Korean J Community Nutr. 2020 Feb;25(1):61-70. Korean.
Published online Feb 29, 2020.
Copyright © 2020 The Korean Society of Community Nutrition
Original Article

Relation between the Total Diet Quality based on Korean Healthy Eating Index and the Incidence of Metabolic Syndrome Constituents and Metabolic Syndrome among a Prospective Cohort of Korean Adults

Saerom Shin,1 and Seungmin Lee2
    • 1Department of Food and Nutrition, Graduate School, Sungshin Women's University, Seoul, Korea, Master's graduate.
    • 2Department of Food and Nutrition, Sungshin Women's University, Seoul, Korea, Associate Professor.
Received February 10, 2020; Revised February 17, 2020; Accepted February 19, 2020.

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults.

Methods

Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model.

Results

After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level.

Conclusions

A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.

Keywords
diet quality; Korean Healthy Eating Index; metabolic syndrome; prospective cohort

Tables

Table 1
Subjects' general characteristics at baseline

Table 2
Nutrient and food group intakes for first and fifth quintiles of Korean Healthy Eating Index scores

Table 3
Incidence risk of metabolic syndrome components for first and fifth quintiles of Korean Healthy Eating Index scores in men (N=2,805)

Table 4
Incidence risk of metabolic syndrome components for first and fifth quintiles of Korean Healthy Eating Index scores in women (N=2,744)

Table 5
Incidence risk of metabolic syndrome across quintiles of Korean Healthy Eating Index scores in men (N=2,805)

Table 6
Incidence risk of metabolic syndrome across quintiles of Korean Healthy Eating Index scores in women (N=2,744)

Acknowledgments

This study was supported by a research grant from Sungshin Women's University (2017-2-11-052).

References

    1. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2016: Korea National Health and Nutrition Examination Survey (KNHANES VII-1). Cheongju: Korea Centers for Disease Control and Prevention; 2017.
    1. Korean Society of Cardiometabolic Syndrome. Metabolic syndrome fact sheet in Korea 2018 [internet]. Korean Society of Cardiometabolic Syndrome; 2018 [cited 2020 Feb 13].
    1. Galassi A, Reynolds K, He J. Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 2006;119(10):812–819.
    1. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112(17):2735–2752.
    1. Ministry of Health and Welfare. The 4th health plan (2016~2020) [Internet]. Sejong: Ministry of Health and Welfare; 2016 [updated 2016 Mar 15]. [cited 2017 Feb 30].
    1. Mirmiran P, Moslehi N, Mahmoudof H, Sadeghi M, Azizi F. A longitudinal study of adherence to the Mediterranean dietary pattern and metabolic syndrome in a non-Mediterranean population. Int J Endocrinol Metab 2015;13(3):e26128
    1. Sadykova K, Shalkharova Z, Nuskabayeva G, Zhunissova M, Madenbay K. Relation between adherence to Mediterranean diet and components of the metabolic syndrome in the Kajakhastani population. Georgian Med News 2018;274:97–102.
    1. Fung TT, Hu FB, Wu K, Chiuve SE, Fuchs CS, Giovannucci E. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets and colorectal cancer. Am J Clin Nutr 2010;92(6):1429–1435.
    1. Kant AK, Schatzkin A, Graubard BI, Schairer C. A prospective study of diet quality and mortality in women. JAMA 2000;283(16):2109–2115.
    1. Mai V, Kant AK, Flood A, Lacey JV Jr, Schairer C, Schatzkin A. Diet quality and subsequent cancer incidence and mortality in a prospective cohort of women. Int J Epidemiol 2005;34(1):54–60.
    1. Ahn S, Jun S, Kang M, Shin S, Wie GA, Baik HW. Association between intake of antioxidant vitamins and metabolic syndrome risk among Korean adults. J Nutr Health 2017;50(4):313–324.
    1. Kim M, Kim J, Bae W, Kim S, Lee Y, Na W. Relationship between nutrients intakes, dietary quality, and serum concentrations of inflammatory markers in metabolic syndrome patients. Korean J Community Nutr 2011;16(1):51–61.
    1. Shin H, Yoon YS, Lee Y, Kim CI, Oh SW. Dairy product intake is inversely associated with metabolic syndrome in Korean adults: Anseong and Ansan cohort of the Korean Genome and Epidemiology Study. J Korean Med Sci 2013;28(10):1482–1488.
    1. Baik I, Abbott RD, Curb JD, Shin C. Intake of fish and n-3 fatty acids and future risk of metabolic syndrome. J Am Diet Assoc 2010;110(7):1018–1026.
    1. Baik I, Shin C. Prospective study of alcohol consumption and metabolic syndrome. Am J Clin Nutr 2008;87(5):1455–1463.
    1. Oh SM, Kim HC, Ahn SV, Chi HJ, Suh I. Association between meat consumption and carotid intima-media thickness in Korean adults with metabolic syndrome. J Prev Med Public Health 2010;43(6):486–495.
    1. Kim YJ, Hwang JY, Kim H, Park S, Kwon O. Diet quality, physical activity, and their association with metabolic syndrome in Korean adults. Nutrition 2019;59:138–144.
    1. Shin S, Lee S. Association between total diet quality and metabolic syndrome incidence risk in a prospective cohort of Korean adults. Clin Nutr Res 2019;8(1):46–54.
    1. National Institute of Health, Korean Centers for Disease Control and Prevention. Examination and survey quality control of the Korean Genome and Epidemiology Study [Internet]. National Institute of Health; 2019 [updated 2019 Aug 8]. [cited 2019 Oct 30].
    1. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007;75(1):72–80.
    1. Yook SM, Park S, Moon HK, Kim K, Shim JE, Hwang JY. Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data. J Nutr Health 2015;48(5):419–428.
    1. Ministry of Health and Welfare. Dietary guidelines for Korean adults [Internet]. Ministry of Health and Welfare; 2009 [updated 2009 Dec 8]. [cited 2014 Mar 27].
    1. The Korean Nutrition Society. Dietary reference intakes for Koreans. 1st revision. Seoul: The Korean Nutrition Society; 2010.
    1. Guenther PM, Reedy J, Krebs-Smith SM. Development of the healthy eating index-2005. J Am Diet Assoc 2008;108(11):1896–1901.
    1. Fogli-Cawley JJ, Dwyer JT, Saltzman E, McCullough ML, Troy LM, Meigs JB. The 2005 Dietary Guidelines for Americans and risk of the metabolic syndrome. Am J Clin Nutr 2007;86(4):1193–1201.
    1. Kesse-Guyot E, Ahluwalia N, Lassale C, Hercberg S, Fezeu L, Lairon D. Adherence to Mediterranean diet reduces the risk of metabolic syndrome: a 6-year prospective study. Nutr Metab Cardiovasc Dis 2013;23(7):677–683.

Metrics
Share
Tables

1 / 6

PERMALINK