Fermented foods are produced through controlled microbial activity and are valued for their extended shelf life, sensory attributes, and potential health benefits. This study examined the effects of production methods on microbial ecology by comparing microbial community structure, Shannon diversity, and pH changes in traditional and commercially produced Korean fermented foods. Cabbage and radish kimchi were fermented for four weeks to assess microbial succession and physicochemical changes, and additional fermented foods, including soy sauce, soybean paste, pepper paste, fruit vinegar, yogurt, and aged kimchi, were compared according to production method. Microbial communities were analyzed using amplicon sequencing targeting the V3-V4 regions of the bacterial 16S rRNA gene and the fungal internal transcribed spacer (ITS) region. Traditionally produced cabbage kimchi exhibited high microbial diversity at the early fermentation stage, initially dominated by Weissella and Leuconostoc, followed by a gradual shift toward lactic acid bacteria dominance at later stages. In contrast, commercially produced cabbage kimchi maintained a simplified microbial community dominated by a limited number of lactic acid bacteria throughout fermentation. Radish kimchi showed production-method-dependent patterns, with the rapid dominance of lactic acid bacteria during traditional fermentation and partial recovery of microbial diversity during commercial fermentation. Shannon diversity was consistently higher in traditionally produced kimchi during fermentation. In contrast, commercially produced kimchi exhibited more rapid acidification. Across other fermented foods, traditionally produced soy-based products exhibited complex microbial communities dominated by Bacillus spp., whereas commercially produced products were characterized by yeast-dominant profiles. Fruit vinegar and yogurt showed low microbial diversity regardless of the production method. These findings demonstrate the importance of production strategies in shaping microbial ecology, fermentation dynamics, and resulting product characteristics across various Korean fermented foods.

Background/Objectives: Korean traditional fermented foods may confer metabolic and anti-inflammatory benefits; however, their high sodium content raises concerns, particularly given age-related differences in sodium sensitivity. This study examined age-specific associations between fermented food intake and high-sensitivity C-reactive protein (hs-CRP), a marker of low-grade systemic inflammation, and assessed whether sodium intake modifies these associations. Methods: Data from KNHANES 2015-2018 were used to analyze 17,984 adults. Fermented foods were categorized into 10 groups (grains, jang, vinegars, vegetables, fish, fruits, dairy, alcoholic beverages, sauces, and tea/beverages). Intake (% of total energy) was classified into quartiles. Elevated hs-CRP was defined as ≥1 mg/L. Complex-sample multivariable logistic regression was used to assess age-stratified associations and interactions with total sodium and fermented food-derived sodium (SPSS 29.0; p < 0.05). Results: Fermented food intake decreased with age (p < 0.001). In adults aged 20-39, higher intake was associated with lower odds of elevated hs-CRP (Q4 vs. Q1: OR = 0.699, 95% CI 0.542-0.901; p for trend = 0.002). A similar inverse association was observed in those aged 40-64 (Q4: OR = 0.817, 95% CI 0.691-0.967; p for trend = 0.006), which remained significant after adjustment for fermented food-derived sodium. Among adults ≥65, significant interactions were observed for both fermented food-derived sodium (p = 0.040) and total sodium (p = 0.042), indicating variation across sodium intake levels. Conclusions: The association between fermented food intake and systemic inflammation differs by age. In older adults, this relationship appears to be modified by dietary sodium context, highlighting the importance of age-specific dietary considerations.

Background/Objectives: Aging increases the risk of metabolic diseases, such as diabetes, hypertension, dyslipidemia, and obesity, which may contribute to cataract development. This study examined whether metabolic diseases mediate the relationship between the dietary inflammatory index (DII) and cataract prevalence using structural equation modeling (SEM). Methods: Data were obtained from 9260 individuals aged 40 and older who participated in the 8th Korea National Health and Nutrition Examination Survey (KNHANES 2019–2021). DII scores, calculated from 24 h dietary recall, reflect the inflammatory potential of the diet, with higher scores indicating a more pro-inflammatory profile. SEM was applied to assess mediation effects, and analyses were conducted using SPSS 29.0 and AMOS 29.0. Results: Among the participants, 1853 individuals (20.0%) were diagnosed with cataracts, and the mean DII was 1.5 ± 2.8. In the high DII group, the risk of hypertension (β = 0.077, p < 0.001) and dyslipidemia (β = 0.033, p = 0.001) increased significantly. Hypertension (β = 0.187, p < 0.05), diabetes mellitus (β = 0.132, p < 0.05), dyslipidemia (β = 0.108, p < 0.05), and obesity (β = 0.025, p < 0.05) had direct effects on cataract prevalence. Diabetes 0.002 (p < 0.05), hypertension 0.014 (p < 0.05), and dyslipidemia 0.004 (p < 0.05) also showed significant indirect effects. Conclusions: Metabolic diseases mediate the relationship between DII and cataracts. Managing inflammation and metabolic health may reduce cataract risk.

Background/Objectives: Fermented foods promote digestion and may help prevent chronic diseases. However, studies on their relationship with health indicators in Korea remain limited. This study aimed to identify fermented food consumption patterns among middle-aged Korean adults and to analyze their association with high-sensitivity C-reactive protein (hs-CRP) and chronic disease. Methods: This study analyzed 7111 adults aged 40–64 years from the 6th–7th Korea National Health and Nutrition Examination Survey (KNHANES, 2015–2018). hs-CRP values were categorized as <1 mg/L, 1–3 mg/L, and ≥3 mg/L. Latent profile analysis (LPA) classified fermented foods into 10 categories using Mplus 8.11, with LMR-LRT significance and entropy ≥ 0.7 determining the number of classes. Logistic regression analysis using SPSS 29.0 was conducted to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for hs-CRP and chronic disease (p < 0.05). Results: LPA identified four consumption patterns: (LFP), (FABP), (FDP), and (FGP). hs-CRP was highest in LFP (1.0 ± 1.2 mg/L), followed by FABP (0.8 ± 1.1 mg/L) and FDP and FGP (0.9 ± 1.2 mg/L) (p < 0.001). Compared to LFP, FGP had ORs of 0.810 (95% CI: 0.690–0.950, p < 0.005) for hypertension and 0.586 (95% CI: 0.459–0.747, p < 0.001) for diabetes. For dyslipidemia, ORs were 0.832 (95% CI: 0.720–0.962, p < 0.005) for FABP and 0.832 (95% CI: 0.719–0.962, p < 0.005) for FDP. Conclusions: This study classified fermented food consumption patterns and analyzed their association with hs-CRP and chronic disease. FGP and FDP showed lower inflammation and reduced odds of hypertension, diabetes, and dyslipidemia compared to LFP. These findings highlight the potential of healthy fermented food consumption patterns to support inflammation control and chronic disease prevention.

BACKGROUND/OBJECTIVES:Metabolic syndrome (MetS) is closely connected to dietary and lifestyle factors, with diet being one of the primary risk factors for MetS, acting as a key factor in both prevention and management. In this study, we analyzed the mediating effect of the Korean Healthy Eating Index (KHEI) on the relationship between lifestyle patterns and MetS in middle-aged Koreans using data from the 2019-2021 Korea National Health and Nutrition Examination Survey (KNHANES). SUBJECTS/METHODS:This study examined data from 5,196 adults aged 40-64 yrs who participated in the eighth KNHANES. Data on 5 lifestyle factors-smoking, alcohol consumption, physical activity, sleep duration, and stress perception-were analyzed. The latent class analysis (LCA) was performed using Mplus 8.11, and SPSS PROCESS Macro v4.2 was used for statistical analysis to analyze the mediating effect of the KHEI. RESULTS:The model categorized lifestyle factors into three into 3 clusters: 'Low Activity Class,' 'Low Activity and Smoking Class,' and 'Multiple Risk Class.' The KHEI mediation analysis showed significant effects: 0.0205 (95% confidence interval [CI], 0.0062-0.0363) in the 'Low Activity and Smoke Class,' and 0.0420 (95% CI, 0.0133-0.0726) in the 'Multiple Risk Class.' The mediating effect of the KHEI domain "adequacy" was significant in these groups, with effects of 0.0357 (95% CI, 0.0184-00563) and 0.0662 (95% CI, 0.0364-0.6491), for the respective groups. Balance of energy intake was significant in the group with 'Multiple Risk Class' (0.0189; 95% CI, 0.0044-0.0378). CONCLUSION:The results suggest that a healthy diet improves health management and reduces risk factors for MetS. Nonetheless, better strategies for dietary improvement through a detailed analysis of KHEI components are warranted.

Background/Objectives: Aging increases the risk of metabolic diseases, such as diabetes, hypertension, dyslipidemia, and obesity, which may contribute to cataract development. This study examined whether metabolic diseases mediate the relationship between the dietary inflammatory index (DII) and cataract prevalence using structural equation modeling (SEM). Methods: Data were obtained from 9260 individuals aged 40 and older who participated in the 8th Korea National Health and Nutrition Examination Survey (KNHANES 2019-2021). DII scores, calculated from 24 h dietary recall, reflect the inflammatory potential of the diet, with higher scores indicating a more pro-inflammatory profile. SEM was applied to assess mediation effects, and analyses were conducted using SPSS 29.0 and AMOS 29.0. Results: Among the participants, 1853 individuals (20.0%) were diagnosed with cataracts, and the mean DII was 1.5 +/- 2.8. In the high DII group, the risk of hypertension (beta = 0.077, p < 0.001) and dyslipidemia (beta = 0.033, p = 0.001) increased significantly. Hypertension (beta = 0.187, p < 0.05), diabetes mellitus (beta = 0.132, p < 0.05), dyslipidemia (beta = 0.108, p < 0.05), and obesity (beta = 0.025, p < 0.05) had direct effects on cataract prevalence. Diabetes 0.002 (p < 0.05), hypertension 0.014 (p < 0.05), and dyslipidemia 0.004 (p < 0.05) also showed significant indirect effects. Conclusions: Metabolic diseases mediate the relationship between DII and cataracts. Managing inflammation and metabolic health may reduce cataract risk.

Purpose: This study aimed to explore the perceptions held by practicing dietitians of the importance of their tasks performed in current work environments, the frequency at which those tasks are performed, and predictions about the importance of those tasks in future work environments.Methods: This was a cross-sectional survey study. An online survey was administered to 350 practicing dietitians. They were asked to assess the importance, performance frequency, and predicted changes in the importance of 27 tasks using a 5-point scale. Descriptive statistics were calculated, and the means of the variables were compared across categorized work environments using analysis of variance.Results: The importance scores of all surveyed tasks were higher than 3.0, except for the marketing management task. Self-development, nutrition education/counseling, menu planning, food safety management, and documentation/data management were all rated higher than 4.0. The highest performance frequency score was related to documentation/data management. The importance scores of all duties, except for professional development, differed significantly by workplace. As for predictions about the future importance of the tasks surveyed, dietitians responded that the importance of all 27 tasks would either remain at current levels or increase in the future.Conclusion: Twenty-seven tasks were confirmed to represent dietitians’ job functions in various workplaces. These tasks can be used to improve the test specifications of the Korean Dietitian Licensing Examination and the curriculum of dietetic education programs.

Objectives: This study aimed to determine whether a mobile health (mhealth) intervention is effective in reducing weight and changing dietary behavior among employees with overweight and obesity. The study also investigated whether engagement with the intervention affected its effectiveness. Methods: The intervention involved the use of a dietary coaching app, a wearable device for monitoring physical activity and body composition, and a messenger app for communicating with participants and an intervention manager. A total of 235 employees were recruited for a 12-week intervention from eight workplaces in Korea. Questionnaire surveys, anthropometric measurements, and 24-h dietary recalls were conducted at baseline and after the intervention. Results: After the intervention, significant decreases in the mean body weight, body mass index, body fat percentage, and waist circumference were observed. Furthermore, the consumption frequencies of multigrain rice and legumes significantly increased, whereas those of pork belly, instant noodles, processed meat, carbonated beverages, and fast food significantly decreased compared with those at baseline. The mean dietary intake of energy and most nutrients also decreased after the intervention. When the participants were categorized into three groups according to their engagement level, significant differences in anthropometric data, dietary behaviors, and energy intake were observed following the intervention, although there were no differences at baseline, indicating that higher engagement level led to greater improvements in weight loss and dietary behavior. Conclusions: The intervention had positive effects on weight loss and dietary behavior changes, particularly among employees with higher engagement levels. These results indicate the importance of increasing the level of engagement in the intervention to enhance its effectiveness. The mhealth intervention is a promising model for health promotion for busy workers with limited time.

Objectives: A mobile health intervention program was provided for employees with overweight and obesity for 12 weeks, and a process evaluation was completed at the end of the program. We investigated participant engagement based on app usage data, and whether engagement was associated with the degree of satisfaction with the program. Methods: The program involved the use of a dietary coaching app and a wearable device for monitoring physical activity and body composition. A total of 235 employees participated in the program. App usage data were collected from a mobile platform, and a questionnaire survey on process evaluation and needs assessment was conducted during the post-test. Results: The engagement level of the participants decreased over time. Participants in their 40s, high school graduates or lower education, and manufacturing workers showed higher engagement than other age groups, college graduates, and office workers, respectively. The overall satisfaction score was 3.6 out of 5. When participants were categorized into three groups according to their engagement level, the upper group was more satisfied than the lower group. A total of 71.5% of participants answered that they wanted to rejoin or recommend the program, and 71.9% answered that the program was helpful in improving their dietary habits. The most helpful components in the program were diet records and a 1:1 chat with the dietary coach from the dietary coaching app. The barriers to improving dietary habits included company dinners, special occasions, lack of time, and eating out. The workplace dietary management programs were recognized as necessary with a need score of 3.9 out of 5. Conclusions: Participants were generally satisfied with the mobile health intervention program, particularly highly engaged participants. Feedback from a dietary coach was an important factor in increasing satisfaction.

[This corrects the article on p. 529 in vol. 17, PMID: 37266119.].

This study aimed to develop and assess the effectiveness of a web-based nutrition education program for self-managing IBS symptoms using the IMB model. This study used single-arm, pre–post study design to test the effectiveness of the nutrition education program after its development. Participants were adults in their twenties and thirties in South Korea with IBS according to the ROME IV diagnostic criteria (n = 49). For statistical analysis, normality was verified using the Shapiro–Wilk test, and variables that met the assumption of normality were analyzed using the paired t-test, and variables that did not meet the assumption of normality were analyzed using the Wilcoxon signed-rank test. p < 0.05 was considered statistically significant. IBS patients (n = 49) experienced a statistically significant increase in nutrition knowledge after receiving nutrition education (p = 0.015). IBS patients (n = 35) with no prior experience in nutrition education or diet modification also demonstrated a statistically significant increase in self-efficacy (p = 0.044) and nutrition knowledge (p = 0.016). The web-based nutrition education program based on the IMB model developed in this study was found to be effective. These results will contribute to diversifying symptom prevention strategies for patients with IBS.

BACKGROUND/OBJECTIVES Metabolic syndrome is closely associated with lifestyle factors, including diet and nutritional intake. Modern trends show a shift in food consumption from healthy home-cooked meals to processed and instant foods. Therefore, this study analyzed the association between ultra-processed food intake and the development of metabolic syndrome in Korean adults based on the data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2013–2018. SUBJECTS/METHODS The subjects of this study were 17,414 adults aged 19–80 years who participated in the 6th–7th KNHANES. Processed food was classified into four categories, NOVA1 to NOVA4, using 24-h recall data. The higher the NOVA category, the more processed the food. Statistical analysis was conducted using logistic regression to investigate the prevalence of metabolic syndrome according to the consumption of ultra-processed foods. RESULTS Among the diagnostic criteria for metabolic syndrome, hypertension (odds ratio [OR], 0.72; 95% confidence interval [CI], 0.62–0.85; Q4 vs. Q1, P-trend < 0.001) and high triglycerides (OR, 0.83; 95% CI, 0.72–0.94; Q4 vs. Q1, P-trend < 0.001) showed a correlation with the percentages of energy consumed from ultra-processed foods. The OR for metabolic syndrome, according to the percentages of energy consumed from ultra-processed foods, is shown only for men. The OR showed that the percentages of energy consumed from ultra-processed foods were associated with increased metabolic syndrome. CONCLUSIONS This study suggests that consumption of ultra-processed foods raises the risk of metabolic syndrome especially among men. To prevent metabolic syndrome, it is necessary to prepare appropriate dietary guidelines for Korean adults.

BACKGROUND/OBJECTIVES: Many studies have revealed an association between fat mass and the obesity-related gene (FTO) and obesity. On the other hand, no meta-analysis was conducted with data from only Koreans. Therefore, this study performed a meta-analysis using Korean data to provide evidence for the association between FTO single nucleotide polymorphisms (SNPs) and the risk of obesity among Korean adults. SUBJECT/METHODS: Meta-analysis was finally conducted with data extracted from seven datasets of four studies performed on Korean adults after the screening passed. Five kinds of FTO SNPs (rs9939609, rs7193144, rs9940128, rs8050136, and rs9926289) were included, and the relationship between FTO SNPs and body mass index (BMI) was investigated using linear regression with an additive model adjusted for covariants, such as age, sex, and area. RESULTS: The minor alleles of FTO SNPs were associated with increased BMI (odds ratio [OR], 1.31; 95% confidence interval [CI], 1.21-1.42). In sub-group analysis, FTO rs9939609 T>A was significantly associated with BMI (OR, 1.23; 95% CI, 1.06-1.42). The other FTO SNPs together were significantly associated with BMI (OR, 1.37; 95% CI, 1.25-1.49). The publication bias was not observed based on Egger's test. CONCLUSIONS: This meta-analysis showed that minor alleles in the FTO SNPs were significantly associated with an increased BMI among Korean adults. This meta-analysis is the first to demonstrate that minor alleles in the FTO SNPs contribute significantly to the increased risk of obesity among Korean adults using data from a Korean population.

properly BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2; 95% confidence interval [CI], 1.59-2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2; 95% CI, 1.13-1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2; 95% CI, 0.1-1.51; P < 0.05; I2 = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.

BACKGROUND/OBJECTIVES The dietary intake of foods with fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) is known to adversely affect patients with irritable bowel syndrome (IBS). However, the effects of FODMAP have been studied predominantly among Western populations. This study aimed to identify foods high in FODMAP content which form a part of the Korean adult diet and obtain basic data for the preparation of IBS guidelines. SUBJECTS/METHODS An online survey of 1,000 adults from the general population in the age group of 20 to 40 years was performed. Data from 787 participants (men, 386; women, 401) were analyzed. The general characteristics of the participants, health status, IBS diagnosis using the Rome III diagnostic criteria, semi-quantitative food frequency questionnaire findings, and food items causing symptoms were analyzed. RESULTS Overall, 169 participants (21.5%) had IBS. The contribution of the FODMAP nutrients in both IBS and healthy groups was as follows: fructan > lactose > excess fructose > sorbitol > mannitol > galacto-oligosaccharides (GOS). The fructan intake was 4.6 ± 2.2 g/day and 4.3 ± 2.5 g/day in the IBS and healthy groups (P = 0.014), respectively. In the IBS group, the ratio of the intake of fructan to the total FODMAP intake was 39.5%, 29.8%, and 5.8% through onions, garlic, and bananas, respectively. CONCLUSIONS Fructan was the FODMAP nutrient most consumed by Korean adults. Therefore, given the difference in the dietary habits of each country’s population, the dietary guidelines for IBS should be country specific.

Nutrient imbalance, exceptionally high sodium, and low potassium intake have been reported to cause obesity. Thus, this study analyzed the relationship between the Na/K intake ratio and obesity. The subjects of this study were 7,523 persons aged 30-49 from the 6th~7th period (2013-2018) of the Korean National Health and Nutrition Examination Survey. Obesity was defined as BMI ≥25 kg/m2 and waist circumference ≥ 90cm for men and ≥85cm for women. The Na/K intake ratio was based on 24-hour recall data. A total of 24 food groups were classified according to a classification system provided by the Korean Nutrition Society. To analyze the relationship between the Na/K intake ratio and obesity, Generalized Linear Model (GLM) and logistic regression analysis were used. As a result of the analysis of the relationship between Na/K intake ratio and obesity, T3 was 1.273 times (CI: 1.125-1.440, P0.001) T1 in BMI criteria, and T3 was 1.244 times in waist circumference (CI: 1.089-1.422, P=0.005). Also, among those with a Na/K intake ratio of 1 or higher, food intake to total energy intake was analyzed according to obesity. The food group with the highest intake ratio in the obese group was beverages, alcoholic beverages, tea, noodles, dumplings, soups, fried foods, and kimchi (P0.005). Therefore, it is necessary to present the contents of an appropriate Na/K intake ratio and energy intake control during weight control education for obese people.