The Korea National Health and Nutrition Examination Survey (KNHANES) is a national surveillance system that has been assessing the health and nutritional status of Koreans since 1998. Based on the National Health Promotion Act, the surveys have been conducted by the Korea Centers for Disease Control and Prevention (KCDC). This nationally representative cross-sectional survey includes approximately 10 000 individuals each year as a survey sample and collects information on socioeconomic status, health-related behaviours, quality of life, healthcare utilization, anthropometric measures, biochemical and clinical profiles for non-communicable diseases and dietary intakes with three component surveys: health interview, health examination and nutrition survey. The health interview and health examination are conducted by trained staff members, including physicians, medical technicians and health interviewers, at a mobile examination centre, and dieticians’ visits to the homes of the study participants are followed up. KNHANES provides statistics for health-related policies in Korea, which also serve as the research infrastructure for studies on risk factors and diseases by supporting over 500 publications. KCDC has also supported researchers in Korea by providing annual workshops for data users. KCDC has published the Korea Health Statistics each year, and microdata are publicly available through the KNHANES website (http://knhanes.cdc.go.kr).

The relation of food insecurity in elders with outcomes such as overweight and depression, and the influence of participation in food assistance programs on these relations, has not been established. The aim of this study was to examine the relation between food insecurity and weight and depression in elders, and determine whether participation in food assistance programs modifies the effect of food insecurity on weight and depression. Two longitudinal data sets were used: the Health and Retirement Study (1996-2002) and the Asset and Health Dynamics Among the Oldest Old (1995-2002). The relation of food insecurity and participation in food assistance programs was assessed by multilevel linear regression analysis. Food insecurity was positively related to weight and depression among elders. Some analyses supported that food-insecure elders who participated in food assistance programs were less likely to be overweight and depressed than those who did not participate in food assistance programs. This finding implies that food assistance programs can have both nutritional and non-nutritional impacts. The positive impact of participation in food assistance programs of reducing or preventing poor outcomes resulting from food insecurity will improve elders' quality of life, save on their healthcare expenses, and help to meet their nutritional needs.

BackgroundSkeletal muscle mass (SMM) plays a crucial role in systemic glucose metabolism.ObjectiveTo obtain reference data on absolute and relative values of SMM for Korean children and adolescents.MethodsCross-sectional results from 1919 children and adolescents (1024 boys) aged 10–18 years that underwent dual-energy X-ray absorptiometry (DXA) during the Korean National Health and Nutrition Examination Survey 2009–2011 were analyzed. SMMs were evaluated as follows; absolute SMM (appendicular skeletal muscle mass [ASM]) and relative SMMs, namely, height-adjusted skeletal muscle index (SMI; ASM/height2), %SMM (ASM/weight x 100), and skeletal muscle-to-body fat ratio (MFR; ASM/body fat mass).ResultsPercentile curves illustrated the developmental patterns of the SMMs of Korean children and adolescents. ASM and SMI increased with age in both genders, and increased from age 10 throughout adolescence in boys, whereas in girls, they increased until age 13 and then stabilized. In boys, %SMM and MFR were highest at age 15 and then slowly stabilized or decreased, whereas in girls, they peaked at age 10 to 11 and then decreased through adolescence. Cut-off values for low MFR were identified and a significant association was found between a low MFR and high risk of metabolic syndrome. However, this association was found to be dependent on gender and the level of BMI.ConclusionThis study provides reference values of absolute and relative SMM for Korean children and adolescents. Detailed body composition analyses including skeletal muscle and fat mass might provide improved measures of metabolic risk.

Little is known about the effect of dietary carbohydrate, glycaemic index (GI) and glycaemic load (GL) on the risk of the metabolic syndrome, especially in populations with white rice as the staple food. The study examined the cross-sectional relationship between carbohydrate, GI, GL and risk of the metabolic syndrome. There were a total of 910 middle-aged Korean adults. Dietary carbohydrate, GI and GL were determined by an interview-administered FFQ. The metabolic syndrome was defined using the modified criteria published in the Third Report of the National Cholesterol Education Program Adult Treatment Panel III. The risk of developing the metabolic syndrome was positively related to dietary carbohydrate (P for trend¼0·03), GI (P for trend¼0·03) and GL intakes (P for trend¼ 0·02) in women after adjusting for potential confounding variables. Among the components of developing the metabolic syndrome, the risk of high TAG and low HDL-cholesterol were positively related to high GI and GL intakes in women. The risk of developing the metabolic syndrome was considerably higher in the highest quintiles of carbohydrate (OR 6·44; 95 % CI 2·16, 19·2), GI (OR 10·4; 95 % CI 3·24, 33·3) and GL intakes (OR 6·68; 95 % CI 2·30, 19·4) than in the lowest quintiles among women with a BMI $ 25 kg/m 2 . However, there was no difference in risk across quintiles of carbohydrate, GI and GL among women with a BMI , 25 kg/m 2 . In conclusion, both the quantity and quality of carbohydrate intake has a positive relationship with the risk of the metabolic syndrome in women but this relationship was dependent on the BMI level. Dietary carbohydrate: Glycaemic index: Glycaemic load: Metabolic syndromeDiets high in carbohydrates have been known to influence adverse changes in blood lipid and lipoprotein concentrations (1 -5) and also cause the aggravation of glucose intolerance (6,7) . Given that the quality as well as the amounts of carbohydrate-containing foods have been addressed, the concept of glycaemic index (GI) and glycaemic load (GL) has been proposed. As an indicator of carbohydrate quality, the GI measures how much each carbohydrate-containing food raises blood glucose levels by comparing it with the same amount of either glucose or white bread (8) . The GL (GI £ amount of carbohydrate available in each food item) is an indicator that reflects both the quantity and quality of the carbohydrates (9) . Previous studies related to carbohydrates, GI and GL have mostly focused on the effects that they may have on CVDand diabetes-related risk factors (4,10 -14) . The relationship between carbohydrate, GI and GL intake and the metabolic syndrome is important to consider because this syndrome is an important precursor of CVD and diabetes (15) as a clustering phenomenon of metabolic phenotypes such as dyslipidaemia, high resting blood pressure, high fasting glucose and abdominal obesity. However, all but one previous study (4) did not examine the metabolic syndrome itself. Moreover, most findings related to the quantity and quality of carboh...

Objective: To examine the prevalence of food insecurity and to identify factors that contribute to it in the Republic of Korea. Design: A cross-sectional study. Setting: Data were selected from a secondary data set, the third Korean Welfare Panel Study. Household food insecurity was measured with a six-item Korean version of the US Household Food Security Survey Module. The differences in proportions or means of household characteristics, householder's characteristics, economic status and social benefits by food insecurity status were tested with the x 2 or t test. The independent associations of food insecurity with each characteristic were assessed with multivariate logistic regression analysis. Subjects: The sample size consisted of 6238 households. Results: The prevalence of food insecurity was 5?3 % among all households and 25?7 % among low-income households. Risk factors that were associated with a higher risk of food insecurity included living alone, unemployment, no job, low household income and living in a leased or rented home. For low-income households, living in a leased or rented home increased the risk of food insecurity. Among food-insecure households, 26?1 % of the full sample of households and 34?3 % of low-income households were participating in food assistance programmes. Conclusions: Food insecurity among the Korean population was related to household type, income, job status and housing. Food assistance programmes were not enough to completely alleviate food insecurity.

The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. Results: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. Conclusion: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.

To evaluate the association between dietary mushroom intake and breast cancer risk, a total of 362 women between the ages of 30 and 65 years who were histologically confirmed to have breast cancer were matched to controls by age (62 years) and menopausal status. Mushroom intake was measured via a food frequency questionnaire that was administered by well-trained interviewers. The associations between the daily intake and the average consumption frequency of mushrooms with breast cancer risk were evaluated using matched data analysis. Both the daily intake (5th vs. 1st quintile, OR 5 0.48, 95% CI 5 0.30-0.78, p for trend 0.030) and the average consumption frequency of mushrooms (4th vs. 1st quartile, OR 5 0.54, 95% CI 5 0.35-0.82, p for trend 0.008) were inversely associated with breast cancer risk after adjustment for education, family history of breast cancer, regular exercise [ ‡22.5 MET (metabolic equivalent)-hr/week], BMI (body mass index, Kg/m 2 ), number of children and whether they are currently smoking, drinking or using multivitamin supplements. Further adjustments were made for energy-adjusted carbohydrate, soy protein, folate and vitamin E levels, which tended to attenuate these results. After a stratification was performed according to menopausal status, a strong inverse association was found in postmenopausal women (OR 5 0.16, 95% CI 5 0.04-0.54, p for trend 5 0.0058 for daily intake; OR 5 0.17, 95% CI 5 0.05-0.54, p for trend 5 0.0037 for average frequency), but not in premenopausal women. In conclusion, the consumption of dietary mushrooms may decrease breast cancer risk in postmenopausal women. ' 2007 Wiley-Liss, Inc.Key words: mushrooms; menopausal status; breast cancer; casecontrol study Mushrooms have been consumed worldwide to maintain general human health because of the general understanding that mushrooms are excellent sources of nutrition. A number of bioactive compounds have been identified in many mushroom species. 1,2 The most actively investigated mushroom-derived substances are the polysaccharides, which have antitumor and immunomodulating properties. [1][2][3][4][5][6][7][8][9][10][11] The extracts of mushroom have been increasingly sold as dietary supplements based on the claim that they enhance immune fractions and promote health. 12 However, there are little data available on the potential preventive benefits of mushrooms as dietary constituents. To our knowledge, there have only been 3 epidemiologic studies [13][14][15] that have researched the association between mushroom intake and cancer risk (2 on stomach cancer and 1 on breast cancer). All of these studies were performed in Asian countries (2 in Korea 13,15 and 1 in Japan 14 ).Korea is widely known for its consumption of mushrooms with medicinal properties to promote health and to prevent or treat diseases. 2,16 This is the reason why we previously initiated a study on the effect of mushroom intake on common cancers in Korea and found an inverse association between mushroom intake and stomach cancer, 13 which is one of the ...

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