SUBCLINICAL CARDIOVASCULAR DISEASE AND ITS ASSOCIATED RISK FACTORS IN DIFFERENT POPULATION GROUPS

Examination of the prevalence of subclinical cardiovascular disease (SCD) may help us to delineate future trends of coronary heart disease (CHD) mortality. There are substantial differences in the prevalence of SCD in different population groups. Identification of explaining factors for the difference in SCD rates across different population groups can provide new preventive strategies for reducing CHD morbidity or mortality. Based on this, the EBCT and Risk Factor Assessment among Japanese and U.S. Men in the Post World War II Birth Cohort (ERA-JUMP) Study is an ongoing population-based-cross-sectional study to examine differences in SCD rates across Japanese, Japanese American, and U.S. white men, and Korean men aged 40-49 years. As a part of the ERA-JUMP study, the present study demonstrated that: 1) among middle-aged men, Koreans in South Korea had a significantly higher level of carotid intima-media thickness than the Japanese in Japan. Middle-aged Korean men may continue to be at more increased risk for CHD than Japanese men at least over the near future. 2) Of polyunsaturated fatty acids, the proportion of linoleic acid was significantly and inversely associated with unfavorable levels of lipoprotein subclasses in three population groups of Japanese, Japanese American, and white men; an inverse association of docoxahexaenoic acid occurred only in white men. 3) Associations between pulse wave velocity (PWV) and cardiovascular risk factors were segmental-specific among white men. Brachial-ankle PWV had a mixed characteristic of stiffness of the central and peripheral arteries, compared to carotid-femoral PWV having a characteristic of the central arteries.Public health importance of these findings is that: First, we can provide scientific information imperative to addressing a health-related problem (i.e., increasing risk for cardiovascular disease in South Korea). Second, the promotion of enriched intakes of linoleic acid (e.g., sunflower, corn, safflower oils) and fish-derived n-3 fatty acids (e.g., mackerel or salmon) should be addressed to public in habitual diet in the prevention of CHD by establishing practical guidelines. Finally, incorporation of both measures of brachial-ankle PWV and carotid-femoral PWV into the assessment of arterial stiffness should be considered when screening a high-risk group for cardiovascular disease

Secondhand Tobacco Smoke Exposure and Associated Factors among College Students on Campus and in the Home: A Preliminary Study

To explore the prevalence of secondhand tobacco smoke (SHS) exposure of college students at two locations, i.e., on campus and in the home, and to identify factors associated with SHS exposure at each location, a preliminary cross-sectional study was conducted on 1754 nonsmoking students from two universities in Korea. In total, 83.1% were exposed to SHS at least once a week on campus or at home; the average SHS exposure was 3.4 times per week. Specifically, 79.7% and 23.5% were exposed to SHS on campus and in the home, respectively. On campus, SHS exposure was significantly more prevalent in freshmen and sophomore students. In the home, SHS exposure was significantly more prevalent among females, those with smokers in their families, and those who rated their health as poor. SHS exposure was common among nonsmoking college students, with more than two-thirds exposed on campus. The prevalence of SHS exposure was greater on campus than in the home; the factors associated with SHS exposure were location-specific

Impact of Cardiorespiratory Fitness on Survival in Men with Low Socioeconomic Status

Aims Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and heightened mortality, it remains unclear whether moderate-to-high levels of CRF are associated with survival benefits in low SES populations. This study evaluated the hypothesis that SES and CRF predict all-cause mortality and cardiovascular disease mortality and that moderate-to-high levels of CRF may attenuate the association between low SES and increased mortality. Methods This study included 2368 men, who were followed in the Kuopio Ischaemic Heart Disease Study cohort. CRF was directly measured by peak oxygen uptake during progressive exercise testing. SES was characterized using self-reported questionnaires. Results During a 25-year median follow-up, 1116 all-cause mortality and 512 cardiovascular disease mortality events occurred. After adjusting for potential confounders, men with low SES were at increased risks for all-cause mortality (hazard ratio 1.49, 95% confidence interval: 1.30–1.71) and cardiovascular disease mortality (hazard ratio1.38, 1.13–1.69). Higher levels of CRF were associated with lower risks of all-cause mortality (hazard ratio 0.54, 0.45–0.64) and cardiovascular disease mortality (hazard ratio 0.53, 0.40–0.69). In joint associations of SES and CRF with mortality, low SES-unfit had significantly higher risks of all-cause mortality (hazard ratio 2.15, 1.78–2.59) and cardiovascular disease mortality (hazard ratio 1.95, 1.48-2.57), but low SES-fit was not associated with a heightened risk of cardiovascular disease mortality (hazard ratio 1.09, 0.80-1.48) as compared with their high SES-fit counterparts. Conclusion Both SES and CRF were independently associated with subsequent mortality; however, moderate-to-high levels of CRF were not associated with an excess risk of cardiovascular disease mortality in men with low SES.peerReviewe

A cross-sectional association of obesity with coronary calcium among Japanese, Koreans, Japanese-Americans, and US-Whites

[Aims] Conflicting evidence exists regarding whether obesity is independently associated with coronary artery calcium (CAC), a measure of coronary atherosclerosis. We examined an independent association of obesity with prevalent CAC among samples of multi-ethnic groups whose background populations have varying levels of obesity and coronary heart disease (CHD). [Methods and results] We analysed a population-based sample of 1212 men, aged 40–49 years free of clinical cardiovascular disease recruited in 2002–06; 310 Japanese in Japan (JJ), 294 Koreans in South Korea (KN), 300 Japanese Americans (JA), and 308 Whites in the USA (UW). We defined prevalent CAC as an Agatston score of ≥10. Prevalent CAC was calculated by tertile of the body mass index (BMI) in each ethnic group and was plotted against the corresponding median of tertile BMI. Additionally, logistic regression was conducted to examine whether an association of the BMI was independent of conventional risk factors. The median BMI and crude prevalence of CAC for JJ, KN, JA, and UW were 23.4, 24.4, 27.4, and 27.1 (kg/m2); 12, 11, 32, and 26 (%), respectively. Despite the absolute difference in levels of BMI and CAC across groups, higher BMI was generally associated with higher prevalent CAC in each group. After adjusting for age, smoking, alcohol, hypertension, lipids, and diabetes mellitus, the BMI was positively and independently associated with prevalent CAC in JJ, KN, UW, but not in JA. [Conclusion] In this multi-ethnic study, obesity was independently associated with subclinical stage of coronary atherosclerosis among men aged 40–49 years regardless of the BMI level

Effects of the Healthy Children, Healthy Families, Healthy Communities Program for Obesity Prevention among Vulnerable Children: A Cluster-Randomized Controlled Trial

Background: We aimed to examine whether the Healthy Children, Healthy Families, and Healthy Communities Program, consisting of multi-level strategies for obesity prevention tailoring the context of socioeconomically vulnerable children based on an ecological perspective, would be effective on improving their healthy lifestyle behaviors and obesity status. Methods: Participants were 104 children (and 59 parents) enrolled in public welfare systems in Seoul, South Korea. Based on a cluster-randomized controlled trial (no. ISRCTN11347525), eight centers were randomly assigned to intervention (four centers, 49 children, 27 parents) versus control groups (four centers, 55 children, 32 parents). Multi-level interventions of child-, parent-, and center-level strategies were conducted for 12 weeks. Children’s healthy lifestyle behaviors and obesity status were assessed as daily recommended levels and body mass index ≥85th percentile, respectively. Parents’ parenting behaviors were measured by the Family Nutrition and Physical Activity scale. Results: Compared to the control group, the intervention group showed significant improvements in total composite scores of healthy-lifestyle behaviors—including 60-min of moderate physical activity—but not in obesity status among children. Moreover, the intervention group showed significant improvements in parenting behaviors among parents. Conclusion: The multi-level strategies for obesity prevention based on an ecological perspective may be effective for promoting healthy lifestyles among socioeconomically vulnerable children

Adolescent Overweight and Obesity: Links to Socioeconomic Status and Fruit and Vegetable Intakes

Whether adolescent overweight/obesity is linked to socioeconomic status (SES) and fruit and vegetable (F/V) intakes has not been confirmed. We aimed to determine whether there is an association between SES and adolescent overweight/obesity and to test the mediating effect of F/V intakes. This cross-sectional study included the data of 63,111 adolescents extracted from the 2013 Korea Youth Risk Behavior Web-based Survey. Overweight/obesity was defined as a body mass index ≥ 85th percentile, while F/V intakes were categorized as high (recommended levels: ≥1 fruit serving and ≥3 vegetable servings per day) versus low. Among girls, low SES (beta = 0.50, p < 0.001) and F/V intakes (beta = −0.17, p = 0.038) were both significantly associated with overweight/obesity; the former association was significantly mediated by F/V intakes (Sobel test: z = 2.00, p = 0.046). Among boys, neither SES nor F/V intakes was significantly associated with overweight/obesity. Adolescent overweight/obesity was significantly linked to low SES and F/V intakes among girls only; low SES indirectly increased the risk of overweight/obesity via low F/V intakes. Therefore, promoting F/V intakes for socially disadvantaged girls should be prioritized as a population-based strategy for preventing adolescent overweight/obesity in South Korea

Electrochemical oxidation and microfiltration of municipal wastewater with simultaneous hydrogen production: Influence of organic and particulate matter

Electrochemical reactions, which can produce molecular hydrogen via water splitting, can degrade organic contaminants in water simultaneously. This study focused on the production of hydrogen gas during the electrochemical treatment of organic matter and colloids present in actual municipal wastewater. The electrochemical system used in this study consisted of a BiO_(x)–TiO_2/Ti anode and two stainless steel cathodes. Hydrogen generation was enhanced in the presence of wastewater organic matter and/or supplemental NaCl. During the electrochemical reaction, the chemical oxygen demand, proteins, and turbidity were removed well, whereas the dissolved organic carbon, carbohydrates, and organic acids concentrations remained unchanged or rather increased. The increase in dissolved carbon content was ascribed to the conversion of particulate colloids to soluble fractions and thereafter incomplete mineralization. Both the loss of organic fluorophores and the formation of large molecular organics during electrochemical oxidation exhibited the degradation of primarily present organics as well as the solubilization of particulate colloids. The accumulation and formation of oxalate and chlorinated intermediates, such as trichloromethane, also occurred. The wastewater particles larger than 0.1 μm in size were responsible for the formation of dissolved organic intermediates, but such colloidal particles seemed beneficial to hydrogen generation. Microfiltration in conjunction with electrochemical treatment showed the potential to produce good quality effluent at a high permeability while simultaneously generating hydrogen energy

Improved quality of life with cardiac rehabilitation for post-myocardial infarction patients in Korea

Background: Health-related quality of life (HRQOL) has been used as a primary health outcome in cardiac rehabilitation programs (CRP). Aims: This study aimed to evaluate the effects of an 8-week CRP on HRQOL and exercise capacity in myocardial infarction (MI) patients in Korea. Methods: After matching on gender, age, and left ventricular ejection fraction, 60 subjects with a first acute MI were allocated to either a CRP group (n = 31) or a Control group (n = 29). The 8-week CRP included hospital-based, supervised exercise training (three times per week, average intensity of 65% VO2peak) and individual education sessions. The Control group was instructed on a home-based exercise regimen without contact during the 8 weeks. At baseline and 8 weeks, HRQOL was assessed by the Quality of Life Index (QLI)-cardiac version III; exercise capacity by a treadmill test. Results: After adjusting for education level, the overall QLI, health/functioning and psycho/spiritual scores showed greater increases in the CRP group than the Control group (p = .014, p = .016, and p = .036, respectively). We observed significant improvements in VO2peak (p < .0001), anaerobic threshold (p < .0001), and maximal exercise duration (p < .0001) in the CRP group, compared to the Control group. Conclusions: These findings suggest that the Korean CRP can lead to significant improvements in HRQOL outcomes and exercise capacity. © 2006 European Society of Cardiology