): 233.     CrossRef
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    So Hyun Park, Mi Ja Kim, Chang Gi Park, Linda McCreary, Crystal Patil, Kathleen F. Norr
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  • Relationship between adhering to dietary guidelines and the risk of obesity in Korean children
    Soo Hyun Yu, YoonJu Song, Mijung Park, Shin Hye Kim, Sangah Shin, Hyojee Joung
    Nutrition Research and Practice.2014; 8(6): 705.     CrossRef
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Lack of Association between Self-reported Saltiness of Eating and Actual Salt Intake
Yunryong Chang, Min-Seon Park, So-Yeon Chung, Sun Young Lee, Hyuk Tae Kwon, Jung-Un Lee
Korean J Fam Med 2012;33(2):94-104.   Published online March 30, 2012
DOI: https://doi.org/10.4082/kjfm.2012.33.2.94
Background

Reducing salt intake is known to be an important factor for lowering blood pressure and preventing cardiovascular disease. Estimating amount of salt intake is a necessary step towards salt intake reduction. Self-reported saltiness of diet is a method most easily used to measure a patient's salt intake. The purpose of this study was to examine the value of self-reported saltiness of diet in measuring salt intake.

Methods

We used data from 681 participants who visited a health center at a university hospital between August 2003 and November 2005. A self-administered questionnaire was used to collect information on self-reported saltiness of diet, other dietary habits and lifestyle factors. Salt intake was estimated on the basis of 24-hour dietary recall with a computer-aided nutritional analysis program (CAN-Pro 2.0, Korean Nutrition Society).

Results

There was no statistically significant difference between the mean salt intake of the self-reported salty diet group (13.7 ± 4.8 g/d) and the self-reported unsalty diet group (13.3 ± 4.4 g/d). If we assume calculated salt intake as the gold standard, the sensitivity and specificity of self-reported saltiness were 39.5% and 63.6%, respectively. Salt intake was increased with higher calorie intake, frequency of eating breakfast (≥5 times/wk) and being satiated with usual diet in men, but it was increased only with higher calorie intake in women. Regardless of actual salt intake, the group satiated with a usual diet tended to be in the group of self-reported salty diet.

Conclusion

Self-reported saltiness of diet was not associated with actual salt intake. Further studies will be needed on the simpler and more objective tools to estimate salt intake.

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Brief Communication

The aim of this study is to assess the prevalence, types, and trends of dietary supplement (DS) use. We analyzed the Dietary Supplement Questionnaire data of Korean aged 19 years old or older from the Nutrition Survey of the 4th Korea National Health and Nutrition Survey. Each reported DS was coded based on ingredients according to the 2010 Korean Food and Drug Administration Notification. The prevalence (standard error) of current DS use was 20.6% (0.7) for men, 32.2% (0.7) for women. Those with DS use for longer than two weeks during previous one year were 27.2% (0.7), and 40.2% (0.8), for men and women respectively. Vitamin mineral supplement (221.6/103 persons) was the most frequently consumed DS in Korean adults. The trend for DS use in Korean adults is changing as well as increasing.

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Original Articles

What Types of Dietary Supplements Are Used in Korea? Data from the Korean National Health and Nutritional Examination Survey 2005.
Hoon Ho Yi, Hyun Ah Park, Jae Heon Kang, Joo Ho Kang, Kyung Woo Kim, Young Gyu Cho, Hye Ryoung Song, Jung Sun Lee
Korean J Fam Med 2009;30(12):934-943.   Published online December 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.12.934
Background
Dietary supplements affect the health and disease status of Koreans. We assessed the patterns of dietary supplements use and the related factors in Korean adults from the 2005 Korea National Health and Nutrition Survey (KNHANES). Methods: Among the subjects, 2,024 men and 2,811 women underwent all the three parts of 2005 KNHANES, which consisted the health survey, the health examination, and the nutritional survey. Reported supplements were classifi ed according to the 2008 Korea Food and Drug Administration Notification. We assessed the relationship between supplements use and socioeconomic state, health behaviors, and chronic diseases. Results: Twenty-nine percent of Korean adults was taking dietary supplements. Vitamin/mineral supplements were the most commonly taken one. Glucosamine/mucopolysaccharide, ginseng, spirulina/chlorella, omega-3, and aloe followed in listing. Supplement users were likely to be woman and middle-aged. Supplement use was associated with older, high income, with spouse, higher education, urban-living, regular exercise, non-smoker, and lower BMI. Musculoskeletal diseases were associated with supplement use. Conclusion: Dietary supplement use is prevalent in Korean adults. The supplement use was associated with some demographics characteristics, health behavior, and chronic diseases. These factors should be considered when evaluating the effi cacy of dietary supplements.

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Complaints of Fatigue and Dietary Life in Medical Students.
Sung Min Lee, Sung Gon Lee, Jae Eun Lee, Eun Hee Kong, Jong Soon Choi
Korean J Fam Med 2009;30(11):880-886.   Published online November 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.11.880
Background
Fatigue is a common problem in medical students and is thought to be related to poor academic performance. Fatigue is expected to be highly related to dietary habits, but previous research was not enough. Therefore, the aims of this study were to investigate the relationship between dietary habits and the prevalence of fatigue and also to give an update on basic research data for improving academic performance in medical students. Methods: The study group consisted of 170 healthy second-year medical students attending three university school of medicine in Busan. They completed a questionnaire dealing with fatigue (Fatigue Severity Scale), dietary habits, lifestyle, and academic performance. Results: On multivariate logistic regression analyses, skipping breakfast (completely skipping breakfast everyday versus having breakfast everyday; odds ratio 7.23; 95% confi dence interval, 2.07 to 25.28; P = 0.002) was positively correlated with the complaints of fatigue. Conclusion: Skipping breakfast was associated with the complaints of fatigue in medical students.
  • 2,449 View
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Use of Dietary Supplements in Cancer Patients.
Bong Cheol Kim, Yun Mi Song, Seung Jin Park, Sun Young Kim, Jung Im Gwak
Korean J Fam Med 2009;30(8):632-640.   Published online August 20, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.8.632
Background
Dietary supplements (DS) have been increasingly utilized as a way of the promoting health and com-plementary therapy. This study aimed to evaluate the patterns of dietary supplement use in Korean cancer patients and to examine the related factors. Methods: Between April and May of 2008, 366 patients who were hospitalized for diagnosis and treatment of cancer in a university affiliated tertiary hospital were surveyed using a self-administered structured questionnaire after receiving written informed consent. Among them, 322 patients with adequate answers were fi nally included. Results: Two hundred forty patients (72.3%) reported to have ever taken DS with the mean number of 3.6 ± 2.98. Vitamins were the most frequently used, followed by ginseng steamed red, ginseng, and glucosamine. The most infl uential factor regarding DS use was the recommendation by family members or relatives. The main reason for DS use was for resolution of fatigue, followed by supplementation of therapy, and immune enhancement. Information concerning DS most eager to know about was the effect of DS (44.6%), followed by interaction of DS with therapeutics (33.2%). Doctor (74.4%) was the most preferred health care provider to be consulted concerning DS, but only 34% of DS users have actually consulted with a doctor. Multiple logistic regression analysis showed that increasing age, Catholicism, and higher educational level were associated with higher use of DS. Conclusion: DS use was very prevalent in cancer patients. In spite of the great need, only small proportion of cancer patients using DS has consulted with a doctor.

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  • Korean Red Ginseng extract reduces hypoxia-induced epithelial-mesenchymal transition by repressing NF-κB and ERK1/2 pathways in colon cancer
    Eui Joo Kim, Kwang An Kwon, Young Eun Lee, Ju Hyun Kim, Se-Hee Kim, Jung Ho Kim
    Journal of Ginseng Research.2018; 42(3): 288.     CrossRef
  • 2,848 View
  • 19 Download
  • 1 Crossref
Dietary Intake of Calcium and Distal Colorectal Adenomatous Polyps in Korean Adults.
Ji Young Son, Siwon Hur, Jong Jin Kim, Hyuk Tae Kwon, Be Long Cho
Korean J Fam Med 2009;30(2):106-111.   Published online February 10, 2009
DOI: https://doi.org/10.4082/kjfm.2009.30.2.106
Background
Colorectal cancer has the fourth prevalence of carcinoma and the fourth cause of death from malignant neoplasm, which has been increasing in Korea. In this study, we tried to investigate the association of dietary intake of calcium anddistal colorectal adenomatous polyps known as precursors of colorectal cancer. Methods: 2,456subjects who visited Health Promotion Center in one university Hospital in Seoul Korea from June 2003 to June 2006 got sigmoidoscopy and completed 24-hour dietary recall. Results: Among the selected 2,408 subjects, the prevalence of distal colorectal adenoma found in sigmoidoscopy was 12.54%. After adjusting for age, and total serum cholesterol by multiple logistic regression, the odds ratio of the male subjects who have the highest quintile of dietary intake of calcium was 0.512 (95% CI: 0.305-0.859 P = 0.011) compared with the lowest. Conclusion: In male subjects, highest quintile of dietary calcium density was associated with the low risk of distal colorectal adenomatous polyps.
  • 2,241 View
  • 11 Download
Relations between the Dietary Habits and Components of the Metabolic Syndrome in Premenopausal Women.
Eun Jung Oh, Hee Kyung Joh, Ran Lee, Hyun Jin Do, Seung Won Oh, Youl Lee Lym, Jae Kyung Choi, Hyuk Jung Kweon, Dong Yung Cho
J Korean Acad Fam Med 2008;29(10):746-761.   Published online October 10, 2008
Background: In these days the metabolic syndrome threatens many people of Korea. Several studies have suggested that the dietary habits are associated with the risk of the metabolic syndrome. The purpose of this study was to find out relations between the components of the metabolic syndrome and the dietary habits. Methods: The subjects of this study included 1,005 non- smoking premenopausal females aged from 20 to 49 years old who visited the health promotion center of a university hospital. Dietary questionnaire was composed of dietary habits and specific food intake frequency during the past 3 months. Results: The subjects who had more than one metabolic components were 361 (36%), and those who had the metabolic syndrome was 35 (3.5%). After multivariate logistic analysis adjusted with age, BMI, smoking status, alcohol intake, and exercise, the abdominal obesity risk was significantly increased in those who had irregular meals (P for trend= 0.049), skip meals (P for trend=0.050), faster meal time (P=0.017), and intake of saturated fat more frequently (P=0.043). The abdominal obesity risk was significantly increased in those who overate or binged eating ≥3 times/week than <1 time/week {OR (95% CI), 2.49 (1.07∼5.80)}, intake fruit <1 time/week than 6∼7 times/week {OR (95% CI), 4.46 (1.20∼16.54)}. A risk for high blood pressure was significantly increased in those who had breakfast 1∼2 times/week than those had it 6∼7 times/week {OR (95% CI), 1.91 (1.07∼3.42)}. The risk for impaired fasting glucose was significantly increased in those had breakfast <1 time/week than those who had 6∼7 times/week {OR (95% CI), 2.27 (1.20∼4.28), P for trend=0.018}. Conclusion: There was a correlation between dietary habits and metabolic syndrome components. Among the dietary habits, irregular meals, skipping breakfast, skipping meals, fast meal time, overeating or binge eating tendency, low intake of fruits and high intake of saturated fat were associated with the risk of the metabolic syndrome components. (J Korean Acad Fam Med 2008; 29:746-761)
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Beta-glucan for Glycemic Control Effects in Adults: a Meta-analysis.
Gyo Soon Hwang, Yong Kyun Roh, Hong Ji Song, Yoon Young Lee, Hyung Joon Kim, In Hong Hwang, Soo Young Kim, Hye Min Cho
J Korean Acad Fam Med 2008;29(7):475-483.   Published online July 10, 2008
Background: Recently, there has been an increase of emerging concerns between dietary fiber and diabetics. Increasing intake of dietary fiber leads to delaying absorption of glucose, and lowering of serum insulin levels. In the past studies, there were inconsistent glycemic control effect of beta-glucan. Our purpose was to assess the glycemic control effect of beta-glucan in adults. Methods: Electronic searches (Cochrane, PubMed, EMBase), hand-searching and review of reference were done. The search term for beta-glucans [mh], "Avena sativa" [mh], "Hordeum" [mh], beta glucan* [tw], oat [tw], barley [tw], with no language restriction were used. All RCT that included available data of beta-glucan or that could impute dose of beta-glucan, at least one relevant outcome of glycemic control, run-in period more than 2 weeks, and intervention period of more than 2 weeks or greater were selected. A fixed-effect model was used to assess the summary effect of studies. Results: A total of 43 articles were identified, 4 studies met our inclusion criteria and then analyzed. In pooled analysis, the effect size of fasting glucose level was 0.13 (95%CI: −1.25 to 1.51), and serum insulin level was −0.95 (95%CI, −2.37 to 0.47). It was impossible to adjust for sex and age owing to the lack of raw data. Conclusion: In this review, the results suggested that there were negative impacts of beta-glucan on fasting glucose and serum insulin level in adults, but we concluded that there was insufficient evidence to confirm about glycemic control effect. More powerful and well-designed RCT were required to confirm about glycemic control effect of beta-glucan. (J Korean Acad Fam Med 2008;29:475-483)
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Relationship between Physical Activity, Dietary Habits and Overweight of 7-year-old Korean Children.
Myeong Ho Jung, Ji Hyun Song, Jung Yoon Chun, Young Gyu Cho, Yang Hyun Kim, Min Jung Kim, Hyun Ah Park, Jae Heon Kang, Sung Hee Lee, Sung Hyun Kim
J Korean Acad Fam Med 2007;28(3):195-203.   Published online March 10, 2007
Background
Recently, the prevalence of childhood obesity has increased dramatically, but the cause still remains incompletely understood. The goal of this study was to present a direction for treatment and prevention of childhood obesity on the basis of the data of physical activity energy expenditure, inactive time and dietary habits of Korean children. Methods: A total of 56 children were selected from 8 elementary schools in Seoul and Gwacheon-city. Children's physical activity pattern and dietary habits were obtained by questionnaire. The children wore accelerometer on their wrists from Friday to Tuesday over the whole weekend. Then, we calculated the activity energy expenditure using the activity counts recorded on the accelerometer. Results: Neither the physical activity energy expenditure (kcal/kg) nor the activity pattern showed a significant difference between the normal weight group and the overweight group. The overweight children spent more time watching TV and using the computer. The overweight group did not have breakfast and ate much more and faster in terms of dietary habit. Conclusion: This study suggests that bad habituations in diet and increase of inactivity time can play more important role than physical activity in causing overweight in 7-year-old children. (J Korean Acad Fam Med 2007;28: 195-203)
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Dietary Underreporting from the 2001 Korean National Health and Nutrition Survey.
Hyun Ah Park, Jung Sun Lee, Sook Mee Son
J Korean Acad Fam Med 2006;27(10):822-829.   Published online October 10, 2006
Background
: Underreporting in self-reported dietary survey is a potential source of bias in nutritional epidemiology. We assessed if dietary underreporting existed in the 2001 Korean National Health and Nutrition Survey (KNHANS) and evaluated the health related factors and nutrients associated with dietary underreporting.

Methods : The subjects were 2,552 men and 3,335 women, 18 years of age or older, with a complete 24 hour recall and physical examination data including height and weight. Basal metabolic rate (BMR) was calculated from weight and height using WHO equations. Questionnaire to assess daily physical activity and regular exercise was done. EI/BMR ratio was used to evaluate dietary underreporting.

Results : The mean EI/BMR ratio of Korean men and women were 1.43±0.56 and 1.41±0.57, respectively. Among the total, 20.6% of men and 22.8% of women reported their energy intake lower than their BMR. Age was negatively related with EI/BMR ratio only in women (P<0.001). Body mass index, education level, and household income were negatively and daily physical activity was positively associated with the EI/BMR ratio in both sexes. Lower EI/BMR ratio was significantly associated with lower reported fat energy density (% of energy intake) and higher reported carbohydrate and protein energy densities. The EI/BMR ratio was related negatively with nutrient energy densities of Vitamin C, Calcium, and Iron.

Conclusion : We could confirm selective dietary underreporting in the 2001 KNHNS. Caution should be paid on the interpretation of the nutrition survey data and efforts should be exercised to reduce dietary underreporting at data collection stages.
  • 1,374 View
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Association of Smoking Status and Dietary Pattern -A Data of Male Screeners at a Health Promotion Center-.
Sang Yeon Suh, Su Young Kim, Kyung Hee Cho, Yu Il Kim, Taiwoo Yoo, Bong Ryul Huh
J Korean Acad Fam Med 2005;26(11):686-692.   Published online November 10, 2005
Background
: Smoking greatly increases the risk of cancer, cardiovascular diseases and osteoporosis. Besides direct harm from smoking, some dietary pattern of smokers have been reported to increase such risk. This study aimed to analyze various nutrients by smoking status, and to find out whether smokers maintain harmful dietary patterns.

Methods : One thousand and six hundred fourteen men were selected who visited the health promotion center of an university hospital in Seoul. The inclusion criteria was the completion of dietary survey. Dietary analysis was done by calculation of amounts of each nutrients from 24-hour recall method. We compared total intake of each nutrients and total calories by smoking status with analysis of variance (ANOVA). Then we adjusted the results for exercise and education level by ANCOVA (analysis of covariance).

Results : The study subjects were 840 current smokers (52.0%), 479 ex-smokers (29.7%) and 295 non-smokers (18.3%). The consumption of total fat and cholesterol was significantly high in smokers than non-smokers (P=0.012, P=0.005). The alcohol intake was higher in smokers and ex-smokers than non-smokers (P<0.001, P=0.007). The smokers and ex-smokers had less calcium than non-smokers (P=0.001, P=0.044). Furthermore, the smokers exercised less than ex-smokers and non-smokers (P<0.001).

Conclusion : The smokers consumed more total fat and cholesterol which increases the risk of cardiovascular diseases. They also had less calcium and drank more alcohol. Comprehensive approach which includes intervention for dietary intakes in addition to smoking cessation is desirable to decrease health risk for smokers.
  • 1,622 View
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The Relation between Father's and Adolescent's Health Behavior.
Su Nam Yang, Tae Yeun Kim, Sung Ryul Kim, Ji Ho Choi, Hee Jeong Koh
J Korean Acad Fam Med 2005;26(4):211-217.   Published online April 10, 2005
Background
: Adolescence is an important period with respect to health promotion, because development of health behavior at this stage is the foundation of health in adults. Among the social factors, family factor which affects the primary social function can be the most fundamental. We investigated the effects of fathers' health behavior on the health behavior of their children during adolescence.

Methods : From June to August 1999, 300 adolescent students from middle schools and high schools of areas including four cities (Seoul, Incheon, Anyang, Gunpo) and their fathers were questioned about general characteristics and health behavior such as smoking, alcohol drinking, exercise, duration of sleep, body weight, height and eating habits for breakfast ('Alameda 7'). The relationship between fathers' health behavior and their adolescents' health behavior was analyzed by chi-squared test.

Results : Among 300 adolescents and their fathers, 211 pairs responded appropriately to the questionnaires. Adolescent's smoking was not associated with father's smoking. In drinking there was no significant association between fathers and adolescents, but in drinking amount, fathers' high drinking amount was significantly associated in all students, especially in females and high school students. Regular diet, exercise, sleep did not show significant association between father and adolescent. The proportion of obesity in adolescents whose fathers were obese was significantly greater compared to those whose fathers were not.

Conclusion : High drinking amount and obesity had a statistical significance of association between fathers and adolescents. When we consider adolescents' health behavior, their fathers' health behavior must be considered.
  • 1,723 View
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The Relation of Health-related Behaviors and Family Function in Adolescents.
Tae Un Kim, Su Nam Yang, Ji Ho Choi, Sung Ryul Kim, Hee Jeong Koh
J Korean Acad Fam Med 2005;26(1):9-14.   Published online January 10, 2005
Background
: It is well known that family is not only the basis but also one of the major factors for personal health management. In this study, we examined to find out the association of family function with health behavior.

Methods : From June to August, 1999, a total of 800 middle and high school students, selected from several metropolitan, medium and small sized cities and a 'myon', were questionnaired on their health-related behaviors like smoking, alcohol intake, diet, exercise and sleeping by means of 'Korean Family Function Assessment Tool'.

Results : Among the total, 599 students gave appropriate answers. They were composed of 323 (53.9%) middle school and 276 (46.1%) high school students. Male to female sex ratio was 307 (51.3%) to 292 (48.7%). In the aspect of smoking, smoking group and non-smoking group showed 127.0±23.3 and 144.9±23.6, respectively, in terms of Korean Family Function Assessment Tool and were statistically significant (P<0.01). The students were divided into three groups as heavy alcohol drinkers who consumed alcohol more than 168 g-in case of girls the datum point was 132 g-per week, light drinkers and non-drinkers. Their KFFAT scores were also significantly different from each other (P<0.01). On tukey multiple comparison, there was a significant difference primarily between the drinkers and the non-drinkers (P<0.05). Similar findings were shown between the regular and the irregular diet group (P<0.01). But there as no significance with respect to exercise and sleeping.

Conclusion : Among the health-related behaviors of adolescents, smoking, alcohol intake and diet habit were significantly associated with family function, but exercise and sleeping were not.
  • 1,661 View
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Dietary Habits in Functional Dyspepsia.
Woo Kil Jung, Jung Hoon Kim, Young Sik Kim
J Korean Acad Fam Med 2004;25(1):40-45.   Published online January 10, 2004
Background
: Dyspepsia is a common symptom and bacause functional dyspepsia is a heterogeneous disorder its pathophysiology is not well established. We need to conceptualize in a so called "biopsychosocial model". Many Koreans tend to consider the importance of dietary habits in causes and treatment of diseases and actually many physicians recommend dietary modification for patients of functional dyspepsia. Therefore, the aim of the present study was to determine if dietary habits was associated with functional dyspepsia.

Methods : Functional dyspepsia was defined and classified by Rome II criteria. This study was performed by case and control method at the outpatient department of family medicine of six university hospitals in Seoul. Self-administered questionnaire for the demographic characteristics and dietary habits were performed in 472 functional dyspeptic patients and 236 normal controls.

Results : Only the economic status among the demographic factors was associated with functional dyspepsia and on the dietary factors. The functional dyspeptic patients reported less than 2 days regular eating for one week (OR=2.01, P=0.019, 95% CI: 1.12∼3.60) and more than 3 days overeating for one week (OR= 2.01, P=0.020, 95% CI: 1.12∼3.63), but no significant difference was found in the daily eating frequency, meal duration, frequency of spicy food comsumption, and breakfast.

Conclusion : Functional dyspepsia was associated with irregular eating patterns and overeating behavior for one week. To prevent functional dyspepsia behavioral modification such as eating regularly and avoiding overeating should be advised.
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Change of Body Composition in Obese Women with Short-term Low Calory Diets.
Hong Ki Lee, Young Gan Lee, Bok Gi Lee, Kyu Rae Lee, Kyoung Kon Kim, Hee Cheol Kang, Bang Bu Yun
J Korean Acad Fam Med 2004;25(1):21-27.   Published online January 10, 2004
Background
: A reasonable weight reduction method is to reduce fat-body mass while preserving fat-free mass. Recently, many people in Korea have been trying reckless diet therapy for weight reduction by means of low calory and protein diets, which gave rise to many side effects consequently. For reasonable weight reduction, this study was undertaken to investigate the significant dietary factors that change body composition during short-term low calory diet.

Methods : Twenty six healthy obese women aged 23∼37 years, whose BMI was greater than 24, volunteered for the 6 week diet therapy from January to April in 2003. All subjects were instructed to eat approximately 1,200 kcal/day and keep a dietary diary. In the beginning the 3rd week and the 6th week of the study, subjects' body weight were measured and fat body weight were measured by BIA. In the 6th week, the analysis of the dietary diary was conducted.

Results : There was a significant positive correlation between the protein intake per ideal body weight in the first 3 weeks and the fat-free mass increase in the latter 3 weeks (P<0.05). At the same time, the fat intake in the first 3 weeks had positive correlation with the fat-free mass in the latter 3 weeks, also (P<0.05). But, we could not find any significant values that had effect on the fat-free mass increase in multiple regression analysis.

Conclusion : The protein intake in the first 3 weeks helped to preserve the fat-free mass in the latter 3 weeks, and had positive effects.
  • 1,784 View
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Meta Analysis for the Relation between Korean Dietary Factors and Stomach Cancer.
Youn Jin Kim, Cheol Hwan Kim, Su Jung Shim
J Korean Acad Fam Med 2002;23(9):1098-1106.   Published online September 10, 2002
  • 1,371 View
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A hospital based case control study on the risk factors of stomach cancer.
Jae Ik Bae, Yun Mi Song, Jun Hyeon Yoo
J Korean Acad Fam Med 2001;22(4):539-547.   Published online April 1, 2001
Background
: For gastric cancer, primary prevention by risk factor modification might have some important roles. However, previous studies having investigated the factors associated with stomach cancer reported various results. In addition, there were only a few studies based on Korean population.

Methods : A case-control study was carried out on 106 cases matched for age and sex with 106 controls in a tertiary care hospital. In patients who were aged 75 years or less and had been newly diagnosed as adenocarcinoma of stomach between July 1996 and January 1997 were included into the case group. Information on baseline characteristics, health habits, dietary habits of study subjects was obtained through an interview using structured questionnaire. Conditional logistic regression analysis was used to evaluate the factors associated with stomach caner.

Results : Salt preference was associated with significantly increased risk of stomach cancer(odds ratio[OR]=9.81, 95% confidence interval[CI]=2.28-42.2). Eating broiled food more than three times a week significantly increased the risk of stomach cancer (OR=3.33, 95% CI=1.16-9.55) compared to eating it less than once a week. Blood type, family history of stomach cancer, smoking, and alcohol consumption were not associated with stomach cancer.

Conclusion : Salt preference and frequent eating of broiled food are the risk factors significantly associated with stomach cancer in this study subjects.
  • 1,343 View
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Relationships between leptin and gender, obesity indices, cardiovascular risk factors, and diet in Korean adolescents.
Hye Soon Park, Young Sik Kim, Mi Kyung Sung, Chung Ja Seung
J Korean Acad Fam Med 2001;22(3):303-315.   Published online March 1, 2001
Background
: Obesity in adolescents has been shown to be significantly associated with long-term mortality and morbidity. Leptin serceted by adipose tissue regulates body weight, and obese people show high leptin levels as well as as leptinresistance. The objective of this study was to ex-amine the relationships of leptin concentration with various indices of obesity, cardiovascular risk factors, and diet in adolescents.

Methods : We conducted cross sectional study with sixty-eight obese (28 male and 40 female)and 80 normal weight adolescents (40 male and 40 female), aged 12-18y, from and urban area in South Korea. Weight, height, body fat, waist and hip circumference, blood pressure, and fasting serum glucose, total, LDL, and HDL-cholesterol, triglyceride, and leptin were measured, and a 24 dietary recall obtained.

Results : Females had, on average, two-times higher leptin concentrations per fat mass than males. Circulating leptin was strongly associated with body fat (male:r=0.69, p<0.01; female:r=0.67, p<0.01), and waist circumference (male:r=0.65, p<0.01; female:r=0.64, p<0.01). The correlations between log.leptin and some cardiovascular risk factors were weakly positive. None of the association between log.leptin and nutrient intakes were significant. In a multiple regression model, body fat, gender, and waist circumference were found to be significant independent determinants of leptin concentration.

Conclusion : These results show that female adolescents have higher leptin levels compared to male adolescents, independent of the concomitant variation in total body fat mass. Although leptin concentration did not have direct association with intakes, there was significant correlations with obesity and several cardiovascualr risk factors in Korean adolescents.
  • 1,521 View
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The association between dietary fat and body fat in obese adults.
Ka Young Lee, Ki Jung Kim
J Korean Acad Fam Med 2001;22(1):87-95.   Published online January 1, 2001
Background
: There are different opinions on whether the percentage of dietary fat is associated with the development of obesity and on it's treatment. In this country, dietary fat intake has been smaller compared to the Western countries. The purpose of this study was to find whether intake of dietary fat is related to percentage body fat in obese adults cross-sectionally.

Methods : Nutrient intake form 24-hour dietary recall and percent body fat from bioelectrical impedance method were measured in 51 obese adults. Total energy intake was associated with intake of dietary fat and body size. Thus, the association of intake of dietary fat and three types of fat with percentage body fat were examined after adjustment for total energy intake by using 4 statistical models (standard multivariate model, and nutrient residual model, energy-partition model, and multivariate nutrient density model).

Results : In all of these models, the results for types of fat and total fat showed similar results. Higher intake of total fat, saturated and polyunsaturated fat was associated with increased percentage body fat, while higher intake of monounsaturated fat was associated with decreased percentage body fat.

Conclusion : We found positive association between dietary intake of fat and percentage body fat in obese adults. Our results suggest that reducing fat intake would be a helpful way to prevent and treat obesity in adults.
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The effect of diet education provided by physicians and dieticians on serum lipid profiles during more than 1 year.
Ka Young Lee, Tae Jin Park, Eun Ryung Kwon, Ki Jung Kim
J Korean Acad Fam Med 2000;21(12):1523-1533.   Published online December 1, 2000
Background
: The purpose of this study was to compare the long-term effect of the cholestreol-lowering diet education provided by physicians with the education provided by dieticians on serum lipid profiles of hypercholestreolemic patients.

Methods : Among 248 ambulatory patients who had mean baseline serum total cholesterol (TC) level >200mg/dL and received cholesterol-lowering diet education from physicians or dieticians, 41 patients who checked serum lipid profiles three times during the mean of 403 days after education were included as subjects. The differences in means of all serum lipid profiles associated with education methods after controlling for follow-up duration, differences in means of all serum lipid profiles associated with follow-up duration after controlling for education methods, any interaction between education methods and follow-up duration on serum lipid profiles were analyzed by using repeated measures of analysis of variance. The difference between the baseline lipid levels and the third lipid levels after education were analyzed by using Wilcoxon signed ranks tests in each group. Correlations between baseline serum lipid profiles and the last changes in serum lipid profiles were analyzed.

Results : There were no significant differences in means of all serum lipid profiles associated with education methods of follow-up duration except LDL-cholesterol (LDL-C). The first LDL-C level after education was significantly lower in the group educated by physicians compared with the baseline LDL-C, but there was no such change in the group educated by dieticians. There were no interactions between education methods and follow-up duration on all serum lipid profiles. The last change of total cholesterol in both groups and LDL-C only in the group educated by dieticians were significant. Correlation coefficients between baseline triglyceride (TG) and change in TG, baseline LDL-C and change in LDL-C, baceline total cholesterol (TC) and change in TC in patients with TC 240mg/dL were -0.500 (P=0.002), -0.597 (P<0.001), and -0.578 (P=0.001), respectively.

Conclusion : The changes of serum lipid profile during more than 1 year after education were not significantly different according to diet education methods, but total cholesterol level was significantly degreased in both groups.
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Weight control behaviors of obese adolescents.
Su Yeon Park, Yun Ju Kang, Yong Kyung Shin, Sun Im Moon, Hye Ree Lee
J Korean Acad Fam Med 2000;21(2):254-264.   Published online February 1, 2000
Background
: As childhood-onset obesity has been known to have a poor prognosis, and its prevalence is rapidly increasing, many children and adolescents are becoming concerned about obesity and try various weight control methods. This study assessed the experience and behaviors of weight control in obese adolescents.

Methods : A total of 732 among 840 obese students from 28 schools in Seoul metropolitan area were assessed with a self-administered questionnaire.

Results : Middle school students showed the highest trial rate of weight control. Elementary and high school girls showed significantly higher trial rates of weight control than boys(p<0.05). The methods more frequently used were physical exercise, and diet, drugs and other methods, and visits to obesity clinics in than order. Elementary school girls most frequently tried physical exercise while high school girls went on a diet more frequently. All groups of girls were dieting significantly more often than boys(p<0.05). High school girls were the most frequent users of drugs and other methods while elementary school boys and middle schoolgirls visited obesity clinics most frequently. Unhealthy weight control methods observed were monodiet(2.7%), fasting(1.9%), dieting pills(1.4%), and vomiting(0.1%). The mean number of weight control methods was decreased with increasing age. The possibility of overall weight control was significantly higher in girls, having higher weight dissatisfaction levels. The possibility of physical exercise was significantly higher in younger ages, having mother with a career and a family history of obesity. The possibility of dieting was significantly higher in girls, older ages, having higher obesity index. The possibility of using drugs and other methods was significantly higher if they had higher weight dissatisfaction levels and a family history of obesity. The possibility of visiting obesity clinics was significantly higher if they had higher obesity index.

Conclusion : Although, exercise and diet were frequently chosen by obese adolescents for weight control, the number unhealthy methods chosen were found to be higher and physical exercise decreased wit increasing age. Therefore, an appropriate weight control program that is not detrimental to normal growth and development is called for in early adolescence.
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The factors associated with Body Mass Index of adults.
Moo Kyung Bae, Woo Keun Lee, Chun Hwa Song, Keun Mi Lee, Seung Pil Jung
J Korean Acad Fam Med 1999;20(7):906-916.   Published online July 1, 1999
Background
: Overweight and obesity are associated with increased mortality and morbidity. Obesity is influenced by multiple factors, both genetic and environmental factors. We investigated the relationship between socioeconomic, behavioral, dietary, reproductive factors and body mass index(BMI).

Methods : The subjects were 3000 adults who had visited the Health Screening and Diagnosis Center of Yeungnam University School of Medicine from February to June, 1997. We evaluated BMI and occupation, exercise, smoking, alcohol intake, total calorie intake, fat and carbohydrate intake in both gender and reproductive factors in women. Then, we analyzed the association between BMI and such variables as above.

Results : 1629 men and 1371 women were analyzed. The mean BMI was 23.4±2.8kg/M² in men, 22.9±3.1kg/M² in women. In both gender, 9.7% of our population had BMI over 27. Mean BMI increased with age. Those who were active and light smokers(≤20cigarette/day) had the lowest BMI in men. But no relationship was observed between BMI and exercise, smoking in women. Heavy alcohol drinkers(>1cup/day) had higher BMI than other group in both gender. We found significant correlation between BMI and total calorie intake, calorie intake to recommended calorie ratio in both gender. In women, the group whose number of parity was above 3 had significantly higher BMI than the other. And age at first birth was significantly correlated with BMI in a negative direction.

Conclusion : Our results showed that BMI was associated with age, smoking, alcohol, total calorie intake, calorie intake to recommended calorie ratio, parity, age at first birth. Socioeconomic class, exercise and diet composition appeared to have little influence.
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Randomized Controlled Trial

Comparison of modifications of intra-abdominal fat between low calorie diet alon and low calorie diet with exercise in Korean women.
Jae Woo Ahn, Jae Hean Kang, Seong Won Kim, Young Hwan Kim, Hye Soon Park, Hyun Soo Kim, Yun Jun Yang
J Korean Acad Fam Med 1999;20(1):62-70.   Published online January 1, 1999
Background
: Obesity and its complications are increasing as social economic standard of living is improving and life style has been changing in Korea. There is growing evidence that the visceral/subcutaneus adipose tissue area ratio (VSR) on computed tomography (CT) is closely related to the obesity complication. Therefore, it is important to determine whether the VSR reduction is produced during weight loss. The purpose of this study was to observe and compare the amount of reduction of intraabdominal fat between low calorie diet(LCD) alone and LCD with exercise.

Methods : Sixty obese females were randomly prescribed a LCD alone or a LCD with exercise. Thirty obese females were treated with a LCD of 1,000kcal/d for 8 weeks (group A). Another thirty obese females were treated with a LCD of 1,000kcal/d combined with supervised aerobic exercise for 8 weeks(group B). Weight, height, BMI, and body fat distribution were measured in all subjects immediately before and after 8 weeks of this study. The body fat distribution was assessed by CT, by which the total abdominal adipose tissue area (AT), subcutaneous abdominal adipose tissue (SAT), intraabdominal adipose tissue(VAT), and visceral/subcutaneous adipose tissue ara ratio (VSR) were measured at the level of the umbilicus. A venous blood sample was taken after an overnight fast to determine lipid, glucose, and insulin concentrations in all subjects before and after 8 weeks of this study.

Results : Body weight, BMI, CT measurement of total(AT), visceral (VAT), and subcutaneous(SAT) fat were found to be decreased significantly in the two groups B decreased significantly (P<0.05) during weight loss. Fasting plasma glucose and total cholesterol levels significantly decreased in the both groups(P<0.001). Fasting plasma insulin and triglyceride levels significantly decreased in the group B, but not in group A.

Conclusion : This study shows that the VSR decreased significantly in group B, but not in group A. Fasting plasma inulin and triglyceride levels decreased significantly in group B, but not in group A. These results suggest that the LCD with exercise is more effective in reducing expected complications of obesity than LCD alone.
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Original Articles
Development of an OPD-based childhood obesity control program and the effects of its utilization.
Hye Ree Lee, Yun Ju Kang, Jae Yong Shim
J Korean Acad Fam Med 1998;19(10):787-800.   Published online October 1, 1998
Background
: Although childhood obesity is an increasing public health problem in our society and a number of regimens have been developed and distributed for the treatment of adult obesity, few studies have focused on therapeutic programs for obese children. The objective of this study was to develop and measure the effects of an OPD-based childhood obesity control program.

Methods : The OPD-based childhood obesity control program was developed by reviewing the preexisting literature and consulting specialists. It was applied to the 4-6th grade obese(obesity index≥30%) children. The effects of intervention were assessed by the changes in obesity-related behavior, caloric and nutrient intake and exercise amount. The effects in the OPD-based group(group I) were also compared with the school-based group(group II)and the no intervention group(group III).

Results : The OPD-based program was developed based on behavioral modification principles such as self monitoring, stimulus control, positive reinforcement, social support, cognitive change and behavioral contracts and contained diet and exercise therapy. The developed program was applied to 34 pairs(child and mother) in the treatment group of which 21 pairs completed the basic sessions and 17 pairs completed the additional follow up session. Significant changes, decreases in obesity index were observed in the OPD-based group. No significant changes were found in the school-based group whereas increased degrees of obesity were found in the no intervention group. Obesity related behavior scores were significantly increased in both the OPD- and school-based groups. The children in both the OPD-based group showed significant decrease in dietary intake and increase in exercise amount.

Conclusion : Although it was a short-term treatment result, the OPD-based program was more effective than the school-based program in childhood obesity control. We suggest that a control program of comparable intensity and individualization as ours is required, for effective childhood obesity control.
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Comparison of clinical usefulness of low-calorie-diet combined with exercise and low-calorie-diet alone.
Jae Heon Kang, Sung Won Kim, Hye Soon Park, Hyun Soo Kim
J Korean Acad Fam Med 1998;19(2):167-176.   Published online February 1, 1998
Background
: To assess the efficacy and safety of low-calorie-diet(LCD) using formular diet and to compare clinical usefulness of LCD combined with exercise with LCD alone, sixty obese females were prescribed LCD with exercise or LCD alone, randomly.

Methods : Thirty obese females were treated with LCD of 1,000 kcal/d for 8 weeks(group A). Another thirty obese females were treated with LCD of 1,000 kcal/d combined with supervised aerobic exercise for 8 weeks(group B).

Results : 22 out of 30 obese females in group A[37.3±5.0yr ; body fat 40.3±3.9%] and 26 out of 30 obese female in group B[37.9±7.6yr ; body fat 41.5±3.7%] completed the study. At the eighth week, mean weight loss was 5.8±2.1kg(8.1%) for group A, and 6.8±1.6kg(9.7%) for group B. Differences in weight loss between two groups were statistically significant(p<0.05). In group A, blood pressure, serum glucose, uric acid, total cholesterol, HDL-cholesterol, sodium, chloride, body fat were significantly reduced, and serum zinc, calcium, phosphorus were significantly increased(p<0.05). In group B, blood pressure, serum glucose, uric acid, total cholesterol, HDL-cholesterol, triglyceride, insulin, iron, sodium, body fat were significantly reduced, and serum zinc, calcium, phosphorus, magnesium were significantly increased(p<0.05). However, the differences of the changes in the above laboratory data between two groups were not statistically significant. Side effects were few and occurred mainly during the frist week of the trial.

Conclusion : Low calorie diet for 8 weeks decreased body fat, BP, glucose, uric acid, total cholesterol, HDL-cholesterol levels significantly, and when combined with exercise weight loss was much more than LCD only.
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