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In May 2023, the Committee of Clinical Practice Guidelines of the Korean Diabetes Association published the revised clinical practice guidelines for Korean adults with diabetes and prediabetes. We incorporated the latest clinical research findings through a comprehensive systematic literature review and applied them in a manner suitable for the Korean population. These guidelines are designed for all healthcare providers nationwide, including physicians, diabetes experts, and certified diabetes educators who manage patients with diabetes or individuals at risk of developing diabetes. Based on recent changes in international guidelines and the results of a Korean epidemiological study, the recommended age for diabetes screening has been lowered. In collaboration with the relevant Korean medical societies, recently revised guidelines for managing hypertension and dyslipidemia in patients with diabetes have been incorporated into this guideline. An abridgment containing practical information on patient education and systematic management in the clinic was published separately.
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BACKGROUND/OBJECTIVES@#The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. @*SUBJECTS/METHODS@#The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. @*RESULTS@#The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. @*CONCLUSIONS@#A ‘U’ or ‘J’ shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.
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Objectives@#The purpose of this study was to evaluate the consumption pattern of sugarsweetened beverages (SSB) and compare body composition changes by SSB consumption based on 28 days of dietary records from a four-week time-restricted eating intervention among young adults in Korea. @*Methods@#A total of 33 participants completed the four-week dietary intervention with 8-hour time-restricted eating (TRE). The body composition was measured by bioelectrical impedance analysis at baseline, and daily dietary records were collected for 28 days during the intervention after 4 weeks. @*Results@#Based on 924 days of dietary records, the average eating occasion of SSB was 0.9 times per day, and the average amount of SSB was 205.8 g/times. Based on an individual’s usual intake of 28 days, the average eating frequency of SSB was 16.6 times out of 28 days, and the average amount of SSB was 184.0 g/day. The average energy intake from SSB was 131.0 kcal /day (8.7% of energy), and sugar intake from SSB was 18.2 g/day (4.9% of energy). The sugar intake was 2.6% of energy from sweetened dairy products, followed by 2.0% from coffee drinks, 0.5% from soda and juice and 0.2% from others.When subjects were divided into high (14 days or more) and low (less than 14 days) SSB groups based on eating frequency, the weight change in the low SSB group was -2.0 kg over 4 weeks, which was significantly lower than -0.7 kg in the high SSB group. However, no significant difference was found in muscle mass, fat mass and body fat percent between the two groups. @*Conclusions@#This study suggests that low consumption of sugar-sweetened beverages is more desirable in weight management despite having the dietary intervention of timerestricted eating without counting calories. Thus, further longitudinal studies on the association between SSB and obesity in Korean adults are necessary.
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Background@#Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients. @*Methods@#Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed. @*Results@#The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine. @*Conclusion@#Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.
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Background@#Concerns have been raised regarding thyroid disorders caused by excessive iodine in Koreans, who have iodine-rich diets. This study evaluated iodine status using dietary iodine intake and urinary iodine in papillary thyroid cancer (PTC) patients. @*Methods@#Dietary data of PTC patients were assessed using a 24-hour recall and food frequency questionnaire (FFQ), and urinary iodine concentrations (UICs) were also obtained. To compare the iodine status of PTC patients, Korean adults with or without thyroid disease from the Korea National Health and Nutrition Examination Survey, which had 24-hour recall data and urinary iodine measurements, were analyzed. @*Results@#The median daily iodine intake by 24-hour recall was 341.7 μg/day in PTC patients, similar to the levels of other Korean adults. Based on UICs, the prevalence of excessive iodine was 54.4% in PTC patients, which was similar to the prevalence among subjects with thyroid disease (55.4%) but slightly higher than that in subjects without thyroid disease (47.7%). Based on dietary iodine by 24-hour recall, the prevalence of excessive iodine intake was 7.2%, which was higher than that among subjects with (4.4%) or without (3.9%) thyroid disease. The dietary iodine intake based on 24-hour recall was closely correlated with the UIC (r=0.4826) in PTC patients, but dietary iodine by FFQ was not significantly correlated with either 24-hour recall or UIC-based dietary iodine. @*Conclusion@#Excessive iodine intake was more common in PTC patients than in subjects without thyroid disease. Further longitudinal research is necessary to elucidate the role of dietary iodine in PTC.
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Purpose@#Variations in the iodine contents of foods is critical for estimating the iodine intake. This study aimed to update the iodine database of common Korean foods and evaluated the iodine intake in Korean adults. @*Methods@#A list of 855 Korean foods was selected for the updated iodine database. The updated database was established with Version 1 and 2 by applying an average or minimum value for the imputed values. The iodine intake was estimated in 5,927 Korean adults using the data from the 2013–2015 Korea National Health and Nutrition Examination Survey. @*Results@#The analytical values in the updated database were 166 (19.4%), followed in order by 318 (37.2%), 247 (28.9%), and 124 (14.5%) for the adapted, imputed, and missing values, respectively. The median of dietary iodine intake was 352.1 μg/day (± 2,166.1) and 343.4 μg/day (± 2,161.9) in Version 1 and 2 among the total population. The contribution rates of each food group to the iodine intake were 55.7% for seaweeds, which showed a similar trend in Version 2. When subjects were divided by consumption of seaweeds, the median iodine intake was 495.7 μg in the consumer group, which was almost double (241.2 μg) that of the non-consumer group. The proportion of subjects who consumed below the Estimated Average Requirement of iodine was 11.0% in the non-consumer group. In contrast, 11.6% in the consumer group of seaweed consumed above the Upper Level of iodine. When the dietary iodine and urinary iodine were examined, the regression coefficient was 0.11718 in Version 1 and 0.11512 in Version 2 after adjusting for age and sex. @*Conclusion@#This study presented the variation of iodine intake in Korean adults by applying different versions of the iodine database. As the iodine intake can vary due to the highly variable concentrations in the major food sources, an iodine database is necessary to be monitored, and caution should be taken when the database is used in research.
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BACKGROUND/OBJECTIVES@#Regional disparities in dietary factors might be related to regional disparities in cardiometabolic health. Therefore, this study investigated the associations of cardiometabolic risk factors and dietary factors with regional types in Korean adults. @*SUBJECTS/METHODS@#Based on data from the 2007–2017 Korea National Health and Nutrition Examination Survey, the study included 39,781 adults aged ≥ 19 years who completed the dietary survey and a health examination. Healthy and unhealthy dietary factors (fat, sodium, fruit, and vegetable intakes) were evaluated using 1-day 24-h dietary recall method, as well as the use of nutrition labels with a questionnaire. @*RESULTS@#Of the participants, 48.7%, 36.0%, and 15.2% lived in metropolitan, urban, and rural areas, respectively. Adults living in urban and rural had higher odds ratios (ORs) for obesity (OR for urban, 1.07; 95% confidence interval (CI), 1.01–1.14; OR for rural, 1.14; 95% CI, 1.05–1.24) than adults living in metropolitan areas; these associations were significantly observed in middle-aged adults. Compared to metropolitan residents, rural residents had lower ORs for hypertension in middle-aged (OR, 0.86; 95% CI, 0.76–0.96) and metabolic syndrome in older adults (OR, 0.78; 95% CI, 0.67–0.91). Regarding urban residents, a lower OR for diabetes in middle-aged adults (OR, 0.85; 95% CI, 0.74–0.97) and a higher OR for hypertension in older adults (OR, 1.19; 95% CI, 1.02–1.39) were observed. Overall rural residents had higher ORs of excessive carbohydrate, low fruit, and high salted-vegetable intakes than metropolitan residents. Low fruit intake was positively associated with obesity, metabolic syndrome, and hypertension, after adjustment for regional type and other confounders in total participants. @*CONCLUSIONS@#These findings indicate that cardiometabolic risk and unhealthy dietary factors differ among regional types and age groups within Korea. Nutritional policy and interventions should consider regional types for prevention and management of cardiometabolic risk factors.
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Background@#Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. @*Methods@#A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. @*Results@#Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. @*Conclusions@#High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.
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Background@#Low-density lipoprotein (LDL) cholesterol is a strong predictor of cardiovascular disease, resulting in the promotion of low-fat diets that emphasize the need to lower LDL cholesterol levels. We investigated the relationship between dietary carbohydrate intake and cardiovascular risk factors according to LDL cholesterol levels in Korean adults who typically consumed high-carbohydrate, low-fat diets. @*Methods@#A total of 25,925 Korean adults were selected from the 2007-2015 Korea National Health and Nutrition Examination Surveys. Dietary carbohydrate intake was grouped into quintiles and cardiovascular risk factors included obesity, metabolic syndrome, type 2 diabetes, and dyslipidemia. Multiple logistic regression models were used to examine association between carbohydrate intake and cardiovascular risk factors by sex and LDL cholesterol levels. @*Results@#Subjects with LDL cholesterol ≥130 mg/dL had significantly less energy and fat intake than those with LDL cholesterol <130 mg/dL both in men and women. In men, a higher carbohydrate intake was related to increased prevalence of atherogenic dyslipidemia and low high-density lipoprotein (HDL) cholesterol regardless of LDL cholesterol levels. Meanwhile, dietary carbohydrate intake was positively associated with low HDL cholesterol but inversely associated with hypercholesterolemia only in women with LDL cholesterol <130 mg/dL. @*Conclusions@#High carbohydrate intake in Korean adults is associated with low HDL cholesterol or atherogenic dyslipidemia regardless of LDL cholesterol levels. Carbohydrate intake should be carefully recommended according to the lipid profiles of individuals for the prevention and management of cardiovascular disease.
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PURPOSE: This study evaluated the glycemic response of diets using estimated glycemic load (eGL), which had been developed for mixed meals for Korean adults, and examined its associations with cardiometabolic risk factors among Korean adults. METHODS: A total of 4,655 men and 6,760 women aged 19 years and above were included from the 2013 ~ 2016 Korea National Health and Nutrition Examination Survey. eGL was calculated by each meal (breakfast, lunch, dinner, and snack) and then summed to give daily total eGL. A multiple logistic regression analysis was used to examine the association. RESULTS: Mean daily total eGL was 112.6 in men and 99.3 in women. Daily total eGL was positively associated with carbohydrate and fiber intakes, but negatively associated with protein and fat intakes in both men and women (p < 0.05 for all). Daily total eGL showed an inverse association with HDL-cholesterol level in both men and women (p = 0.0036 for men and p = 0.0008 for women). Men in the highest quintile of daily total eGL showed a 66% increased risk of hypercholesterolemia (OR, 1.66; 95% CI, 1.10 ~ 2.50; p for trend = 0.0447) compared with those in the lowest quintile. CONCLUSION: These findings suggest that eGL based on carbohydrate, protein, fat and fiber intakes can reflect glycemic response and therefore can be used as an index for dietary planning, nutrition education and in the food industry.
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Adult , Female , Humans , Male , Asian People , Diet , Dyslipidemias , Education , Food Industry , Glycemic Load , Hypercholesterolemia , Korea , Logistic Models , Lunch , Meals , Nutrition Surveys , Risk FactorsABSTRACT
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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.
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Adult , Female , Humans , Male , Dietary Carbohydrates , Dietary Fiber , Dyslipidemias , Hand , Hypercholesterolemia , Logistic Models , Metabolic Diseases , Methods , Prospective Studies , Risk FactorsABSTRACT
BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to reduce the risk of neural tube defects. The purposes of this study were to investigate the awareness, knowledge, and use of folic acid supplements along with their associated factors among non-pregnant Korean women of childbearing age. SUBJECTS/METHODS: From August 2012 to March 2013, 704 women aged 19–45 years completed a self-administered questionnaire regarding their awareness, knowledge, and use of folic acid as well as questions to identify risk of inadequate folate intake. RESULTS: Approximately 67% of women reported that they had heard of folic acid, and 23.7% had knowledge of both the role of folic acid in preventing birth defects and appropriate time for taking folic acid supplements to prevent birth defects. However, only 9.4% of women took folic acid supplements at the time of the survey. Women aged 19–24 years, unmarried women, and women who had never been pregnant were less likely to be aware and knowledgeable of folic acid or take folic acid supplements. In addition, women at high risk of inadequate folate intake were less likely to take folic acid supplements. In a multivariate analysis, women aged 19–24 years, women with a high school diploma or lower education level, and unmarried women were less likely to be aware and have knowledge of folic acid. The percentage of women taking folic acid supplements was significantly higher among knowledgeable women than among unknowledgeable women. CONCLUSIONS: These results support our hypothesis that women with knowledge of folic acid are more likely to take folic acid supplements. Therefore, educational programs or campaigns to improve knowledge regarding the importance of folic acid and to promote consumption of folic acid supplements as well as folate-rich foods are needed to target young, less educated, and unmarried women.
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Female , Humans , Pregnancy , Congenital Abnormalities , Dietary Supplements , Education , Folic Acid , Multivariate Analysis , Neural Tube Defects , Single PersonABSTRACT
PURPOSE: Although an Asian diet is typically high in carbohydrate and low in fat, there has been a steady increase in the rate of cardiometabolic disease in Asian countries over the past decade. We evaluated food patterns of a high-carbohydrate diet and examined their associations with metabolic disease. MATERIALS AND METHODS: Using data from the 2013–2015 Korean National Health and Nutrition Examination Survey, we included a total of 13106 subjects aged 20 years or older in this study. Diet was divided into seven groups according to the percentage of energy from carbohydrates. Food patterns were evaluated as individual servings per food group. Multivariate logistic regression was conducted to estimate odds ratios (OR) for metabolic disease. RESULTS: The proportions of men and women exceeding the recommended range of carbohydrate intake were 58.0% and 60.0%, respectively. A higher carbohydrate diet was associated with intake of low energy and saturated fats, with more grains and fruit, but less meat, fish, egg, bean (MFEB), and dairy consumption. Carbohydrate intake decreased by 3.0–3.4% per serving of MFEB and milk. In men, the highest carbohydrate group showed an OR of 1.35 [95% confidence interval (CI), 0.91 to 1.99] for metabolic syndrome, although this failed to show statistical significance. In women, the highest carbohydrate group had an OR of 1.38 (95% CI, 1.06 to 1.80) for a reduced level of high-density lipoprotein cholesterol. CONCLUSION: This study suggests that a very-high-carbohydrate diet for the Korean population is attributable to lower consumption of MFEB and dairy products and is associated with several metabolic risk factors. The appropriate distribution of macronutrients for the prevention and management of metabolic disease should be explored.
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Female , Humans , Male , Asian People , Carbohydrates , Cholesterol , Dairy Products , Diet , Dyslipidemias , Fats , Fruit , Lipoproteins , Logistic Models , Meat , Metabolic Diseases , Milk , Nutrition Surveys , Odds Ratio , Ovum , Risk FactorsABSTRACT
OBJECTIVES: Although dietary supplements use in Korea has been rapidly increasing and women are more likely to take dietary supplements more than men, only a few studies have been conducted to investigate factors contributing to gender differences in dietary supplement use in the Korean population. The aim of this study is to evaluate the prevalence of dietary supplement use and also identify gender-specific key factors that contribute to it using the data of the 4th KNHANES. METHODS: Subjects were divided into user and non-user groups according to the answer given to the question that asked whether they had used any dietary supplement for more than 2 weeks on a regular basis during the previous year. Factors related to dietary supplement use were examined by general characteristics, health behavior and eating behavior. RESULTS: Prevalence of dietary supplement use was 13.6% for men and 20.6% for women. Users were more likely to be middle-aged, have higher income and education, have a spouse, or reside in dong areas in both men and women. Regarding health behaviors, men with desirable lifestyle behavior were more likely to take dietary supplements, while men who smoked were less likely to take dietary supplements. Regarding disease history, both men and women with a current disease had higher odds of taking supplements. With regard to dietary behavior, frequent eating out and nutrition attitude were associated with higher odds of taking supplements in both men and in women. CONCLUSIONS: Health or dietary behavior related factors that were associated with taking supplements differed by gender. These findings can be useful for planning gender-specific dietary education and health programs.
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Female , Humans , Male , Dietary Supplements , Eating , Education , Feeding Behavior , Health Behavior , Korea , Life Style , Nutrition Surveys , Prevalence , Smoke , SpousesABSTRACT
BACKGROUND/OBJECTIVES: Dietary sugar intake, particularly added sugar and sugar-sweetened beverages, has received worldwide attention recently. Investigation of dietary behaviors may facilitate understanding of dietary sugar intakes of children and adolescents. However, the relationship between dietary sugar intake and dietary behaviors in the Korean population has not been investigated. Thus, this study aimed to estimate dietary sugar intake and food sources according to sex as well as examine the relationship of dietary sugar intake with frequent snacking and dietary patterns among Korean children and adolescents. SUBJECTS/METHODS: We pooled data from five studies involving Korean children and adolescents conducted from 2002 to 2011. A total of 2,599 subjects aged 9-14 years were included in this study. Each subject completed more than 3 days of dietary records. RESULTS: Mean daily total sugar intake was 46.6 g for boys and 54.3 g for girls. Compared with boys, girls showed higher sugar intakes from fruits (7.5 g for boys and 8.8 g for girls; P = 0.0081) and processed foods (27.9 g for boys and 34.9 g for girls; P < 0.0001). On average, 95.4% of boys and 98.8% of girls consumed snacks during the study period, and total sugar intake showed a significantly increasing trend with increasing energy intake from snacks (P < 0.0001 for both sexes). Two dietary patterns were identified by cluster analysis: Traditional and Westernized patterns. Total sugar intake was higher in the Westernized pattern (56.2 g for boys and 57.2 g for girls) than in the Traditional pattern (46.5 g for boys and 46.3 g for girls). CONCLUSIONS: These results suggest that multilateral and practical development of a nutrition education and intervention program that considers dietary behaviors as well as absolute sugar intake is required to prevent excessive sugar intake in Korean children and adolescents.
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Adolescent , Child , Female , Humans , Beverages , Diet Records , Education , Energy Intake , Fruit , Korea , SnacksABSTRACT
BACKGROUND/OBJECTIVE: Even though the prevalence of metabolic syndrome in adolescents is increasing, little is presently known about this syndrome in adolescents. This study aimed to cluster metabolic risk factors as well as examine the associations between identified patterns and nutrient intake using data from the Korean National Health Examination and Nutritional Assessment (KNHANES). SUBJECTS/METHODS: A total of 2,958 subjects aged 10 to 18 years along with both biochemical and dietary data information were obtained from KNHANES 2007-2010. Six components of metabolic syndrome were used to identify any patterns via factor analysis. Individuals were categorized into quartile groups according to their pattern score. RESULTS: Three clustering patterns with high loadings were identified and named as follows: 1) high blood pressure, 2) dyslipidemia, and 3) glucose abnormality patterns. The high blood pressure pattern showed high loadings of systolic and diastolic blood pressures, the dyslipidemia pattern showed high loadings of triglyceride and HDL-cholesterol levels, and the glucose abnormality pattern showed high loadings of fasting blood glucose levels. Intakes of fat and riboflavin were significantly decreased, whereas those of sodium and niacin were significantly increased across the quartiles in the dyslipidemia pattern. No nutrient intake except that of thiamin was significantly associated with the high blood pressure or glucose abnormality pattern. CONCLUSION: Our findings show that metabolic syndrome risk factors in the Korean adolescent population are characterized by three distinct patterns, which are differentially associated with dietary factors. Characterizing metabolic risk factors and providing specific dietary guidelines for target groups are important.
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Adolescent , Humans , Blood Glucose , Cluster Analysis , Dyslipidemias , Factor Analysis, Statistical , Fasting , Glucose , Hypertension , Korea , Niacin , Nutrition Assessment , Nutrition Policy , Nutrition Surveys , Prevalence , Riboflavin , Risk Factors , Sodium , TriglyceridesABSTRACT
BACKGROUND/OBJECTIVE: Even though the prevalence of metabolic syndrome in adolescents is increasing, little is presently known about this syndrome in adolescents. This study aimed to cluster metabolic risk factors as well as examine the associations between identified patterns and nutrient intake using data from the Korean National Health Examination and Nutritional Assessment (KNHANES). SUBJECTS/METHODS: A total of 2,958 subjects aged 10 to 18 years along with both biochemical and dietary data information were obtained from KNHANES 2007-2010. Six components of metabolic syndrome were used to identify any patterns via factor analysis. Individuals were categorized into quartile groups according to their pattern score. RESULTS: Three clustering patterns with high loadings were identified and named as follows: 1) high blood pressure, 2) dyslipidemia, and 3) glucose abnormality patterns. The high blood pressure pattern showed high loadings of systolic and diastolic blood pressures, the dyslipidemia pattern showed high loadings of triglyceride and HDL-cholesterol levels, and the glucose abnormality pattern showed high loadings of fasting blood glucose levels. Intakes of fat and riboflavin were significantly decreased, whereas those of sodium and niacin were significantly increased across the quartiles in the dyslipidemia pattern. No nutrient intake except that of thiamin was significantly associated with the high blood pressure or glucose abnormality pattern. CONCLUSION: Our findings show that metabolic syndrome risk factors in the Korean adolescent population are characterized by three distinct patterns, which are differentially associated with dietary factors. Characterizing metabolic risk factors and providing specific dietary guidelines for target groups are important.
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Adolescent , Humans , Blood Glucose , Cluster Analysis , Dyslipidemias , Factor Analysis, Statistical , Fasting , Glucose , Hypertension , Korea , Niacin , Nutrition Assessment , Nutrition Policy , Nutrition Surveys , Prevalence , Riboflavin , Risk Factors , Sodium , TriglyceridesABSTRACT
BACKGROUND AND OBJECTIVES: Iodine is essential for thyroid hormone production and the iodine intake of Koreans is high. Few studies have examined the association between iodine intake and thyroid disease in the Korean population due to the lack of an iodine database. Therefore, this study established an iodine database, evaluated iodine intake levels, and explored the association between iodine intake and thyroid disease. MATERIALS AND METHODS: We obtained data for 9998 subjects who had both biochemical and dietary data from the 2007-2009 Korea National Health and Nutrition Examination Survey. RESULTS: An iodine database was established for 667 food items. The median iodine intake in the population was 375.4 microg per day. The iodine contribution by food group was 65.6% from seaweed, 18.0% from salted vegetables, and 4.8% from fish. When subjects were divided into five groups across quintiles of iodine intake per 1000 kcal, excluding extreme subjects who consumed above the upper limit, age, sex, income, education, drinking, and smoking differed across the groups. While the energy and fat intakes decreased, other nutrients increased across the quintile groups. The consumption of seaweeds, fish, eggs, and salted vegetables increased across the quintile groups. After adjusting for all potential confounding variables, the odds ratio for thyroid disease in the highest quintile was 1.63 compared to that in the lowest quintile (p for trend=0.0352). CONCLUSION: The iodine intake of the Korean population is high, with high consumption of seaweeds, salted vegetables, and fish positively associated with thyroid disease.