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Lee CM, Seo YB, Paek YJ, Lee ES, Kang HS, Kim SY, Roh S, Park DW, An YS, Jo SH. Evidence-Based Guideline for the Treatment of Smoking Cessation Provided by the National Health Insurance Service in Korea. Korean J Fam Med 2024; 45:69-81. [PMID: 38414371 DOI: 10.4082/kjfm.23.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/03/2023] [Indexed: 02/29/2024] Open
Abstract
Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8-12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine's clinical guideline development process, this is South Korea's first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.
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Affiliation(s)
- Cheol Min Lee
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yoo-Bin Seo
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea
| | - Yu-Jin Paek
- Department of Family Medicine and Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Eon Sook Lee
- Department of Family Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
| | - Hye Seon Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bucheon St. Mary's Hospital, Bucheon, Korea
| | - Soo Young Kim
- Department of Family Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Sungwon Roh
- Department of Psychiatry, Hanyang University Hospital, Seoul, Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yoo Suk An
- Department of Psychiatry, Seoul National University Hospital, Seoul, Korea
| | - Sang-Ho Jo
- Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
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Yoo MY, Song HJ, Park KH, Seo YG, An HJ, Paek YJ, Noh HM. Relationship between Eating Alone and Handgrip Strength in Korean Older Adults. Nutrients 2024; 16:654. [PMID: 38474782 DOI: 10.3390/nu16050654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/19/2024] [Accepted: 02/23/2024] [Indexed: 03/14/2024] Open
Abstract
Sarcopenia is defined as an age-related decline in muscle mass, muscle strength, and physical performance. Eating alone has been linked to various health issues in older adults. This study investigated the relationship between eating alone and handgrip strength (HGS) in older adults using data from 7278 individuals (≥65 years) who participated in the 2014-2019 Korea National Health and Nutrition Examination Survey. HGS was measured using a digital grip strength dynamometer, relative HGS was calculated by dividing HGS by body mass index, and dynapenia was defined as an HGS < 28 kg for men and <18 kg for women. Multivariable logistic regression analysis showed that women who ate two meals alone were more likely to exhibit dynapenia than those who never ate alone (odds ratio [OR], 1.3; 95% confidence interval [CI], 1.03-1.77). If the groups that never ate alone or ate one meal alone were combined as the reference group, the probability of dynapenia was higher in the combined groups that ate two or three meals alone (OR, 1.25; 95% CI, 1.04-1.50). No association was observed between eating alone and dynapenia in men. This suggests that eating alone is a modifiable related factor of dynapenia in older women.
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Affiliation(s)
- Min Young Yoo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Hye-Ji An
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang 14068, Republic of Korea
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Park J, Lim MK, Kim Y, Paek YJ, Cho SI. National Smoking Cessation Services (NSCS) enrollment and their effect on long-term tobacco cessation in Korea: Results from a 1-year prospective follow-up of NSCS participants. Tob Induc Dis 2024; 22:TID-22-33. [PMID: 38333885 PMCID: PMC10851190 DOI: 10.18332/tid/178499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/08/2024] [Accepted: 01/11/2024] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION The study aimed to identify predictors associated with long-term tobacco cessation at 12-month follow-up among users of the National Smoking Cessation Services (NSCS) in Korea. METHODS To measure the long-term effect of NSCS delivery, the target sample size of 5167 adult smokers registered in the NSCS in 2018 was enrolled with proportional random sampling. A multiple logistic regression analysis (crude, adjusted) was performed to identify the changes in smoking status at the 12-month follow-up after the last NSCS enrollment and the potential factors associated with changes in smoking status. RESULTS The response rate to reach the number of subjects targeted was 22.4%. A total of 41.2% of the tobacco users enrolled had successfully quit at baseline, and the 7-day point prevalence of tobacco cessation at the follow-up at 12 months, via a telephone survey, was 34.4%. Factors positively associated with cessation at the 12-month follow-up were longer experience with tobacco abstinence and additional quitting attempts with or without NSCS enrollment, although every additional quit attempt with NSCS use had a better outcome. In addition, having a successful quit outcome with NSCS use at the baseline and having more satisfaction with the service of professional counseling or incentives than others provided by NSCS, increased cessation at follow-up after adjustment of other factors considered. CONCLUSIONS In addition to multiple quitting attempts, longer experience with tobacco abstinence, and additional enrollment in NSCS, the service experience, and satisfaction with the content that NSCS offered, might improve the lasting success of abstinence. These results might be considered to improve the contents and protocols of the NSCS for better outcomes.
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Affiliation(s)
- Jinju Park
- Central Division of Cardio-cerebrovascular Disease Management, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Kyung Lim
- Department of Social and Preventive Medicine, Inha University College of Medicine, Incheon, Republic of Korea
| | - Yunhee Kim
- Department of Nursing, Pukyong National University, Busan, Republic of Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Sung-il Cho
- Department of Public Health Sciences, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea
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Kim Y, Lee J, Lee E, Lim J, Kim Y, Lee CT, Jang SH, Paek YJ, Lee WC, Lee CW, Kim HY, Goo JM, Choi KS, Park B, Lee DH, Seo HG. Strategies to Improve Smoking Cessation for Participants in Lung Cancer Screening Program: Analysis of Factors Associated with Smoking Cessation in Korean Lung Cancer Screening Project (K-LUCAS). Cancer Res Treat 2024; 56:92-103. [PMID: 37562437 PMCID: PMC10789955 DOI: 10.4143/crt.2022.1598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/05/2023] [Indexed: 08/12/2023] Open
Abstract
PURPOSE Smoking cessation intervention is one of the key components of successful lung cancer screening program. We investigated the effectiveness and related factors of smoking cessation services provided to the participants in a population-based lung cancer screening trial. MATERIALS AND METHODS The Korean Lung Cancer Screening Project (K-LUCAS) is a nationwide, multi-center lung cancer screening trial that evaluates the feasibility of implementing population-based lung cancer screening. All 5,144 current smokers who participated in the K-LUCAS received a mandatory smoking cessation counseling. Changes in smoking status were followed up using a telephone survey in 6 months after lung cancer screening participation. The lung cancer screening's impact on smoking cessation is analyzed by variations in the smoking cessation interventions provided in screening units. RESULTS Among 4,136 survey responders, participant's motivation to quit smoking increased by 9.4% on average after lung cancer screening. After 6 months from the initial screening, 24.3% of participants stopped smoking, and 10.6% of participants had not smoked continuously for at least 6 months after screening. Over 80% of quitters stated that participation in lung cancer screening motivated them to quit smoking. Low-cost public smoking cessation program combined with lung cancer screening increased the abstinence rates. The smokers were three times more likely to quit smoking when the smoking cessation counseling was provided simultaneously with low-dose computed tomography screening results than when provided separately. CONCLUSION A mandatory smoking cessation intervention integrated with screening result counselling by a physician after participation in lung cancer screening could be effective for increasing smoking cessation attempts.
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Affiliation(s)
- Yeol Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jaeho Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eunju Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Juntae Lim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Yonghyun Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Choon-Taek Lee
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Hun Jang
- Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Won-Chul Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chan Wha Lee
- Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea
| | - Hyae Young Kim
- Department of Diagnostic Radiology, National Cancer Center, Goyang, Korea
| | - Jin Mo Goo
- Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Kui Son Choi
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Boyoung Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Duk Hyoung Lee
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hong Gwan Seo
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
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Seo YG, Paek YJ, Kim JH, Kim JK, Noh HM. Relationship between heated tobacco product use and allergic rhinitis in Korean adults. Tob Induc Dis 2023; 21:146. [PMID: 37954489 PMCID: PMC10632938 DOI: 10.18332/tid/174130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 08/18/2023] [Accepted: 10/13/2023] [Indexed: 11/14/2023] Open
Abstract
INTRODUCTION Combustible cigarette (CC) smoking is a risk factor for chronic obstructive pulmonary disease (COPD) and asthma, and some studies reported that tobacco smoking might affect the development or symptom control of allergic rhinitis, sinusitis, and atopic dermatitis. However, evidence on the health risks of heated tobacco products (HTPs) is lacking. We investigated the prevalence of respiratory and allergic diseases according to tobacco use types in Korean adults. METHODS We used data from 18230 adults in the Korea National Health and Nutrition Examination Survey. Multiple logistic regression analyses were performed to assess the prevalence of respiratory and allergic diseases according to tobacco use types (current exclusive CC use, current exclusive HTPs use, and dual use of CC and HTPs). RESULTS The prevalence of exclusive CC users, exclusive HTPs users, dual users of CC and HTPs was 15% (n=2740), 1% (n=182), and 2.4% (n=435), respectively. The prevalence of COPD was higher among past tobacco users (AOR=2.37; 95% CI: 1.02-5.51) versus no tobacco use group. The prevalence of asthma was higher among past tobacco users or exclusive CC users (AOR=1.73; 95% CI: 1.26-2.38, and AOR=1.57; 95% CI: 1.08-2.26) versus non-users of tobacco. The prevalence of allergic rhinitis was higher among past tobacco users versus non-users of tobacco (AOR=1.33; 95% CI: 1.13-1.57), and the prevalence of allergic rhinitis was higher among exclusive HTPs users versus non-users of tobacco or exclusive CC users (AOR=1.60; 95% CI: 1.06-2.42, and AOR=1.74; 95% CI: 1.14-2.66). The adjusted odds of sinusitis and atopic dermatitis were not significantly different between tobacco use types. CONCLUSIONS Exclusive use of HTPs was associated with allergic rhinitis in Korean adults. Further longitudinal studies are needed to clarify the health risk of HTPs.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea
| | - Joo-Hee Kim
- Department of Internal Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea
| | - Jwa-Kyung Kim
- Department of Internal Medicine & Kidney Research Institute, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University, Anyang, Republic of Korea
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Park MJ, Seo YG, Noh HM, Kim Y, Yoon JL, Paek YJ. Effectiveness of National Residential Smoking Cessation Program. Int J Environ Res Public Health 2021; 18:ijerph18189901. [PMID: 34574823 PMCID: PMC8466792 DOI: 10.3390/ijerph18189901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/17/2021] [Accepted: 09/18/2021] [Indexed: 11/16/2022]
Abstract
We aimed to investigate the effectiveness of the Korean national five-day residential smoking cessation program and the factors affecting the long-term smoking cessation of participants. The residential smoking cessation program (2017-2018) recruited smokers with a smoking duration ≥ 20 years and who have attempted to quit smoking more than twice and/or smokers with chronic morbidities. Participants underwent an intensive intervention, including individual psychological therapy, group therapy, medical counseling, and pharmacotherapy. The 6-month continuous abstinence rate (CAR) was assessed via self-reports, the urine cotinine levels, and/or expired-air carbon monoxide levels. Logistic regression was used to analyze the adjusted odds ratio (aOR) to assess factors related to smoking cessation. Overall, 484 participants who completed the residential program and questionnaire were evaluated. The 3- and 6-month CAR were 81.82% and 63.22%, respectively. The aOR of 6-month continuous abstinence was lower among participants with severe nicotine dependence (aOR: 0.46, 95% confidence interval [CI]: 0.26-0.81) and higher among participants with combination therapy of varenicline with short-term nicotine replacement therapy (NRT) (aOR: 1.64, 95% CI: 1.07-2.51), with higher self-efficacy (aOR: 1.97, 95% CI: 1.15-3.37). The residential smoking cessation program was effective. High self-efficacy, combination therapy of varenicline with short-term NRT, and low nicotine dependence were associated with a high 6-month CAR.
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Affiliation(s)
- Mi-Jeong Park
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea; (M.-J.P.); (J.L.Y.)
| | - Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Korea; (Y.-G.S.); (H.-M.N.)
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Korea; (Y.-G.S.); (H.-M.N.)
| | - Yeol Kim
- National Cancer Center, Division of Center for Cancer Prevention and Detection, Goyang 10408, Korea;
- National Cancer Center, National Cancer Control Institute, Goyang 10408, Korea
| | - Jong Lull Yoon
- Department of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong 18450, Korea; (M.-J.P.); (J.L.Y.)
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Korea; (Y.-G.S.); (H.-M.N.)
- Correspondence: ; Tel.: +82-31-380-3805
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Seo YG, Jo MW, Paek YJ, Choi J. Effects of morbidity on smoking cessation: a national smoking cessation program. Addict Sci Clin Pract 2021; 16:47. [PMID: 34321084 PMCID: PMC8317329 DOI: 10.1186/s13722-021-00257-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022] Open
Abstract
Background In smokers with chronic diseases, we examined the abstinence rates over 6 months and its affecting factors in the context of the Korea National Health Insurance Service (NHIS) smoking cessation program. Methods To identify 6-month abstinence, we extracted a sample of 15,017 participants using the multi-stage stratified cluster sampling method from the 359,047 individuals enrolled in the 2016 NHIS smoking cessation program and 1500 smokers responded to the telephone survey. From this group, 1245 individuals (48.50 ± 12.55 years; men 89.8%) were enrolled, as they had no missing information for confounding variables. We compared chronic disease distribution between participants and current smokers in the 2016 Korea National Health and Nutrition Examination Survey. We evaluated the factors affecting continuous abstinence rate (CAR) across patients with different chronic diseases: hypertension, diabetes mellitus (DM), dyslipidemia (DL), chronic obstructive pulmonary disease, and major depressive disorder (MDD). Results While participation of DM patients was high, the participation of DL patients was relatively low. The CAR over 6 months was 44.74%. The adjusted odds ratio (OR) for continuous abstinence over 6 months was significantly lower in the MDD group than in the no-MDD group (OR 0.43, 95% confidence interval [CI] 0.21 to 0.85). The factors of program completion (complete versus incomplete: OR 3.11, 95% CI 2.43 to 3.98), region (non-metropolitan areas versus Seoul metropolitan area: OR 1.28, 95% CI 1.01 to 1.61), and nicotine dependence (severe versus light or moderate: OR 0.64, 95% CI 0.50 to 0.83) were significantly associated with CAR. Conclusions The smoking cessation program was not actively recruiting smokers with chronic diseases. The CARs in each disease group were not different from those in the non-disease groups, except that the MDD group had a lower CAR over 6 months than the no-MDD group. Recruiting smokers with chronic diseases and improving their CARs depends on the careful identification of their characteristics.
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Affiliation(s)
- Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jaekyung Choi
- Department of Family Medicine, Research Institute of Medical Science, School of Medicine, Konkuk University, Konkuk University Medical Center, Seoul, Republic of Korea
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Tran TPT, Park J, Park E, Shin SH, Paek YJ, Kim YH, Lim MK. Effect of Additional Motivational Interviewing on Smoking Abstinence for 1-Year among Korean Adolescents: Results from A Comparative Retrospective Study in Quitline. Int J Environ Res Public Health 2020; 17:ijerph17218025. [PMID: 33142682 PMCID: PMC7662252 DOI: 10.3390/ijerph17218025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the effect of additional motivational enhancement through telephone-based counseling on short- and long-term smoking abstinence among Korean adolescents. METHODS A comparative retrospective study was conducted based on the longitudinal follow up in Quitline from 2010 to 2017. A total of 533 and 178 adolescent smokers voluntarily participated in the 1-year quitting counseling only (group A, who were ready to quit) and the additional 4-week motivational interviewing before 1-year quitting counseling (group B, who were ambivalent about quitting), respectively. The outcomes were self-reported continuous abstinence at 30-day, 6-month, and 1-year follow up. Logistic regression was applied to estimate the effect of potential factors, including motivational enhancement, on cessation outcome. RESULTS At baseline, adolescents in group B had a lower motivation to quit than those in group A (p < 0.001). The successful quit rates at 30-day, 6-month, and 1-year follow up were 37.2%, 12.8%, and 11.4% in group A and 33.7%, 15.2%, and 11.2% in group B, respectively. After adjusting factors as appropriate, successful quit rates in group B were not significantly different from the rates in group A. Higher self-efficacy increased the successful quit rate at 30-day, 6-month, and 1-year follow up, similar in subgroup analysis by gender. Never-drinking showed significant association with 30-day successful quit in the whole population and among boys. The lower number of smoking triggers was associated with an increased 30-day successful quit rate among boys only. CONCLUSIONS Counseling for motivational enhancement could be a promising approach for better quitting outcomes. Improving self-efficacy and eliminating smoking triggers should be continuously strengthened during the quitting process.
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Affiliation(s)
- Thi Phuong Thao Tran
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
| | - Jinju Park
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
| | - Eunjung Park
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
| | - Sang Hwa Shin
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
| | - Yu-Jin Paek
- Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang 14068, Korea;
| | - Yun Hee Kim
- Department of Nursing, Pukyong National University, Busan 48513, Korea;
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea; (T.P.T.T.); (J.P.)
- Division of Cancer Prevention & Early Detection, National Cancer Control Institute, National Cancer Center, Goyang 10408, Korea; (E.P.); (S.H.S.)
- Correspondence: ; Tel.: +82-31-920-2016; Fax: +82-31-920-2929
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Park J, Seo YG, Paek YJ, Song HJ, Park KH, Noh HM. Effect of alternate-day fasting on obesity and cardiometabolic risk: A systematic review and meta-analysis. Metabolism 2020; 111:154336. [PMID: 32777443 DOI: 10.1016/j.metabol.2020.154336] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/15/2020] [Accepted: 08/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND & AIMS Alternate-day fasting (ADF) is related to weight reduction, lowered risks of weight regain, and relative lean body mass preservation compared to continuous energy restriction. This meta-analysis aimed to assess the effects of ADF on obesity-related factors and cardiometabolic risk factors in adults. METHODS Using PubMed, EMBASE, and Cochrane online databases, an electronic search was performed. Randomized controlled trials were investigated to evaluate ADF effects on body mass index (BMI), body weight (BW), waist circumference, body fat mass (FM), lean body mass, and cardiometabolic risk factors in adults aged ≥18 years. By utilizing a random-effects model, meta-analyses to assess weighted mean difference (WMD) with 95% confidence intervals (CIs) were performed for eight randomized controlled trials (total participants = 728). RESULTS We observed significant effects of ADF for BMI (WMD -0.73 kg/m2, 95% CI -1.13 to -0.34), FM (WMD -1.27 kg, 95% CI -2.09 to -0.46), and total cholesterol (WMD -8.14 mg/dL, 95% CI -14.59 to -1.69). Subgroup analyses indicated that significant intervention effects were observed for BMI, BW, FM, and total cholesterol when compared to the control, the participants were overweight, and the study duration was <6 months. ADF is effective in reducing waist circumference in adults aged ≥40 years with obesity. However, there was no difference between ADF and continuous energy restriction, time-restricted feeding, or control with regard to lean body mass. CONCLUSIONS Current evidence suggests that ADF effectively lowers BMI, BW, FM, and total cholesterol in adults with overweight within 6 months compared to the control.
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Affiliation(s)
- Jihyun Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do 14068, Republic of Korea
| | - Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do 14068, Republic of Korea.
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do 14068, Republic of Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do 14068, Republic of Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do 14068, Republic of Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do 14068, Republic of Korea
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Jo AR, Park MJ, Lee BG, Seo YG, Song HJ, Paek YJ, Park KH, Noh HM. Association between Falls and Nutritional Status of Community-Dwelling Elderly People in Korea. Korean J Fam Med 2020; 41:111-118. [PMID: 32208403 PMCID: PMC7093673 DOI: 10.4082/kjfm.18.0112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 06/09/2019] [Indexed: 01/06/2023] Open
Abstract
Background Malnutrition is a well-known risk factor of falls, although studies examining the association between nutritional status and falls are rare. We aimed to investigate the association between nutritional status and falls according to gender among Korean older adults. Methods The study included 10,675 participants (4,605 men and 6,070 women) aged 65 years and older and used data from the 2011 Survey of Living Conditions and Welfare Needs of Korean Older Persons. Nutritional status of the participants was assessed using the Nutritional Screening Initiative checklist, and the participants were categorized into the following groups: “good,” “moderate nutritional risk,” and “high nutritional risk.” Odds ratios (OR) of fall risk in the above groups based on gender were evaluated using multivariate logistic regression analyses. Results Fallers in both genders showed significant association with older age, lower household income, inadequate exercise, and poor nutritional status compared with non-fallers. Considering the good nutritional status group as the reference group, the high nutritional risk group showed a higher risk of falls in men (OR, 1.59; 95% confidence interval [CI], 1.26–1.99); both moderate and high nutritional risk groups showed a higher risk of falls after adjusting for confounding factors in women (OR, 1.39; 95% CI, 1.19–1.62 and OR, 1.90; 95% CI, 1.61–2.24, respectively). Conclusion The risk of falls was associated with poor nutritional status, and statistical significance of the association between nutritional status and falls was stronger in women than in men.
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Affiliation(s)
- Ah-Ra Jo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Mi-Jeong Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Byung-Gue Lee
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hong-Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
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Affiliation(s)
- Yu-Jin Paek
- Department of Family Medicine, Hallym University College of Medicine, Chuncheon, Korea
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Lee H, Song HJ, Paek YJ, Park KH, Noh HM, Kim G, Seo YG. Clinical Characteristics Associated with Electrocardiographic Left Ventricular Hypertrophy in Clinical Normotensives without a History of Hypertension: a Cross-Sectional Study. Korean J Fam Med 2019; 40:106-115. [PMID: 30727705 PMCID: PMC6444087 DOI: 10.4082/kjfm.17.0069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/12/2017] [Indexed: 11/03/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Hyoeun Lee
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Geonhyeok Kim
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
- Corresponding Author: Young-Gyun Seo https://orcid.org/0000-0001-8294-1741 Tel: +82-31-380-3805, Fax: +82-31-380-1782, E-mail:
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Lee HS, Jeong WW, Choi YJ, Seo YG, Noh HM, Song HJ, Paek YJ, Kim YM, Lim HJ, Lee HJ, Jang HB, Park SI, Park KH. Association between Physical Fitness and Cardiometabolic Risk of Children and Adolescents in Korea. Korean J Fam Med 2018; 40:159-164. [PMID: 30466203 PMCID: PMC6536905 DOI: 10.4082/kjfm.17.0085] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 08/29/2017] [Indexed: 11/17/2022] Open
Abstract
Background This study aimed to investigate the association between physical fitness and cardiometabolic health of Korean children and adolescents. Methods In total, 168 participants (89 boys and 79 girls) aged 10–16 years were recruited for the Intervention for Childhood and Adolescent Obesity via Activity and Nutrition Study in 2016. The subjects were categorized into two groups using the definition of metabolic syndrome by the International Diabetes Federation: metabolically unhealthy (with at least two of the five criteria) and healthy groups (with less than one criterion). Correlation analysis of the participants’ general characteristics was performed. Odds ratios (ORs) of physical fitness for cardiometabolic risk were evaluated via logistic regression. Results Metabolically unhealthy children showed greater weight, height, and body mass index, higher Children’s Depression Inventory score, and longer screen time than did the metabolically healthy children. Metabolically healthy children showed greater upper and lower extremity muscular strength than did the metabolically unhealthy children (P=0.04 and P<0.001, respectively). In the multiple logistic regression analysis, lower extremity muscle strength was inversely related to the clustered cardiometabolic risk of the children and adolescents with or without adjustment for confounders (OR, 4.32; 95% confidence interval [CI], 1.87–9.97; OR, 7.64; 95% CI, 1.55– 37.74, respectively). Conclusion Physical fitness, especially lower extremity muscle strength, is significantly inversely associated with individual and clustered cardiometabolic risks in Korean children and adolescents.
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Affiliation(s)
- Hyun-Suk Lee
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Won-Wook Jeong
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jeong Choi
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Young-Gyun Seo
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hong-Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yoon-Myung Kim
- University College, Yonsei University International Campus, Incheon, Korea
| | - Hyun-Jung Lim
- Department of Medical Nutrition, Kyung Hee University, Yongin, Korea
| | - Hye-Ja Lee
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Korea
| | - Han-Byul Jang
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Korea
| | - Sang-Ick Park
- Center for Biomedical Sciences, Korea National Institute of Health, Cheongju, Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
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Kim J, Yu H, Lee S, Paek YJ. Awareness, experience and prevalence of heated tobacco product, IQOS, among young Korean adults. Tob Control 2018; 27:s74-s77. [PMID: 30158210 PMCID: PMC6252497 DOI: 10.1136/tobaccocontrol-2018-054390] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 06/11/2018] [Accepted: 06/12/2018] [Indexed: 11/17/2022]
Abstract
Introduction Philip Morris International introduced ‘IQOS’ to the Korean market in June 2017. To monitor the use of IQOS among young Korean adults, we identified their awareness, experience and current use of IQOS. Methods Three months after the introduction of IQOS in Korea, we conducted an online survey with 228 general young adults, aged 19–24 years. Results 87 participants (38.1%) were aware of IQOS, 13 (5.7%) were IQOS ever users and 8 (3.5%) were current IQOS users. All the current IQOS users were triple users of conventional cigarettes and electronic cigarettes (e-cigarettes). There were no IQOS-only users and one IQOS ever user was a non-cigarette smoker. Among the eight current IQOS users who smoked 9.1 conventional cigarettes a day on average, four smoked 10–20 HEETS sticks a day. The current IQOS users decided to use IQOS because they believed it was less harmful or to stop smoking. The current conventional cigarette smokers were much more likely to be aware of IQOS (OR 4.496; 95% CI 2.185 to 9.250) and to be IQOS ever users (OR 11.649; 95% CI 1.024 to 132.564). Conclusion Awareness, experience and use of IQOS among young Korean adults were relatively higher than among their Japanese counterparts. Current IQOS users were more likely to smoke conventional cigarettes and/or e-cigarettes, which contradicts the tobacco industry’s claims that conventional cigarette smokers will switch to heated tobacco products. Until obtaining robust evidence concerning heated tobacco products, the government should regulate the tobacco industry’s marketing tactics and health claims.
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Affiliation(s)
- Jinyoung Kim
- Southern Gyeonggi Regional Smoking Cessation Centre, Hallym University, Anyang, Republic of Korea
| | - Hyunjae Yu
- School of Communication, Sogang University, Seoul, Republic of Korea
| | - Sungkyu Lee
- National Tobacco Control Centre, Korea Health Promotion Institute, Seoul, Republic of Korea
| | - Yu-Jin Paek
- Southern Gyeonggi Regional Smoking Cessation Centre, Hallym University, Anyang, Republic of Korea.,Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
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Lee S, Kim J, Paek YJ. Exposure of smoking scenes in popular movies among Koreans from 2006-2015. Tob Induc Dis 2018. [DOI: 10.18332/tid/83873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Affiliation(s)
- Yu-Jin Paek
- Department of Family Medicine, Hallym University School of Medicine, Chuncheon, Korea
| | - Jae-Kyung Choi
- Department of Family Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Eon-Sook Lee
- Department of Family Medicine, Inje University School of Medicine, Pusan, Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Noh HM, Kim UY, Park YS, Song YR, Oh HY, Park KH, Paek YJ, Roh YK, Song HJ. Sex differences in the association between obesity and albuminuria among Korean adults: a cross-sectional study using the Korea National Health and Nutrition Examination Survey data. Clin Exp Nephrol 2016; 21:27-34. [PMID: 26902522 PMCID: PMC5283500 DOI: 10.1007/s10157-016-1238-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 01/19/2016] [Indexed: 11/26/2022]
Abstract
Background The association between obesity and albuminuria in the general population remains unclear. We aimed to identify the association between obesity and albuminuria as well as sex differences regarding the associations using several obesity indices, including waist circumference (WC), body mass index (BMI), and waist-to-height ratio (WHR). Methods This study included 3841 subjects (1730 males and 2111 females; age 20–80 years) who participated in the Fifth Korea National Health and Nutrition Examination Survey conducted in 2011. Subjects with hypertension, diabetes, renal failure, or a malignant tumor and those who were pregnant or menstruating were excluded. Albuminuria was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g. Anthropometric parameters were categorized into sex-specific quartiles. Logistic regression models were used to assess the associations between each anthropometric parameter and albuminuria. Results All of the obesity indices of the fourth quartile group of females showed a twofold higher risk for albuminuria than the second quartile group, and it was persistently significant after adjusting for age, smoking, and physical activity. After further adjustment for high blood pressure and impaired fasting glucose and triglyceride levels, WC and BMI of the fourth quartile group of females still showed a significantly higher risk for albuminuria than the second quartile group (odds ratios 1.96 and 2.24; 95 % confidence intervals 1.03–3.74 and 1.15–4.37). None of the associations between albuminuria and the obesity indices were significant in males. Conclusion Higher WC and BMI were significantly associated with the risk of albuminuria among females, but not males. Electronic supplementary material The online version of this article (doi:10.1007/s10157-016-1238-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Un-Young Kim
- Daejeon Woori Spine Hospital, Daejeon, Republic of Korea
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Young Rim Song
- Department of Internal Medicine, Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, Republic of Korea
| | - Hye-Young Oh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea
| | - Yong Kyun Roh
- Department of Family Medicine, Kangnam Sacred Heart Hospital, Seoul, Republic of Korea.
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Gyeonggi-do, 431-796, Republic of Korea.
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Affiliation(s)
- Min Kyu Choi
- Department of Family Medicine, Hallym University School of Medicine, Chuncheon, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University School of Medicine, Chuncheon, Korea
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Lee S, Jang M, Noh HM, Oh HY, Song HJ, Park KH, Paek YJ. Time to First Cigarette and Hypertension in Korean Male Smokers. Korean J Fam Med 2015; 36:221-6. [PMID: 26435812 PMCID: PMC4591387 DOI: 10.4082/kjfm.2015.36.5.221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/26/2015] [Accepted: 07/09/2015] [Indexed: 11/30/2022] Open
Abstract
Background Morning blood pressure surge affects to cardiovascular disease risk. Short time to first cigarette (TTFC) after waking can enhance morning blood pressure surge, and accelerate atherosclerosis Methods We investigated that the relationship between TTFC and blood pressure. The study subjects included male current smokers (n=211) who had health check-up in Hallym University Sacred Heart Hospital from July to September, 2014. We categorized the subjects into 2 groups according to TTFC; early TTFC (TTFC <30 minutes) and late TTFC (TTFC ≥30 minutes), and the subjects who were taking antihypertensive medications or had a high blood pressure (>140 mm Hg or 90 mm Hg) were defined as hypertensive group. Multivariate logistic regression was performed to estimate the odds ratio and 95% confidence interval to investigate the association between TTFC and hypertensive group. Results Compared with late TTFC, early TTFC had higher odds (odds ratio [OR], 3.87; 95% confidence interval [CI], 1.89-7.94) for hypertensive group. After adjusting confounding factors, early TTFC was significantly associated with an increased risk of hypertension (OR, 4.43; 95% CI, 1.84-10.70). Conclusion early TTFC after waking is associated with hypertension. It suggests delaying TTFC might help to control of blood pressure among the current smokers who are not ready to immediately quit smoking.
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Affiliation(s)
- Saerom Lee
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Miae Jang
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hye-Young Oh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Kyung Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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Chun S, Lee S, Son HJ, Noh HM, Oh HY, Jang HB, Lee HJ, Kang JH, Song HJ, Paek YJ, Park KH. Clinical Characteristics and Metabolic Health Status of Obese Korean Children and Adolescents. Korean J Fam Med 2015; 36:233-8. [PMID: 26435814 PMCID: PMC4591389 DOI: 10.4082/kjfm.2015.36.5.233] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 04/07/2015] [Accepted: 08/10/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND This study aimed to determine the prevalence of metabolically healthy and unhealthy obesity (MHO and MUO, respectively) and examine the demographic, anthropometric, and lifestyle predictors of metabolic health status in Korean children and adolescents. METHODS This study was based on data collected from the Korean Children-Adolescent Study in 2010. A total of 1,700 children (846 boys and 854 girls) were included in the primary cohort and classified into metabolically healthy and unhealthy groups according to factors related to the metabolic syndrome. Demographic and biochemical features were evaluated in study participants. Logistic regression estimated the odds ratios of having more fat mass among MUO compared with MHO children after adjusting for confounding factors. RESULTS Mean body mass index was higher in the MUO group than in the MHO group (24.83 vs. 23.02 kg/m(2), respectively). The proportion of obese participants was also higher in the MUO group (59.4%) than in the MHO group (20.7%). MHO children were more likely to have parents with better socioeconomic status and a higher fruit and vegetable intake compared with MUO children. Higher fat mass and percent fat was associated with MUO according to multiple logistic regression analysis. CONCLUSION Fat mass and percent fat are associated with metabolically healthy phenotypes of obesity among children and adolescents.
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Affiliation(s)
- Sunyoung Chun
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Saerom Lee
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hyo-Jae Son
- Department of Family Medicine, Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hye-Young Oh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Han Byul Jang
- Division of Metabolic Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, Korea
| | - Hye-Ja Lee
- Division of Metabolic Disease, Center for Biomedical Science, Korea National Institute of Health, Cheongju, Korea
| | - Jae-Heon Kang
- Department of Family Medicine, Obesity Research Institute, Inje University Seoul Paik Hospital, Seoul, Korea
| | - Hong-Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Kyung-Hee Park
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
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Paek YJ, Lee S, Kim YH, Lee KS, Yim HW, Kim MS, Kim CH, Jeung O. Effect on smoking quit rate of telling smokers their health risk appraisal in terms of health age: a randomized control trial. Asian Pac J Cancer Prev 2015; 15:4963-8. [PMID: 24998572 DOI: 10.7314/apjcp.2014.15.12.4963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We evaluated whether providing health risk appraisal for Koreans (KHRA) in terms of 'health age' during smoking cessation program would effectively help smokers quit smoking or not. MATERIALS AND METHODS A total of 332 male smokers aged between 30-65 years old, registered for a smoking cessation program in a public health center in a city, were recruited and underwent a baseline survey from January 2010 to February 2011. They were then prospectively randomized to a conventional counseling group (n=165) or a KHRA group (n=167), and received conventional counseling or KHRA-based counseling for six months. Abstinence rates were identified through carbon monoxide measurement (at the 4th and 24th weeks) or urinary cotinine level (at the 12th week). RESULTS The abstinence rate confirmed by exhaled carbon monoxide was significantly higher in the KHRA group (61.1%) than the control group (49.1%) at the 4th week (absolute difference 12.0%, 95% CI: 1.4%-22.6%). However, there was no difference in abstinence rates between the two groups at the 12th and 24th weeks. The predicting factors of 24 week's smoking cessation success were age, older than 50 years old (OR 2.02, 95% CI: 1.16-3.52), lower Fagerstrom Test for Nicotine Dependence score less than 4 (OR 1.84, 95% CI: 1.03-3.29), and higher Self Efficacy/Temptation score (OR 1.79, 95% CI: 1.05-3.06). CONCLUSIONS Smoking cessation counseling with KHRA could be effective compared to conventional counseling in the short period of smoking cessation. Further study is needed to evaluate the long-term efficacy of KHRA in tobacco dependence treatment and to establish the indication and target population of this tool.
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Affiliation(s)
- Yu-Jin Paek
- Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Geonggi-do, Korea E-mail :
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Kwon YM, Kim GW, Yim HW, Paek YJ, Lee KS. Association between dietary fat intake and bone mineral density in Korean adults: data from Korea National Health and Nutrition Examination Survey IV (2008 ∼ 2009). Osteoporos Int 2015; 26:969-76. [PMID: 25491765 DOI: 10.1007/s00198-014-2977-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 11/23/2014] [Indexed: 12/20/2022]
Abstract
UNLABELLED We determined the relation between dietary fat intake and bone mineral density, and our study showed that low- as well as high-fat diet was associated with the risk of osteoporosis. Our study provides significant evidence of the specific dietary components that may be important modifiable factors for the prevention of osteoporosis. INTRODUCTION Osteoporosis and osteoporosis-related fractures have become major public health problems. It is important to understand the various factors that influence bone health and to prevent osteoporosis by correcting modifiable risk factors for the disease. Previous studies suggested that dietary habits and body composition were potent factors associated with bone mineral density. The aim of this study was to determine the independent effect of dietary fat intake on bone mineral density while controlling for other possible confounders, including fat mass and lean body mass. METHODS This study was based on data obtained in the Fourth Korea National Health and Nutrition Examination Survey. After serial exclusion of subjects according to the selection criteria, 7,192 subjects were included in our analysis. We divided the study population into quintiles according to dietary fat calorie/total calorie intake and compared the adjusted means of bone mineral density between quintiles. RESULTS The bone mineral density was higher in men and women with a medium fat energy intake compared to those with a low- and high-fat energy intake, but the finding was statistically significant only in women. The results were valid after controlling for body fat percentage and lean body mass. CONCLUSIONS We found that dietary fat intake is an independent modifiable risk factor for osteoporosis, regardless of body fat or lean body mass, especially in women. However, further investigations with accurate analyses of food intake and nutritional consumption, in addition to long-term follow-up data, are necessary to recommend an osteoporosis-preventive diet in Koreans.
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Affiliation(s)
- Y-M Kwon
- Department of Family Medicine, SamYook Medical Center, Seoul, South Korea
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Lee J, Lee DR, Lee DH, Paek YJ, Lee WC. Influence of maternal environmental tobacco smoke exposure assessed by hair nicotine levels on birth weight. Asian Pac J Cancer Prev 2015; 16:3029-34. [PMID: 25854401 DOI: 10.7314/apjcp.2015.16.7.3029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at 35th week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). MATERIALS AND METHODS A total of 871 non-smoking healthy pregnant women were recruited by one Korean hospital between 1 October 2006 and 31 July 2007. Hair samples were collected and anthropometric questionnaires administered at 35th week of gestation. The primary outcome was birth weight and secondary outcomes were the risk of babies being SGA and LBW. RESULTS Log-transformed hair nicotine concentrations were inversely related with birth weight after adjusting for confounding variables (β=-0.077, p=0.037). After stratifying hair nicotine levels by tertiles (T1, low [0.0-0.28 ng/mg]; T2, medium [0.29-0.62 ng/mg]; and T3, high [0.63-5.99 ng/mg]), the mean birth weight in each groups were 3,342 g (T1) 3,296 g (T2) and 3,290 g (T3), respectively. However the difference between groups was not statistically significant by analysis of co-variance (ANCOVA) adjusting for covariates (p=0.062). In logistic regression analysis, the risk of SGA was higher in the T3 (OR=1.59, 95%CI 1.05-2.42) than in the reference group (T1), after controlling for confounding variables. The risk of low birth weight (<2,500 g, LBW) was not significantly higher (OR=1.44, 95%CI 0.95-2.19), but the risk of babies being below 3,000g birth weight was increased in the T3 group (OR=1.53, 95%CI 1.00-2.36) compared with that in the T1 group. CONCLUSIONS Maternal ETS exposure during pregnancy was inversely related with birth weight. The risk of SGA increased in the highest ETS exposure group compared with in the low exposure group. To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed.
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Affiliation(s)
- Jungun Lee
- Department of Family Medicine, Sanbon Medical Center, Wonkwang University, College of Medicine, Gyeonggi-do, Republic of Korea E-mail : ,
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Noh HM, Ahn EM, Yun JM, Cho BL, Paek YJ. Angelica keiskei Koidzumi extracts improve some markers of liver function in habitual alcohol drinkers: a randomized double-blind clinical trial. J Med Food 2014; 18:166-72. [PMID: 25531033 DOI: 10.1089/jmf.2014.3222] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Alcohol induces oxidative stress and inflammatory response, which can lead to hepatitis and cirrhosis. Previous studies reported that the extracts of Angelica keiskei Koidzumi (AKE) have antioxidant and anti-inflammatory properties, suggesting that AKE could improve abnormalities associated with alcoholic liver disease. In this study, the effectiveness of AKE supplementation was assessed in 82 habitual alcohol drinkers (male: more than 14 units per week, female: more than 7 units per week) with abnormal liver biochemistry in a placebo-controlled, randomized double-blind trial over 12 weeks. Among the subjects, 65% (n=43) were heavy drinkers consuming more than 35 units per week. Among heavy drinkers, gamma-glutamyl transferase levels of 19 subjects per AKE-treated group were significantly decreased (21.16±37.63, P=.016) with significant differences observed compared to the 24 subjects per placebo group (P=.046). However, no significant differences were observed in aspartate aminotransferase and alanine aminotransferase levels between the AKE- and placebo-treated groups. These results suggest that AKE supplementation might improve liver function in heavy drinkers.
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Affiliation(s)
- Hye-Mi Noh
- 1 Department of Family Medicine, Hallym University College of Medicine , Anyang, Korea
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Affiliation(s)
- Yu-Jin Paek
- Department of Family Medicine, Hallym University School of Medicine, Chuncheon, Korea
| | - Jong-Lull Yoon
- Department of Family Medicine, Hallym University School of Medicine, Chuncheon, Korea
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Abstract
Background: Vitamin C is a commonly used antioxidant supplement; however, its effects on obesity and fat distribution are equivocal. We examined nationally representative data to determine whether intake of vitamin C is related to abdominal obesity. Methods: In total, 16,414 adults (58 % women) from the 2007 - 2010 Korea National Health and Nutrition Examination Survey were included in the analysis. Vitamin C intake was calculated using 24-hour recalls and categorized into quintiles. The multivariate models in logistic regression analysis were adjusted for age, energy intake, sodium intake, smoking, alcohol consumption, physical activity, education, income, pre-existing disease conditions, survey year, and menopausal status (in women only). Results: Compared with the lowest quintile (Q1) of vitamin C intake, the adjusted odds ratios of Q2, Q3, Q4, and Q5 for abdominal adiposity were 0.92, 0.86, 0.81, and 0.70, respectively, in women (p for trend = 0.0007). This association was maintained after adjusting for the confounding factors; however, we observed no association between intake of vitamin C and abdominal obesity in men. Conclusions: Vitamin C intake showed a negative association with abdominal obesity in women. Further research is warranted on the association between and the mechanism of vitamin C in abdominal obesity.
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Affiliation(s)
- Min-Kyu Choi
- Department of Family Medicine, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, South Korea
| | - Hong Ji Song
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, South Korea
| | - Yu-Jin Paek
- Department of Family Medicine, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, South Korea
| | - Hae-Jeung Lee
- Department of Food & Nutrition, Eulji University, Seongnam, South Korea
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Kim JY, Oh S, Chang MR, Cho YG, Park KH, Paek YJ, Yoo SH, Cho JJ, Caterson ID, Song HJ. Comparability and utility of body composition measurement vs. anthropometric measurement for assessing obesity related health risks in Korean men. Int J Clin Pract 2013; 67:73-80. [PMID: 23241051 DOI: 10.1111/ijcp.12038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Obesity is commonly assessed by body mass index (BMI) of which limitations come from an inability to distinguish body fat mass from lean mass. Several anthropometric measurements, including BMI, waist circumference, waist-to-height ratio and waist-to-hip ratio have been used to predict metabolic syndrome. The purpose of this study was to evaluate the utility of FMI or BF% combined with previous known anthropometric indices to assess the risk of metabolic syndrome in clinical practice. METHODS In 5534 men visiting a hospital for health check-ups, blood tests, anthropometric measurements and body composition analysis using BIA were performed. Logistic regression analysis was performed to compare the odds ratios for metabolic syndrome and each component of metabolic syndrome among BMI, waist-to-height ratio, waist-to-hip ratio, FMI and BF%. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) for metabolic syndrome was compared between several measurements. The net reclassification improvement with integrated discrimination improvement was used for assessing value of body composition measurement. RESULTS The adjusted odds ratios of metabolic syndrome was 1.80 (95% CI, 1.71-1.89) for FMI and 1.15 (95% CI, 1.13-1.17) for BF%. Odds ratio of each metabolic component was highest for FMI among several anthropometric and body composition measurements. AUCs using the ROC curve for metabolic syndrome was highest for waist-to-height ratio, 0.823 (95% CI, 0.808-0.837) by National Cholesterol Education Program criteria. FMI caused a mild increase in integrated discrimination improvement when combined with waist-to-height ratio. CONCLUSIONS Waist-to-height ratio seems to be the best screening tool for evaluating metabolic syndrome in Korean men, and adding FMI could result in a modest increase in integrated discrimination improvement.
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Affiliation(s)
- J Y Kim
- Department of Family Medicine, Seoul National University Bundang Hospital, College of Medicine, Seoul National University, Seoul, Korea
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Paek YJ, Jung KS, Hwang YI, Lee KS, Lee DR, Lee JU. Association between low pulmonary function and metabolic risk factors in Korean adults: the Korean National Health and Nutrition Survey. Metabolism 2010; 59:1300-6. [PMID: 20045536 DOI: 10.1016/j.metabol.2009.12.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 11/26/2009] [Accepted: 12/02/2009] [Indexed: 12/18/2022]
Abstract
Impaired lung function is a risk factor for cardiovascular events and mortality. In addition, lung function impairment is also associated with insulin resistance and type 2 diabetes mellitus. It is well known that a common mechanism, such as insulin resistance and obesity, underlies metabolic syndrome. Our aim was to evaluate the association between impaired lung function and metabolic risk factors using data from a nationwide survey of chronic obstructive pulmonary disease prevalence in Korea and the Korean National Health and Nutrition Survey in 2001. The study population included 4001 subjects (aged > or =18 years) who underwent spirometry at least twice. We analyzed the association of low pulmonary function with metabolic syndrome components using multiple linear regression and also analyzed the association of metabolic syndrome with restrictive lung disease and obstructive lung disease using multiple logistic regression adjusted for waist to height ratio, sex, age, smoking, and the other covariates. Waist girth, systolic blood pressure, and triglyceride were associated with forced vital capacity (FVC); and only triglyceride was so with forced expiratory volume in 1 second (FEV(1)), but not with FEV(1)/FVC ratio. The odds ratio of metabolic syndrome for restrictive lung disease (FVC <80%, FEV(1)/FVC >0.7) was 1.40 (95% confidence interval, 1.01-1.98), and that for obstructive lung disease (FEV(1)/FVC <0.7) was 0.93 (95% confidence interval, 0.67-1.28) after adjustment for covariates. These results indicate that low pulmonary function in the general population is associated with clustering of metabolic syndrome risk factors and, furthermore, that restrictive lung disease is also related to metabolic syndrome.
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Affiliation(s)
- Yu-Jin Paek
- Department of Family Medicine, Health Promotion Center, Hallym University Sacred Heart Hospital, Gyeonggi 431-070, South Korea
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Park J, Cho B, Paek Y, Kwon H, Yoo S. Development of a pain assessment tool for the older adults in Korea: The validity and reliability of a Korean version of the geriatric pain measure (GPM-K). Arch Gerontol Geriatr 2009; 49:199-203. [DOI: 10.1016/j.archger.2008.07.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2008] [Revised: 07/23/2008] [Accepted: 07/24/2008] [Indexed: 11/30/2022]
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Paek YJ. Evidence-based Complementary and Alternative Medicine for Cancer Prevention. J Korean Med Assoc 2008. [DOI: 10.5124/jkma.2008.51.5.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yu-Jin Paek
- Department of Family Medicine, Hallym University College of Medicine, Korea.
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Kim DH, Tsai ST, Cho HJ, Chang WD, Kim CH, Cheng HS, Cho B, Guo FR, Paek YJ, Hsueh KC, Billing CB, Williams KE. P2-3 THE EFFICACY AND TOLERABILITY OF VARENICLINE, AN α4β2 NICOTINIC ACETYLCHOLINE RECEPTOR PARTIAL AGONIST, FOR SMOKING CESSATION IN TAIWANESE AND KOREAN SMOKERS. Int J Cardiol 2007. [DOI: 10.1016/s0167-5273(08)70605-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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