우유 섭취와 대사증후군의 관련성

이창진(Chang Jin Lee),정효지(Hyo Jee Joung) 대한지역사회영양학회 2012 대한지역사회영양학회지 Vol.17 No.6

This study aimed to examine associations between milk intake and metabolic syndrome. The subjects included 1,928 males and 3,103 females, aged 19 to 64 years, from the data of ‘The Korean National Health and Nutrition Survey 2007-2010’. Daily intake of milk and dairy products was obtained by a 24 hour dietary recall method and divided into two categories by equivalent weight of one serving. The average individual intakes of milk and dairy products were 59.4 g and 74.1 g per day respectively. Milk intake was inversely associated with metabolic syndrome (OR: 0.69, 95% CI: 0.54~0.89), central obesity (OR: 0.75, 95% CI: 0.62~0.91), and hypertriglyceridemia (OR: 0.73, 95% CI: 0.59~0.90). The total intake of dairy products was also inversely associated with metabolic syndrome (OR: 0.74, 95% CI 0.60~0.92), central obesity (OR: 0.73, 95% CI: 0.62~0.86), hypertension (OR: 0.80, 95% CI: 0.65~0.99). The association between intakes of milk and dairy products and metabolic syndrome was significant in women, but not in men. These results indicate that increased consumption of milk and its products is associated with a reduced likelihood of metabolic syndrome and metabolic syndrome risk factors. Further research on causal relationship and dose-response association between milk intake and metabolic syndrome risk is necessary prior to applying the observed results in nutrition policies and programs to prevent the metabolic syndrome. (Korean J Community Nutr 17(6) : 795~804, 2012)

건강한 한국인에서 김치의 섭취가 대사증후군의 위험에 미치는 상관관계

오인명 ( In Myung Oh ),정효지 ( Hyo Jee Joung ),오상우 ( Sang Woo Oh ),윤영숙 ( Yeong Sook Yoon ),유경화 ( Kyoung Hwa Yoo ),박지은 ( Ji Eun Park ),박주상 ( Ju Sang Park ),장은정 ( Eun Jeong Jang ),박상종 ( Sang Jong Park ),박상운 한국정맥경장영양학회 2013 한국정맥경장영양학회지 Vol.5 No.3

Hospital, Goyang, Korea Purpose: Metabolic Syndrome (MetS) is defined as the coexistence of several metabolic risk factors. Diet is thought to play a major role in development of MetS. We attempted to determine whether the Korean diet is related to a reduced risk for development of MetS. Methods: A total of 425 healthy Korean adults were recruited by advertisement to Bundang Jesaeng Hospital from January 1 to June 30, 2009; those not taking regular medications and without diagnosis of disease were included. Data were collected on three-day dietary intake, anthropometric measurements, and diagnostic parameters, including levels of lipid panel, glucose, adiponectin, and inflammatory cytokines (interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α]) for MetS from individuals enrolled in the study. The National Cholesterol Education Program (NCEP) scoring system was used for diagnosis of MetS. Results: Out of 425 (11.8%) subjects, 50 were diagnosed as having MetS. As NCEP scores increased, the levels of inflammatory cytokines (IL-6, TNF-α) showed an increasing tendency, however, the adiponectin level had decreased (P<0.0001). A greater amount of total vegetable consumption appeared to be associated with decreased risk for MetS. A higher carbohydrate consumption represented by the amount of rice intake (refined starch) appeared to be associated with higher risk of MetS. However, increasing consumption of rice combined with Kimchi showed an association with increased high-density lipoprotein cholesterol (56.7±1.6 vs. 62.8±2.2, P for trend: 0.0321) and decreased adiponectin level (9.0±0.8 vs. 11.4±1.2, P for tend: 0.0255). Conclusion: Among healthy Korean volunteers consuming an ordinary Korean diet, the prevalence of MetS was found to be 11.8%. Greater consumption of rice showed an association with greater risk of MetS, while greater consumption of rice combined with Kimchi, the main staple of the Korean diet, showed an association with lower risk of MetS. (J Korean Soc Parenter Enter Nutr 2013; 5(3):110-116)

고등학생의 건강 불균등 요인별 분해

안병철 (Byung Chul Ahn),정효지 (Hyo Jee Joung) 한국학교보건학회 2007 韓國學校保健學會誌 Vol.20 No.1

Purpose: With economic development and prolonged longevity, the level of health and health disparities have became growing concerns for individual and society as well. Since youth's health status are influenced by households' socioeconomic status and associated with heath status in later stage of life, assessing health inequality in the youth is a significant step toward lessening health disparity and promoting health. We measured health inequality in high school students and decomposed it into health factors. Methods: The subjects included 3,787 high school students of 12th graders from the Korea Education and Employment Panel (KEEP) in 2004. True health status was assumed as a latent variable and estimated by ordered logistic regression model. The predicted health was used as a measure of individual health after rescaling to [0,1] interval. Total health inequality was then measured by Gini coefficient and was decomposed into health factors. Results: Health inequality in high school students was observed. Of total health inequality, 44% was explained by biological factors such as body mass index (BMI) (32.5%) and gender (13.5%). Behavioral factors such as smoking, drinking, physical activity, hours in bed and hours of computer usage added to 11.7%. Household income and work experiences explained 5.6% and 8.8%, respectively. School satisfaction explained 14.6%. Other school related factors such as self-assessed achievement and experience of being bullied accounted for 15.5%. Conclusion: Among the health factors, biological factor was the most important contributor in health disparity. Other factors such as health behaviors, socioeconomic factors, school satisfaction and school related factors exhibited somewhat similar magnitude. For policy purposes, it is recommended to look into modifiable factors depending BMI, gender and school surroundings.

한국 성인의 식사 패턴에 따른 사회경제적 특성, 영양섭취실태 및 대사성 증후군 위험 요인에 대한 연구 : 2001년도 국민건강영양조사자료를 이용하여

송윤주(Song Yoon Ju),정효지(Joung Hyo Jee),백희영(Paik Hee-Young) 韓國營養學會 2005 Journal of Nutrition and Health Vol.38 No.3

초경전 여아에서 운동의 기계적 스트레인과 칼슘섭취량에 따른 발꿈치뼈 골밀도의 분포

신은경,김기숙,김희영,이인숙,정효지,조성일,Shin, Eun-Kyung,Kim, Ki-Suk,Kim, Hee-Young,Lee, In-Sook,Joung, Hyo-Jee,Cho, Sung-Il 대한예방의학회 2005 예방의학회지 Vol.38 No.3

Objectives : The effects of exercise on bone density have been found to be inconsistent in previous studies. We conducted a cross-sectional study in premenarcheal girls to test two hypotheses to explain these inconsistencies. Firstly,'the intensity of mechanical strain, in terms of the ground reaction force(GRF), has more important effects on the bone mass at a weight-bearing site', and secondly, 'calcium intake modifies the bone response to exercise'. Methods : The areal bone mineral density was measured at the Os calcis, using peripheral dual energy X-ray absorptiometry, in 91 premenarcheal girls aged between 9 and 12 years. The intensity of mechanical strain of exercise was assessed by a self-report questionnaire and scored by the GRF as multiples of body weight, irrespective of the frequency and duration of exercise. The energy and calcium intake were calculated from the 24-hour dietary recall. An analysis of covariance(ANCOVA) was used to determine the interaction and main effects of exercise and calcium on the bone density, after adjusting for age, weight, height and energy intake. Results : The difference in the bone density between moderate and low impact exercise was more pronounced in the high than low calcium intake group. The bone density for moderate impact exercise and high calcium intake was significantly higher than that for low impact exercise (p=0.046) and low calcium intake, after adjusting for age, weight, height and energy intake. Conclusions : Our study suggests that the bone density at a weight-bearing site is positively related to the intensity of mechanical loading exercise, and the calcium intake may modify the bone response to exercise at the loaded site in premenarcheal girls.

9-12세 정상 아동에서 종골 골밀도와 체성분의 연관성

신은경,김기숙,김희영,이인숙,정효지,조성일,Shin, Eun-Kyung,Kim, Ki-Suk,Kim, Hee-Young,Lee, In-Sook,Joung, Hyo-Jee,Cho, Sung-Il 대한예방의학회 2004 예방의학회지 Vol.37 No.1

Objectives : This cross-sectional study aimed to quantify the relationship between the bone mineral density at the os calcis and the body mass composition in healthy children. Methods : The areal bone mineral density was measured at the os calcis with peripheral dual energy X-ray absorptiometry. The fat free mass, fat mass and percentage fat mass were measured using bioelectric impedance, in 237 Korean children, aged 9 to 12 years. The sexual maturity was determined by self assessment, using standardized series of the 5 Tanner stage drawings, accompanied by explanatory text. Results : From multiple linear regression models, adjusted for age, sexual maturity and height, the fat free mass was found to be the best predictor of the calcaneal bone mineral density in both sexes. About 15 and 20% variabilities were found in the calcaneal bone mineral densities of the boys and girls, respectively, which can be explained by the fat free mass. After weight adjustment, the percentage fat mass was negatively associated with the calcaneal bone mineral density in both sexes. Conclusions : The findings of this study suggest that the fat free mass, among the body compositions, is the major determinant of bone mineral density at the os calcis in Korean children aged 9 to 12 years. Obesity, defined as the percentage fat mass, is assumed to have a negative effect on the calcaneal bone density in children of the same weight.

서울 지역 일부 아동 및 청소년의 성장발달 및 식생활 비교 연구 : 체조성 변화와 비만실태 (Ⅰ)

송윤주(Song Yoon Ju),정효지(Joung Hyo Jee),김영남(Kim Young Nam),백희영(Paik Hee Young) 韓國營養學會 2006 Journal of Nutrition and Health Vol.39 No.1

전문가 포커스 그룹을 활용한 한식 데이터베이스 작성과 한식 섭취 수준에 따른 식품군 섭취 균형도 평가

강민지 ( Minji Kang ),정현주 ( Hyun Ju Jung ),정효지 ( Hyo Jee Joung ),심재은 ( Jae Eun Shim ),이상은 ( Sang Eun Lee ),박영희 ( Young Hee Park ),백희영 ( Hee Young Paik ) 한국식생활문화학회 2014 韓國食生活文化學會誌 Vol.29 No.1

본 연구는 한국인의 한식 섭취 수준과 그에 따른 식생활의 특성을 살펴보기 위해 수행되었다. 일반인과 전문가에게 실시한 한식 인식도 조사 선행 연구 결과를 바탕으로 전문가 포커스 그룹의 검토 및 토의를 거쳐 한식 여부를 결정, 데이터베이스화 하고, 국민건강영양조사 자료로부터 현재 한국인의 한식 섭취 수준을 분석하였다. 제4기(2007-2009) 국민건강영양조사에 나타난 총 1,590종의 음식 중 부재료의 차이로 인한 유사 음식들을 통합하여 1,322종의 음식에 대해 전문가 포커스 그룹을 실시한 결과 이 중 973종(73.6%)이 한식으로 분류되었다. 한편 제4기(2007-2009) 국민건강영양 조사에 참여한 22,113명의 식품섭취자료로부터 계산한 한국인의 한식 섭취율은 80.1%였다. 한식 섭취율은 남녀 모두 연령에 따라서 차이를 보였는데, 65세 이상의 한식 섭취율이 가장 높았다. 또한 읍면 지역에 거주할수록, 가구소득수준이 낮을수록 한식 섭취율이 높았다. 식이섭취 요인에 따라 살펴보았을 때, 주말 보다는 주중에서, 끼니 구분에 따라서는 아침 식사에서 한식 섭취율이 높았다. 하루 섭취 음식 중 가장 높은 섭취 빈도를 보인 한식은 배추김치, 쌀밥, 잡곡밥인 것으로 나타났는데, 섭취 빈도가 높은 상위 20가지, 50가지, 100가지 음식중에서 한식이 80.0% 이상을 차지하였다. 한식섭취 수준에 따른 식품군 균형도를 살펴보기 위해 식사구성안 준수도를 분석하였을 때, 곡류, 고기·생선·계란·콩류, 채소류, 과일류는 한식 섭취 수준이 높아짐에 따라 준수도가 증가한 반면(p<0.001), 우유·유제품류, 유지·당류는 감소하였으며(p<0.001), 이러한 결과는 남녀 모두 비슷한 양상을 보였다. 따라서 본 연구를 토대로 현재 한국인의 하루섭취 음식 중 대부분이 한식에 해당하였으나, 연령에 따른 차이가 있었고, 외식 및 간식 섭취 등 식생활 행동에 영향을 받는 것을 알 수 있었다. 앞으로 한식을 정의하는데 있어 다양한 시도가 이루어져야 하겠으며, 이를 토대로 한식 섭취 수준에 따른 식생활 특성 및 질병 관련 요인에 관한 후속 연구도 이루어져야 할 것으로 사료된다. This study was conducted to develop a Han-sik database as well as to assess the effects of Han-sik on dietary quality among Koreans. The Han-sik database was developed by a focus group composed of food and nutrition specialists considering the results of Han-sik perception surveys conducted in previous studies for frequently consumed dishes. Among the 1,322 dish items identified in the 4th (2007-2009) Korea National Health and Nutrition Examination Survey (KNHANES), 973 items (73.6%) were classified as Han-sik. Han-sik usage was defined as the percentage of Han-sik items of all individually consumed dish items in the dietary data of 22,113 subjects who participated in a 24-hour diet recall in the 4th (2007-2009) KNHANES. Dietary quality was evaluated based on adherence to the Korean Food Guidance System (KFGS), which was calculated as the percentage of the number of servings consumed in each food group out of recommended servings according to age and sex. Mean usage of Han-sik was 80.1% and was higher in older age groups, rural areas, as well as in households at the lowest income level. Han-sik usage was also higher on weekdays as well as for breakfast. Adherence to the KFGS was significantly higher for grains, meat·fish·egg·beans, vegetables, and fruits (p<0.001) but lower for milk·dairy products and oils·fats·sugars (p<0.001) across the quartiles of Han-sik usage. The results of this study indicate that Han-sik usage is high among Koreans. Further studies are needed to update the Han-sik database as well as investigate the association between health-related factors and Han-sik use.

군집분석과 요인분석 이용한 우리나라 성인의 식사패턴 비교 분석

송윤주(Yoon Ju Song),백희영(Hee Young Paik),정효지(Hyo Jee Joung) 대한지역사회영양학회 2009 대한지역사회영양학회지 Vol.14 No.6

The purpose of this study was to explore dietary patterns and compare dietary patterns using cluster and factor analysis in Korean adults. This study analyzed data of 4,182 adult populations who aged 30 and more and had all of socio-demographic, anthropometric, and dietary data from 2005 Korean Health and Nutrition Examination Survey. Socio-demographic data was assessed by questionnaire and dietary data from 24-hour recall method was used. For cluster analysis, the percent of energy intake from each food group was used and 4 patterns were identified: traditional, bread, fruit & vegetable, milk, noodle & egg, and meat, fish, alcohol. The traditional pattern group was more likely to be old, less educated, living in a rural area and had higher percentage of energy intake from carbohydrates than other pattern groups. Meat, fish, alcohol group was more likely to be male and higher percentage of energy intake from fat. For factor analysis, mean amount of each food group was used and also 4 patterns were identified; traditional, modified, bread, fruit, milk, and noodle, egg, mushroom. People who showed higher factor score of traditional pattern were more likely to be elderly, less educated, and living in a rural area and higher proportion of energy intake from carbohydrates. In conclusion, three dietary patterns defined by cluster and factor analysis separately were similar and all dietary patterns were affected by socio-demographic factors and nutrient profile. (Korean J Community Nutrition 14(6): 722~733, 2009)

지역별 대사증후군 유병율의 수렴현상

안병철 ( Byung Chul Ahn ),홍은주 ( Eun Ju Hong ),정효지 ( Hyo Jee Joung ) 대한보건협회 2013 대한보건연구 Vol.39 No.1

연구목적: 지역 간 건강 격차가 국민건강의 중요한 현안으로 대두되고 있다. 본 연구는 대사증후군의 유병율의 추세를 살펴보고, 지역 간 유병율 격차가 감소 또는 확대되는지 검토하기 위한 것이다. 연구방법: 본 연구에서는 국민건강영양조사 (1998~2010) 자료에서 19세 이상이면서 대사증후군 진단에 관련한 정보를 가진 대상자 41,727명을 추출하여 분석하였다. 대사증후군 분류에는 NCEP Adult Treatment Panel III 기준과 복부비만에 대한 아시아 기준을 적용하였다. 모든 유병율의 계산에는 서베이 가중치를 적용하였다. 서베이 시점 간 지역별 대사증후군 유병율의 변동에 대한 검정은 t검정을 이용하였고, 회귀분석을 이용하여 대사증후군의 수렴 현상을 분석하였다. 연구결과: 1998-2010 기간에 대사증후군 유병율은 22.7%에서 25.9%로 증가하였다. 기준 시점 (1998-2001)에 전남의 유병율이 가장 높은 33.3%였으며, 부산은 가장 낮은 16.5%였다. 2008-2010 시점에는 충남의 유병율이 32.7%로 가장 높았고, 서울과 경기는 23.9%로 가장 낮았다. 대체로 기준 시점에서의 유병율이 낮은 지역의 유병율이 다른 지역에 비해 빠르게 증가하는 것으로 나타나, 지역별 유병율은 수렴하는 것으로 확인되었다. 결론: 지역별 수렴 현상이 지역 내 건강 격차가 존재하는 것을 부정하는 것은 아니므로, 건강격차를 완화하기 위해서는 지역사회의 특성을 반영할 수 있는 효과적인 개입정책을 개발할 필요가 있다. Objectives: Regional disparities in health have became hot issues in national health. This study was to examine trends of metabolic syndrome and evaluate whether the prevalence gaps across region converge in Korea. Methods: We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES 1998-2010). Samples were consisted of 41,727 subjects aged over 19 years with anthropometric information and health examination. Metabolic syndrome was defined by NCEP Adult Treatment Panel III criteria except central obesity which was diagnosed according to Asian-Pacific criteria. All prevalence rates were calculated as weighted average across regions. Changes in regional prevalence between periods were tested by t-test. Convergence in regional prevalence rates were examined using regression analysis. Results: The overall prevalence of metabolic syndrome increased from 22.7% in 1998-2001 to 25.9% in 2010. In 1998-2001, Jeonnam recorded the highest prevalence of 33.3% whereas Busan displayed the lowest of 16.5%. In 2008-2010, prevalence was 32.7% for Chungnam and 23.9% for Seoul and Gyunggi. In general, regions which recorded lower prevalence in the reference period (1998-2001) tended to show faster growth over the last decade than other regions indicating the existence of convergence effects. Conclusion: Regional convergence of metabolic risks does not deny the existence of within-region health disparities. In battling health risks and lessening health disparities, it is necessary to develop effective intervention policies which should reflect regional characteristics.