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Impact of dietary risk factors on cardiometabolic and cancer mortality burden among Korean adults: results from nationally representative repeated cross-sectional surveys 1998-2016

  • Jo, Garam (Department of Public Health Science, Graduate School, Korea University) ;
  • Oh, Hannah (Department of Public Health Science, Graduate School, Korea University) ;
  • Singh, Gitanjali M. (Friedman School of Nutrition Science and Policy, Tufts University) ;
  • Park, Dahyun (Department of Public Health Science, Graduate School, Korea University) ;
  • Shin, Min-Jeong (Department of Public Health Science, Graduate School, Korea University)
  • 투고 : 2019.11.22
  • 심사 : 2020.04.08
  • 발행 : 2020.08.01

초록

BACKGROUND/OBJECTIVES: Dietary factors are important contributors to cardiometabolic and cancer mortality. We examined the secular trends of nine dietary factors (fruits, vegetables, whole grains, nuts and seeds, milk, red meat, processed meat, sugar-sweetened beverages, and calcium) and the associated burdens of cardiometabolic and cancer mortality in Korea using representative cross-sectional survey data from 1998 to 2016. SUBJECTS/METHODS: Using dietary data from Korean adults aged ≥ 25 years in the Korea National Health and Nutrition Examination Survey (KNHANES), we characterized secular trends in intake levels. We performed comparative risk assessment to estimate the population attributable fraction and the number of cardiometabolic and cancer deaths attributable to each dietary factor. RESULTS: A total of 231,148 cardiometabolic and cancer deaths were attributable to nine dietary risk factors in Korea from 1998 to 2016. Suboptimal intakes of fruits and whole grains were the leading contributors. Although the intakes of fruits, vegetables, and whole grains moderately improved over time, the intake levels in 2016 (192.1 g/d, 225.6 g/d, and 10.9 g/d, respectively) remained far below the optimal levels. Deaths attributable to the low intakes of nuts and seeds (4.5 g/d), calcium (440.5 mg/d), and milk (37.1 g/d) and the high intakes of red meat (54.7 g/d), processed meat (4.7 g/d), and sugar-sweetened beverages (33.0 g/d) increased since 1998. Compared with older age groups (≥ 45 years), more unfavorable changes in dietary patterns were observed in the younger population aged 25-44 years, including more sharply increased intakes of processed meat. CONCLUSIONS: We observed improvement in the intakes of fruits, vegetables, and whole grains and unfavorable changes in the intakes of processed meat and sugar-sweetened beverages over the past few decades. Our data suggest that to reduce the chronic disease burden in Korea, more effective nutritional policies and interventions are needed to target these dietary risk factors.

참고문헌

  1. Mc Namara K, Alzubaidi H, Jackson JK. Cardiovascular disease as a leading cause of death: how are pharmacists getting involved? Integr Pharm Res Pract 2019;8:1-11.
  2. Naghavi M, Abajobir AA, Abbafati C, Abbas KM, Abd-Allah F, Abera SF, Aboyans V, Adetokunboh O, Afshin A, Agrawal A, Ahmadi A, Ahmed MB, Aichour AN, Aichour MT, Aichour I, Aiyar S, Alahdab F, Al-Aly Z, Alam K, Alam N, Alam T, Alene KA, Al-Eyadhy A, Ali SD, Alizadeh-Navaei R, Alkaabi JM, Alkerwi A, Alla F, Allebeck P, Allen C, Al-Raddadi R, Alsharif U, Altirkawi KA, Alvis-Guzman N, Amare AT, Amini E, Ammar W, Amoako YA, Anber N, Andersen HH, Andrei CL, Androudi S, Ansari H, Antonio CA, Anwari P, Arnlov J, Arora M, Artaman A, Aryal KK, Asayesh H, Asgedom SW, Atey TM, Avila-Burgos L, Avokpaho EF, Awasthi A, Babalola TK, Bacha U, Balakrishnan K, Barac A, Barboza MA, Barker-Collo SL, Barquera S, Barregard L, Barrero LH, Baune BT, Bedi N, Beghi E, Bejot Y, Bekele BB, Bell ML, Bennett JR, Bensenor IM, Berhane A, Bernabe E, Betsu BD, Beuran M, Bhatt S, Biadgilign S, Bienhoff K, Bikbov B, Bisanzio D, Bourne RR, Breitborde NJ, Bulto LN, Bumgarner BR, Butt ZA, Cahuana-Hurtado L, Cameron E, Campuzano JC, Car J, Cardenas R, Carrero JJ, Carter A, Casey DC, Castaneda-Orjuela CA, Catala-Lopez F, Charlson FJ, Chibueze CE, Chimed-Ochir O, Chisumpa VH, Chitheer AA, Christopher DJ, Ciobanu LG, Cirillo M, Cohen AJ, Colombara D, Cooper C, Cowie BC, Criqui MH, Dandona L, Dandona R, Dargan PI, das Neves J, Davitoiu DV, Davletov K, de Courten B, Defo BK, Degenhardt L, Deiparine S, Deribe K, Deribew A, Dey S, Dicker D, Ding EL, Djalalinia S, Do HP, Doku DT, Douwes-Schultz D, Driscoll TR, Dubey M, Duncan BB, Echko M, El-Khatib ZZ, Ellingsen CL, Enayati A, Ermakov SP, Erskine HE, Eskandarieh S, Esteghamati A, Estep K, Farinha CS, Faro A, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes JC, Ferrari AJ, Feyissa TR, Filip I, Finegold S, Fischer F, Fitzmaurice C, Flaxman AD, Foigt N, Frank T, Fraser M, Fullman N, Furst T, Furtado JM, Gakidou E, Garcia-Basteiro AL, Gebre T, Gebregergs GB, Gebrehiwot TT, Gebremichael DY, Geleijnse JM, Genova-Maleras R, Gesesew HA, Gething PW, Gillum RF, Giref AZ, Giroud M, Giussani G, Godwin WW, Gold AL, Goldberg EM, Gona PN, Gopalani SV, Gouda HN, Goulart AC, Griswold M, Gupta R, Gupta T, Gupta V, Gupta PC, Haagsma JA, Hafezi-Nejad N, Hailu AD, Hailu GB, Hamadeh RR, Hambisa MT, Hamidi S, Hammami M, Hancock J, Handal AJ, Hankey GJ, Hao Y, Harb HL, Hareri HA, Hassanvand MS, Havmoeller R, Hay SI, He F, Hedayati MT, Henry NJ, Heredia-Pi IB, Herteliu C, Hoek HW, Horino M, Horita N, Hosgood HD, Hostiuc S, Hotez PJ, Hoy DG, Huynh C, Iburg KM, Ikeda C, Ileanu BV, Irenso AA, Irvine CM, Islam SM, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Javanbakht M, Jayaraman SP, Jeemon P, Jha V, John D, Johnson CO, Johnson SC, Jonas JB, Jurisson M, Kabir Z, Kadel R, Kahsay A, Kamal R, Karch A, Karimi SM, Karimkhani C, Kasaeian A, Kassaw NA, Kassebaum NJ, Katikireddi SV, Kawakami N, Keiyoro PN, Kemmer L, Kesavachandran CN, Khader YS, Khan EA, Khang YH, Khoja AT, Khosravi MH, Khosravi A, Khubchandani J, Kiadaliri AA, Kieling C, Kievlan D, Kim YJ, Kim D, Kimokoti RW, Kinfu Y, Kissoon N, Kivimaki M, Knudsen AK, Kopec JA, Kosen S, Koul PA, Koyanagi A, Kulikoff XR, Kumar GA, Kumar P, Kutz M, Kyu HH, Lal DK, Lalloo R, Lambert TL, Lan Q, Lansingh VC, Larsson A, Lee PH, Leigh J, Leung J, Levi M, Li Y, Li Kappe D, Liang X, Liben ML, Lim SS, Liu PY, Liu A, Liu Y, Lodha R, Logroscino G, Lorkowski S, Lotufo PA, Lozano R, Lucas TC, Ma S, Macarayan ER, Maddison ER, Magdy Abd El Razek M, Majdan M, Majdzadeh R, Majeed A, Malekzadeh R, Malhotra R, Malta DC, Manguerra H, Manyazewal T, Mapoma CC, Marczak LB, Markos D, Martinez-Raga J, Martins-Melo FR, Martopullo I, McAlinden C, McGaughey M, McGrath JJ, Mehata S, Meier T, Meles KG, Memiah P, Memish ZA, Mengesha MM, Mengistu DT, Menota BG, Mensah GA, Meretoja TJ, Meretoja A, Millear A, Miller TR, Minnig S, Mirarefin M, Mirrakhimov EM, Misganaw A, Mishra SR, Mohamed IA, Mohammad KA, Mohammadi A, Mohammed S, Mokdad AH, Mola GL, Mollenkopf SK, Molokhia M, Monasta L, Montanez JC, Montico M, Mooney MD, Moradi-Lakeh M, Moraga P, Morawska L, Morozoff C, Morrison SD, Mountjoy-Venning C, Mruts KB, Muller K, Murthy GV, Musa KI, Nachega JB, Naheed A, Naldi L, Nangia V, Nascimento BR, Nasher JT, Natarajan G, Negoi I, Ngunjiri JW, Nguyen CT, Nguyen QL, Nguyen TH, Nguyen G, Nguyen M, Nichols E, Ningrum DN, Nong VM, Noubiap JJ, Ogbo FA, Oh IH, Okoro A, Olagunju AT, Olsen HE, Olusanya BO, Olusanya JO, Ong K, Opio JN, Oren E, Ortiz A, Osman M, Ota E, Pa M, Pacella RE, Pakhale S, Pana A, Panda BK, Panda-Jonas S, Papachristou C, Park EK, Patten SB, Patton GC, Paudel D, Paulson K, Pereira DM, Perez-Ruiz F, Perico N, Pervaiz A, Petzold M, Phillips MR, Pigott DM, Pinho C, Plass D, Pletcher MA, Polinder S, Postma MJ, Pourmalek F, Purcell C, Qorbani M, Quintanilla BP, Radfar A, Rafay A, Rahimi-Movaghar V, Rahman MH, Rahman M, Rai RK, Ranabhat CL, Rankin Z, Rao PC, Rath GK, Rawaf S, Ray SE, Rehm J, Reiner RC, Reitsma MB, Remuzzi G, Rezaei S, Rezai MS, Rokni MB, Ronfani L, Roshandel G, Roth GA, Rothenbacher D, Ruhago GM, Sa R, Saadat S, Sachdev PS, Sadat N, Safdarian M, Safi S, Safiri S, Sagar R, Sahathevan R, Salama J, Salamati P, Salomon JA, Samy AM, Sanabria JR, Sanchez-Nino MD, Santomauro D, Santos IS, Santric Milicevic MM, Sartorius B, Satpathy M, Schmidt MI, Schneider IJ, Schulhofer-Wohl S, Schutte AE, Schwebel DC, Schwendicke F, Sepanlou SG, Servan-Mori EE, Shackelford KA, Shahraz S, Shaikh MA, Shamsipour M, Shamsizadeh M, Sharma J, Sharma R, She J, Sheikhbahaei S, Shey M, Shi P, Shields C, Shigematsu M, Shiri R, Shirude S, Shiue I, Shoman H, Shrime MG, Sigfusdottir ID, Silpakit N, Silva JP, Singh JA, Singh A, Skiadaresi E, Sligar A, Smith DL, Smith A, Smith M, Sobaih BH, Soneji S, Sorensen RJ, Soriano JB, Sreeramareddy CT, Srinivasan V, Stanaway JD, Stathopoulou V, Steel N, Stein DJ, Steiner C, Steinke S, Stokes MA, Strong M, Strub B, Subart M, Sufiyan MB, Sunguya BF, Sur PJ, Swaminathan S, Sykes BL, Tabares-Seisdedos R, Tadakamadla SK, Takahashi K, Takala JS, Talongwa RT, Tarawneh MR, Tavakkoli M, Taveira N, Tegegne TK, Tehrani-Banihashemi A, Temsah MH, Terkawi AS, Thakur JS, Thamsuwan O, Thankappan KR, Thomas KE, Thompson AH, Thomson AJ, Thrift AG, Tobe-Gai R, Topor-Madry R, Torre A, Tortajada M, Towbin JA, Tran BX, Troeger C, Truelsen T, Tsoi D, Tuzcu EM, Tyrovolas S, Ukwaja KN, Undurraga EA, Updike R, Uthman OA, Uzochukwu BS, van Boven JF, Vasankari T, Venketasubramanian N, Violante FS, Vlassov VV, Vollset SE, Vos T, Wakayo T, Wallin MT, Wang YP, Weiderpass E, Weintraub RG, Weiss DJ, Werdecker A, Westerman R, Whetter B, Whiteford HA, Wijeratne T, Wiysonge CS, Woldeyes BG, Wolfe CD, Woodbrook R, Workicho A, Xavier D, Xiao Q, Xu G, Yaghoubi M, Yakob B, Yano Y, Yaseri M, Yimam HH, Yonemoto N, Yoon SJ, Yotebieng M, Younis MZ, Zaidi Z, Zaki ME, Zegeye EA, Zenebe ZM, Zerfu TA, Zhang AL, Zhang X, Zipkin B, Zodpey S, Lopez AD, Murray CJ; GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the global burden of disease study 2016. Lancet 2017;390:1151-210.
  3. Statistics Korea. Causes of Death Statistics in 2017. Daejeon: Statistics Korea; 2015.
  4. Norat T, Chan D, Lau R, Aune D, Vieira R. The Associations between Food, Nutrition and Physical Activity and the Risk of Colorectal Cancer. London: World Cancer Research Fund/American Insitute for Cancer Research; 2010.
  5. Ruel G, Shi Z, Zhen S, Zuo H, Kroger E, Sirois C, Levesque JF, Taylor AW. Association between nutrition and the evolution of multimorbidity: the importance of fruits and vegetables and whole grain products. Clin Nutr 2014;33:513-20.
  6. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, Amann M, Anderson HR, Andrews KG, Aryee M, Atkinson C, Bacchus LJ, Bahalim AN, Balakrishnan K, Balmes J, Barker-Collo S, Baxter A, Bell ML, Blore JD, Blyth F, Bonner C, Borges G, Bourne R, Boussinesq M, Brauer M, Brooks P, Bruce NG, Brunekreef B, Bryan-Hancock C, Bucello C, Buchbinder R, Bull F, Burnett RT, Byers TE, Calabria B, Carapetis J, Carnahan E, Chafe Z, Charlson F, Chen H, Chen JS, Cheng AT, Child JC, Cohen A, Colson KE, Cowie BC, Darby S, Darling S, Davis A, Degenhardt L, Dentener F, Des Jarlais DC, Devries K, Dherani M, Ding EL, Dorsey ER, Driscoll T, Edmond K, Ali SE, Engell RE, Erwin PJ, Fahimi S, Falder G, Farzadfar F, Ferrari A, Finucane MM, Flaxman S, Fowkes FG, Freedman G, Freeman MK, Gakidou E, Ghosh S, Giovannucci E, Gmel G, Graham K, Grainger R, Grant B, Gunnell D, Gutierrez HR, Hall W, Hoek HW, Hogan A, Hosgood HD 3rd, Hoy D, Hu H, Hubbell BJ, Hutchings SJ, Ibeanusi SE, Jacklyn GL, Jasrasaria R, Jonas JB, Kan H, Kanis JA, Kassebaum N, Kawakami N, Khang YH, Khatibzadeh S, Khoo JP, Kok C, Laden F, Lalloo R, Lan Q, Lathlean T, Leasher JL, Leigh J, Li Y, Lin JK, Lipshultz SE, London S, Lozano R, Lu Y, Mak J, Malekzadeh R, Mallinger L, Marcenes W, March L, Marks R, Martin R, McGale P, McGrath J, Mehta S, Mensah GA, Merriman TR, Micha R, Michaud C, Mishra V, Mohd Hanafiah K, Mokdad AA, Morawska L, Mozaffarian D, Murphy T, Naghavi M, Neal B, Nelson PK, Nolla JM, Norman R, Olives C, Omer SB, Orchard J, Osborne R, Ostro B, Page A, Pandey KD, Parry CD, Passmore E, Patra J, Pearce N, Pelizzari PM, Petzold M, Phillips MR, Pope D, Pope CA 3rd, Powles J, Rao M, Razavi H, Rehfuess EA, Rehm JT, Ritz B, Rivara FP, Roberts T, Robinson C, Rodriguez-Portales JA, Romieu I, Room R, Rosenfeld LC, Roy A, Rushton L, Salomon JA, Sampson U, Sanchez-Riera L, Sanman E, Sapkota A, Seedat S, Shi P, Shield K, Shivakoti R, Singh GM, Sleet DA, Smith E, Smith KR, Stapelberg NJ, Steenland K, Stockl H, Stovner LJ, Straif K, Straney L, Thurston GD, Tran JH, Van Dingenen R, van Donkelaar A, Veerman JL, Vijayakumar L, Weintraub R, Weissman MM, White RA, Whiteford H, Wiersma ST, Wilkinson JD, Williams HC, Williams W, Wilson N, Woolf AD, Yip P, Zielinski JM, Lopez AD, Murray CJ, Ezzati M, AlMazroa MA, Memish ZA. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the global burden of disease study 2010. Lancet 2012;380:2224-60.
  7. Begg SJ, Vos T, Barker B, Stanley L, Lopez AD. Burden of disease and injury in Australia in the new millennium: measuring health loss from diseases, injuries and risk factors. Med J Aust 2008;188:36-40.
  8. Danaei G, Ding EL, Mozaffarian D, Taylor B, Rehm J, Murray CJ, Ezzati M. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med 2009;6:e1000058.
  9. Farzadfar F, Danaei G, Namdaritabar H, Rajaratnam JK, Marcus JR, Khosravi A, Alikhani S, Murray CJ, Ezzati M. National and subnational mortality effects of metabolic risk factors and smoking in Iran: a comparative risk assessment. Popul Health Metr 2011;9:55.
  10. Afshin A, Micha R, Khatibzadeh S, Fahimi S, Shi P, Powles J, Singh G, Yakoob MY, Abdollahi M, Al-Hooti S, Farzadfar F, Houshiar-Rad A, Hwalla N, Koksal E, Musaiger A, Pekcan G, Sibai AM, Zaghloul S, Danaei G, Ezzati M, Mozaffarian D2010 Global Burden of Diseases, Injuries, and Risk Factors Study: NUTRItrition and ChrOnic Diseases Expert Group (NUTRICODE), and Metabolic Risk Factors of ChrOnic Diseases Collaborating Group. The impact of dietary habits and metabolic risk factors on cardiovascular and diabetes mortality in countries of the Middle East and North Africa in 2010: a comparative risk assessment analysis. BMJ Open 2015;5:e006385.
  11. Murray CJ, Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S. Comparative quantification of health risks conceptual framework and methodological issues. Popul Health Metr 2003;1:1.
  12. Meier T, Grafe K, Senn F, Sur P, Stangl GI, Dawczynski C, Marz W, Kleber ME, Lorkowski S. Cardiovascular mortality attributable to dietary risk factors in 51 countries in the WHO European Region from 1990 to 2016: a systematic analysis of the global burden of disease study. Eur J Epidemiol 2019;34:37-55.
  13. He Y, Li Y, Yang X, Hemler EC, Fang Y, Zhao L, Zhang J, Yang Z, Wang Z, He L, Sun J, Wang DD, Wang J, Piao J, Liang X, Ding G, Hu FB. The dietary transition and its association with cardiometabolic mortality among Chinese adults, 1982-2012: a cross-sectional population-based study. Lancet Diabetes Endocrinol 2019;7:540-8.
  14. Cho Y, Cudhea F, Park JH, Lee JT, Mozaffarian D, Singh G, Shin MJ. Estimating change in cardiovascular disease and diabetes burdens due to dietary and metabolic factors in Korea 1998-2011: a comparative risk assessment analysis. BMJ Open 2016;6:e013283.
  15. Cho Y, Cudhea F, Park JH, Mozaffarian D, Singh G, Shin MJ. Burdens of cardiometabolic diseases attributable to dietary and metabolic risks in Korean adults 2012-2013. Yonsei Med J 2017;58:540-51.
  16. Micha R, Shulkin ML, Penalvo JL, Khatibzadeh S, Singh GM, Rao M, Fahimi S, Powles J, Mozaffarian D. Etiologic effects and optimal intakes of foods and nutrients for risk of cardiovascular diseases and diabetes: systematic reviews and meta-analyses from the Nutrition and Chronic Diseases Expert Group (NutriCoDE). PLoS One 2017;12:e0175149.
  17. Feigin VL, Roth GA, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, Mensah GA, Norrving B, Shiue I, Ng M, Estep K, Cercy K, Murray CJ, Forouzanfar MH; Global Burden of Diseases, Injuries and Risk Factors Study 2013 and Stroke Experts Writing Group. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet Neurol 2016;15:913-24.
  18. Shulkin ML, Micha R, Rao M, Singh GM, Mozaffarian D. Major dietary risk factors for cardiometabolic disease: current evidence for causal effects and effect sizes from the global burden of diseases (GBD) 2015 study. Circulation 2016;133:AP279.
  19. Kim Y. The Korea National Health and Nutrition Examination Survey (KNHANES): current status and challenges. Epidemiol Health 2014;36:e2014002.
  20. Singh GM, Danaei G, Farzadfar F, Stevens GA, Woodward M, Wormser D, Kaptoge S, Whitlock G, Qiao Q, Lewington S, Di Angelantonio E, Vander Hoorn S, Lawes CM, Ali MK, Mozaffarian D, Ezzati M; Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group; Asia-Pacific Cohort Studies Collaboration (APCSC); Diabetes Epidemiology: Collaborative analysis of Diagnostic criteria in Europe (DECODE); Emerging Risk Factor Collaboration (ERFC); Prospective Studies Collaboration (PSC). The age-specific quantitative effects of metabolic risk factors on cardiovascular diseases and diabetes: a pooled analysis. PLoS One 2013;8:e65174.
  21. Forouzanfar MH, Afshin A, Alexander LT, Anderson HR, Bhutta ZA, Biryukov S, Brauer M, Burnett R, Cercy K, Charlson FJ, Cohen AJ, Dandona L, Estep K, Ferrari AJ, Frostad JJ, Fullman N, Gething PW, Godwin WW, Griswold M, Hay SI, Kinfu Y, Kyu HH, Larson HJ, Liang X, Lim SS, Liu PY, Lopez AD, Lozano R, Marczak L, Mensah GA, Mokdad AH, Moradi-Lakeh M, Naghavi M, Neal B, Reitsma MB, Roth GA, Salomon JA, Sur PJ, Vos T, Wagner JA, Wang H, Zhao Y, Zhou M, Aasvang GM, Abajobir AA, Abate KH, Abbafati C, Abbas KM, Abd-Allah F, Abdulle AM, Abera SF, Abraham B, Abu-Raddad LJ, Abyu GY, Adebiyi AO, Adedeji IA, Ademi Z, Adou AK, Adsuar JC, Agardh EE, Agarwal A, Agrawal A, Kiadaliri AA, Ajala ON, Akinyemiju TF, Al-Aly Z, Alam K, Alam NK, Aldhahri SF, Aldridge RW, Alemu ZA, Ali R, Alkerwi A, Alla F, Allebeck P, Alsharif U, Altirkawi KA, Martin EA, Alvis-Guzman N, Amare AT, Amberbir A, Amegah AK, Amini H, Ammar W, Amrock SM, Andersen HH, Anderson BO, Antonio CA, Anwari P, Arnlov J, Artaman A, Asayesh H, Asghar RJ, Assadi R, Atique S, Avokpaho EF, Awasthi A, Quintanilla BP, Azzopardi P, Bacha U, Badawi A, Bahit MC, Balakrishnan K, Barac A, Barber RM, Barker-Collo SL, Barnighausen T, Barquera S, Barregard L, Barrero LH, Basu S, Batis C, Bazargan-Hejazi S, Beardsley J, Bedi N, Beghi E, Bell B, Bell ML, Bello AK, Bennett DA, Bensenor IM, Berhane A, Bernabe E, Betsu BD, Beyene AS, Bhala N, Bhansali A, Bhatt S, Biadgilign S, Bikbov B, Bisanzio D, Bjertness E, Blore JD, Borschmann R, Boufous S, Bourne RR, Brainin M, Brazinova A, Breitborde NJ, Brenner H, Broday DM, Brugha TS, Brunekreef B, Butt ZA, Cahill LE, Calabria B, Campos-Nonato IR, Cardenas R, Carpenter DO, Carrero JJ, Casey DC, Castaneda-Orjuela CA, Rivas JC, Castro RE, Catala-Lopez F, Chang JC, Chiang PP, Chibalabala M, Chimed-Ochir O, Chisumpa VH, Chitheer AA, Choi JY, Christensen H, Christopher DJ, Ciobanu LG, Coates MM, Colquhoun SM, Manzano AG, Cooper LT, Cooperrider K, Cornaby L, Cortinovis M, Crump JA, Cuevas-Nasu L, Damasceno A, Dandona R, Darby SC, Dargan PI, das Neves J, Davis AC, Davletov K, de Castro EF, De la Cruz-Gongora V, De Leo D, Degenhardt L, Del Gobbo LC, del Pozo-Cruz B, Dellavalle RP, Deribew A, Jarlais DC, Dharmaratne SD, Dhillon PK, Diaz-Torne C, Dicker D, Ding EL, Dorsey ER, Doyle KE, Driscoll TR, Duan L, Dubey M, Duncan BB, Elyazar I, Endries AY, Ermakov SP, Erskine HE, Eshrati B, Esteghamati A, Fahimi S, Faraon EJ, Farid TA, Farinha CS, Faro A, Farvid MS, Farzadfar F, Feigin VL, Fereshtehnejad SM, Fernandes JG, Fischer F, Fitchett JR, Fleming T, Foigt N, Foreman K, Fowkes FG, Franklin RC, Furst T, Futran ND, Gakidou E, Garcia-Basteiro AL, Gebrehiwot TT, Gebremedhin AT, Geleijnse JM, Gessner BD, Giref AZ, Giroud M, Gishu MD, Giussani G, Goenka S, Gomez-Cabrera MC, Gomez-Dantes H, Gona P, Goodridge A, Gopalani SV, Gotay CC, Goto A, Gouda HN, Gugnani HC, Guillemin F, Guo Y, Gupta R, Gupta R, Gutierrez RA, Haagsma JA, Hafezi-Nejad N, Haile D, Hailu GB, Halasa YA, Hamadeh RR, Hamidi S, Handal AJ, Hankey GJ, Hao Y, Harb HL, Harikrishnan S, Haro JM, Hassanvand MS, Hassen TA, Havmoeller R, Heredia-Pi IB, Hernandez-Llanes NF, Heydarpour P, Hoek HW, Hoffman HJ, Horino M, Horita N, Hosgood HD, Hoy DG, Hsairi M, Htet AS, Hu G, Huang JJ, Husseini A, Hutchings SJ, Huybrechts I, Iburg KM, Idrisov BT, Ileanu BV, Inoue M, Jacobs TA, Jacobsen KH, Jahanmehr N, Jakovljevic MB, Jansen HA, Jassal SK, Javanbakht M, Jayaraman SP, Jayatilleke AU, Jee SH, Jeemon P, Jha V, Jiang Y, Jibat T, Jin Y, Johnson CO, Jonas JB, Kabir Z, Kalkonde Y, Kamal R, Kan H, Karch A, Karema CK, Karimkhani C, Kasaeian A, Kaul A, Kawakami N, Kazi DS, Keiyoro PN, Kemmer L, Kemp AH, Kengne AP, Keren A, Kesavachandran CN, Khader YS, Khan AR, Khan EA, Khan G, Khang YH, Khatibzadeh S, Khera S, Khoja TA, Khubchandani J, Kieling C, Kim C, Kim D, Kimokoti RW, Kissoon N, Kivipelto M, Knibbs LD, Kokubo Y, Kopec JA, Koul PA, Koyanagi A, Kravchenko M, Kromhout H, Krueger H, Ku T, Defo BK, Kuchenbecker RS, Bicer BK, Kuipers EJ, Kumar GA, Kwan GF, Lal DK, Lalloo R, Lallukka T, Lan Q, Larsson A, Latif AA, Lawrynowicz AE, Leasher JL, Leigh J, Leung J, Levi M, Li X, Li Y, Liang J, Liu S, Lloyd BK, Logroscino G, Lotufo PA, Lunevicius R, MacIntyre M, Mahdavi M, Majdan M, Majeed A, Malekzadeh R, Malta DC, Manamo WA, Mapoma CC, Marcenes W, Martin RV, Martinez-Raga J, Masiye F, Matsushita K, Matzopoulos R, Mayosi BM, McGrath JJ, McKee M, Meaney PA, Medina C, Mehari A, Mejia-Rodriguez F, Mekonnen AB, Melaku YA, Memish ZA, Mendoza W, Mensink GB, Meretoja A, Meretoja TJ, Mesfin YM, Mhimbira FA, Millear A, Miller TR, Mills EJ, Mirarefin M, Misganaw A, Mock CN, Mohammadi A, Mohammed S, Mola GL, Monasta L, Hernandez JC, Montico M, Morawska L, Mori R, Mozaffarian D, Mueller UO, Mullany E, Mumford JE, Murthy GV, Nachega JB, Naheed A, Nangia V, Nassiri N, Newton JN, Ng M, Nguyen QL, Nisar MI, Pete PM, Norheim OF, Norman RE, Norrving B, Nyakarahuka L, Obermeyer CM, Ogbo FA, Oh IH, Oladimeji O, Olivares PR, Olsen H, Olusanya BO, Olusanya JO, Opio JN, Oren E, Orozco R, Ortiz A, Ota E, Pa M, Pana A, Park EK, Parry CD, Parsaeian M, Patel T, Caicedo AJ, Patil ST, Patten SB, Patton GC, Pearce N, Pereira DM, Perico N, Pesudovs K, Petzold M, Phillips MR, Piel FB, Pillay JD, Plass D, Polinder S, Pond CD, Pope CA, Pope D, Popova S, Poulton RG, Pourmalek F, Prasad NM, Qorbani M, Rabiee RH, Radfar A, Rafay A, Rahimi-Movaghar V, Rahman M, Rahman MH, Rahman SU, Rai RK, Rajsic S, Raju M, Ram U, Rana SM, Ranganathan K, Rao P, Garcia CA, Refaat AH, Rehm CD, Rehm J, Reinig N, Remuzzi G, Resnikoff S, Ribeiro AL, Rivera JA, Roba HS, Rodriguez A, Rodriguez-Ramirez S, Rojas-Rueda D, Roman Y, Ronfani L, Roshandel G, Rothenbacher D, Roy A, Saleh MM, Sanabria JR, Sanchez-Riera L, Sanchez-Nino MD, Sanchez-Pimienta TG, Sandar L, Santomauro DF, Santos IS, Sarmiento-Suarez R, Sartorius B, Satpathy M, Savic M, Sawhney M, Schmidhuber J, Schmidt MI, Schneider IJ, Schottker B, Schutte AE, Schwebel DC, Scott JG, Seedat S, Sepanlou SG, Servan-Mori EE, Shaddick G, Shaheen A, Shahraz S, Shaikh MA, Levy TS, Sharma R, She J, Sheikhbahaei S, Shen J, Sheth KN, Shi P, Shibuya K, Shigematsu M, Shin MJ, Shiri R, Shishani K, Shiue I, Shrime MG, Sigfusdottir ID, Silva DA, Silveira DG, Silverberg JI, Simard EP, Sindi S, Singh A, Singh JA, Singh PK, Slepak EL, Soljak M, Soneji S, Sorensen RJ, Sposato LA, Sreeramareddy CT, Stathopoulou V, Steckling N, Steel N, Stein DJ, Stein MB, Stockl H, Stranges S, Stroumpoulis K, Sunguya BF, Swaminathan S, Sykes BL, Szoeke CE, Tabares-Seisdedos R, Takahashi K, Talongwa RT, Tandon N, Tanne D, Tavakkoli M, Taye BW, Taylor HR, Tedla BA, Tefera WM, Tegegne TK, Tekle DY, Terkawi AS, Thakur JS, Thomas BA, Thomas ML, Thomson AJ, Thorne-Lyman AL, Thrift AG, Thurston GD, Tillmann T, Tobe-Gai R, Tobollik M, Topor-Madry R, Topouzis F, Towbin JA, Tran BX, Dimbuene ZT, Tsilimparis N, Tura AK, Tuzcu EM, Tyrovolas S, Ukwaja KN, Undurraga EA, Uneke CJ, Uthman OA, van Donkelaar A, van Os J, Varakin YY, Vasankari T, Veerman JL, Venketasubramanian N, Violante FS, Vollset SE, Wagner GR, Waller SG, Wang JL, Wang L, Wang Y, Weichenthal S, Weiderpass E, Weintraub RG, Werdecker A, Westerman R, Whiteford HA, Wijeratne T, Wiysonge CS, Wolfe CD, Won S, Woolf AD, Wubshet M, Xavier D, Xu G, Yadav AK, Yakob B, Yalew AZ, Yano Y, Yaseri M, Ye P, Yip P, Yonemoto N, Yoon SJ, Younis MZ, Yu C, Zaidi Z, Zaki ME, Zhu J, Zipkin B, Zodpey S, Zuhlke LJ, Murray CJ; GBD 2015 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the global burden of disease study 2015. Lancet 2016;388:1659-724.
  22. Cuzick J. A Wilcoxon-type test for trend. Stat Med 1985;4:87-90.
  23. Rural Development Administration. Consumer Friendly Food Composition Table for Adults. Suwon: Rural Development Administration; 2009.
  24. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2017: Korea National Health and Nutrition Examination Survey (KNHANES VII-2). Cheongju: Korea Centers for Disease Control and Prevention; 2018.