Inflammation is associated with chronic disease. High-sensitivity C-reactive protein (hs-CRP) is a predictor of chronic disease. The dietary inflammatory index (DII) is used to determine the overall inflammatory potential of diet. A cross-sectional analysis of Health Examinee cohort data (2012-2014) from Korea was performed. Subjects were 40-79 years of age (8,332 males; 19,754 females). The DII was used to analyze the relationship between subject characteristics, nutrient intake, and the hs-CRP. Additionally, the relationship between DII and hs-CRP as a predictor of chronic disease was examined. The DII was divided into 4 quartile: Q1 = -7.21 to -1.88 (median: -3.020), Q2 = -1.87 to -0.02 (median: -0.410), Q3 = -0.01 to 1.87 (median = 0.870) and Q4 = 1.88 to 7.34 (median = 3.040). For each group, the carbohydrate/protein/fat intake ratio was Q1 = 66.7:16.6:19.2, Q2 = 67.2:15.6:18.7, Q3 = 67.3:15.1:18.4 and Q4 = 67.3:14.0:17.9. The odds of elevated hs-CRP were 1.241 times higher in participants with the most proinflammatory diets than those with the most anti-inflammatory diets [hs-CRP; odds ratio (95% confidence interval) for Q4 vs Q1: 1.241 (1.071, 1.438); p for trend = 0.002]. An association was found between a high DII and high levels of hs-CRP. The DII may be applied to measure the association between diet and chronic diseases.

This study was intended to develop a Korean-dietary inflammatory index (K-DII) for metabolic disease patients, by using health examinee cohort data. It was also intended to evaluate the validity of K-DII.BR Based on 18 food groups in the Korean Genome and Epidemiology Study (KoGES), food groups were reclassified into 51 groups. Food groups showing significance correlation with hs-CRP by binomial logistic regression analysis were selected. In order to evaluate the validity of the developed K-DII, the researchers analyzed the correlation with health indicators and the relationship between the odd ratio of metabolic syndrome and K-DII. ANOVA and logistic regression analysis were carried out, according to tertile of K-DII, by using SPSS 23 version.BR Final 17 food groups were selected as factors utilized for the formula to calculate the K-DII assessment tool. The formula was the sum of product of intakes and beta values in each food group. A significant difference was shown in age, body mass index, waist measurement, diastolic blood pressure, triglyceride and hs-CRP, according to tertile of K-DII. In the results of analyzing metabolic syndrome risk according to K-DII, it was shown that metabolic syndrome risk in the group having the highest K-DII was 1.204 times higher than the lowest K-DII group (95% Cl; 1.123-1.290)(p=0.002, p for trend=0.000).BR The K-DII was composed of food groups that represented the inflammatory potential in Korean diet. Its strong relationship with metabolic syndrome showed a usefulness in assessing the inflammatory status of total diets. It is hoped that the K-DII can be utilized in actual clinical settings as a nutritional assessment tool, after validation in different metabolic disease patients.

Inflammation is known to be associated with chronic diseases such as cardiovascular disease and cancer. In particular, a high‐sensitivity C‐reactive protein (hs‐CRP) has been reported as a predictor of chronic disease induction. Dietary inflammatory index (DII) is a score used to determine the overall inflammatory potential of diet. There are limited studies which have shown the association between the DII score and inflammatory biomarkers in Korean. In this study we performed to analyze the association between two inflammatory biomarkers such as hs‐CRP and WBC and DII in healthy Korean. We performed cross‐sectional analysis of Health Examinee Cohort (2012–2014). Subjects were between the ages of 40 or 79 (8,332 males and 19,754 females). Information on food consumption was obtained using a 24 hour recall method which was used for calculating DII scores. Blood samples provided measurement of hs‐CRP and WBC counts. The dichotomous variable was entered into logistic regression models to measure odds ratios (ORs) of having higher hs‐CRP levels (>3mg/L) or WBC levels (>median) compared to lower levels (≤3mg/L or ≤median), with increasing DII, respectively. The DII scores of females (0.02 ± 2.50) were higher than males (−0.058 ± 2.48) (p<0.001). There was a positive correlation between DII and hs‐CRP and WBC (hs‐CRP; r=0.032, p=0.000, WBC; r=0.039, p=0.000). Odds of an elevated hs‐CRP or WBC were 1.181 times and 1.143 times higher in participants with the most proinflammatory diets compared to those with the most anti‐inflammatory diets, respectively [hs‐CRP; OR(95% CI) for T3 vs T1:1.181 (1.019,1.370); P trend=0.085, WBC; OR(95% CI) for T3 vs T1:1.143 (1.066,1.2261); P trend=0.001]. The analysis of association between DII, hs‐CRP and WBC in Korean showed that the higher DII, the higher hs‐CRP and WBC. Therefore the DII can be used for assessing the inflammatory potential of diet in Korean. Furthermore, the DII can be applied to measure the association between diets and chronic diseases. Support or Funding Information This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIP) (No. NRF‐2016R1A2B1014466) Characteristics of subject Characteristic Total (n=28,086) Men (n=8,332) Women (n= 19,754) p‐value Age (years)* 52.47 ± 8.00 53.27 ± 8.422 52.14 ± 7.79 0.000 BMI (kg/m 2 ) 23.58 ± 2.91 24.27 ± 2.74 23.29 ± 2.93 0.000 SBP (mmgh) 121.10 ± 14.82 124.18 ± 14.06 119.80 ± 14.94 0.000 DBP (mmgh) 74.73 ± 9.78 77.28 ± 9.65 73.65 ± 9.63 0.000 Fasting glucose (mg/dl) 91.87 ± 9.23 94.26 ± 9.83 90.86 ± 8.78 0.000 hS‐CRP 0.97 ± 1.19 1.13 ± 1.32 0.90 ± 1.13 0.000 WBC blood (Thous/uL) 5.60 ± 1.50 6.02 ± 1.61 5.42 ± 1.41 0.000 DII −0.002 ± 2.49 −0.058 ± 2.48 0.02 ± 2.50 0.014 DII/1000 kcal 0.002 ± 2.28 0.190 ± 2.26 −0.076 ± 2.28 0.000 Smoker Past, smoking 3778 (13.5) 3514 (42.2) 264 (1.3) 0.000 Yes 3123 (11.1) 2667 (32.0) 456 (2.3) No 21185 (75.4) 2151 (25.8) 19034 (96.4) Education Uneducated 546 (2.0) 90 (1.1) 456 (2.3) 0.000 Elementary school 2781 (9.9) 524 (6.3) 2257 (11.5) Middle school 3938 (14.1) 870 (10.5) 3068 (15.6) High school 10855 (38.8) 2698 (32.4) 8157 (41.5) University 8430 (30.2) 3308 (39.8) 5122 (26.1) Graduate school 1408 (5.0) 826 (9.9) 582 (3.0) Family income (10,000 won) less than 100 2033 (7.4) 433 (5.2) 1600 (8.3) 0.000 100‐less than 200 11532 (41.8) 3148 (38.1) 8384 (43.4) 300‐less than 400 6252 (22.7) 1892 (22.9) 4360 (22.6) 400‐less than 600 5063 (18.4) 1679 (20.3) 3384 (17.5) Over 600 2690 (9.8) 1101 (13.3) 1589 (8.2) Characteristics of subject by tertile of DII Characteristic Tertile 1 (n=9,391) Tertile 2 (n=9,359) Tertile 3 (n=9,336) p‐value DII −2.78 ± 1.117 −0.013 ± 0.687 2.81 ± 1.138 0.000 (−7.21–1.22) (−1.21–1.18) (−1.19–7.34) Age (years)* 53.26 ± 7.892 52.35 ± 7.986 51.81 ± 8.070 0.000 Sex 0.111 Men 2843 (30.3) 2791 (29.8) 2698 (28.9) Women 6548 (69.7) 6568 (70.2) 6638 (71.1) BMI (kg/m 2 ) 23.4782 ± 2.79658 23.5991 ± 2.90675 236848 ± 3.02237 0.000 SBP (mmgh) 121.282 ± 14.7331 120.943 ± 14.7769 121.088 ± 14.9594 0.290 DBP (mmgh) 74.619 ± 9.8040 74.624 ± 9.6909 7.4960 ± 9.8503 0.024 Fasting glucose (mg/dl) 91.973 ± 9.2174 91.912 ± 9.2024 91.739 ± 9.2971 0.199 hs‐CRP 0.9381 ± 1.16046 0.9658 ± 1.17561 1.0222 ± 1.25450 0.000 WBC blood(Thous/uL) 5.5230 ± 1.46777 5.6034 ± 1.49021 5.6749 ± 1.54109 0.000 Smoker Past. smoking 1344 (14.3) 13.7 (14.0) 1127 (12.1) 0.000 Yes 874 (9.3) 1023 (10.9) 1226 (13.1) Ho 7173 (76.4) 7029 (75.1) 6983 (74.8) chronic disease(n) 0 8252 87.9% 8384 89.6% 8374 89.7% 0.000 1 1097 11.7% 954 10.2% 933 10.0% 2 42 0.4% 21 0.2% 29 0.3% exercise practice (for a week) 0 3865 41.2% 4527 48.4% 5088 54.5% 0.000 1–2 1260 13.4% 1159 12.4% 1073 11.5% 3–4 2094 22.3% 1834 19.6% 1564 16.8% 5–6 1225 13.0% 1044 11.2% 861 9.2% 7 947 10.1% 795 8.5% 750 8.0% Education Uneducated 131 (1.4) 169 (1.8) 246 (2.7) 0.000 Elementary school 858 (9.2) 938 (10.1) 985 (10.6) Middle school 1317 (14.1) 1281 (13.7) 1340 (14.5) High school 3609 (38.6) 3646 (39.1) 3600 (38.8) University 2919 (31.2) 2816 (30.2) 2695 (29.1) Graduate school 524 (5.6) 478 (5.1) 406 (4.4) Family income (10,000 won) less than 100 583 (6.3) 640 (7.0) 810 (8.9) 0.000 100‐les* than 200 3840 (41.3) 3820 (41.5) 3872 (42.7) 300‐less than 400 2074 (22.3) 2125 (23.1) 2053 (22.6) 400‐less than 600 1794 (19.3) 1686 (18.3) 1583 (17.4) Over 600 1003 (10.8) 928 (10.1) 759 (8.4) Correlation between anthropometric and dietary inflammatory index with inflammatory markers(hs‐CRP, WBC) Variable log hs‐CRP WBC r P r P Age 0.151 0.000 −0.042 0.000 BMI 0.328 0.000 0.154 0.000 SBP 0.150 0.000 0.108 0.000 DBP 0.152 0.000 0.112 0.000 Exercise practice −0.026 0.000 −0.078 0.000 Chronic disease 0.036 0.000 −0.034 0.000 DII 0.032 0.000 0.039 0.000 by spearman's correlation coeffients. Associations between the dietary inflammatory index and hs‐CRP Variable Tertile 1 Tertile 2 OR (95% CI) Tertile 3 OR (95% CI) p‐value hs‐CRP Crude 1(reference) 1.135(0.999–1.290)1) 1.282(1.131–1.452) 0.001 Adjusted 1 1 1.134(0.997–1.290) 1.277(1.125–1.449) 0.001 Adjusted 2 1 1.084(0.947–1.240) 1.181(1.019–1.370) 0.085 WBC Crude 1(reference) 1.071(1.011–1.134) 1.169(1.104–1.238) 0.000 Adjusted 1 1 1.053(0.993–1.117) 1.144(1.079–1.214) 0.000 Adjusted 2 1 1.059(0.995–1.126) 1.143(1.066–1.226) 0.001 OR(95% CI): Odds ratios (95% confidence Interval)

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

BACKGROUND/OBJECTIVES:As the prevalence of chronic diseases has risen, the need for straightforward diagnostic tools for monitoring nutrition status to improve nutrition counseling and disease prevention has likewise increased.This study developed an easily usable dietary behavior pattern diagnosis checklist and investigated its correlation with dietary quality index.SUBJECTS/METHODS: A draft dietary pattern evaluation tool was generated by analyzing previous studies.The draft questionnaire comprised 61 questions for assessing dietary habits.A survey was administered to 320 adults (19 to 64 years old) using the dietary pattern evaluation tool and 24-hour-recall method between March and May of 2014 in Jeonbuk province and the metropolitan area.Principal component analysis with varimax rotation was performed to identify dietary behavior patterns.Nutritional analysis was conducted using CAN-Pro 4.0, and the Diet Quality Index-International (DQI-I) was calculated to assess dietary quality.The correlation between dietary pattern scores and DQI-I scores was also analyzed. RESULTS:The factor analysis resulted in a total of 34 questions mapped to four main dietary behavior patterns: "high fat and calorie" pattern (12 questions), "overeating/binge" pattern (nine questions), "dietary impulse" pattern (eight questions), and "unbalanced food intake" pattern (five questions).The four dietary behavior patterns were negatively correlated with DQI-I adequacy and total scores (P < 0.01). CONCLUSIONS:The dietary pattern evaluation tool developed in this study can be used to diagnose a client's dietary behavior problems and is available as a nutrition counseling tool in the field.

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

본 연구에서는 도시기반코호트자료를 활용하여 정상인과 대사증후군의 식사염증지수를 비교 분석한 후 대사증후군의 판정 개수에 따른 식사염증지표의 차이를 보고자 연구를 수행하였다. 본 연구의 대상자는 2012년-2014년 한국인유전체역학조사사업(Korean Genome Epidemiology Study; KoGES)의 예방유전체 도시기반코호트 기반조사에 참여한 40세 이상 대상으로 여자 22,620명, 남자 10,531명 총 33,151명을 대상으로 분석하였다. 24시간 회상법 자료를 사용하여 식품과 영양소분석을 하였으며, 이를 기반으로 식사염증지표를 분석하였다. 연구 대상자의 대사증후군 유병률은 전체 20.5%로 조사되었다. 전체 대상자의 대사증후군과 정상인의 영양소 분석 결과 나트륨의 섭취량이 대사증후군에서 높게 나타났으며, 칼슘(p0.001), 인(p0.05), 칼륨(p0.01), 비타민 B2(p0.001), 니아신(p0.01), 식이섬유(p0.05), 비타민 A(p0.01)가 대사증후군이 정상군 보다 낮게 섭취하는 것으로 조사되었다. 본 연구의 영양 질적 평가 결과 전체 대상자 중 정상군에서 단백질(p0.01), 비타민 A(p0.01), 비타민 B2(p0.001), 니아신(p0.01), 칼슘(p0.01)이 대사증후군보다 영양 질적지수가 높은 것으로 조사되었다. 연구 대상자의 식사염증지표 분석 결과 전체 대상자 중 정상군은 -0.02 점, 대사증후군은 0.07 점으로 대사증후군에서 식사염증지표가 높은 것으로 조사되었다(p0.01). 전체 대상자의 식사염증지표에 따른 대사증후군 발생위험도 분석 결과 2분위의 교차비는 1.089(1.019-1.162), 3분위 1.111(1.041-1.187)로 조사되었다(p0.05). 여자의 식사염증지표에 따른 대사증후군 발생위험도 분석결과 2분위의 교차비는 1.097(1.007-1.194), 3분위 1.142(1.050-1.243)로 조사되었다(p0.05). 대사증후군의 판정지표 개수에 따른 여자 대사증후군의 식사염증지표는 MetS-3군 0.09점, MetS-4군 0.21 점, MetS-5군 0.45 점으로 대사증후군 판정 개수가 증가할수록 식사염증지표가 높은 것으로 조사되었다(p for trend0.01). 본 연구 결과 한국인 대사증후군의 항염증 식사를 위한 식사요법 개발이 요구되는 바이다. 또한, 본 연구 자료는 항염증성 식사에 대한 기초자료로의 사용이 가능하리라 생각된다.

This study was conducted to validate a food frequency questionnaire (FFQ) to assess vitamin K intake in clinical and research settings based on data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V). We collected a subset of data on informative food items using the 24-hour recall method from adults aged 19 to 64 years from KNHANES V. The cumulative percent contribution and cumulative multiple regression coefficients for vitamin K intake from each food were computed. Twenty-five foods items were selected for the FFQ to assess vitamin K intake. The FFQ was validated against intakes derived from a 5-day food record (5DR) (n = 48). To assess the reliability of the FFQ, participants completed the self-administered FFQ (FFQ1) and a second FFQ (FFQ2) after a 6-month period (n = 54). Data were analyzed using Pearson's correlation coefficients, the cross-classification method, and Bland-Altman plots. Mean intakes were similar for vitamin K between the FFQ and dietary records, with significant correlations observed (r = 0.652), and cross-classification analyses demonstrated no major misclassification of participants into intake quartiles. Bland-Altman plots showed no serious systematic bias between the administrations of the two dietary assessment methods over the range of mean intakes. FFQ reliability was high, with a Pearson's correlation coefficient of 0.560. This pilot study shows promising validation and reliability evidence for the use of this FFQ, which is focused on vitamin K intake in adults, as an efficient screening tool in clinical and research settings.

Low vitamin K nutritional status has been associated with increased risk of fracture, however inconsistent results exist to support the role of vitamin K on bone mineral density depending on ethnic difference and gender. Our objective was to determine vitamin K intake in Korean adults, examine correlation between vitamin K intake and bone mineral density. This study analyzed raw data from the fifth Korea National Health and Nutrition Examination Survey for adults (2,785 men, 4,307 women) aged over 19 years. Cross-sectional analyses showed only positive association between vitamin K intake and femur bone mineral density in men after adjusting bone-related factors. However, women in high tertiles of vitamin K intake had a significantly higher bone mineral density both in femur and lumber as compared to women in lowest tertiles (p<0.05). The risk for osteoporosis was decreased as vitamin K intake increased in women, but this effect was not persisted after adjusting factors. The findings of this study indicate that low dietary vitamin K intake was associated with low bone mineral density in subjects. From these results we may suggest an increase in dietary vitamin K intakes for maintaining bone mineral density. (2010-02CON-21-C, 2011-02CON-06-C)

Phylloquinone (vitamin K1) is related to blood coagulation and bone formation by carboxylation of γ-glutamic acid. It has been demonstrated that vitamin K1 has favorable effects on suppressing inflammatory cytokines formation in vitro. This study determined whether vitamin K1 is also capable of suppressing inflammatory reaction in high-fat diet (HFD)-induced obese mice. Four-week-old C57BL/6J male mice were fed a 10% fat normal diet group(N) or a 45% kcal fat diet group(HFD), with or without 200 mg/1000 g vitamin K1(HFD+K1) for 12 weeks. Weight change, adipose tissue weight and serum inflammatory cytokines were measured. Compared with the N, total fat mass, leptin, osteoprotogerine(OPG), and fasting blood glucose levels were higher in HFD. Supplementation of vitamin K1 in HFD resulted in 10% less fat accumulation than in HFD (p<0.05). Serum levels of leptin were higher in the HFD+K1 group than in the HFD group (p<0.05). Serum OPG level of the HFD group and HFD+K1 group was 2.21±0.28 ng/ml, 2.58±0.10 ng/ml, respectively (p<0.05). In conclusion, vitamin K1 supplementation seems to tend to prevent weight gain and fat accumulations and depress the inflammatory reaction in high-fat diet induced obese state.

Vitamin K is a co‐factor for γ‐glutamic carboxylase, which is an essential enzyme for the γ‐carboxylation of vitamin K‐dependent proteins. Menaquinone (vitamin K2) has been reported to have favorable effects on bone metabolism and energy metabolism. In the present study we investigated the effects of the long‐term supplementation effects of menaquinone on inflammatory status and weight control in high‐fat diet (HFD)‐induced obese mice. A total of twenty‐one male, 4‐week‐old C57BL/6 mice were fed and randomly divided into 3 groups (7 animals in each group; randomized block design), a normal diet (ND), 45% HFD and a 45% HFD + menaquinone (HFD ‐K2) for 3 months. Weight change, adipose tissue weight and serum proinflammatory cytokines were determines.Compared with the ND, the HFD increased total fat mass, leptin, osteoprotogerine, and fasting blood glucose levels. Consumption of HFD containing menaquinone resulted in significantly less weight gain (12% less, p<0.05). Interestingly, menaquinone supplementation significantly decreased the total fat accumulation (p<0.05) and leptin levels (p<0.05) and reduced serum glucose by 17% compared with the HFD group.In conclusion, the present study demonstrates that menaquinone supplementation had favorable effects on weight control and body composition possibly through suppressing inflammation.Further studies on the mechanism of menaquinone supplementation in the regulation of body fat accumulation would provide valuable data on the prevention of lifestyle related disorders, including diabetes and obesity.Grant Funding Source: Funded by the Ministry of Education, Science and Technology in Korea(project no:2012R1A1A3012499

Although there is evidence that vitamin D deficiency relates to expression of chronic disease, relationship between vitamin D and cardiovascular disease predictors have not been clearly demonstrated in Korean. Our objective was to assess the correlation between vitamin D and the cardiovascular and inflammatory markers in overweight and obese people who had not been exposed to a particular disease. We enrolled 171 healthy adults (159 men and 12 pre-menopausal women) with no history of cardiovascular disease and with a body mass index >23 kg/m2 in this study. In addition, levels of serum vitamin D and concentrations of the inflammatory markers hs-CRP, interleukin-6, and adiponectin were measured. The average age of our study subjects was 48.53 years old, and 64.8% of all male subjects and 91.9% of all female subjects were in the vitamin D deficient status. Serum vitamin D levels showed a positive correlation with age (p<0.05), HDL-cholesterol (p<0.05), and adiponectin (p<0.05) levels. However, there was a negative correlation of vitamin D with triglyceride (p<0.01) and interleukin-6 levels (p<0.05). In addition, even after adjusting for factors that may affect the cardiovascular index (age, sex, body mass index, smoking, and alcohol intake), serum vitamin D levels showed a significant correlation with triglyceride (p<0.05), HDL-cholesterol (p<0.05), and adiponectin (p<0.05) levels. Therefore, the results of this study suggest that vitamin D may be a predictor of cardiovascular disease for overweight and obese people who are likely to be at a risk for cardiovascular disease.

It is well known that vitamin K works for blood clotting reaction and helps forming bones by boosting formation of osteoblast. Recently it has been reported that it also prevents various illnesses like type 2 diabetes, obesity and cardiovascular disorders. However, there has been insufficient development of nutrition intake tools for estimating vitamin K intakes and analyzing the amount of vitamin K intakes for Korean people. Therefore, this study aims to provide the basic data for developing tools to analyze vitamin K intakes by analyzing Koreans’ vitamin K intakes and its food sources. This study used the primitive data of the 5th the Korean National Health and Nutrition Examination Survey, and analyzed data from 8,027 subjects who participated in the survey among total 9,691 subjects of the nutrition examination survey.The vitamin K intakes were shown as 248.03±4.34 μg/day for men and 199.25±3.54 μg/day for women(p<0.001). In case of intakes for each age group, this study found 127.64±3.09 μg/day for teens, 208.10±8.67 μg/day for 20s, 264.88±7.08 μg/day for 30s, 271.63±7.68 μg/day for 40s, 294.17 ± 10.49 μg/day for 50s, 256.20±11.28 μg/day for 60s and 220.05±6.55 μg/day for 70s(p<0.001). For the contribution of vitamin K to each food group, vegetable was the highest(84.3%) and then respectively seaweed(5.5%), fruits(2.9%), seasoning(2.8%), fat and oil(2.2%), beans(1.2%). As dish sources for vitamin K, we found respectively cabbage kimchi(14.9%), seasoned spinach(9.5%), soybean past soup with dried radish greens(4.8%), rich soybean paste stew(3.9%) and gimbap(2.9%) in the order.This study found that Koreans’ average vitamin K intakes is 233 μg/day, which means that Koreans’ vitamin K intakes is relatively higher than Westerners. It is considered that such results reflect Koreans’ dietary composition which helps to frequently intake food that contains a lot of vitamin K like cabbage, spinach and radish greens as side dishes.

There is little information on dietary vitamin K intake and nutritional status of daily requirements of vitamin K in Korea. The objective of this study was to investigate the vitamin K intake and major food sources of Vitamin K in Koreans. The survey data from the 2010-2011 Korean National Health and Nutrition Examination Survey of 7,792 subjects (aged 19-64 years) were examined. Total vitamin K intake was calculated from 24-hour dietary recall using a vitamin K food database, Computer Aided Nutritional analysis Program and the United States Department of Agriculture database. The geometric mean of vitamin K was estimated as 322.40 ± 6.33 ug/day for men and 271.20 ± 4.92 ug/day for women. Daily vitamin K intake increased significantly with age (p for trend < 0.001). The main food source of vitamin K was vegetables (72.84%), including cabbage kimchi (19.26%), spinach (17.38%), sesame leaves (7.11%), radish leaves (6.65%), spring onions (6.28%), and laver (4.82%), followed by seaweed, seasonings, and fat and oils. We observed that the vitamin K intake of Koreans was relatively higher than that reported by other studies in Western countries and differed depending on age.

Several reports suggest that obesity is a risk factor for osteoporosis. Vitamin K plays an important role in improving bone metabolism. This study examined the effects of vitamin K1 and vitamin K2 supplementation on the biochemical markers of bone turnover and morphological microstructure of the bones by using an obese mouse model. Four-week-old C57BL/6J male mice were fed a 10% fat normal diet group or a 45% kcal high-fat diet group, with or without 200 mg/1000 g vitamin K1 (Normal diet + K1, high-fat diet + K1) and 200 mg/1000 g vitamin K2 (Normal diet + K2, high-fat diet + K2) for 12 weeks. Serum levels of osteocalcin were higher in the high-fat diet + K2 group than in the high-fat diet group. Serum OPG level of the high-fat diet group, high-fat diet + K1 group, and high-fat diet + K2 group was 2.31 ± 0.31 ng/ml, 2.35 ± 0.12 ng/ml, and 2.90 ± 0.11 ng/ml, respectively. Serum level of RANKL in the high-fat diet group was significantly higher than that in the high-fat diet + K1 group and high-fat diet + K2 group (p<0.05). Vitamin K supplementation seems to tend to prevent bone loss in high-fat diet induced obese state. These findings suggest that vitamin K supplementation reversed the high fat diet induced bone deterioration by modulating osteoblast and osteoclast activities and prevent bone loss in a high-fat diet-induced obese mice.

As prevalence of metabolic syndrome has rapidly increased over the past decade, lifestyle changes including dietary habits are considered as a therapeutic cornerstone for metabolic syndrome, cardiovascular complications and type 2 diabetes. We evaluated the effectiveness of a telephone-delivered nutrition education to improve metabolic parameters compared with a single-visit with a dietitian in subjects with metabolic syndrome. A total of seventy-one adults who met diagnostic criteria for the metabolic syndrome were randomly assigned to either the single-visit group or the in-depth nutrition education group during a 3-month intervention study period. The in-depth telephone-delivered nutrition education group had an initial visit with a dietitian and additional two telephone counseling during the first 4 weeks of the study periods. Sixty-six subjects completed a 3-month intervention study. The trial examined participant's anthropometric changes and dietary intakes as well as changes in the metabolic syndrome factors. At the end of the trial, the in-depth nutrition education group showed significantly higher reduction in weight, body fat and abdominal circumference compared with the other group (p < 0.05). In the in-depth nutrition groups, the prevalence of metabolic syndrome was decreased to 45.5%, while 69.7% of the subjects were metabolic syndrome patients in the single-visit group (p < 0.05). These results demonstrate that the telephone-intervention counseling is a feasible mean to deliver dietary intervention in patients with metabolic syndrome.

This study analyzed the reasons for continuing education among dietitians. An internet-based survey of 622 dieticians was conducted from August 31, 2012 to September 12, 2012. Based on data from the Participation Reasons Scale (PRS) questionnaire, factor analysis was conducted by principle component analysis for the extraction of major factors. Subsequent reliability analysis was performed by assessing Cronbach's ${\alpha}$. The ANOVA-test was performed to compare the participation reason scores for each factors according to general characteristics. Statistical analysis was performed using SPSS ver.17.0, and P<0.05 was considered significant. Factor analysis for the participation reasons revealed four types of factors. These factors were "maintenance and development of professional competencies", "interaction and responsibility of professionals", "job stability and personal profits" and "services for customers" respectively. Among the participation reasons, "maintenance and development of professional competencies" was the first reason with a 29.34% variance. In addition, the participation reasons for continuing education differed according to age (P<0.05), the highest level of education (P<0.05), workplace (P<0.01), and work experience in dietetic area (P<0.001). In conclusion, continuing education programs for dietitians should focus on effectively developing and promoting professionalism.

This study examined the change in inflammation makers and morphological microstructure of bones in mice fed on high‐fat diet. Four‐week‐old C57BL/6J male mice were divided into 2 groups: the control group was fed 10% kcal fat diet, and the high‐fat diet group was fed 45% kcal fat diet for 12 weeks. Inflammation markers were measured by using ELISA kits and microcomputed tomography (micro‐CT) was used to measure the morphological microstructure of the femoral bone. Leptin and IL‐6 levels were significantly higher in the high‐fat diet group (p < 0.01). Oosteocalcin was not significantly different between groups; however type I collagen C‐telopeptide was significantly higher in the high‐fat diet group (p < 0.01). The thickness of bone trabecula was significantly reduced in the high‐fat diet group as compared to the control group (p < 0.05), and the gap within the bone trabecula was significantly wider in the high‐fat diet group (p < 0.05). A positive correlation (p < 0.05) was observed between IL‐6 levels and the gap within the bone trabecula. These results showed that obesity induction in mice by feeding high‐fat diet during the growth phase resulted in a change in the bone microstructure and showed that bone microstructure was correlated with inflammation index. Therefore, restriction of excessive fat intake may be required to suppress inflammation reactions and promote normal bone formation.

This study surveyed dietary intake and adherence to the Korean national dietary guidelines in Korean adolescents. To elucidate basic data for use in nutrition education, which aims to improve adolescent compliance with the national dietary guidelines and to increase the intake of dietary fiber, we evaluated the sources of fiber in adolescent diets. This study included 182 male and 212 female students from 2 middle schools in the Jeonju province. From November 15~20, 2011, we surveyed the students for general characteristics, adherence to the Korean national dietary guidelines, and dietary intake. Dietary fiber intake was 16.57 ± 6.95 g/day for male students and 16.14 ± 7.11 g/day for female students. The food groups that contributed most to dietary fiber intake were (in descending order) cereals, vegetables, seasoning, and fruits. The fiber-containing food items consumed most were cabbage- kimchi, cooked rice, instant noodles, and cabbage. Based on adherence to the Korean national dietary guidelines, the vegetable-based intake of dietary fiber in groups 1 (score 15~45), 2 (score 46~52), and 3 (score 53~75) were 4.41 ± 2.595 g/day, 4.12 ± 2.692 g/day, and 5.49 ± 3.157 g/day, respectively (p<0.001). In addition, the total intake of dietary fiber varied significantly among the three groups (p<0.001) as follows: Group 1, 14.99 ± 6.374 g/day; Group 2, 15.32 ± 6.772 g/day; and Group 3, 18.79 ± 7.361 g/day. In this study, we discovered that adherence to the Korean national dietary guidelines correlates with improved intake of dietary fiber. Therefore, marketing and educational development is needed to promote adherence to the Korean national dietary guidelines. In addition, nutritional education is needed to improve dietary fiber consumption through the intake of vegetables and fruits other than kimchi.

Few studies have shown the correlation between metabolic syndrome and bone mineral density (BMD). The main pathogenic mechanisms of metabolic syndrome rely on chronic low-level inflammatory status and oxidative stress. There are few studies that examine the gender-specific effects of inflammation and antioxidants on BMD. In this study, we evaluated the relative contribution of these factors in patients with metabolic syndrome. We conducted a cross-sectional study of 67 men and 46 postmenopausal women with metabolic syndrome; metabolic syndrome was defined as having three or more metabolic syndrome risk factors. BMD, body fat mass, and lean body mass were evaluated. We also examined the levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), adiponectin, vitamin E, and C in serum. Log-transformed hs-CRP levels were significantly higher in lumbar spine osteoporotic subjects than in normal subjects for women but not for men. There was no significant difference between the normal group and the osteoporotic group in other inflammatory markers. Stepwise regression analyses for BMD of the lumbar spine showed that lean body mass and vitamin E were significant determinants in men. Lean body mass and log-transformed hs-CRP were significant determinants in women Analysis for BMD of the femoral neck showed that lean body mass was a significant determinant for both men and women. There was no significant factor among the inflammatory markers or antioxidant vitamins affecting the femoral neck BMD for either gender. In conclusion, while hs-CRP is an independent predictor of the BMD of the lumbar spine in women, vitamin E showed profound effects on BMD in men but not women with metabolic syndrome.