Analysis of Kimchi, vegetable and fruit consumption trends among Korean adults: data from the Korea National Health and Nutrition Examination Survey (1998-2012)

Protective Effect of Novel Lactobacillus plantarum KC3 Isolated from Fermented Kimchi on Gut and Respiratory Disorders

Probiotics have been shown to possess anti-inflammatory effects in the gut by directly reducing the production of pro-inflammatory cytokines and by secreting anti-inflammatory molecules. However, their systemic anti-inflammatory effects have not been thoroughly investigated. In this study, we aimed to develop probiotics that have efficacy in both intestinal and lung inflammation. Lactobacillus plantarum KC3 (KC3), which was isolated from kimchi, was selected as a pre-candidate based on its inhibitory effects on the production of pro-inflammatory cytokines in vitro. To further validate the effectiveness of KC3, we used ear edema, DSS-induced colitis, and ambient particulate-matter-induced lung inflammation models. First, KC3 exhibited direct anti-inflammatory effects on intestinal cells with the inhibition of IL-1β and TNF-α production. Additionally, KC3 treatment alleviated ear edema and DSS-induced colic inflammation, improving colon length and increasing the number of regulatory T cells. Beyond its local intestinal anti-inflammatory activity, KC3 inhibited pro-inflammatory cytokines in the bronchoalveolar fluid and prevented neutrophil infiltration in the lungs. These results suggest that KC3 could be a potential functional ingredient with respiratory protective effects against air-pollutant-derived inflammation, as well as for the treatment of local gut disorders.

Does kimchi deserve the status of a probiotic food?

Kimchi is a traditional fermented vegetable side dish in Korea and has become a global health food. Kimchi undergoes spontaneous fermentation, mainly by lactic acid bacteria (LAB) originating from its raw ingredients. Numerous LAB, including the genera Leuconostoc, Weissella, and Lactobacillus, participate in kimchi fermentation, reaching approximately 9-10 log colony forming units per gram or milliliter of food. The several health benefits of LAB (e.g., antioxidant and anti-inflammatory properties) combined with their probiotic potential in complex diseases including obesity, cancer, atopic dermatitis, and immunomodulatory effect have generated an interest in the health effects of LAB present in kimchi. In order to estimate the potential of kimchi as a probiotic food, we comprehensively surveyed the health functionalities of kimchi and kimchi LAB, and their effects on human gut environment, highlighting the probiotics function.

Consumer Trend of Using Ready-to-Use Salted Napa Cabbage at Home: Current Consumer Behaviors, Beliefs, and Opinions about the Main Ingredient of Kimchi

ABSTRACT

Salted napa cabbage is the most important ingredient of kimchi. Currently, people have started to prepare ready-to-use salted napa cabbage at home. This study focused on this trend by investigating consumers' beliefs, opinions, and actual use of the products by conducting a telephone survey (895 female consumers) and face-to-face interviews (n = 514) in 2016 and a telephone survey (n = 200) in 2021. Most respondents (93 and 91% in 2016 and 2021, respectively) answered that convenience was the main reason for using salted napa cabbage. Regarding consumption behavior, 22 and 16% of the respondents in each year used salted napa cabbage after storing it for more than 24 h. In particular, 85 and 91% of consumers stored the product at room temperature, and 60 and 58% used it without washing, which could affect the quality of the food, as microorganisms could multiply during the storage. Inappropriate handling increased by age group, especially in 2021 (P < 0.05). In the query on satisfaction after using the products, 85 and 80% of respondents were satisfied because the product was convenient (54%) and hygienic (17%). Conversely, the respondents who were not satisfied with the products did not like the degree of salting and unhygienic status of the products. The majority (93 and 80%) of consumers preferred buying salted napa cabbage again because of its convenience. Although consumers thought that hygiene and quality were important factors, many respondents (83 and 72%) were not aware of foodborne illnesses associated with kimchi. Nevertheless, consumers intended to pay more for safe, salted napa cabbage (72 and 76%). The results of this study provide useful and credible data for understanding the factors affecting consumers' consumption and general beliefs and opinions on the use of salted napa cabbage, especially for food safety management.

HIGHLIGHTS

Two sides of the same coin: Meta-analysis uncovered the potential benefits and risks of traditional fermented foods at a large geographical scale

Traditional fermented foods, which are well-known microbial resources, are also bright national cultural inheritances. Recently, traditional fermented foods have received great attention due to their potential probiotic properties. Based on shotgun metagenomic sequencing data, we analyzed the microbial diversity, taxonomic composition, metabolic pathways, and the potential benefits and risks of fermented foods through a meta-analysis including 179 selected samples, as well as our own sequencing data collected from Hainan Province, China. As expected, raw materials, regions (differentiated by climatic zones), and substrates were the main driving forces for the microbial diversity and taxonomic composition of traditional fermented foods. Interestingly, a higher content of beneficial bacteria but a low biomass of opportunistic pathogens and antibiotic resistance genes were observed in the fermented dairy products, indicating that fermented dairy products are the most beneficial and reliable fermented foods. In contrast, despite the high microbial diversity found in the fermented soy products, their consumption risk was still high due to the enrichment of opportunistic pathogens and transferable antibiotic resistance genes. Overall, we provided the most comprehensive assessment of the microbiome of fermented food to date and generated a new view of its potential benefits and risks related to human health.

Metatranscriptomic and metataxonomic insights into the ultra-small microbiome of the Korean fermented vegetable, kimchi

Presently, pertinent information on the ultra-small microbiome (USM) in fermented vegetables is still lacking. This study analyzed the metatranscriptome and metataxonome for the USM of kimchi. Tangential flow filtration was used to obtain a USM with a size of 0.2 μm or less from kimchi. The microbial diversity in the USM was compared with that of the normal microbiome (NM). Alpha diversity was higher in the USM than in NM, and the diversity of bacterial members of the NM was higher than that of the USM. At the phylum level, both USM and NM were dominated by Firmicutes. At the genus level, the USM and NM were dominated by Lactobacillus, Leuconostoc, and Weissella, belonging to lactic acid bacteria. However, as alpha diversity is higher in the USM than in the NM, the genus Akkermansia, belonging to the phylum Verrucomicrobia, was detected only in the USM. Compared to the NM, the USM showed a relatively higher ratio of transcripts related to “protein metabolism,” and the USM was suspected to be involved with the viable-but-nonculturable (VBNC) state. When comparing the sub-transcripts related to the “cell wall and capsule” of USM and NM, USM showed a proportion of transcripts suspected of being VBNC. In addition, the RNA virome was also identified, and both the USM and NM were confirmed to be dominated by pepper mild mottle virus (PMMoV). Additionally, the correlation between metataxonome and metatranscriptome identified USM and NM was estimated, however, only limited correlations between metataxonome and metatranscriptome were estimated. This study provided insights into the relationship between the potential metabolic activities of the USM of kimchi and the NM.

Association between different types of plant-based diet and dyslipidaemia in Korean adults

This study investigated the association between the different types of plant-based diets and dyslipidaemia in Korean adults using data from the nationally representative sample. Using the 2012–2016 Korea National Health and Nutrition Survey data, a total of 14 167 adults (≥19 years old) participated in this study. Dietary intake was assessed by a semi-quantitative FFQ. Three different plant-based diet indices (overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), unhealthful plant-based diet index (uPDI)), were calculated. Dyslipidaemia and its components (hypertriacylglycerolaemia, hypercholesterolaemia, low HDL-cholesterol, high LDL-cholesterol, use of anti-hyperlipidaemia agent) were measured. Multivariable logistic regression analysis was used to examine the associations between plant-based diet and dyslipidaemia and individual lipid disorders. Totally, 47% of overall population had dyslipidaemia. Individual in the highest quintile of uPDI had 22% greater odds of dyslipidaemia (95 % CI 1·05, 1·41) and 48 % higher odds of hypertriacylglycerolaemia (95 % CI 1·21, 1·81) and 16% higher odds of low HDL-cholesterol (OR: 1·16, 95 % CI 1·00, 1·35) than those in the lowest quintile of uPDI. PDI was associated with 16 % higher odds of low HDL-cholesterol, and hPDI was associated with 25% lower odds of high LDL-cholesterol. However, neither PDI nor hPDI was significantly associated with the prevalence of dyslipidaemia. Greater adherence to unhealthful plant-based diets was associated with greater odds of the dyslipidaemia and its components suggesting the importance of the quality of plant-based diet in South Korean adults for dyslipidaemia prevention.

Korean traditional foods as antiviral and respiratory disease prevention and treatments: A detailed review

BACKGROUND

Korean traditional food (KTF), originated from ancestral agriculture and the nomadic traditions of the Korean peninsula and southern Manchuria, is based on healthy food that balances disease prevention and treatment. Fermented foods that include grains, herbs, fruits, and mushrooms are also an important practice in KTF, providing high levels of Lactobacilli, which confer relevant health benefits, including antiviral properties. Some of these probiotics may also protect against the Influenza virus through the modulation of innate immunity.

SCOPE AND APPROACH

The emerging of the COVID-19 pandemic, in addition to other diseases of viral origin, and the problems associated with other respiratory disorders, highlight how essential is a healthy eating pattern to strengthen our immune system.Key Findings and Conclusions: The present review covers the information available on edible plants, herbs, mushrooms, and preparations used in KTF to outline their multiple medicinal effects (e.g., antidiabetic, chemopreventive, antioxidative, anti-inflammatory, antibacterial), emphasizing their role and effects on the immune system with an emphasis on modulating properties of the gut microbiota that further support strong respiratory immunity. Potential functional foods commonly used in Korean cuisine such as Kimchi (a mixture of fermented vegetables), Meju, Doenjang, Jeotgal, and Mekgeolli and fermented sauces, among others, are highlighted for their great potential to improve gut-lung immunity. The traditional Korean diet and dietary mechanisms that may target viruses ACE-2 receptors or affect any step of a virus infection pathway that can determine a patient's prognosis are also highlighted. The regular oral intake of bioactive ingredients used in Korean foods can offer protection for some viral diseases, through protective and immunomodulatory effects, as evidenced in pre-clinical and clinical studies.

Quality of plant-based diets and risk of hypertension: a Korean genome and examination study

BACKGROUND AND AIMS

Plant-based diets have been suggested to have beneficial effects on various health outcomes. However, the evidence on the association of plant-based diet quality with health outcomes is very limited in Asian populations, who may have a different dietary pattern than western populations. This study explored the prospective association between different types of plant-based diets and risk of hypertension using recently established indices in South Koreans.

METHODS

Analyses were based on a community-based cohort of 5636 men and women (40-69 years of age at baseline, mean ± SD 50.6 ± 8.5 years) living in Ansan and Ansung, South Korea (2001-2016) without hypertension and related chronic diseases at baseline. Registration card and telephone registration number were used for the sampling. Dietary intakes were assessed using a validated food frequency questionnaire. Based on the questionnaire, scores of three plant-based diet indices [overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI)] were calculated.

RESULTS

Over a follow-up of 14 years, 2244 participants developed hypertension. Individuals in the highest vs. lowest quintile of hPDI had 35% lower incidence of hypertension [hazard ratio (HR) 0.65, 95% CI 0.57, 0.75] and uPDI had 44% higher incidence of hypertension (HR 1.44, 95% CI 1.24, 1.67), adjusting for demographic characteristics, and lifestyle factors (P trend ≤ 0.0001 for both indices). A similar inverse association of hPDI was observed with risk of hypertension by age, sex, residence area, and obesity. The PDI was not associated with hypertension.

CONCLUSIONS

Our results highlight the importance of considering the quality of plant foods (relatively higher healthy plant foods and relatively lower less healthy plant foods consumption) for the prevention of hypertension in a population with a long-term adherence to predominantly plant-based diets.

Trends and Dietary Assessment According to Fruit and Vegetable Intake in Korean Elderly People: Analysis Based on the Korea National Health and Nutrition Examination Survey 1998, 2008, and 2018

The study aimed to examine the 20-year trends in fruit and non-starch/unsalted vegetable intake among the Korean elderly aged 65 years or older based on the Korea National Health and Nutrition Examination Survey (KNHANES) data. A total of 3722 elderly citizens aged 65 years or older who participated in the dietary survey (24-h recall of dietary intake) of the 1998, 2008, and 2018 NHANES were selected as the subjects of this study. Fruit and non-starchy/unsalted vegetable intake increased by approximately 86.53 g over the past 20 years, from 268.27 g in 1998 to 355.8 g in 2018. In particular, 65-74-year-olds had an increased intake by approximately 130.38 g over the past 20 years, from 277.34 g in 1998 to 407.72 g in 2018. In addition, snacks intake significantly increased over the past 20 years (p for trend < 0.001). Intake according to daily meal cooking location increased by approximately 130 g over the past 20 years, from 64.50 g in 1998 to 123.39 g in 2008, and to 198.01 g in 2018. The annual proportion of the total elderly population who meet the amount of vegetable food intake recommended by the World Health Organization (WHO)/World Cancer Research Fund (WCRF) (400 g or more fruits and non-starchy vegetables) increased by approximately 11.28%p (percentage points) over the past 20 years, from 21.78% in 1998 to 24.63% in 2008, and to 33.06% in 2018. The results of this study suggest that more fundamental measures are required to increase the fruit and non-starchy vegetable intake among the elderly. Furthermore, it is thought that the results of this study can be used as basic data in establishing dietary policy. In addition, it is thought that it can be used in developing nutrition education and dietary guidelines for enhancing fruit and vegetable intake.

Association between unhealthy plant-based diets and the metabolic syndrome in adult men and women: a population-based study in South Korea

No studies have investigated the associations between established plant-based diet indices and the metabolic syndrome (MetS). We evaluated the associations between an overall plant-based diet index (PDI), healthy PDI (hPDI), unhealthy PDI (uPDI) and the MetS in a nationally representative sample using data from 14 450 Korean adults (≥19 years) in the Korea National Health and Nutrition Examination Survey 2012-2016. Dietary intakes were assessed by a semi-quantitative FFQ. In the PDI, all plant foods received positive scores. In the hPDI, only healthy plant foods received positive scores. In the uPDI, only unhealthy plant foods received positive scores. All indices reverse scored animal food intake. Multivariable logistic regression models were used to examine the associations between three PDI and the MetS by sex, adjusting for potential risk factors. A total of 23·3 % of Korean adults had the MetS. In the overall study population, individuals in the highest quintile of uPDI had greater odds (OR 1·54, 95 % CI 1·28, 1·86, Ptrend < 0·001) of the MetS than those in the lowest quintile. Higher uPDI score was associated with higher odds of hypertriacylglycerolaemia in men and abdominal obesity, high fasting glucose and hypertriacylglycerolaemia in women. No significant associations were observed between PDI, hPDI and the MetS. Greater adherence to unhealthy plant-based diets was associated with greater odds of the MetS and its components suggesting the importance of the quality of plant-based diet in South Korean adults. Sex differences may be considered when recommending plant-based diets for the prevention and management of metabolic diseases.

Pickled Vegetable and Salted Fish Intake and the Risk of Gastric Cancer: Two Prospective Cohort Studies and a Meta-Analysis

An increased risk of gastric cancer for pickled vegetable and salted fish intake has been suggested, yet the lack of a dose-response association warrants a quantitative analysis. We conducted a meta-analysis, combining results from our analysis of two large Korean cohort studies and those from previous prospective cohort studies. We investigated the association of pickled vegetable and salted fish intake with gastric cancer in the Korean Genome Epidemiology Study and the Korean Multi-center Cancer Cohort Study using Cox proportional hazard models. We then searched for observational studies published until November 2019 and conducted both dose-response and categorical meta-analyses. The pooled relative risk (RR) of gastric cancer incidence was 1.15 (95% Confidence Interval (CI), 1.07–1.23) for 40 g/day increment in pickled vegetable intake in a dose-response manner (P for nonlinearity = 0.11). As for salted fish intake, the pooled risk of gastric cancer incidence was 1.17 (95% CI, 0.99–1.38) times higher, comparing the highest to the lowest intake. Our findings supported the evidence that high intake of pickled vegetable and salted fish is associated with elevated risk of gastric cancer incidence.

Association between fruit and vegetable consumption and risk of metabolic syndrome determined using the Korean Genome and Epidemiology Study (KoGES)

PURPOSE

This study examined the association between fruit and vegetable consumption and the risk of metabolic syndrome (MetS) and its components in middle-aged and older adults using data from the Korean Genome and Epidemiology Study.

METHODS

A total of 5688 participants aged 40-69 years without MetS at baseline were recruited and followed for 8 years. Fruit and vegetable consumption was assessed using a semi-quantitative food-frequency questionnaire at baseline and after 4 years. A multivariate Cox proportional hazards model was used to examine the risk of incident MetS and its components according to fruit and vegetable consumption.

RESULTS

A total of 2067 participants (1020 men and 1047 women) developed MetS during the 8-year follow-up period. Frequent fruit consumers (≥ 4 servings/day) had a lower risk of incident MetS than did rare consumers (< 1 serving/day) in both men and women (hazard ratio (HR) = 0.55, 95% CI 0.44-0.67, p < 0.0001 for men; HR = 0.57, 95% CI 0.47-0.70, p for trend < 0.0001 for women) after adjusting for confounders. Frequent fruit consumption was inversely associated with incidence of abdominal obesity, hypertriglyceridemia, and elevated blood pressure. Frequent vegetable consumption was inversely associated with a risk of hyperglycemia only in men (HR = 0.65, 95% CI 0.44-0.96, p for trend = 0.0275), but no association was observed with risk of incident MetS.

CONCLUSIONS

High fruit consumption was associated with a reduced risk of incident MetS and its components, whereas high vegetable consumption was associated with a reduced risk of incident hyperglycemia, but not with MetS in middle-aged and older adults.

Trends in incidence and survival of esophageal cancer in Korea: Analysis of the Korea Central Cancer Registry Database

BACKGROUND AND AIM

The diagnostic and therapeutic modalities of esophageal cancer have recently improved in Asia, and its prognosis is expected to change. This study provides a population-based report on the epidemiology of esophageal cancer in Korea.

METHODS

Cancer incidence data from 1999 to 2013 were obtained from the Korea Central Cancer Registry, covering the entire population. Age-standardized incidence rates and annual percent changes were calculated according to subsites and histological types. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2013. Relative excess rates were compared between patients diagnosed from 2009 to 2013 and 2006 to 2008.

RESULTS

The age-standardized incidence rates decreased from 8.8 per 100 000 populations in 1999 to 5.9 in 2013 with an annual percent change of -2.6% in men and -2.2% in women. The most common histological type was squamous cell carcinoma, accounting for 90.2% of all esophageal cancers in 2013, followed by adenocarcinomas (3.1%), and their incidences decreased. The proportion of localized and regional cancer tended to increase compared with that of distant cancer. Five-year relative survival of squamous cell carcinoma improved from 12.1% (1993-1995) to 34.6% (2009-2013). Relative excess rate was 0.72 (95% confidence interval 0.65-0.80) in localized stage and 0.88 (95% confidence interval, 0.82-0.95) in regional stage comparing patients diagnosed from 2009 to 2013 and 2006 to 2008.

CONCLUSIONS

The incidence of esophageal cancer has decreased in Korea for the past 15 years, and 5-year survival rates have improved significantly. These increases may be attributable to more effective detection of early-stage disease.

Analysis of Iodine Content in Salts and Korean Sauces for Low-Iodine Diet Education in Korean Patients with Thyroid Cancer Preparing for Radioiodine Therapy

PURPOSE

A low-iodine diet is necessary in patients about to undergo radioiodine therapy for thyroid cancer to decrease the competitive absorption of ingested nonradioactive iodine. This study aimed to assess the iodine concentrations in salts and basic Korean sauces, and to provide fundamental data for guidelines on a low-iodine diet before radioiodine therapy.

METHODS

The iodine contents of refined salts, solar sea salts, fish sauces, and commonly used Korean sauces with added refined salt were determined by ICP-MS.

RESULTS

The iodine content of refined salts was found to be very low (0.033 ± 0.05 μg/100 g) compared with that of solar sea salts (434 ± 73.6 μg/100 g). The iodine contents of Korean soy sauce, Korean soybean paste, Gochujang seasoned with refined salt were also very low (0.010, 0.044, 0.002 μg/100 g, respectively). However, the mean iodine contents of the shrimp and fish Jeots analyzed in this study were found to be 41.3 ± 4.2 and 24.8 ± 4.5 μg/100 g, respectively.

CONCLUSION

This study is the first to investigate the iodine contents of the salts and basic sauces used in Korea. The results show that refined salts and Korean traditional sauces seasoned with them can be safely used in low-iodine diets before radioiodine therapy.

Association between Fruit and Vegetable Consumption and Risk of Hypertension in Middle-Aged and Older Korean Adults

BACKGROUND

High fruit and vegetable (F/V) intake may be beneficial for hypertension prevention. However, a prospective association has not been investigated in a Korean population, and differences exist between typical diets in Korea and those of Western populations.

OBJECTIVE

The aim of this prospective study was to investigate the association between F/V intake and risk of incident hypertension in middle-aged and older Korean adults using the data from the Korean Genome and Epidemiology Study (KoGES).

DESIGN

The KoGES is a large community-based cohort study of Korean adults aged 40 to 69 years, which began in May 2001. Questionnaires on demographic information and lifestyle factors were completed at baseline. Anthropometrics and biochemical measurements were conducted biennially. Fruit and vegetable consumption was assessed with a semiquantitative food frequency questionnaire. Hypertension was defined as a systolic blood pressure≥140 mm Hg or diastolic blood pressure ≥90 mm Hg.

PARTICIPANTS AND SETTING

A total of 4,257 participants (2,085 men, 2,172 women) without hypertension at baseline were evaluated.

MAIN OUTCOME MEASURES

The primary outcome was incident hypertension.

STATISTICAL ANALYSIS PERFORMED

Multivariate Cox proportional hazard models were used to examine hazard ratios (HRs) and 95% CIs for incident hypertension according to F/V consumption.

RESULTS

During the 8-year follow-up, 1,158 participants (606 men and 552 women) developed hypertension. Among men, frequent fruit consumers (≥4 servings/day) had a 56% lower risk of incident hypertension than did infrequent consumers (<1 serving/day) (HR=0.44, 95% CI=0.32 to 0.60, P for trend <0.0001). Among women, frequent fruit consumers had a 67% lower risk of incident hypertension than did infrequent consumers (HR=0.33, 95% CI=0.24 to 0.45, P for trend <0.0001), after adjustment for potential confounders. However, there was no association between vegetable consumption and risk of incident hypertension in either men or women.

CONCLUSION

A higher intake of fruit was prospectively associated with a lower risk of incident hypertension in middle-aged and older Korean adults, regardless of sex.

Relationship Between Plant Food (Fruits, Vegetables, and Kimchi) Consumption and the Prevalence of Rhinitis Among Korean Adults: Based on the 2011 and 2012 Korea National Health and Nutrition Examination Survey Data

The aim of the current study was to analyze the relationship between plant food (fruits, vegetables, and kimchi) and the prevalence of rhinitis among Korean adults using data from the 2011 and 2012 Korea National Health and Nutrition Examination Survey. A total of 7494 subjects aged from 19 to 64 years participated in a rhinitis morbidity survey, health behavior interview, and 24-h dietary recall test. Individuals with energy intakes less than 500 kcal or more than 5000 kcal were excluded. The results showed that kimchi intake was inversely associated with the prevalence of rhinitis. The prevalence of rhinitis decreased with increasing kimchi consumption. The quintile 4 (range of kimchi intake: 108.0-180.0 g) groups, compared with the reference of quintile 1 (0-23.7 g), showed a decrease of 18.9% (odds ratio [OR] = 0.811, 95% confidence interval [CI] = 0.672-0.979) in Model 4. In conclusion, consumption of kimchi lowers the risk of rhinitis, suggesting that its use should be encouraged among the Korean population.

Faith-based intervention to increase fruit and vegetable intake among Koreans in the USA: a feasibility pilot

OBJECTIVE

In the USA, adults of Korean descent tend to eat fewer vegetables than adults in South Korea. The present pilot study examined the feasibility of developing and implementing a faith-based intervention to improve knowledge, attitudes and intake of fruit and vegetables (F&V) for Koreans in the USA.

DESIGN

Feasibility pilot using a cluster-randomized intervention trial design. The multicomponent intervention included motivational interviewing sessions by telephone and church-based group activities.

SETTING

Eleven of the largest Korean churches in Southern California.

SUBJECTS

Adults (n 71) from the eleven Korean churches.

RESULTS

Feasibility was demonstrated for the study procedures, including recruitment of churches and individual participants. Allocating time throughout the study for church collaboration and having a study church coordinator to coordinate multiple churches were crucial. Participants' attendance at church activities (89 %) and participation by pastors and fellow churchgoers exceeded expectations. Participants' use of intervention materials was high (94 % or above) and satisfaction with coaching sessions was also high (75 % or above). Having a centralized coach trained in motivational interviewing, instead of one at each church, proved practical. Pilot results are promising for F&V knowledge, attitudes and behaviours. The intervention group improved knowledge and intake of the recommended amounts of F&V, above that of the control group.

CONCLUSIONS

This pilot suggests that Koreans in the USA can be reached through their church and that a faith-based intervention study can be implemented to increase F&V intake. Preliminary results for the intervention appear promising but further research is needed to properly evaluate its efficacy.

Distant Site Effects of Ingested Prebiotics

The gut microbiome is being more widely recognized for its association with positive health outcomes, including those distant to the gastrointestinal system. This has given the ability to maintain and restore microbial homeostasis a new significance. Prebiotic compounds are appealing for this purpose as they are generally food-grade substances only degraded by microbes, such as bifidobacteria and lactobacilli, from which beneficial short-chain fatty acids are produced. Saccharides such as inulin and other fructo-oligosaccharides, galactooligosaccharides, and polydextrose have been widely used to improve gastrointestinal outcomes, but they appear to also influence distant sites. This review examined the effects of prebiotics on bone strength, neural and cognitive processes, immune functioning, skin, and serum lipid profile. The mode of action is in part affected by intestinal permeability and by fermentation products reaching target cells. As the types of prebiotics available diversify, so too will our understanding of the range of microbes able to degrade them, and the extent to which body sites can be impacted by their consumption.