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High fiber and high carbohydrate intake and its association with the metabolic disease using the data of KNHANES 2013 ~ 2017

고식이섬유 및 고탄수화물 섭취와 대사질환과의 연관성

  • Moon, Heesoo (Department of Food Science and Nutrition, The Catholic University of Korea) ;
  • Ha, Kyungho (Department of Food Science and Nutrition, The Catholic University of Korea) ;
  • Song, YoonJu (Department of Food Science and Nutrition, The Catholic University of Korea)
  • 문희수 (가톨릭대학교 생활과학부 식품영양학과) ;
  • 하경호 (가톨릭대학교 생활과학부 식품영양학과) ;
  • 송윤주 (가톨릭대학교 생활과학부 식품영양학과)
  • Received : 2019.05.09
  • Accepted : 2019.10.30
  • Published : 2019.12.31

Abstract

Purpose: Dietary fiber is a component of carbohydrate that is linked closely with the carbohydrate quality, but few studies have investigated the association of high fiber intake with the cardiometabolic risk factors in Koreans. This study examined the association of high fiber and high carbohydrate intake with the cardiometabolic risk factors among Korean adults. Methods: This study included 15,095 adults aged ≥20 years, who participated in the 2013 ~ 2017 KNHANES. The dietary intake was obtained using a 24-h dietary recall method. The associations of high fiber and high carbohydrate intake with metabolic syndrome and dyslipidemia were examined by sex using multiple logistic regression analysis. Results: The median of dietary fiber was 23.6 g/day in men and 20.0 g/day in women. Dietary fiber intake increased gradually as dietary carbohydrate groups increased except for ≥80% of energy from the carbohydrate group. Women in the highest quintile of fiber intake showed a 33% lower risk of metabolic syndrome compared with those in the third quintile. When stratified into low fiber (LF) and high fiber (HF) groups using Adequate Intake of fiber for Koreans, men in the third quartile of carbohydrate intake showed a 44% and 51% higher risk of metabolic syndrome and atherogenic dyslipidemia than in the first quartile, respectively, but only in the LF group. Women in the second quartile of carbohydrate intake showed an 83% higher risk of hypercholesterolemia than in the first quartile in the LF group. On the other hand, as no significant association was observed between the carbohydrate intake and metabolic diseases among the HF groups in both sexes. Conclusion: These findings suggest that a high fiber intake might be associated with a reduced risk of metabolic syndrome and high carbohydrate intake with a low dietary fiber intake might be associated with an increased risk of several metabolic abnormalities among Korean adults. Further prospective studies will be needed to confirm the effects of high fiber and high carbohydrate intake on the cardiometabolic risk factors among Koreans.

본 연구는 2013 ~ 2017년 국민건강영양조사의 검진조사에 참여한 만 20세 이상 성인을 대상으로 고식이섬유 섭취 및 고탄수화물 섭취와 대사질환 간의 연관성을 확인하였다. 한국 성인의 평균 식이섬유 섭취량은 24.1 g/일이었으며, 탄수화물 섭취 수준이 증가할수록 식이섬유 섭취량도 증가하는 경향을 보였다. 고식이섬유 섭취와 대사증후군과의 연관성을 확인하기 위해 식이섬유 섭취량을 5분위수로 분류하였을 때, 충분섭취량 이상의 고식이섬유 섭취는 대사증후군 위험 감소와 연관이 있었다. 또한, 식이섬유 섭취가 탄수화물 섭취와 밀접한 관련이 있다는 점을 반영하여 고탄수화물 섭취와 대사질환과의 연관성을 식이섬유 섭취수준에 따라 확인하고자 하였다. 이에 식이섬유 충분섭취량을 기준으로 하여 성별로 저식이섬유 섭취 그룹과 고식이섬유 섭취 그룹으로 분류한 후, 탄수화물 에너지 섭취비율과 대사질환과의 연관성을 분석한 결과 식이섬유 섭취수준에 따라 고탄수화물 섭취와 대사질환과의 연관성이 다름을 확인하였다. 저식이섬유 섭취 그룹에서는 남자의 경우 탄수화물 섭취가 삼분위군 일 때 일분위군에 비해 대사증후군과 죽상경화성 이상지질혈증의 교차비가 유의적으로 증가하고, 여자의 경우 탄수화물 섭취가 이분위군일 때 일분위군에 비해 고콜레스테롤혈증의 교차비가 유의적으로 증가하였다. 그리고 고식이섬유 섭취 그룹에서는 남자의 경우 탄수화물 섭취비율이 증가할수록 고중성 지방혈증의 위험도가 증가하는 경향을 보였다. 본 연구의 결과는 한국 성인의 고식이섬유 섭취가 대사증후군의 낮은 위험도와 관련이 있다는 근거를 제시하였으며, 특히 남자의 경우 고탄수화물 섭취와 대사지표와의 연관성을 살펴볼 때 식이섬유 섭취 수준을 살펴보는 것이 필요함을 제시했다는데 의의가 있다. 따라서, 향후 우리나라 사람들을 대상으로 전향적인 연구를 실시하여 식이섬유, 탄수화물 섭취와 대사질환과의 인과관계를 검증할 필요가 있으며, 이를 통해 탄수화물의 질적 섭취에 대한 실질적인 섭취 지침을 마련할 필요가 있다.

Keywords

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