Dietary pattern analysis is important complementary approach for identifying associations between diet and chronic disease. A case-control study was conducted in order to examine dietary patterns and the risk of colon cancer in Korea. Data were collected from both 137 cases with either colorectal cancer or large bowl adenomatous polyps and 134 controls regarding social-demographic characteristics and food intake using a semi-quantitative food frequency questionnaire. We conducted factor analysis and identified 6 major dietary patterns: 'Well-being diet' characterized by higher intakes of potatoes, yogurt, soybean paste and vegetables, 'Meat & fish', 'Milk & juice', 'Pork & alcohol', 'Rice & kimchi', and 'Coffee & cake'. We calculated factor scores for each participant and examined the associations between dietary patterns and colon cancer risk. After adjusting for potential confounders, there was a relative risk for colon cancer of 0.16 (95% confidence interval, 0.07 - 0.34) when comparing the highest with the lowest tertile of the 'Well-being' pattern. Significant trends of decreasing risk of colon cancer also emerged with the 'Milk & juice' (OR = 0.40, 95% CI = 0.20 - 0.79). In contrast, inverse associations of the risk were found for 'Pork & alcohol' (OR = 1.92, 95% CI = 0.93 - 3.97), 'Coffee & cake' (OR = 2.18, 95% CI = 1.07 - 4.46). For the 'Meat & fish' pattern, the decreased risk of colon cancer was observed in the second tertile, but not in the highest tertile when comparing to the lowest. The 'Rice & kimchi' pattern had a nonsignificant association with the risk. These data suggest that major dietary patterns derived from the FFQ associated with the risk of colon cancer in Korea. Since foods are not consumed in isolation, dietary pattern research in natural eating behavior may be useful for understanding dietary causes of colon cancer.
There are limited data on healthy dietary patterns protective against metabolic syndrome (MetSyn) development. We identified dietary patterns among middle-aged and older adults and investigated the associations with the incidence of MetSyn. A population-based prospective cohort study included 5,251 male and female Koreans aged 40-69 years. At baseline, all individuals were free of MetSyn, other major metabolic diseases, and known cardiovascular disease or cancer. Cases of MetSyn were ascertained over a 6-year of follow-up. Dietary patterns and their factor scores were generated by factor analysis using the data of a food frequency questionnaire. We performed pooled logistic regression analysis to estimate multivariable-adjusted relative risk (RR) and 95% confidence interval (CI) for associations between factor scores and MetSyn risk. Two dietary patterns were identified; (1) a healthy dietary pattern, which included a variety of foods such as fish, seafood, vegetables, seaweed, protein foods, fruits, dairy products, and grains; and (2) an unhealthy dietary pattern, which included a limited number of food items. After controlling for confounding factors, factor scores for the healthy dietary pattern were inversely associated with MetSyn risk (P-value for trend < 0.05) while those for the unhealthy dietary pattern had no association. Individuals in the top quintile of the healthy diet scores showed a multivariable-adjusted RR [95% CI] of 0.76 [0.60-0.97] for MetSyn risk compared with those in the bottom quintile. The beneficial effects were derived from inverse associations with abdominal obesity, low HDL-cholesterol levels, and high fasting glucose levels. Our findings suggest that a variety of healthy food choices is recommended to prevent MetSyn.
In order to investigate dietary risk factors for hypertension in th elderly, dietary intakes and dietary habits of 405 elderly subjects, aged 60-94, were assessed by the questionnaire, anthropometric measurement and a 24-hour dietary recall. The prevalence of definite (>95mmHg for diastolic or>160mmHg for systeolic blood pressue) and borderline(90-95mmHg for diastolic or 140-160mmHg for systolic blood pressure) hypertensive subjects 33.3% and 19.3%, respectively. The distribution of the subjects for Body Mass Index(BMI), waist-hip ratio, and alcohol consumption were significantly different among definite, borderline, and normal groups(p<0.05). The distribution of the subjects for smoking, exercise, and preference of salty food were not significantly different among definite, borderline, and normal groups(p>0.05). From the generalized logistic regression analysis of the risk factors for the hypertension, the subjects with over 27 of BMI had significantly higher risk of hypertension. Alcohol consumption and preference of salty food were significant risk factors of hypertension in the elderly. Dietary risk factors for the hypertension that had significant relationship to the hypertension were intakes of potassium, calcium, phosphate, sodium, vitamin B1, niacin, and folate. There was no significant difference of consumption frequencies of food and dish among definite, borderline, and normal groups(p>0.05). The amount of intakes for cereals and grain product, bean and their products, eggs were significantly different among definite, borderline, and normal groups(p<0.05). In summary, the amount of dietary intakes to hypertension in elderly population. Longitudinal studies for dietary risk factors on incidence of hypertension are needed in general population, especially in the elderly.
This study investigated whether dietary factors are more influential factor than other health behavior such as drinking, smoking and exercise on abnormal serum cholesterol level inspite of Korean dietary pattern differences compared to Europeans and Americans. A double case control study model has been used for the study design. One model consisted of high blood cholesterol cases and control. the other model consisted of low blood cholesterol cased and controls. 5.398 sedentary male workers who had taken medical examinations at a university hospital were used as the study subjects. Out of the study subjects, 36individuals with high blood cholesterol cases and 30 individuals with low blood cholesterol cases were selected. For the 66 individual control selection, the individual control selection, the individuals matching method was adopted. The food frequency method was used to collect the data for assessment of the dietary factors. A standardized questionnaire was used to investigate other health behavior. logistic regression analysis was employed to measure the relative importance between the factors considered. There were no statistically significant differences observed in nutrients consumption or other health behavior among the low, normal and high blood cholesterol groups, An overmatching effect had been suspected as the cause of those findings. However, the results of logistic regression analysis to identify the factors influencing high serum cholesterol showed that odd ratios of dietary factors such as tocopherol(3.0) and saturated fatty acid(1.6) were higher than I. I of smoking and 1.2 of drinking. Similar results were also observed incases of low serum cholesterol. The above findings imply that although the dietary pattern is quite different from that of Europeans and America, the dietary factor is still a significant factor for abnormal blood cholesterol in Koreans. Therefore, the dietary risk factor identified in high fat consumption populations are still relevant for the relatively healthy Korean as guideline for preventive health practices. (Korean J Community Nutrition 2(5) : 721∼727, 1997)
Dyslipidemia is a component of the metabolic syndrome and a risk factor for cardiovascular diseases. Nutrition counseling is important to improve dyslipidemia. The purpose of this study was to evaluate the effectiveness of nutrition counseling in adults with risk factors for dyslipidemia diagnosed by the national health screening program. The nutrition counseling for adults with risk factors for dyslipidemia was carried out at a public health center in Gyeonggi-do. Thirty four patients out of forty five participants in the program completed the nutrition counseling program. The nutrition counseling was provided 3 times during a 12-week period. Individualized nutrition counseling to improve dietary habits was conducted after examining participants' dietary intake through questionnaires about dietary habits and whether they practice dietary guidelines. Data about serum lipid profiles, body composition, nutrition knowledge, the practice of dietary guidelines, and dietary behavior were collected before and after nutrition counseling to evaluate the effectiveness of nutrition counseling. All data were statistically analyzed by SPSS program (Korea ver.18.0) and significant difference was evaluated by paired t-test and ${\chi}^2$-test. Body weight, body fat and WHR were significantly decreased after nutrition counseling. Total-cholesterol, TG, and LDL-cholesterol were significantly decreased but HDL-cholesterol did not show significant changes. Both scores of nutrition knowledge and the practice of dietary guidelines improved significantly (p < 0.001). This study shows that nutrition counseling helps to encourage healthy eating practices and to improve serum lipid profiles of adults with risk factors for dyslipidemia. Overall, results indicated that nutrition counseling resulted in positive changes to lower the reliance on medications. Therefore, nutrition counseling should be considered for the initial treatment of dyslipidemia.
This cross-sectional study was conducted to describe the changes of plasma cardiovascular disease(CVD) risk factors in Korea. Overnight fasting plasma levels of total cholesterol, high density lipoprotein(HDL)-cholesterol, triacylglycerol and glucose were analyzed. Blood pressure and anthropometric data were also measured. Health practice factors such as smoking status, alcohol consumption and frequency fo exercise were evaluated by a self-administered questionnaire. Questions regarding dietary habits and food preferences were also asked. Seventy eight percent of the subjects had more than one CVD risk factor. Plasma total cholesterol, triacylglycerol, and fasting blood glucose were significantly increased according to the subjects body mass index$(kg/m^2$, BMI), whereas HDL-cholesterol, low density lipoprotein(LDL)-cholesterol and blood pressure showed no significant differences with BMI. Current smokers had significantly high plasma total cholesterol, LDL-cholesterol and triacylglycerol levels. Alcohol consumption significantly increased plasma total cholesterol and fasting blood sugar, but regular exercise had no effects on the plasma CVD risk factors. Overeating and frequency of fast food consumption were positively correlated with the CVD risk score, whereas intake of grains, meats and vegetables were negatively correlated with that score. A stepwise multiple regression analysis was performed to examine the effects of specific dietary factors on plasma lipid levels. For plasma total cholesterol level, the frequency of fast food intake explained 8% of the variance, followed by habitual overeating, frequency of grain intake and high cholesterol food intake(Model $R^2$=22.4%). For plasma triacylglycerol level, preference of oily foods accounted for 7.5% of the variance, followed by eating breakfast, preference of fruit and frequency of grain intake(Model $R^2$=22.0%). The findings suggest that intervention programs to reduce the risk of CVD should focus on health practice through reducing BMI, smoking cessation and moderate or no alcohol drinking. Moreover, desirable dietary habits such as eating breakfast, not overeating and reduced intake of fast food may improve CVD risk.
Vijayakumar, Aswathy;Kim, Yangha;Kim, Hyesook;Kwon, Oran
Nutrition Research and Practice
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제15권4호
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pp.528-540
/
2021
BACKGROUND/OBJECTIVES: In a healthy person, from 35 years of age, there is an annual loss of muscle mass at the rate of 1-2% and is associated with a decline in the quality of life. This study aimed to identify the particular dietary patterns associated with the risk of lower lean muscle mass in Korean postmenopausal women. SUBJECTS/METHODS: The Korea National Health and Nutrition Examination Survey (KNHANES) is a population-based, continuous cross-sectional annual survey. The participants of the KNHANES IV (2008-2009) and V (2010-2011) were considered for this study. The study sample consisted of 1548 postmenopausal women, aged 45-86 years. Lower lean muscle mass was defined as having appendicular skeletal muscle mass corrected for body weight less than 1 standard deviation of the young reference group aged 20 to 39 years in KNHANES IV and V. To identify the dietary pattern using factor analysis, 24-h recall data was used. RESULTS: The prevalence of lower lean muscle mass was 31.3% in this study population. Four dietary patterns were identified by factor analysis; 'Diverse', 'Western', 'Traditional', and 'Snacks and beverages'. The 'Western' pattern, highest factor loadings for flour and bread, potatoes, red meat, processed meat, eggs, and cheese, was significantly associated with a high (60%) risk of lower lean muscle mass (odds ratio [95% confidence interval] = 1.60 [1.07-2.39], P for trend = 0.01) after adjustments for potential covariates. The other 3 dietary patterns were not associated with lower lean muscle mass. CONCLUSIONS: The study findings suggest that the 'Western' dietary pattern that includes flour and bread, potatoes, red meat, processed meat, eggs, and cheese, may be associated with a higher risk of lower lean muscle mass in Korean postmenopausal women.
Objectives: This study was performed to identify the socioeconomic factors, health behavior factors and dietary patterns that have an influence on the fasting blood glucose in adults. Methods: This study used data collected from the 2007, 2008, 2009 Korea National Health and Nutrition Examination Survey. The final sample included 4163 subjects who were 30-59 years old and who had completed the necessary health examinations, the health behaviors survey and nutrition survey. Results: Eleven dietary patterns emerged from the factor analysis with different factor loading. After controlling for potential confounders, multiple regression analysis of the dietary patterns showed that 'fruits', 'alcohols', and 'starchy foods' affected the fasting blood. Lower consumption of 'fruits' and higher consumption of 'alcohols' and 'starch foods' were significantly associated only with an increased risk of high blood glucose. Conclusions: In the light of the results of this study, it appears pretty likely that the risk of developing high blood glucose can be reduced by changing a person's dietary patterns.
Purpose: Unbalanced diets and decreased physical activity have contributed to increased prevalence of obesity and metabolic syndrome in adolescents. We have performed a systematic review and data analysis to examine the association between dietary pattern and metabolic syndrome risk factors in adolescents. Methods: We searched the PubMed and BioMedLib databases for appropriate articles published during the past 10 years and selected 6 articles. The studies reviewed applied factor analysis or cluster analysis to extract dietary patterns. For data analysis, we examined the association between dietary patterns and the prevalence of metabolic syndrome risk factors using data of 3,168 adolescents (13 to 18 years) obtained from 4 consecutive Korean Nutrition Health and Nutrition Examination Surveys (1998, 2001, 2005, and 2007 to 2009). Results: Our systematic review confirmed that western dietary patterns are positively associated with metabolic syndrome risk factors such as obesity and elevated triglycerides, while traditional dietary patterns were negatively associated. Data analysis found that the number of adolescents aged 16 to 18 years who had "Rice & Kimchi" dietary pattern decreased, while the number having western dietary patterns increased during the 1998 to 2009 time frame. There were no changes in the dietary patterns in adolescents aged 13 to 15 years. The risk of elevated serum triglycerides and reduced serum high density lipoprotein cholesterol was high in the "Rice & Kimchi" dietary pattern compared to the other dietary pattern groups. Conclusion: Because adolescents' dietary patterns are changing continuously and have long-term effects, further studies on the dietary patterns of adolescents and their health effects into adulthood are necessary.
Korea's aging population has been remarkably increased. They want to have not only extension of life expectancy but also improving quality of life. To maintain the quality of life, it is essential to have good nutrition. However, nutritional status of elderly in Korea has problems qualitatively and quantitatively. Risk factors for poor nutrition are advanced age, woman, living alone and low economic status. Another risk factor in rural area is season because seasonal changes can affect food intake of elderly. Thus this study surveyed the health status and dietary intakes of elderly by season in rural area. In this study, the elderly were grouped as group 1 {elderly who have one risk factor for chronic diseases (obesity, hypertension, dyslipidemia, diabetes)} and group 2 (elderly who have more than 2 risk factors). Can-Pro 3.0 was used for dietary data analysis and SPSS 12.0 program was used for statistical analysis. Obesity had the highest percentage 62%, followed by hypertension 59.5%, dyslipidemia 21.5% and diabetes 11.6%. Obesity, hypertension, and dyslipidemia were high in winter and WHR, diabetes and anemia were high in summer. Mean intakes of energy and nutrients were less than RI. Nutrients which were changed most by season were vitamin A and Vitamin C. Intakes of calcium and folic acid were less than recommended in summer. The ratio of CPF for carbohydrate was higher and fat was lower than recommended. In conclusion, the nutrient intake of Group 2 was better in quality but Group 1 was better in quantity. Nutrient intakes were poor in summer. In rural area, more careful nutritional assesment and management are needed for aged population, especially in summer.
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