실천지침 이행률에 따른 대사증후군 중재 효과 비교

남경희(Nam, Kyung-Hui),강지연(Kang, Ji-Yeon),이연주(Lee, Yeon-Ju),성숙희(Sung, Sook-HeeChang),장윤균(Youn-Koun),이지영(Lee, Ji-Young),박일근(Park, Ill-Keun),최태인(Choi, Tae-In) 한국영양학회 2013 Journal of Nutrition and Health Vol.46 No.2

본 연구는 대사증후군 관리를 위한 12주 중재 프로그램으로, 실천지침 이행 정도에 따라 생활습관 변화, 영양소 섭취, 대사증후군 위험인자에 미치는 영향을 알아보고자 하는 목적으로 수행되었다. 1) 연구 대상자는 대사증후군을 가진 남성 근로자로, 모두 기혼자였으며, 교육수준은 높은 편이었다. 12주 중재 프로그램 후 영양성분표시 활용 정도가 유의하게 증가하였으며 과일의 1일 1회 분량 섭취 빈도가 증가하였다. 2) 실천지침 이행률에 따른 신체계측 변화를 살펴보면, 저이행군은 이완기혈압이 감소하였고, 중이행군은 허리둘레의 유의한 감소가 있었다. 고이행군은 수축기혈압, 이완기혈압, LDL콜레스테롤 수치가 유의하게 감소하였고, 고이행군의 수축기혈압과 이완기혈압, LDL콜레스테롤의 변화량은 중이행군보다 유의하게 큰 것으로 나타났다. 3) 저이행군은 단백질과 소금 섭취량, 단백질과 지방의 섭취 비율이 유의하게 감소하였다. 중이행군은 총 열량, 비타민 C의 유의한 감소가 있었으며, 고이행군은 총 열량의 유의한 감소가 있었다. 고이행군은 중이행군에 비해 식이섬유소 섭취량이 유의하게 증가하였다. 4) 저이행군의 대사증후군 위험인자는 3.5개에서 2.8개, 고이행군의 대사증후군 위험인자는 3.3개에서 2.2개로 중재 후 대사증후군 위험인자가 유의하게 적었다. 본 연구 결과 대사증후군을 대상으로 한 식습관 및 생활습관 개선 중재프로그램에서 대상자들의 참여도와 실천정도가 높을수록 건강 개선에 더욱 바람직하였다. 이에 추후 연구에서는 중재 참여 대상자들의 참여율 및 실천지침 이행률을 높여 중재 프로그램의 효과를 극대화할 수 있는 체계적인 프로그램 개발이 이루어져야 할 것이다. This study examined how achievement of session goals contributes to outcomes of subjects after participation in a 12-week lifestyle intervention program in men with metabolic syndrome (MetS). Thirty office workers with MetS, aged 47.2 ± 6.6 years, participated in this study, from March to July, 2011. The intervention program included face-to-face counseling five times during the 12-week period. Counselors and subjects designed session goals for each round. The average of the goal achievement rate was calculated based on compliance for each round. The subjects were divided into three groups according to their tertiles of achievement rate: Low-compliance group (LC, < 59%), medium-compliance group (MC, 59-70%), and high-compliance group (HC, > 70%). Anthropometry, biochemical index, and nutrient intake were examined at baseline and at the end of the 12-week intervention program. After the intervention, diastolic blood pressure (DBP) showed a significant decrease in the LC group, and waist circumference (WC) showed a significant decrease in the MC group. Systolic blood pressure (SBP), DBP, and low-density lipoprotein cholesterol (LDL) showed a significant decrease in the HI group. Changes in SBP and DBP were significantly lower in the HC group than in the MC group (p < 0.05, p < 0.01). Changes in LDL were significantly lower in the HC group than in the MC group (p < 0.05). Results for intake of total energy, protein, fat, and sodium, as well as rates of carbohydrate and fat intake, showed a significant decrease in all participants (p < 0.05). The change in fiber was significantly higher in the HC group than in the MC group (p < 0.05). The change of fruit serving size showed a significant increase in the HC group (p < 0.01). The number of risk factors for MetS showed a significant decrease in the LC and HC groups (p < 0.05), however, no significant mean differences were observed among the three groups. In conclusion, participation in this intervention program resulted in positive effects on risk factors for MetS, nutrient intake, and dietary habits, especially in the High-compliance group. (Korean J Nutr 2013; 46(2): 156 ~ 165)

비자성 자기실험실

최태인(Tae In Choi),송인성(In Sung Song),손우동(Woo Dong Son),최세철(Se Chol Choi),양창섭(Chang Seob Yang) 한국자기학회 1991 한국자기학회 학술연구발표회 논문개요집 Vol.1 No.1

직장인 남성에서 식이 요오드섭취량과 불현성 갑상선기능이상과의 연관성

김은혜(Kim Eun Hye),최태인(Choi Tae-in),박유경(Park Yoo Kyoung) 韓國營養學會 2012 Journal of Nutrition and Health Vol.45 No.3

The prevalence rate of thyroid dysfunction (hypothyroidism and hyperthyroidism) has increased within the Korean population and seems to be affected by iodine dietary habits. Some studies reported that the prevalence of thyroid dysfunction increase both in the area of iodine deficiency and excess. In this study, we tried to discover the difference in iodine intake, anthropometric measurements, and blood parameters between male subjects with or without subclinical thyroid dysfunction. A total of 5,249 subjects (Euthyroid: 4706, SubHypo: 454, SubHyper: 89) were used in this study. There were no significant differences in BMI, body fat, visceral fat, waist circumference, SBP, DBP, total cholesterol, HDL-cholesterol, LDL-cholesterol, TG, fasting serum glucose, HbA1c, alcohol intake, however significant differences were noticed in both age and smoking status. Through a food frequency questionnaire (FFQ), iodine intake per day was estimated. The average iodine intake was similar (SubHypo 392.9 ± 279.0 ㎍, Euthyroid 376.5 ± 281.7 ㎍, SubHyper 357.3 ± 253.8 ㎍) among groups. The main source of iodine intake was eggs (52.8%, 54.2%, 52.4%) followed by milk (16.3%, 15.8%, 17.8%), then sea mustard & sea tangle (12.4%, 11.9%, 11.6%). The prevalence of subclinical hypothyroidism and subclinical hyperthyroidism was higher in subjects whose intake was higher than the recommended nutrient intake (RNI). These results suggest that the excess consumption of iodine intake may act as one of the risk factors regarding thyroid dysfunction in Korea. Therefore, an adequate amount of iodine intake is necessary in order to prevent subclinical thyroid dysfunction and clinical thyroid dysfunction.

건강한 여성 근로자에서 Apolipoprotein E와 혈중 지질 농도와의 관련성

문기은,성숙희,장윤균,박일근,백윤미,김수근,최태인,진영우,Moon, Gi-Eun,Sung, Sook-Hee,Chang, Youn-Koun,Park, Il-Keun,Paek, Yun-Mi,Kim, Soo-Geun,Choi, Tae-In,Jin, Young-Woo 대한예방의학회 2010 예방의학회지 Vol.43 No.3

Objectives: Plasma lipid profiles and Apolipoprotein E (ApoE) are established risk factors for cardiovascular disease (CVD). The knowledge of lipid profile may estimate the potential victims of cardiovascular disease before its initiation and progression and offers the opportunity for primary prevention. The most common ApoE polymorphism has been found to influence plasma lipid concentrations and its correlation with CVD has been extensively investigated in the last decade. Methods: The ApoE polymorphism and its influence on plasma lipid were investigated in healthy woman workers. The information on confounding factors was obtained through a self-administered questionnaire and ApoE polymorphism was investigated using PCR. Results: The relative frequencies of alleles E2, E3 and E4 for the study population (n = 305) were 0.127, 0.750 and 0.121, respectively. ApoE polymorphism was associated with variations in plasma HDL-cholesterol lipid profile. In order to estimate the independent effects of alleles E2 and E4, as compared with E3, on lipid profile, multiple regression was performed after adjustment for confounding variables such as age, BMI, blood pressure, education status, insulin, fasting glucose, HOMA-IR, menopause. ApoE2 had a negative association with HDL cholesterol and ApoE4 had a positive association with LDL cholesterol. Conclusions: This study identified that the ApoE and CVD risk factors contribute to the lipid profiles, similar to other studies. The analysis including dietary intake and other gene in further studies may help to identify clear effects on lipid profiles as risk factor for CVD.

온라인 건강교육프로그램이 남성근로자의 대사증후군 위험요인 및 영양소 섭취에 미치는 영향

강지연(Kang Ji-Yeon),조상운(Cho Sang-Woon),이지영(Lee Ji-Young),성숙희(Sung Sook-Hee),박유경(Park Yoo-Kyoung),백윤미(Paek Yun-Mi),최태인(Choi Tae-In) 韓國營養學會 2010 Journal of Nutrition and Health Vol.43 No.1

Worksite health promotion programs have been associated with reductions in health risks but are labor-intensive and costly to implement. Therefore, innovative strategies to provide a cost-effective approach to health education program are needed. The purpose of this study was to investigate the effects of a worksite on-line health education program by email on metabolic syndrome risk factors and dietary intakes in male workers with metabolic syndrome. Anthropometric and biochemical parameters were measured and the nutrient intakes were assessed through FFQ. The diagnosis of metabolic syndrome was adapted from NCEP-ATP Ⅲ with blood pressure, fasting blood glucose, triglyceride, HDL cholesterol, and Asia-Pacific definition with waist circumference. The education group consisted of 212 male workers and the non-education group of 236 age-matched male workers. The on-line health education program provided 10 sessions by e-mail. After a worksite on-line health education program, systolic blood pressure (p < 0.001), diastolic blood pressure (p < 0.001) and fasting blood glucose (p < 0.001) were significantly decreased and HDL cholesterol (p < 0.001) was significantly increased in the education group. Intakes of total energy (p < 0.05), carbohydrate (p < 0.05), sodium (p < 0.05) were significantly decreased in the education group, but there were no significant differences in dietary intakes in the non-education group after a worksite on-line health education program. The results indicate that online health education program by e-mail is effective for improving metabolic syndrome risk factors and dietary intakes in male workers and show potential for use in the working setting.

12주 중재프로그램이 직장인의 심혈관질환 위험요인, 아디포사이토카인과 영양소 섭취에 미치는 영향

문기은 (Moon,Kieun ),박일근 (Park,Ill Keun ),조연상 (Jo,Yeon Sang ),장윤균 (Chang,Yun Kyun ),백윤미 (Paek,Yun Mi ),최태인 (Choi,Tae In ) 韓國營養學會 2011 Journal of Nutrition and Health Vol.44 No.4

Adipocytokines (adiponectin, leptin and resistin) are known to play a major role in development of cardiovascular disease (CVD) and intervention program is effective in reducing CVD risk factors. However, intervention program to improve the CVD risk factors including adipocytokines has been less studied. This study investigated the effects of 12-weeks worksite intervention program on cardiovascular risk factors, adipocytokines and nutrients intakes in industrial workers. 157 industrial male workers (32 metabolic syndrome (MS) subjects, 125 healthy subjects using age-matched stratified random sampling) received 5 face-to-face counseling based on their health profiles. Anthropometry, biochemical parameters and nutrients intakes were measured. The diagnosis of MS was adapted from modified NCEPATP III criteria (2001) and Asia-Pacific definition criteria (2000) for waist circumference (WC). After the intervention program, WC, BMI, SBP, insulin, leptin and intakes of total energy and fiber were significantly decreased (p < 0.05), while adiponectin was significantly increased (p < 0.05) in MS subjects. The WC, BMI, SBP, total cholesterol, LDL and HDL-cholesterol, HbA1c, leptin and intakes of total energy, protein and fat were significantly decreased (p < 0.05) and adiponectin was significantly increased (p < 0.05) in normal subjects. Multiple linear regression revealed that adiponectin was positively correlated with HDL-cholesterol (p < 0.01). Leptin was positively correlated with WC (p < 0.01), and resistin was positively correlated with HbA1c (p < 0.05) and intakes of total energy (p < 0.05), and negatively correlated with HDL-cholesterol (p < 0.05). The results of the 12 weeks intervention showed a positive impact on adipocytokines and nutrients intakes of industrial workers to reduce cardiovascular risk factors. Further research is needed to verify a tailored long-term worksite intervention program including adipocytokines as a protective factor for the CVD. (Korean J Nutr 2011 44(4): 292 ~ 302)

남성 근로자의 혈중 항산화 영양소 상태와 대사증후군 인자와의 관계

조상운 ( Sang Woon Cho ),백윤미 ( Yun Mi Paek ),강지연 ( Ji Yeon Kang ),박유경 ( Yoo Kyoung Park ),최태인 ( Tae In Choi ) 한국식품영양학회 2009 韓國食品營養學會誌 Vol.22 No.3

The principal objective of this study was to evaluate the association between plasma antioxidant levels and metabolic syndrome in male workers, and to provide basic information regarding the control and prevention of metabolic syndrome. We analyzed 163 male workers who had participated in annual medical examinations from January to December 2007. The subjects were classified into normal and metabolic syndrome groups according to the NCEP-ATP III criteria and the Asia-Pacific criteria for waist circumference. Anthropometric parameters, lifestyles, blood lipid profiles, and antioxidant levels were evaluated. As compared to the normal group, the metabolic syndrome group evidenced significantly higher plasma levels of α-tocopherol(p<0.05) and retinol(p<0.05), but significantly lower plasma levels of lycopene(p<0.05) and β-carotene(p<0.05). This tendency was found to be predominantly attributable to increases in the number of metabolic syndrome components. In our simple regression analysis, higher plasma levels of α-tocopherol(β=0.001, p<0.01) and retinol(β=0.021, p<0.001) were associated with significantly higher risks of metabolic syndrome, but lycopene(β=-1.499, p<0.01) and β-carotene(β=-0.048, p<0.01) were associated with significantly lower risks of metabolic syndrome. Retinol(β=0.013, p<0.05) and β-carotene(β=-0.044, p<0.01) were associated significantly with metabolic syndrome, when adjusted for age and BMI. These data indicate that the plasma levels of α-tocopherol, retinol, lycopene, and β-carotene are associated with metabolic syndrome. Specifically, low lycopene and β-carotene levels in the plasma appear to increase the risk of metabolic syndrome. Therefore, proper nutritional education programs for male workers are required to increase dietary intakes of antioxidant vitamins. Further studies will be necessary to determine whether antioxidant levels can be utilized as a predictive or a preventive factor.

고학력 사무직 남성을 대상으로 한 반복적인 영양교육이 만성질환 예방에 미치는 효과와 DQI-1를 이용한 식사의 질 평가

장미(Mi Jang),김혜련(Hye Ryeon Kim),황명옥(Myung Ok Hwang),백윤미(Yun Mi Paek),최태인(Tae In Choi),박유경(Yoo Kyoung Park) 대한지역사회영양학회 2010 대한지역사회영양학회지 Vol.15 No.5

The purpose of this study was to investigate the effect of 3-month nutrition education (First Time Intervention, FI) + additional 3-month nutrition education (Repeated Intervention, RI) which was performed after the 8-month followup. FI was conducted during 0-3 months and RI for 11-14 months. Ninety-two subjects completed FI program, and 38 out of 92 subjects who received FI finished the RI. Anthropometric data, dietary assessment (24hr recall) and fasting blood analysis were measured at 0 month, 3 months, 11 months and 14 months time points. After FI (3 mo), waist circumference, triglycerides, total cholesterol were significantly decreased. At 11 month follow-up, body weight, BMI, hip circumference, SBP, DBP were significantly rebounced and HDL cholesterol was significantly decreased. Therefore, the effect of short-term nutrition education was not being sustained. After the secondary nutrition intervention (14 mo), waist circumference and hip circumference were again significantly decreased. Total diet quality index-international (DQI-I) score was significantly increased in both FI group and RI group. The changes in DQI-I scores were significantly correlated with the changes in body weight (r = -0.129, p < 0.05) and counts of nutrition education (r = 0.159, p < 0.05), indicating that effective nutrition education helps improve the diet quality leading to a possible role in CVD prevention among male workers. Although a short-term intervention seems to be a success, the effect was not retained in this study. Therefore, we suggest incorporating nutrition education as a routine program for male worker at worksite. (Korean J Community Nutr 15(5): 614~624, 2010)

Apolipoprotein E 다형성과 고지혈증 위험 유무에 따른 혈중 지질농도, 영양소 섭취, 생활습관 및 위험요인과의 관계

이재은(Lee Jae-Eun),조상운(Cho Sang-Woon),강지연(Kang Ji-Yeon),백윤미(Paek Yun-Mi),최창순(Choi Chang-Sun),박유경(Park Yoo-Kyoung),최태인(Choi Tae-In) 韓國營養學會 2008 Journal of Nutrition and Health Vol.41 No.5

This study was performed to investigate Apolipoprotein E phenotypes and the relationship among lipid levels, nutrient intakes, lifestyles and risk factors between subjects with and without hyperlipidemic risk. The data were collected from 675 industrial male workers who had completed annual medical examination. Compared to the normal group, the hyperlipidemic risk group in Apo E3 and E4 had significantly higher BMI (p < 0.05) and showed significantly higher body fat (%), waist circumference and WHR in all types of Apo E (p < 0.05). In addition, the hyperlipidemic risk group had significantly higher total cholesterol, LDL-cholesterol, triglyceride and AI than the normal group in all types of Apo E (p < 0.05). Intakes of protein, calcium, phosphorus, iron, vitamin A, vitamin B1, vitamin B2, vitamin C and niacin in Apo E3 were significantly lower in the hyperlipidemic risk group than in the normal group (p < 0.05). In the logistic regression analysis, after adjustment for other factors, Apo E2 + E4, waist and WHR were the significant risk factors associated with hyperlipidemia, but protein intakes were associated with significantly lower risks of hyperlipidemia (p < 0.05). In conclusion, genetic factor (Apo E2 or Apo E4), anthropometric index and nutrient intake seem to influence hyperlidemic risk. Further studies and efforts will be needed to evaluate the independent relationships among hyperlipidemic risk factors. (Korean J Nutr 2008; 41(5): 402 ~ 413)

면대면 영양교육 후 1년간의 E-mail 영양교육이 직장인 남성의 심혈관 질환 위험인자 감소에 미치는 효과

오혜선(Oh Hye Sun),장미(Jang Mi),황명옥(Hwang Myung Ok),조상운(Cho Sang Woon),백윤미(Paek Yun Mi),최태인(Choi Tae In),박유경(Park Yoo Kyoung) 韓國營養學會 2009 Journal of Nutrition and Health Vol.42 No.6

본 연구에서 직장 남성 근로자 739명 (39세 이하 그룹: 240명, 40대 그룹: 276명, 50대 그룹: 223명)을 대상으로 e-mail 영양교육이 신체계측치, 체구성 및 심혈관 질환 위험인자에 미치는 영향을 조사하고자 하였다. 검진 시 1회, 약 10분의 면대면 영양상담 후 15개 주제의 영양교육자료를 월 1회, 10회에 걸쳐 e-mail을 통해 제공하였으며, 그 결과를 요약하면 다음과 같다. 1) 1년간의 e-mail 영양교육 후, 전체 연구대상자의 체지방률 (p < 0.001), 복부지방률 (p < 0.001), 총 콜레스테롤 (p < 0.01), 수축기 혈압 (p < 0.01), 이완기 혈압 (p < 0.05)이 유의적으로 감소하였다. 2) 연령 그룹별로 살펴보면, 체지방률과 수축기 혈압은 세군 모두에서 유의적으로 감소하였고, 총 콜레스테롤은 39세 이하 그룹에서만 유의적으로 감소하였다 (p < 0.01). 3) 영양교육 전, 39세 이하 그룹의 대사증후군 유병률은 25%, 40대 그룹은 27.2%, 50대 그룹은 36.3%의 분포를 보였다. E-mail 영양교육 후, 39세 이하 그룹의 대사증후군 유병률은 18.3%, 40대 그룹은 27.5%, 50대 그룹은 35.4% 로 교육 전에 비해 영양교육 후 39세 이하 그룹에서의 대사증후군 유병률이 유의적으로 감소하였다 (p < 0.05). 이상과 같이 본 연구에서 e-mail교육 프로그램은 직장인 들에게 신체계측치 및 심혈관 질환 위험인자 감소에 효과가 있음이 확인되었다. 따라서 종합검진 후 1년의 자기관리를 위한 e-mail 영양교육 자료를 개발하여 적용했다는데 본 연구의 의의가 있다고 본다. 본 연구의 결과를 토대로 e-mail 교육 프로그램의 효과를 평가하기 위한 확대연구와 효과의 지속기간에 대한 장기적인 추적연구를 통해 직장인의 건강증진 및 사내 복지 향상과 의료비 절감을 위해 회사 지원 하에 질환에 따른 적절한 영양관리 프로그램으로 적용 될 수 있기를 기대한다. Effective nutrition educations for prevention of chronic diseases for the general population are of great importance these days. The purpose of this study was to evaluate the feasibility of nutrition education for cardiovascular risk factor reduction by e-mail education in male workers. The participants were divided into three groups by age; 28-39 age group, 40-49 age group, and 50-59 age group who got regular checkups for anthropometry and biochemistry. The 1 year program consisted of 15 topics containing information about metabolic syndrome (MS) and healthy eating behavior (intake of salt, fat and alcohol). Seven hundred thirty nine participants volunteered for the study [28-39 age group, n = 240; body mass index (BMI) = 24.9 ± 2.7 ㎏/㎡: 40’ group, n = 276; BMI = 24.8 ± 2.6 ㎏/㎡: 50’ group, n = 223; BMI = 24.9 ± 2.7 ㎏/㎡]. Percentage body fat (p < 0.05) and percentage of abdominal fat (p < 0.05), total cholesterol (p < 0.05), systolic blood pressure (p < 0.05), and diastolic blood pressure (p < 0.05) were significantly decreased in all participants after the 1 year program. The total number of participants who had MS was decreased from 216 to 199 and especially the incidence of MS was decreased 27% in the group of subjects who were under the age 39. The e-mail worksite nutrition education program shows a substantial contribution to the development of effective CVD and chronic disease control and lifestyle nutrition educations that are applicable to and attractive for the large population at risk.