Journal of Preventive Medicine and Public Health

Original Article

Blood Triglycerides Levels and Dietary Carbohydrate Indices in Healthy Koreans: Hye Sook Min, Ji Yeon Kang, Joohon Sung, Mi Kyung Kim; J Prev Med Public Health. 2016;49(3):153-164. Published online May 17, 2016; DOI: https://doi.org/10.3961/jpmph.16.014

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Objectives
Previous studies have obtained conflicting findings regarding possible associations between indices measuring carbohydrate intake and dyslipidemia, which is an established risk factor of coronary heart disease. In the present study, we examined cross-sectional associations between carbohydrate indices, including the dietary glycemic index (GI), glycemic load (GL), total amount of carbohydrates, and the percentage of energy from carbohydrates, and a range of blood lipid parameters.
Methods
This study included 1530 participants (554 men and 976 women) from 246 families within the Healthy Twin Study. We analyzed the associations using a generalized linear mixed model to control for familial relationships.
Results
Levels of the Apo B were inversely associated with dietary GI, GL, and the amount of carbohydrate intake for men, but these relationships were not significant when fat-adjusted values of the carbohydrate indices were used. Triglyceride levels were positively associated with dietary GI and GL in women, and this pattern was more notable in overweight participants (body mass index [BMI] ≥25 kg/m²). However, total, low-density lipoprotein and high-density lipoprotein cholesterol levels were not significantly related with carbohydrate intake overall.
Conclusions
Of the blood lipid parameters we investigated, only triglyceride levels were positively related with dietary carbohydrate indices among women participants in the Healthy Twin Study, with an interactive role observed for BMI. However, these associations were not observed in men, suggesting that the association between blood lipid levels and carbohydrate intake depends on the type of lipid, specific carbohydrate indices, gender, and BMI.

Summary

Citations

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Special Article

An Update on Accumulating Exercise and Postprandial Lipaemia: Translating Theory Into Practice: Masashi Miyashita, Stephen F Burns, David J Stensel; J Prev Med Public Health. 2013;46(Suppl 1):S3-S11. Published online January 30, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.S.S3

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Abstract PDF

Over the last two decades, significant research attention has been given to the acute effect of a single bout of exercise on postprandial lipaemia. A large body of evidence supports the notion that an acute bout of aerobic exercise can reduce postprandial triacylglycerol (TAG) concentrations. However, this effect is short-lived emphasising the important role of regular physical activity for lowering TAG concentrations through an active lifestyle. In 1995, the concept of accumulating physical activity was introduced in expert recommendations with the advice that activity can be performed in several short bouts throughout the day with a minimum duration of 10 minutes per activity bout. Although the concept of accumulation has been widely publicised, there is still limited scientific evidence to support it but several studies have investigated the effects of accumulated activity on health-related outcomes to support the recommendations in physical activity guidelines. One area, which is the focus of this review, is the effect of accumulating exercise on postprandial lipaemia. We propose that accumulating exercise will provide additional physical activity options for lowering postprandial TAG concentrations relevant to individuals with limited time or exercise capacity to engage in more structured forms of exercise, or longer bouts of physical activity. The benefits of accumulated physical activity might translate to a reduced risk of cardiovascular disease in the long-term.

Summary

Citations

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European Journal of Applied Physiology.2017; 117(1): 7. CrossRef
High-Intensity Interval Exercise and Postprandial Triacylglycerol
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Effect of increased physical activities of daily living on postprandial triacylglycerol concentrations in postmenopausal women
Kanako Edamoto, Hyun-Hun Jung, Tetsuhiro Kidokoro, Takuma Yanaoka, Kyoko Kashiwabara, Masaki Takahashi, Masashi Miyashita
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Original Articles

The Association between the Psychosocial Well-being Status and Adverse Lipid Profiles in a Rural Korean Community.: Chang Hoon Kim, Myoung Hee Kim, Sung Il Cho, Jung Hyun Nam, Bo Youl Choi; Korean J Prev Med. 2003;36(1):24-32.

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Abstract PDF: OBJECTIVES
To identify the psychosocial well-being status in a rural community, and examine the association between the psychosocial well-being status and adverse lipid profile. METHOD: In 2001, we surveyed 575 subjects in Yangpyoung, Kyounggido, including medical examination, fasting-blood sample and questionnaires for the psychosocial well-being status, socioeconomic position and behavioral risk factors. The logistic regression analysis was used to examine explanatory factors of the psychosocial well-being status, and association between the psychosocial well-being status and adverse lipid profiles. RESULT: The association between the psychosocial well-being status and adverse lipid profiles was not strong. The total cholesterol and triglyceridelevels were associated with psychosocial well-being. The adjusted odds ratio for moderate psychosocial well-being relating to total cholesterol was 1.90 (95%CI, 0.82-4.04), but that for triglyceride was 0.65 (95%CI, 0.36-1.21). The HDL-Cholesterol and LDL-Cholesterol level were not associated with the psychosocial well-being status. CONCLUSION: The total cholesterol and psychosocial well-being status were weakly associated, but the between the psychosocial well-being status and adverse lipid profiles were not consistent.; Summary

Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea.: Yeon Soon Cha, Young Ho Khang, Moo Song Lee, Weechang Kang, Sung Hoon Jeon, Kee Lak Kim, Sang Il Lee; Korean J Prev Med. 2002;35(2):99-106.

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Abstract PDF: OBJECTIVE
Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults. METHOD: Seven alternative strategies for hyperlipidemia screening were formulated and compared in terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. RESULTS: Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol,high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. CONCLUSIONS: Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.; Summary

Lipid Profiles and Related Factors in Adolescent.: Moran Ki, Boyoul Choi, Mi Kyung Kim, Ki Rang Kim, Jin Nu Fang, Yun Ju Kang; Korean J Prev Med. 2000;33(1):83-90.

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Abstract PDF: OBJECTIVES
To assess the prevalence rate of dyslipidemia and the level of related factors in adolescents groups in Seoul and Yangpyong area. METHODS: Design; School based survey during May-Jun 1996 in Seoul and Yangpyong county. Subject; 2,453 boys and girls, aged 13 to 19 years; 1,137 Seoul and 1,316 Yangpyong county. Main Outcome Measures; Prevalence rates of raised serum total cholesterol, triglycerides, LDL-cholesterol, decreased HDL-cholesterol, obesity, and levels of energy intake and expenditure RESULTS: Energy intake and fat intake of boys were higher than those of girls and they were higher in Seoul. Energy expenditure per day of boys was bigger than that of girls too. Prevalence rate of obesity was higher in boys of Seoul(15.2%) and girls in Yangpyong county(14.0%). Serum lipid profiles(total cholesterol, triglycerides, LDL-cholesterol) were higher among girls and all prevalence rates of dyslipidemia were higher in boys in Seoul and in girls in Yangpyong county. Especially, girls(29.1%) in Yangpyong had raised serum cholesterol level(> or =170 mg/dl). In contrast, boys in Seoul had higher level of decreased HDL-cholesterol(46.8%) compared to Yangpyong(23.6%). The relationships between serum lipid profiles and relative weights and sex are highly significant. And the relationship between triglycerides and energy intake is significant(p=0.038). But, the associations between serum lipid profiles and energy expenditure had borderline significances. CONCLUSIONS: Hypercholesterolemia rates in girls were higher. Obesity prevalence rate was highest in boys of Seoul. Relative weight and sex are significantly related to lipid profiles. Therefore, Korea is in need of preventive strategies for different obesity and gender groups.; Summary

The Risk Factors Associated with Increased Blood Pressure, Sugar and Lipids in Multi-phasic Health Checkup Examinee.: Kang Sook Lee, Sang Deog Cho, Hyun Sook Hong; Korean J Prev Med. 2000;33(1):69-75.

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Abstract PDF: OBJECTIVES
This study was conducted to evaluate the risk factors associated with cardiovascular disease. METHODS: By the questionnaire, the informations of education level, monthly income, alcohol consumption and smoking habit were obtained. Height, weight and blood pressure(BP) were measured by a trained nurse. The level of fasting blood sugar(FBS), total cholesterol, hight-density lipoprotein(HDL) cholesterol and triglyceride were tested by enzyme method about a group of 2888 males and 1696 females ages over 20 who had never taken the medication for hypertension. Statistical analysis, ANOVA, stepwise multiple regression, correlation analysis were performed using SAS package program. RESULTS: There were significant differences among age groups in systolic and diastolic blood pressure, body mass index(BMI), FBS, triglyceride and cholesterol except HDL-cholesterol. The risk factors associated with systolic and diastolic BP significantly in male were BMI, age, alcohol intake, but in female BMI, age. Smoking habit had a significant negative correlation with BP in both sex. In the group of mild hypertension (> or =140 mmHg or> or =90 mmHg defined by JNC-VI) and hypertension (> or =160 mmHg or > or = 95 mmHg defined by WHO), the percent of diabetes (FBS> or =140 mg/dl), hypercholesterolemia (> or =240 mg/dl), and hypertriglyceridemia (> or =200 mg/dl) were signifcantly higher compared with normal group in male and female. BMI, and alcohol consumption had a positive correlation with FBS, total cholesterol and triglyceride. Smoking had a positive correlation with cholesterol and triglyceride but negative correlation with HDL-cholesterol in male. The educational attainment had a negative correlation with BMI, FBS, total cholesterol and triglyceride in female. CONCLUSIONS: This study suggested that drinking, smoking, and BMI and lower educational level were associated with hypertension, hyperlipidemia and diabetes, but further evaluation was needed by prospective intervention study.; Summary

Meta-analysis on the Blood Lipids as Risk Factors of Coronary Heart Diseases in Koreans.: So Yeon Ryu, Ki Soon Kim, Yang ok Kim, Jong Park, Jong Ku Park, Chun Bae Kim, Sun Ha Jee; Korean J Prev Med. 1999;32(4):491-493.

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Abstract PDF: OBJECTIVES
To determine the relations between seven blood lipids such as total cholesterol(TC), triglyceride(TG), HDL-cholesterol(HDL), LDL-cholesterol(LDL), apolipoprotein A-1(Apo A1), apolipoprotein B(Apo B) and lipoprotein(a)(Lp(A)) and the coronary heart diseases(CHD), the quantitative techniques of meta-analysis were applied to studies of blood lipids and CHD in Koreans. METHODS: We searched the Korean and the English literature published from 1980 to August, 1997 by manual search and bibliography review. Information on sample size, study design, participant characteristics(gender, age) and blood lipid levels were abstracted by reviewers using inclusion criteria. Estimates of the effect sizes of blood lipid levels on CHD in Koreans and corresponding 95% confidence intervals were calculated using random-effect models. RESULTS: We identified 16 case-control studies to apply meta-analysis. The overall effect sizes for CHD were 20.3(95% CI : 14.23-26.22) in TC, 24.8(95% CI : 12.6-36.86) in TG, 15.16(95% CI : 3.99 - 26.33) in LDL, -3.48(95% CI : -5.79 - -1.17) in HDL, -9.78(95% CI : -16.98 - -2.58) in Apo-a1, 17.88(95% CI : 9.72 - 26.05) in Apo B and 18.95(95% CI : 17.88 - 20.02) in Lp(a). CONCLUSIONS: Our results suggested that seven blood lipids were significantly associated with CHD in Koreans. Well-designed and prospective studies between blood lipids and CHD in Koreans should be performed.; Summary

Association of Hypertension with Cluster of Obesity, Abnormal glucose and Dyslipidemia in Korean Urban Population.: Kang Sook Lee, Jung A Kim, Jung Il Park; Korean J Prev Med. 1998;31(1):59-71.

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Abstract PDF: To examine the association of hypertension with cluster of obesity, abnormal glucose and dyslipidemia in Korean urban population, we conducted this cross-sectional study among 3027 men and 2127 women age 20-85 years who visited a prevention center between May 1991 and June 1995 for a multiphasic health check at St. Mary's Hospital, Seoul. By the self-administered questionnaire, the informations of educational attainments, monthly income, alcohol consumption, cigarette smoking, and physical excercise level were obtained. Height, weight, and blood pressure were measured by a trained nurse. The fasting blood sugar(FBS), total cholesterol, high density lipoprotein (HDL) cholesterol and triglyceride were tested by enzyme method. Low density lipoprotein (LDL) cholesterol was calculated by 'total cholesterol - HDL cholesterol - triglyceride/5'. For testing the differences of cardiovascular risk factors between hypertension and normotension group, t-test and x2 test were performed and for the age adjusted odds ratios of hypertension in persons with obesity, abnormal glucose, and dyslipidemia compared with normal, logistic regression was performed by using SAS pakage programme. The results obtained were as follows: 1. Age, weight, body mass index, blood glucose, total cholesterol, low density lipoprotein, triglyceride of hypertension group in men and women were significantly higher than normotension group, but height and high density lipoprotein of hypertension group only in women significantly lower than normotension group. The frequency of obesity (body mass index > or =25 kg/m2), abnormal glucose (> or = 120 mg/dl), hypercholesterolemia (> or =240 mg/dl), lower HDL cholesterol (<45 mg/dl in women only), higher LDL cholesterol (> or =160mg/dl), and hypertriglyceridemia (> or =250 mg/dl) in hypertension group of men and women were significantly higher than normotension group. 2. Systolic and diastolic blood pressure were negatively correlated with hight, but positively with age, weight, BMI, total cholesterol, LDL cholesterol, and triglyceride in men and women. And BMI was positively correlated with fasting blood sugar, total cholesterol, LDL cholesterol and triglyceride but negatively with HDL cholesterol. 3. The odds ratios of hypertension were as follows in men and women : among persons who were obese compared with those nonobese, 2.53 (95% Confedence Intervals [C.I.] 2.08-3.07) and 2.22 (95%C.I. 1.71-2.87); among persons who were abnormal glucose compared with those normoglycemic, 1.43 (95%C.I 1.13-1.82) and 2.01 (95%C.I 1.36-2.94); and among persons who were dyslipidemia (hypercholesterolemia or lower HDL cholesterol or higher LDL cholesterol or hypertriglyceridemia) compared with those normal lipid, 1.59 (95%C.I 1.30-1.95) and 1.51 (95%C.I 1.16-1.96). After combined more than one risk factor, the odds ratios were increased. Among persons with cluster of obesity, abnormal glucose, and dyslipidemia, the odds ratio of hypertension was 2.25 (95%C.I 1.47-3.37) in men and 3.02 (95%C.I 1.71-5.30) in women. In conclusion, it was suggested that hypertension was associated with cluster of obesity, abnormal glucose, dyslipidemia in this Korean urban population.; Summary

The Relationship between Change in Obesity Indices and Change in Serum Lipids in Adult Male Workers.: Young Ae Ha, Byung Yeol Chun, Sin Kam, Sung Kook Lee, Min Hae Yeh; Korean J Prev Med. 1996;29(3):439-450.

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Abstract PDF: This study was conducted to evaluate the relationship between change in obesity indices and change in serum lipids in adult male workers. Two-hundred-eight adult male workers of an industry in Taegu city were followed-up from 1991 to 1995. Height, weight, circumferences of hip and waist, blood pressure were measured and serum lipids were analysed. Data on life style were obtained using self-administered questionnaires. Mean differences of anthropometric measurements between 1991 and 1995 were as follows; 1.63kg in weight, 3.61cm in waist circumferences, 4.23cm in hip circumferences, 0.52kg/m2 in BMI and -0.021 in WHR. Those of lipids were as follows; 15.09mg/dl in total cholesterol, 20.43mg/dl in triglyceride, 9.40mg/dl in HDL-cholesterol, 2.87 in MI-index(p<0.01) and 350mg/dl in LDL-cholesterol. The changed value of BMI and Katsura index were strongly correlated with that of total cholesterol(r=0.174, p<0.05), the changed value of BMI correlated with that of triglyceride(r=0.374, p<0.01) and the changed value of weight correlated with that of MI index(r=-0.173, p<0.05). The changed value of WHR was significantly correlated with that of total cholesterol(r=0.162, p<0.05), however, was not significantly correlated with HDL-cholesterol, LDL-cholesterol, triglyceride and MI index. The changed value of weight, BMI and Katsura index were correlated with that of triglyceride(r=0.262, p<0.01; r=0.267, p<0.01; r=0.258, p<0.01) and the changed value of MI index(r=-0.143, p<0.05; r=-0.158; r=-0.144, p<0.01), adjusting the pattern of change in life style. The changed values of HDL-cholesterol and MI index between 1991 and 1995 in low WHR group were significantly higher than those in high WHR group(p<0.05, p<0.01), adjusting the baseline value of them. Similar pattern was observed when considering Katsura index. When stratifying by BMI value of 1991, in low BMI group, the changed value of HDL-cholesterol and MI index showed the same pattern as above, however the of triglyceride was statistically higher in obese group than in non obese group(p<0.05). In conclusion BMI might be a better indicator to predict serum lipids change than other obesity indices.; Summary

A Study of The Relationship between Alcohol Intake, Smoking, Relative Weight and Serum Lipids Level in Young Adult Male Workers.: Ji Ho Lee, Byung Mann Cho, Soo Ill Lee, Don Kyoun Kim; Korean J Prev Med. 1992;25(4):386-398.

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Abstract PDF: In order to study the relationship between life-style and serum lipids level in young adults, the author measured the concentration of serum total cholesterol (TC), triglyceride (TG) and high density lipoprotein cholesterol (HDL-C) and investigated age, relative weight, weekly alcohol intake and daily cigarette smoking through questionnaire in 310 male workers aged 20 to 39, in Ulsan area. The results obtained were as follows: 1. In the factors being able to influence serum lipids level there was negative correlation between age and alcohol intake, and the positive corrrelation between age and relative weight, alcohol intake and relative weight, alcohol intake and smoking with the strongest correlation between alcohol intake and smoking. 2. In univariate analysis, mean total cholesterol concentration were significantly different according to age, smoking and relative weight; mean triglyceride concentration were significantly different according to relative weight only; mean HDL-C concentration were significantly different according to alcohol intake alone. 3. In non-drinkers, HDL-C concentration of smokers were significantly lower than that of nonsmokers but triglyceride concentration of smokers were significant higher. And in drinkers, total cholesterol concentration of smokers was significantly higher than that of non-smokers. 4. In multiple regression analysis, significant independent variables were relative weight, age and smoking in the total cholesterol concentration, and relative weight, age and alcohol intake in the triglyceride concentration, and alcohol intake, relative weight and smoking in the HDL-C concentration. By these independent variables, total variation in each dependent variable was explained 7.9%, 17.6% and 7.4% respectively.; Summary

Lipid Peroxidation in Vivo Monitored as Ethane Exhalation in Hyperoxia.: Jae Cheol Song, Soo Hun Cho, Myung Hee Chung, Dork Ro Yun; Korean J Prev Med. 1987;20(2):221-227.

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Abstract PDF: In vivo ethane production in rats was used as an index of oxygen toxicity. The rats were allocated to four exposure conditions; hyperbaric oxygenation (HBO=5 ATA, 100% O2), normobaric oxygenation (NBO=1 ATA, 100% O2), hyperbaric aeration (HBA=5 ATA, 21% O2) and normobaric aeration (NBA=1 ATA, 21% O2). After 120 minutes of exposure, the rats exposed to high concentration and/or high pressure oxygen exhaled significantly larger amounts of ethane than those exposed to NBA, and the differences in ethane production between any two groups were statistically significant (p<0.01). This finding supports the hypothesis that hypothesis that hyperoxia increase oxygen free-radicals and the radicals produce ethane as a result of lipid peroxidation. It is notable that the ethane exhalation level of the HBA group was significantly higher than that of the NBO group. This difference could not be accounted for by the alveolar oxygen partial pressure difference between the two groups.; Summary

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