Traditional v. modified dietary patterns and their influence on adolescents' nutritional profile

Mediating effect of physical sub-health in the association of sugar-sweetened beverages consumption with depressive symptoms in Chinese college students: A structural equation model

BACKGROUND

Although previous findings with small samples indicated that sugar-sweetened beverages (SSB) consumption was associated with depressive symptoms in adolescents, the mediating effect of physical sub-health in the association is unknown.

METHODS

A survey was conducted among freshmen from 11 provinces in China. A food frequency questionnaire was used to collect dietary behavior, and patient health questionnaire-9 items was used to assess depressive symptoms. A generalized linear model was used to analyze the association between SSB consumption, physical sub-health and depressive symptoms. The structural equation model was used to analyze the mediating effect of physical sub-health.

RESULTS

Of the 31,856 participants, 36.5 % had positive depressive symptoms. After adjusting for variables, carbonate beverages (β = 0.11; 95%CI: 0.07-0.15; P = 0.000) and milk tea (β = 0.07; 95%CI: 0.01-0.13; P = 0.021) consumption was associated with depressive symptoms in boys. Carbonate beverages (β = 0.09; 95%CI: 0.05-0.13; P = 0.000), tea beverages (β = 0.09; 95%CI: 0.04-0.13; P = 0.000), and milk tea (β = 0.08; 95%CI: 0.04-0.11; P = 0.000) consumption was associated with depressive symptoms in girls. The mediating effect of physical sub-health accounted for 81.3 % of the total effect in the mediating model of SSB associated with depressive symptoms.

LIMITATIONS

Retrospective survey has certain information bias. Association observed in the cross-sectional study is uncertain.

CONCLUSIONS

The present study suggests that the consumption of SSB associated with depressive symptoms in Chinese college students, and physical sub-health plays a complete mediating role in the association.

Association of Dietary Patterns with Weight Status and Metabolic Risk Factors among Children and Adolescents

Unhealthy dietary patterns are associated with obesity in children and adolescents. However, few studies have investigated the relationships between dietary patterns and obesity-related metabolic disorders among Asians. We identified dietary patterns in children and adolescents and examined the associations between these patterns and obesity, insulin resistance, and metabolic syndrome in South Korea. This study is a cross-sectional design. We used baseline data from an intervention study of 435 Korean children and adolescents aged 6–17 years. Insulin resistance was assessed as HOMA-IR ≥ 2.6. Metabolic syndrome was diagnosed by cardiovascular disease risk factor clustering. Dietary intakes were estimated using 3-day food records. Factor analysis was used to obtain dietary patterns, and we examined the associations between dietary patterns and obesity-related markers adjusted for potential covariates. Three dietary patterns were identified as fast food and soda (FFS), white rice and kimchi (WRK), and oil and seasoned vegetable (OSV) patterns. Compared with participants in the lower intake of FFS pattern, those in the top intake were associated with a higher waist circumference (WC) (β = 1.55), insulin level (β = 1.25), and body mass index (BMI) (β = 0.53) and it was positively associated with HOMA-IR ≥ 2.6 (OR = 2.11; 95% CI: 1.227–3.638) (p < 0.05). WRK pattern was associated with lower weight and higher HDL cholesterol, and the OSV pattern was associated with a lower weight, WC, and insulin level (p < 0.05). The FFS pattern showed a positive relation with WC, serum insulin, and BMI, and the other two dietary patterns indicated a preventive effect of those parameters. The FFS pattern was associated with significantly elevated insulin resistance among children and adolescents.

Energy Dense Salty Food Consumption Frequency Is Associated with Diastolic Hypertension in Spanish Children

High blood pressure (BP) is a risk factor for cardiovascular disease and sodium consumption is related to high BP. Moreover, sugar-sweetened beverages (SSB) and the Dietary Approach to Stop Hypertension (DASH) influence BP. For this reason, we investigated whether: 1) children with risk of elevated BP had a higher consumption frequency (CF) of energy-dense salty foods (EDSF), high-sugary foods (HSF) and SSB or a low DASH score; and 2) children with a higher CF of EDSF showed a worse anthropometric and metabolic profile. Anthropometry, BP and general biochemical parameters were measured in 687 Spanish children (5-16 years) with normal or excess weight. A food frequency questionnaire was used to calculate EDSF, HSF and SSB consumption, and modified DASH score. Results showed that sex and pubertal stage influenced modified DASH score. Diastolic hypertension was associated to higher CF of EDSF in the whole sample and to higher CF of SSB in pubertal children, both independently of nutritional status. In addition, CF of EDSF was positively associated with CF of HSF and SSB and inversely associated with modified DASH score. Targeted policies and intervention programs, specific for different age ranges, should be established that aim to reduce salt consumption from snacks and processed foods, which could reduce HSF and SSB consumption as well.

Association Between Screen Time, Fast Foods, Sugar-Sweetened Beverages and Depressive Symptoms in Chinese Adolescents

OBJECTIVE

Although previous studies have shown that screen time (ST), fast foods (FFs) and sugar-sweetened beverages (SSBs) consumption are associated with depressive symptoms in adolescents, research on these associations in Chinese adolescents is scarce. This study aimed to examine the association between ST, FFs, SSBs and depressive symptoms in Chinese adolescents, and explore the mediating effects of FFs and SSBs in the association between ST and depressive symptoms.

METHODS

This school-based nationwide survey was carried out among 14,500 students in four provinces of China. The Children's Depression Inventory was used to assess the participants' depressive symptoms. ST, FFs and SSBs consumption was measured by a self-reported questionnaire. The Bayesian multiple mediation model was used to analyze the mediation effect.

RESULTS

ST, FFs and SSBs, were more likely to be associated with depressive symptoms, and ORs (95%CI) was 1.075 (1.036-1.116), 1.062 (1.046-1.078) and 1.140 (1.115-1.166), after we adjusted for sociodemographic variables. Additionally, in Bayesian multiple mediation model, direct effect, mediating effect, total effect, the ratio of mediating effect to total effect was 0.125, 0.034, 0.159, and 0.214, respectively. All path coefficients of the three mediation paths are statistically significant (p < 0.05).

CONCLUSIONS

Our study demonstrates that ST, FFs and SSBs consumption are associated with depressive symptoms in Chinese adolescents. It is likely that FFs and SSBs partially mediate the association between ST and depressive symptoms by chain-mediating effects.

The Quality of a Traditional Dietary Pattern in Relation to Metabolic Syndrome in Elderly South Koreans

Background

The most beneficial dietary pattern in managing metabolic syndrome (MetS) in the elderly has not been ascertained. The aim of this study is to classify dietary patterns and to examine associations between dietary pattern, MetS and body composition in elderly Koreans.

Methods

This study was conducted among Koreans 65 years or older using data from the Korea National Health and Nutrition Examination Survey in 2009. A total of 1,567 study subjects were included. All statistical analyses were conducted using SPSS version 20.0 and dietary patterns were classified by cluster analysis.

Results

There were three dietary patterns derived by cluster analysis in this study. We observed that most South Korean elderly still maintain a traditional dietary pattern. Dietary patterns were classified as balanced (31%), imbalanced (40%), or very imbalanced (30%), with the majority of subjects having an unbalanced diet pattern in which their total energy and nutrient intake was insufficient compared with the Dietary Reference Intake for Koreans. Those in the very imbalanced group had a ratio of macronutrients (carbohydrates:fats:protein) of 81.15:7.18:11.50 and a 54% higher likelihood of having hypertriglyceridemia (P=0.025) compared with those in the balanced group.

Conclusion

The current findings indicate that the diets of South Korean elderly are nutritionally imbalanced, including high carbohydrate consumption, which confers a high risk hypertriglyceridemia. These findings highlight the effect of nutritional imbalance in elderly with MetS.

Dietary patterns and cardiometabolic risk factors among adolescents: systematic review and meta-analysis

This study systematised and synthesised the results of observational studies that were aimed at supporting the association between dietary patterns and cardiometabolic risk (CMR) factors among adolescents. Relevant scientific articles were searched in PUBMED, EMBASE, SCIENCE DIRECT, LILACS, WEB OF SCIENCE and SCOPUS. Observational studies that included the measurement of any CMR factor in healthy adolescents and dietary patterns were included. The search strategy retained nineteen articles for qualitative analysis. Among retained articles, the effects of dietary pattern on the means of BMI (n 18), waist circumference (WC) (n 9), systolic blood pressure (n 7), diastolic blood pressure (n 6), blood glucose (n 5) and lipid profile (n 5) were examined. Systematised evidence showed that an unhealthy dietary pattern appears to be associated with poor mean values of CMR factors among adolescents. However, evidence of a protective effect of healthier dietary patterns in this group remains unclear. Considering the number of studies with available information, a meta-analysis of anthropometric measures showed that dietary patterns characterised by the highest intake of unhealthy foods resulted in a higher mean BMI (0·57 kg/m²; 95 % CI 0·51, 0·63) and WC (0·57 cm; 95 % CI 0·47, 0·67) compared with low intake of unhealthy foods. Controversially, patterns characterised by a low intake of healthy foods were associated with a lower mean BMI (−0·41 kg/m²; 95 % CI −0·46,−0·36) and WC (−0·43 cm; 95 % CI −0·52,−0·33). An unhealthy dietary pattern may influence markers of CMR among adolescents, but considering the small number and limitations of the studies included, further studies are warranted to strengthen the evidence of this relation.

Dietary patterns change over two years in early adolescent girls in Hawai'i

BACKGROUND AND OBJECTIVES

In investigating diet-disease relationships, examination of dietary patterns allows for conclusions to be drawn based on overall intake. This study characterized dietary patterns of early adolescent girls over a two-year period and examined the relationship between dietary patterns and body mass index (BMI).

METHODS AND STUDY DESIGN

Cross-sectional analyses were performed using longitudinal data from food records of early adolescent girls (n=148) 9 to 14 years in Hawai'i from the Female Adolescent Maturation (FAM) study. Dietary patterns were identified using principal component analysis (PCA). Pearson's correlations between BMI percentile and z-score and dietary pattern factor scores at Times 1 (2001-2002) and 2 (2002-2003) were calculated. For each dietary pattern, participants were divided into low, intermediate, and high scorers. Mean BMI percentiles and z-scores were compared between groups using analysis of covariance.

RESULTS

At Time 1, three patterns were identified, characterized by: (1) whole grains, nuts and seeds, added sugar; (2) non-whole grain, tomatoes, discretionary fat; and (3) deep yellow vegetables, other starchy vegetables, cooked dry beans/peas. At Time 2, three different dietary patterns emerged: (1) non-whole grains, meat, discretionary fat; (2) other vegetables, fish, eggs; and (3) whole grain, tomatoes, other vegetables. BMI percentile and z-score differed between high and low scorers on Time 1-Pattern 1 and Time 2-Pattern 3.

CONCLUSION

Results revealed changes in dietary patterns over time and an association between intake and BMI. Findings demonstrate the importance of frequent nutrition assessment to monitor changes in intake that may be improved to prevent obesity.

[Dietary habits of adolescents and associated cardiovascular risk factors: a systematic review]

The scope of this study was to conduct a systematic review to establish the major dietary habits of adolescents and the corresponding association with cardiovascular risk factors. Research was performed in the LILACS, SciELO, PubMed, Scopus and Web of Science databases in addition to a manual search for original articles published between 2005 and 2014. Of the 371 entries identified; 26 fulfilled the inclusion criteria and were covered in the review. The main dietary habits observed were Western (61%) Healthy (42%) and Traditional (38%). Western dietary habits were positively associated with total cholesterol and SM, while Healthy dietary habits were inversely associated with fasting glycaemia, DBP and SM and positively with HDL-C, all of the aforementioned associations with very low (D) quality of evidence in accordance with the GRADE rating. The Traditional dietary habits were considered a risk factor for hyperglycemia, hyperinsulinemia and hypertriglyceridemia and protection for physical activity and eutrophic BMI. Although these results need to be analyzed with caution, due to the low quality of evidence, there is a clear need for actions aimed at promoting healthy dietary habits in adolescents in order to contribute to the prevention of cardiovascular risk factors.

Association between energy drink intake, sleep, stress, and suicidality in Korean adolescents: energy drink use in isolation or in combination with junk food consumption

BACKGROUND

A considerable amount of research suggests that the frequent use of caffeinated energy drinks may be associated with undesirable effects, particularly so in children and adolescents. This study aimed to investigate the associations between energy drink intake and mental health problems, in isolation or in combination with junk food consumption, in a nationally representative sample of Korean adolescents.

METHODS

Data from the 2015 Korean Youth Risk Behavior Web-Based Survey, collected from 68,043 adolescents aged 12-18 years (mean age 15.09 ± 1.72 years), were analyzed. Questionnaires were administered to collect information related to dietary behavior including energy drink intake and junk food consumption. Single item measures of sleep dissatisfaction, stress, depression, suicidal ideation, suicide plan, and suicide attempt were also administered. Associations between energy drink intake and sleep dissatisfaction, perceived severe stress, persistent depressive mood, and suicidality were investigated, and a multivariate approach was taken so that additional variance from demographic and lifestyle factors could be controlled for statistically.

RESULTS

Energy drink intake was significantly associated with sleep dissatisfaction (adjusted odd ratios [AORs] = 1.64 and 1.25), severe stress (AORs = 2.23 and 1.38), depressive mood (AOR = 2.59 and 1.51), suicidal ideation (AORs = 3.14 and 1.43), suicide plan (AORs = 4.65 and 1.78), and suicide attempt (AORs = 6.79 and 1.91), with a higher risk for more frequent use of energy drinks (≥5 times/wk) than for less frequent use (1-4 times/wk). The detrimental effect of energy drinks on mental health was particularly prominent in frequent junk food consumers.

CONCLUSIONS

Our data suggest that energy drink intake had detrimental effects related to stress, sleep dissatisfaction, mood, and suicidality, in isolation or in combination with junk food consumption, in Korean adolescents. However, the cross-sectional study design prevents our ability to assess causal relationships.

Ethnic Differences in the Food Intake Patterns and Its Associated Factors of Adolescents in Kelantan, Malaysia

Objective: The aim of the study was to identify the ethnic differences in dietary patterns and its association with socio-economic, dietary and lifestyle practices among adolescents in Kelantan, Malaysia. Methods: A population-based study of 454 adolescents aged 12 to 19 years was included. A validated food frequency questionnaire was used to assess dietary patterns and three dietary patterns were identified based on the principal component analysis method. Results: Malay adolescents had significantly higher scores for the Western-based food pattern and local-based food pattern, whereas Chinese adolescents showed higher scores for the healthy-based food pattern. Multivariate analyses show that age and physical activity (PA) levels were positively associated with healthy-based food pattern in Malay (All, p < 0.001), whereas higher consumption of eating-out from home (EatOut) (p = 0.014) and fast food (p = 0.041) were negatively associated. High weekly breakfast skipping (p < 0.001) and EatOut (p = 0.003) were positively associated with a Western-based pattern, whereas age (p < 0.001) and household income (p = 0.005) were negatively associated. Higher frequency of daily snacking (p = 0.013) was positively associated with local-based food pattern. For Chinese adolescents, age (p < 0.001), PA levels (p < 0.001) and maternal education level (p = 0.035) showed positive associations with the healthy-based pattern, whereas high EatOut (p = 0.001) and fast food intakes (p = 0.001) were negatively associated. Higher weekly consumption of EatOut (p = 0.007), fast food (p = 0.023) and carbonated beverages (p = 0.023), and daily snacking practice (p = 0.004) were positively associated with higher Western-based food pattern, whereas age (p = 0.004) was inversely associated. Conclusion: This study showed that there were significant differences in dietary patterns and its association factors between Malay and Chinese adolescents. More importantly, these findings suggest that unhealthy dietary and lifestyle practices could increase the risk of adherence to unhealthy Western-based food pattern that is high in fat, sugar and salt contents, and, consequently, increase the risk of developing obesity and metabolic-related disorders during these critical years of growth.

Does Skipping Breakfast and Being Overweight Influence Academic Achievement Among Korean Adolescents?

Objectives

Health status and health behaviors are associated with academic achievement in children and adolescents. The purpose of this study was to investigate whether skipping breakfast and being overweight are related to academic achievement of Korean adolescents.

Methods

Cross-sectional data on a sample of 1,652 high-school seniors (942 males and 710 females) drawn from the 2004 Korea Education Employment Panel were analyzed.

Results

A higher proportion of males (15.3%) than females (6.1%) was overweight (p < 0.001); 37% of males and 41% of females reported skipping breakfast. Overall test scores were significantly higher for females than males (p < 0.05), and in language and foreign language subjects. However, both males and females who reported skipping breakfast had significantly lower scores in language, mathematics, and foreign language than those who did not report skipping breakfast. Overweight males had a lower probability than normal-weight males of having the highest language scores (OR = 0.52, p < 0.05), but there was no difference among females. Females who skipped breakfast had a lower probability of having the highest scores in language (OR = 0.41, p < 0.05), mathematics (OR = 0.24, p < 0.01), or foreign language (OR = 0.18, p < 0.01), while males had a lower probability of having the highest scores in language only (OR = 0.46, p < 0.05).

Conclusion

Skipping breakfast and being overweight are associated with poor academic achievement in Korean adolescents. Eating breakfast and weight control is being discussed as the overlooked factors that may influence better academic achievement.

Meat and milk intake in the rice-based Korean diet: impact on cancer and metabolic syndrome

Over a few decades, Korean diet has changed from traditional diet, mainly composed of rice and vegetables, to Westernised diet rich, in meat and milk, along with the economic development and globalisation. Increasing prevalence of diet-related chronic diseases such as cancer and metabolic syndrome (MetS) is becoming a heavy burden to society and requires further attention. In this review, the association of meat and milk consumption with cancer and MetS among Koreans was discussed. Previous meta-analyses showed that meat intake was positively associated with increased risk of cancers, especially colon, as well as obesity and type 2 diabetes mellitus, and that the intake of milk and dairy products was negatively associated with colorectal cancer, obesity, and type 2 diabetes mellitus, based on studies conducted mostly in Western countries. In Korea and other Asian countries, the association of meat and milk intake with cancers were inconclusive and varied by types of cancers. Conversely, milk intake was negatively associated with MetS risk as reported in Western countries. The difference in results between Korea and Western countries might come from the differences in dietary patterns and study designs. Most Koreans still maintain traditional dietary pattern, although rapid change towards Westernised diet is underway among the younger age group. Randomised clinical trials or prospective cohort studies with consideration of combined effects of various dietary factors in Korea and other Asian countries are needed to elucidate the impact of meat and milk or related dietary patterns in their diet.

Dietary patterns of obese and normal-weight women of reproductive age in urban slum areas in Central Jakarta

Developing countries including Indonesia imperatively require an understanding of factors leading to the emerging problem of obesity, especially within low socio-economic groups, whose dietary pattern may contribute to obesity. In this cross-sectional study, we compared the dietary patterns and food consumption of 103 obese and 104 normal-weight women of reproductive age (19-49 years) in urban slum areas in Central Jakarta. A single 24-h food recall was used to assess energy and macronutrient intakes (carbohydrate, protein and fat) and calculate energy density. A principal component analysis was used to define the dietary patterns from the FFQ. Obese women had significantly higher intakes of energy (8436·6 (sd 2358·1) v. 7504·4 (sd 1887·8) kJ (2016·4 (sd 563·6) v. 1793·6 (sd 451·2) kcal)), carbohydrate (263·9 (sd 77·0) v. 237·6 (sd 63·0) g) and fat (83·11 (sd 31·3) v. 70·2 (sd 26·1) g) compared with normal-weight women; however, their protein intake (59·4 (sd 19·1) v. 55·9 (sd 18·5) g) and energy density (8·911 (sd 2·30) v. 8·58 (sd 1·88) kJ/g (2·13 (sd 0·55) v. 2·05 (sd 0·45) kcal/g)) did not differ significantly. Two dietary patterns were revealed and subjectively named 'more healthy' and 'less healthy'. The 'less healthy' pattern was characterised by the consumption of fried foods (snacks, soyabean and roots and tubers) and meat and poultry products, whereas the more healthy pattern was characterised by the consumption of seafood, vegetables, eggs, milk and milk products and non-fried snacks. Subjects with a high score for the more healthy pattern had a lower obesity risk compared with those with a low score. Thus, obesity is associated with high energy intake and unhealthy dietary patterns characterised by consumption of oils and fats through fried foods and snacks.

Dietary patterns are associated with body mass index and bone mineral density in Chinese freshmen

OBJECTIVE

Our objective was to examine associations between dietary patterns and body mass index (BMI) and bone mineral density (BMD) in Chinese freshmen.

METHODS

A cross-sectional study was done in 1319 college freshmen (aged 18.1 ± 1.2 years old). Diet was assessed by using a validated self-administrated food-frequency questionnaire. Blood pressure, weight, height, waist circumference, and hip circumference were measured and bone measurements were done using Quantitative Ultrasound System.

RESULTS

Four dietary patterns were identified by factor analysis: Western food, animal protein, calcium food, and Chinese traditional patterns. The prevalence of overweight/obesity and osteopenia/osteoporosis were 8.2% (108/1319) and 28.1% (371/1319). The highest tertile of Western food pattern scores had greater odds of overweight/obesity (highest vs. lowest tertile, odds ratio [OR] = 2.00, 95% confidence interval [CI], 1.24-3.22), and the highest tertile of Chinese traditional pattern scores had lower risk of overweight/obesity (highest vs. lowest tertile, OR = 0.65, 95% CI, 0.53-0.80) in an adjusted model. The calcium food pattern and Chinese traditional pattern were negatively associated with the risk of osteopenia/osteoporosis (highest vs. lowest tertile, OR = 0.59, 95% CI, 0.41-0.87; OR = 0.78, 95% CI, 0.55-0.89) after adjusting for confounders.

CONCLUSION

These findings suggested that there was a positive correlation between Chinese traditional dietary pattern and healthy BMI and BMD and that this same association existed between calcium food pattern and BMD in Chinese freshmen. In contrast, the Western-style diet was negatively correlated with healthy BMI in Chinese freshmen.

Dietary patterns and physical inactivity, two contributing factors to the double burden of malnutrition among adults in Burkina Faso, West Africa

A population-based cross-sectional study was carried out in the northern neighbourhoods of Ouagadougou (Burkina Faso), to examine the relationship of nutritional deficiencies and cardiometabolic risk factors (CMRF) with lifestyle in adults. We randomly selected 330 households stratified by income tertile. In each income stratum, 110 individuals aged 25-60 years and having lived in Ouagadougou for at least 6 months were randomly selected. We performed anthropometric, dietary intake and physical activity measurements, and blood sample collection. Cluster analysis of dietary intake identified two dietary patterns: 'urban' (29 % of subjects) and 'traditional' (71 %). The 'urban' cluster exhibited a higher intake of fat and sugar, whereas a higher intake of plant protein, complex carbohydrate and fibre was observed in the 'traditional' pattern. Female sex, low income and lack of education were associated with the 'traditional' cluster, as well as Fe and vitamin A deficiency. CMRF prevalence (abdominal obesity, hypertension, hyperglycaemia, dyslipidaemia) was similar in both clusters. Subjects in the 'traditional' cluster spent more time in physical activity and had less sedentary time than those in the 'urban' cluster. 'Traditional' dietary pattern, low income, female sex and sedentary time were significant contributing factors to the double burden of malnutrition. The rapid nutrition transition is reflected in this co-occurrence of CMRF and nutritional deficiencies. This stresses the need for prevention strategies addressing both ends of the nutrition spectrum.

Association between kimchi intake and asthma in Korean adults: the fourth and fifth Korea National Health and Nutrition Examination Survey (2007-2011)

This study was performed to investigate the relationship between dietary factors and asthma in a representative population-based sample of 19,659 men and women, aged 19-64 years, using data from the fourth and fifth Korean National Health and Nutrition Examination Survey (KNHANES), 2007-2011. The presence of asthma was based on self-reported physician diagnosis of asthma in the Health Interview Surveys. Food intake was estimated by trained interviewers using a 24-h recall method. The prevalence of asthma in Korean adults was 2.4%. Adults with asthma consumed fewer amounts of kimchi (P=.0444) and fish (P=.0175) but had a higher cereal intake than those without asthma (P=.0056). Multiple logistic regression analysis after controlling for confounding factors showed a significant inverse relationship between kimchi consumption and the prevalence of asthma [odds ratio (95% confidence interval) for subjects consuming 1 to <2 servings (40-79.9 g), 2 to <3 servings (80-119.9 g), and ≥3 servings (≥120 g), relative to those consuming <1 serving (<40 g): 0.726 (0.534-0.987), 0.506 (0.348-0.736), and 0.678 (0.502-0.916), respectively; P for trend=0.0131]. These results warrant future studies to explore the mechanisms responsible for the association between kimchi consumption and asthma.

Red meat consumption is associated with an increased overall cancer risk: a prospective cohort study in Korea

Cancer is a leading cause of death, and the dietary pattern in Korea is changing rapidly from a traditional Korean diet to a Westernised diet. In the present study, we investigated the effects of dietary factors on cancer risk with a prospective cohort study. Among 26 815 individuals who participated in cancer screening examinations from September 2004 to December 2008, 8024 subjects who completed a self-administered questionnaire concerning demographic and lifestyle factors, and a 3 d food record were selected. As of September 2013, 387 cancer cases were identified from the National Cancer Registry System, and the remaining individuals were included in the control group. The hazard ratio (HR) of cancer for the subjects older than or equal to 50 years of age was higher (HR 1·80, 95 % CI 1·41, 2·31; P< 0·0001) than that for the other subjects. Red meat consumption, Na intake and obesity (BMI ≥ 25 kg/m2) were positively associated with overall cancer incidence in men (HR 1·41, 95 % CI 1·02, 1·94; P= 0·0382), gastric cancer (HR 2·34, 95 % CI 1·06, 5·19; P= 0·0365) and thyroid cancer (HR 1·56, 95 % CI 1·05, 2·31; P= 0·0270), respectively. Participants who had at least three dietary risk factors among the high intakes of red meat and Na, low intakes of vegetables and fruits, and obesity suggested by the World Cancer Research Fund/American Institute for Cancer Research at baseline tended to have a higher risk of cancer than the others (HR 1·26, 95 % CI 0·99, 1·60; P= 0·0653). In summary, high intakes of red meat and Na were significant risk factors of cancer among Koreans.

Dietary pattern classifications with nutrient intake and body composition changes in Korean elderly

BACKGROUND/OBJECTIVES

The body composition changes in aging increased the risk of metabolic disorder. Recent dietary studies have increasingly focused on the correlations between dietary patterns and chronic diseases to overcome the limitations of traditional single-nutrient studies because nutrients in food have complex relations that interact.

SUBJECTS/METHODS

This study was conducted to classify a dietary pattern among Korean elderly using cluster analysis and to explore the relationships between dietary patterns and body composition changes in Korean elderly aged 65 years or older. The study subjects (n = 1,435) were individuals who participated in the Korean National Health Examination and Nutrition Survey (KNHANES) in 2011.

RESULTS

There were three dietary patterns derived by cluster analysis in this study: 'Traditional Korean' (37.49% of total population), 'Meat and Alcohol' (19.65%) and 'Westernized Korean' (42.86%). The (1) 'Traditional Korean' pattern was characterized by high consumptions of white rice and low protein, low fat, and low milk products, while (2) 'Westernized Korean' pattern ate a Korean-style diet base with various foods such as noodles, bread, eggs and milk, (3) 'Meat and Alcohol' pattern had high consumptions of meat and alcohol. In body composition changes, compared with the 'Traditional Korean' pattern, the 'Meat & alcohol' pattern was associated with a 50% increased risk of having elevated BMI (kg/m²), 'Westernized Korean' pattern was associated with a 74% increased abnormality of ASM/Wt (kg) by logistics analysis. Most of the Korean adult population continues to follow ether a traditional Korean having beneficial effects for successful aging. However, the 'Traditional Korean' pattern showed low protein intake (0.7 g/kg), calcium intake, and vitamin D intake as well as low of appendicular skeletal muscle mass (ASM (kg)) among 3 groups.

CONCLUSIONS

Considering the low ASM, consumption of protein, calcium and vitamin D should be increased for Korean elderly health body composition.

School and neighborhood nutrition environment and their association with students' nutrition behaviors and weight status in Seoul, South Korea

PURPOSE

We examined the association between the school and neighborhood nutrition environments and adolescent nutrition behaviors and weight status.

METHODS

We conducted a cross-sectional survey with 1,342 fourth to ninth graders in 15 schools on their food-eating behaviors. Participants were randomly selected from eight predetermined districts in Seoul, South Korea. Height and weight data from the school annual health check-ups were obtained. Dietitians from each school completed questionnaires on the school nutrition environment. Types of food outlets in a 500-meter radius of the schools were recorded. Healthy eating index was created based on 10 questions on students' eating behaviors, such as breakfast skipping, fruit consumption, and ramen noodle consumption (possible score range 0-10). Generalized estimating equation method was used for statistical modeling.

RESULTS

Higher density of supermarkets and traditional markets in the school neighborhoods was associated with a greater likelihood of child obesity after controlling for individual-level covariates (odds ratio = 1.37, 1.21-1.54). The school nutrition environment was not associated with student's healthy eating habits and weight status. Students who were younger, female, from more affluent families, who had less weekly screen time, or had stay-at-home mothers had higher scores on the healthy eating index. There was a gender difference in the associations between environmental factors and students' eating behaviors and obesity status.

CONCLUSIONS

These findings suggest that the relationship between environmental factors and individual factors and weight status may be more complicated than previously reported in other parts of the world.

Associations between dietary patterns and hypertension among Korean adults: the Korean National Health and Nutrition Examination Survey (2008-2010)

The objective of this study is to identify the dietary patterns associated with the risk of hypertensions among Korean adults using data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2008-2010). This study analyzes data from 11,883 subjects who participated in the health and nutrition survey, aging from 20 to 64 years. We performed factor analysis based on the weekly mean intake frequencies of 36 food groups to identify major dietary patterns. We identified three major dietary patterns in both sexes, namely "traditional", "western" and "dairy and carbohydrate" patterns. Participants in the highest quartile of western pattern scores had significantly higher blood pressure, serum total cholesterol, and triglyceride levels than those in the lowest quartile. Although not statistically significant, a trend (P for trend = 0.0732) toward a positive association between the western dietary pattern and hypertension risk was observed after adjustments for age, sex, education, income, body mass index (BMI), smoking, physical activity, and energy intake. The dairy and carbohydrate pattern was inversely related with BMI and blood pressures and positively associated with serum high-density lipoprotein (HDL)-cholesterol. After adjusting the age, sex, education, income, BMI, smoking, physical activity and energy intake, the dairy and carbohydrate pattern showed inverse associations with hypertension prevalence (OR = 0.64, 95% CI = 0.55-0.75; P for trend < 0.0001). Intakes of fiber, sodium, and antioxidant vitamins were significantly higher in the top quartile for the traditional pattern than in the lowest quartile for the traditional pattern (P for trend < 0.0001). Intakes of fiber (P for trend < 0.0001), calcium (P for trend < 0.0001), retinol (P for trend = 0.0164), vitamin B₁ (P for trend = 0.001), vitamin B₂ (P for trend < 0.0001), niacin (P for trend = 0.0025), and vitamin C (P for trend < 0.0001) were significantly increased across quartiles for the dairy and carbohydrate pattern whereas sodium (P for trend < 0.0001) intake was decreased for this pattern. In conclusion, the dairy and carbohydrate pattern may be associated with a reduced risk of hypertension whereas the western pattern may be associated with an increased risk of hypertension among Korean adults.

Longitudinal comparisons of dietary patterns derived by cluster analysis in 7- to 13-year-old children

Little is known about changes in dietary patterns over time. The present study aims to derive dietary patterns using cluster analysis at three ages in children and track these patterns over time. In all, 3 d diet diaries were completed for children from the Avon Longitudinal Study of Parents and Children at 7, 10 and 13 years. Children were grouped based on the similarities between average weight consumed (g/d) of sixty-two food groups using k-means cluster analysis. A total of four clusters were obtained at each age, with very similar patterns being described at each time point: Processed (high consumption of processed foods, chips and soft drinks), Healthy (high consumption of high-fibre bread, fruit, vegetables and water), Traditional (high consumption of meat, potatoes and vegetables) and Packed Lunch (high consumption of white bread, sandwich fillings and snacks). The number of children remaining in the same cluster at different ages was reasonably high: 50 and 43% of children in the Healthy and Processed clusters, respectively, at age 7 years were in the same clusters at age 13 years. Maternal education was the strongest predictor of remaining in the Healthy cluster at each time point – children whose mothers had the highest level of education were nine times more likely to remain in that cluster compared to those with the lowest. Cluster analysis provides a simple way of examining changes in dietary patterns over time, and similar underlying patterns of diet at two ages during late childhood, that persisted through to early adolescence.

Bitter taste perception and dietary intake patterns in irish children

BACKGROUND/AIMS

Variations in bitter receptor gene TAS2R38 affect the perception of bitter-tasting compound 6-n-propylthiouracil (PROP). The perception of PROP has been associated, in some reports, with the perception of fat and sweet tastes, and various food preferences and intakes. The aim was to investigate nutrient intakes and food patterns in a group of Irish children, using K-means cluster analysis, and compare these with TAS2R38 genotype and PROP taster status.

METHODS

Dietary intake was measured via a 3-day diet history in 483 children aged 7-13 years. Children were genotyped for TAS2R38 variation, and PROP taster status was assessed. Anthropometric and socioeconomic data were also obtained.

RESULTS

No differences were observed in macronutrient, micronutrient, or food group consumption between the TAS2R38 genotype and PROP taster groups. K-means cluster analysis identified two distinct dietary patterns, termed 'more healthful' and 'less healthful' clusters. The clusters did not differ in frequencies of TAS2R38 genotype nor PROP taster status groups, suggesting that dietary patterns are not influenced by bitter taste perception.

CONCLUSION

Bitterness perception, as measured by either TAS2R38 genotype or PROP taster status, does not appear to exert a significant effect on patterns of dietary intakes.

Beverage consumption and individual-level associations in South Korea

Background

Few previous studies investigated consumption distributions of sugar-sweetened beverages (SSBs) over time and individual-level associations in Asia despite the recent interest in SSBs regarding obesity control. This study aimed to provide recent evidence on beverage consumption trends from 2001 to 2009 for overall and subtypes of SSBs and for milk as a comparable healthy beverage in South Korea, as well as associations with individual-level socioeconomic status (SES).

Methods

The Korean National Health and Nutrition Examination Surveys from 2001 to 2009 were used. Consumption prevalence and average caloric intake by SSB type were examined. Associations of SES with consumption were assessed in a multivariate logistic regression model (consumption prevalence) and in a multivariate two-part regression model (overall caloric intake adjusting for consumption probability).

Results

SSB consumption prevalence increased to 38%, 69%, 70%, and 50% by 2009 up from 31%, 66%, 63%, and 32% in 2001 among adolescents, young adults, adults, and the elderly, respectively. Miscellaneous SSBs (sports/energy drinks, coffee/tea products, flavored milk, and others) were the most prevalent and their prevalence increased among adults (from 62% to 69%) and the elderly (from 30% to 47%) between 2001 and 2009. Adolescents consumed the most calories from miscellaneous SSBs among all beverage types although its prevalence was lower than regular soda and milk in both 2001 and 2009. Women (top- income group only) and men in higher income groups showed higher odds of consuming total SSBs (OR = 1.18-1.25), soda (OR = 1.18, men only), fruit drinks (OR = 1.18, the top-income only for both genders), and miscellaneous SSBs (OR = 1.1-1.2). Men with higher-education showed higher odds of total SSB consumption (OR = 1.14-1.20), and all subtypes of SSBs (OR = 1.18, 1.29, 1.19 for soda, fruit drinks, and miscellaneous SSBs, respectively for the top-education group only). There were statistically significant but minimal differences in the overall amount of caloric intake from SSBs by individual SES for both genders.

Conclusions

South Korea is following the global nutrition transition toward greater consumption of SSBs. However, unlike other developed countries, SSB consumption prevalence was higher among high-SES individuals, particularly for fruit drinks and miscellaneous SSBs. Further research is needed to build the international evidence base.

Dietary patterns based on carbohydrate nutrition are associated with the risk for diabetes and dyslipidemia

Several studies have been conducted on dietary patterns based on carbohydrate nutrition in Asian populations. We examined the cross-sectional associations in dietary patterns based on carbohydrate nutrition, including the glycemic index (GI) with dyslipidemia and diabetes among the Korean adult population. We analyzed 9,725 subjects (3,795 men and 5,930 women, ≥ 20 years) from the Fourth Korea National Health and Nutrition Examination Survey. Dietary information was collected using single 24-hour recall. Reduced rank regression was used to derive dietary patterns from 22 food groups as predictor variables and four dietary factors related to the quantity and quality of carbohydrates as response variables. Two dietary patterns were identified: 1) the balanced pattern was characterized by high intake of various kinds of foods including white rice, and 2) the rice-oriented pattern was characterized by a high intake of white rice but low intake of vegetables, fruits, meat, and dairy products. Both patterns had considerable amounts of total carbohydrate, but GI values differed. The rice-oriented pattern was positively associated with hypertriglyceridemia in men and low high density lipoprotein-cholesterol in both men and women. The balanced pattern had no overall significant association with the prevalence of dyslipidemia or diabetes, however, men with energy intake above the median showed a reduced prevalence of diabetes across quintiles of balanced pattern scores. The results show that dietary patterns based on carbohydrate nutrition are associated with prevalence of dyslipidemia and diabetes in the Korean adult population.

Association between dietary behaviors and attention-deficit/hyperactivity disorder and learning disabilities in school-aged children

We aimed to comprehensively investigate the associations between a wide range of measures of dietary behaviors and learning disabilities and attention-deficit/hyperactivity disorder (ADHD) in community-dwelling Korean children in order to generate hypotheses for future work. The present study included 986 children [507 boys, 479 girls; mean (S.D.) age=9.1 (0.7) years] recruited from five South Korean cities. Children's dietary behaviors were assessed by the mini-dietary assessment (MDA) for Koreans. It consists of ten items to assess the level of intake of dairy products, high-protein foods, vegetables, fried foods, fatty meats, salt, and sweetened desserts and whether the subject is eating three regular meals and has a balanced diet. Learning disability was assessed via the Learning Disability Evaluation Scale (LDES). ADHD was assessed via the Diagnostic Interview Schedule for Children version-IV and the ADHD rating scale, and ADHD-related behavioral problems were assessed via the Child Behavior Checklist. After adjusting for potential confounders, a high intake of sweetened desserts, fried food, and salt is associated with more learning, attention, and behavioral problems, whereas a balanced diet, regular meals, and a high intake of dairy products and vegetables is associated with less learning, attention, and behavioral problems. Our data suggest that existing encouraged dietary habits mostly have beneficial effects on learning, attention, and behavioral problems in Korean children. These findings are in general the same results in other studies on ADHD children in other countries. However, the cross-sectional study design prevents our ability to assess causal relationships.

A traditional Korean dietary pattern and metabolic syndrome abnormalities

BACKGROUND AND AIMS

Using national data, we explored the relationship between dietary patterns and metabolic abnormalities to address how the traditional Korean diet, high in carbohydrate and low in animal fat with plenty of plant foods, has influenced metabolic abnormalities in the adult population.

METHODS AND RESULTS

We examined cross-sectional associations between dietary patterns and the risk of metabolic abnormalities in 4,730 subjects aged 20 years or more using both health and dietary data from the 2005 Korean National Health and Nutrition Examination survey. Three evident dietary patterns were derived by cluster analysis: 'Traditional' (50.3% of total population), 'Meat and Alcohol, (15.8%) and 'Korean Healthy' (33.9%). The 'Traditional' group was characterised by high consumptions of rice and kimchi, while the 'Korean healthy' group ate a modified Korean-style diet with various foods such as noodles, bread, eggs and milk, and the 'Meat and Alcohol' group had high consumptions of processed meat and alcohol. Compared with the 'Traditional' pattern, the 'Meat and Alcohol' pattern was associated with a 33% increased risk of having elevated blood glucose, a 21% increased risk of having elevated serum triglycerides and a 21% increased risk of having elevated blood pressure. However, the 'Traditional' pattern showed a 23% increased risk of having low high density lipoprotein (HDL)-cholesterol compared with the other two patterns by logistics analysis.

CONCLUSIONS

Fifty percent of the Korean adult population continues to follow a traditional dietary pattern, having beneficial effects with respect to some metabolic abnormalities. However, the high prevalence of low HDL-cholesterol, attributable to a high-carbohydrate diet, should be considered.

Dietary patterns of adolescents in Germany--associations with nutrient intake and other health related lifestyle characteristics

Background

The aim of this study was to identify dietary patterns among a representative sample of German adolescents and their associations with energy and nutrient intake, socioeconomic and lifestyle characteristics, and overweight status.

Methods

In the analysis, data from the German Health Interview and Examination Survey for Children and Adolescents were used. The survey included a comprehensive dietary history interview conducted among 1272 adolescents aged 12 to 17 years. Dietary patterns were determined with principal component analysis (PCA) based on 48 food groups, for boys and girls separately.

Results

Three dietary patterns among boys and two among girls were identified. Among boys, high adherence to the 'western' pattern was associated with higher age, lower socioeconomic status (SES), and lower physical activity level (PA). High adherence to the 'healthy' pattern among boys, but not among girls, was associated with higher SES, and higher PA. Among boys, high adherence to the 'traditional' pattern was associated with higher age. Among girls, high adherence to the 'traditional and western' pattern was associated with lower age, lower SES and more hours watching TV per day. The nutrient density of several vitamins and minerals, particularly of B-vitamins and calcium, increased with increasing scores of the 'healthy' pattern among both sexes. Conversely, with increasing scores of the 'western' pattern among boys, most nutrient densities decreased, particularly of fibre, beta-carotene, vitamin D, biotin and calcium. Among girls with higher scores of the 'traditional and western' pattern, nutrient densities of vitamin A, C, E, K and folate decreased. Among boys, high adherence to the 'traditional' pattern was correlated with higher densities of vitamin B₁₂ and vitamin D and lower densities of fibre, magnesium and iron. No significant associations between dietary patterns and overweight were found.

Conclusions

Higher scores for dietary patterns characterized by higher consumption of take away food, meat, confectionary and soft drinks ('western' and 'traditional and western') were found particularly among 16- to 17-years old boys and among adolescents with lower SES. These patterns were also associated with higher energy density, higher percent of energy from unsaturated fatty acids and lower percent of energy from carbohydrates as well as lower nutrient densities of several vitamins and minerals. Therefore, nutritional interventions should try to focus more on adolescents with lower SES and boys in general.

A comparison of dietary patterns derived by cluster and principal components analysis in a UK cohort of children

BACKGROUND/OBJECTIVES

The objective of this study was to identify dietary patterns in a cohort of 7-year-old children through cluster analysis, compare with patterns derived by principal components analysis (PCA), and investigate associations with sociodemographic variables.

SUBJECTS/METHODS

The main caregivers in the Avon Longitudinal Study of Parents and Children (ALSPAC) recorded dietary intakes of their children (8279 subjects) using a 94-item food frequency questionnaire. Items were then collapsed into 57 food groups. Dietary patterns were identified using k-means cluster analysis and associations with sociodemographic variables examined using multinomial logistic regression. Clusters were compared with patterns previously derived using PCA.

RESULTS

Three distinct clusters were derived: Processed (4177 subjects), associated with higher consumption of processed foods and white bread, Plant-based (2065 subjects), characterized by higher consumption of fruit, vegetables and non-white bread, and Traditional British (2037 subjects), associated with higher consumption of meat, vegetables and full-fat milk. Membership of the Processed cluster was positively associated with girls, younger mothers, snacking and older siblings. Membership of the Plant-based cluster was associated with higher educated mothers and vegetarians. The Traditional British cluster was associated with council housing and younger siblings. The three clusters were similar to the three dietary patterns obtained through PCA; each principal component score being higher on average in the corresponding cluster.

CONCLUSIONS

Both cluster analysis and PCA identified three dietary patterns very similar both in the foods associated with them and sociodemographic characteristics. Both methods are useful for deriving meaningful dietary patterns.

Nutrition transition among adolescents of a south-Mediterranean country: dietary patterns, association with socio-economic factors, overweight and blood pressure. A cross-sectional study in Tunisia

BACKGROUND

The increase in the burden of chronic diseases linked to the nutrition transition and associated dietary and lifestyle changes is of growing concern in south and east Mediterranean countries and adolescents are at the forefront of these changes. This study assessed dietary intake and association with socio-economic factors and health outcomes among adolescents in Tunisia.

METHODS

Cross-sectional survey (year 2005); 1019 subjects 15-19 y. from a clustered random sample. Dietary intake was assessed by a validated semi-quantitative frequency questionnaire (134 items) as was physical activity; the Diet Quality Index International measured diet quality; dietary patterns were derived by multiple correspondence analysis from intakes of 43 food groups. Body Mass Index (BMI) ≥ 85th and 95th percentile defined overweight and obesity. Waist Circumference (WC) assessed abdominal fat. High blood pressure was systolic (SBP) or diastolic blood pressure (DBP) ≥ 90th of the international reference for 15-17 y., and SBP/DBP ≥ 120/80 mm Hg for 18-19 y.

RESULTS

Energy intake levels were quite high, especially for females. The macro-nutrient structure was close to recommendations but only 38% had a satisfactory diet quality. A main traditional to modern dietary gradient, linked to urbanisation and increased economic level, featured an increasing consumption of white bread, dairy products, sugars, added fats and fruits and decreasing consumption of oils, grains, legumes and vegetables; regarding nutrients this modern diet score featured a decreasing relationship with total fat and an increase of calcium intake, but with an increase of energy, sugars and saturated fat, while vitamin C, potassium and fibre decreased. Adjusted for age, energy and physical activity, this modern pattern was associated with increased overweight in males (2nd vs. 1st tertile: Prevalence Odds-Ratio (POR) = 4.0[1.7-9.3], 3rd vs. 1st: POR = 3.3[1.3-8.7]) and a higher WC. Adjusting also for BMI and WC, among females, it was associated with decreased prevalence of high blood pressure (2nd vs. 1st tertile: POR = 0.5[0.3-0.8], 3rd vs. 1st tertile: POR = 0.4[0.2-0.8]).

CONCLUSION

The dietary intake contrasts among Tunisian adolescents, linked to socio-economic differentials are characteristic of a nutrition transition situation. The observed gradient of modernisation of dietary intake features associations with several nutrients involving a higher risk of chronic diseases but might have not only negative characteristics regarding health outcomes.

The influence of dietary patterns on the nutritional profile in a korean child cohort study

Objectives

The aim of the present study was to identify the major dietary patterns of seven- and eight-year-old Korean children and to examine the relationship between dietary patterns and obesity, nutrient intake, and diet quality.

Methods

The subjects were 284 seven- and eight-year-old children who participated in the Gwacheon child cohort study. Three dietary patterns emerged from the factor analysis: Korean, modified Western, and Western. Cluster analysis was used to classify the subjects into two dietary groups: Korean and Western diet patterns.

Results

The two different dietary patterns were closely related to dietary quality which in turn was related to health risks. The Western diet group had a lower fiber intake, a higher intake of energy, fat and calcium and a higher dietary diversity score (DDS) than the Korean diet group. The number of days when fruit, milk and dairy products were omitted from the diet was higher for the Korean diet group than for the Western group.

Conclusions

Dietary patterns and related diet quality should be considered when designing nutrition policy and intervention programs for children.

Padrões alimentares de adolescentes obesos e diferentes repercussões metabólicas

OBJETIVO: Avaliar a associação de padrões alimentares com alterações metabólicas em adolescentes obesos. MÉTODOS: Estudo transversal envolvendo 76 estudantes (ambos os sexos, 14-19 anos, IMC³P95 e Tanner ³4) de escolas públicas da cidade de São Paulo, Brasil. Foram coletados dados antropométricos e bioquímicos, e aplicados questionários com informações sociodemográficas e registro alimentar de 4 dias, entre 2006 e 2007. Escores fatoriais foram obtidos na análise fatorial e, após ajustes, três padrões alimentares identificados foram associados a fatores de risco biológico por regressão linear múltipla. RESULTADOS: O padrão Tradicional (arroz e massas, feijões, carnes vermelhas, embutidos, óleos e doces) foi positivamente associado com insulina, glicemia e triglicérides e negativamente associado com lipoproteína de alta densidade. O padrão Em Transição (peixe, aves, ovos, pães, manteiga, leite e derivados, hortaliças, frutas, sucos de frutas e açúcar refinado) apresentou as mesmas associações, além de associação similar com a pressão arterial diastólica. O padrão Fast Food (cafeteria, hambúrguer, maionese, bolacha, bolos e tortas, chocolate e refrigerantes) apresentou associação positiva com o colesterol, lipoproteína de baixa densidade e pressão arterial sistólica e diastólica, e associação negativa com insulina e lipoproteína de alta densidade. CONCLUSÃO: Os padrões Tradicional e Em transição apresentaram associações diferentes com o metabolismo lipídico e glicídico quando comparados com o padrão Fast Food. Os três padrões podem ser considerados obesogênicos, porém o padrão Fast Food pareceu ser o mais aterogênico e promotor de hipertensão arterial.

Dietary patterns in Mexican adults are associated with risk of being overweight or obese

Our objective was to identify and describe the major dietary patterns in the Mexican adult population and their association with being overweight or obese. Dietary intake was evaluated by a FFQ that was completed by 15,890 Mexican adults who participated in the National Health and Nutrition Survey 2006. Dietary patterns were generated by cluster analysis based on the percent contribution to total energy intake from 30 food groups. We identified 3 major dietary patterns: refined foods and sweets (RS), traditional (T), and diverse (D). The T pattern was characterized by low dietary diversity, with maize and maize foods accounting for ~47% of energy intake. This pattern had the lowest contribution of most food groups, with the exception of beans (~4.0%). The RS pattern had the highest contribution of alcohol (9.4%), soft drinks (9.4%), white bread (7.7%), fast food, sweets, and snacks. The D pattern had the lowest contribution of maize (15.5%) and the highest contribution of whole-fat dairy (8.0%), rice and pasta, meat, poultry, eggs, saturated fat, fruits, and vegetables. After adjusting for age, gender, physical activity, socioeconomic status, area, and region, the RS and D dietary patterns were associated with 14 and 17% increased risk of being overweight (P < 0.01) and 20% increased risk of being obese, respectively, compared with the T dietary pattern (P < 0.001). These findings support an association of dietary patterns with being overweight or obese in a nationally representative sample of Mexican adults.

Secular trends in dietary patterns and obesity-related risk factors in Korean adolescents aged 10-19 years

BACKGROUND

Along with its rapid economic growth, Korea has been undergoing considerable changes in the diet. But the influence of these changes on nutrition and health profiles has scarcely been investigated.

OBJECTIVE

We explored secular trends in dietary patterns to clarify their influence on obesity and its related risk factors among Korean adolescents using data from three consecutive Korean Nutrition Health and Nutrition Examination Survey (KNHANES).

DESIGN

Using data from the three KNHANES, 4347 adolescents (1572 from 1998, 1484 from 2001, and 1291 from 2005), who completed a 24-h diet recall, were included in the analysis. Percentiles of BMI were used to determine obesity; abdominal obesity was identified by waist circumference; and serum triglycerides and HDL-cholesterol = high density lipoproteins (HDL)-cholesterol were measured for obesity-related risk factors.

RESULTS

We identified evident three dietary patterns: 'traditional' (45.8% of total population), 'modified' (19%), and 'western' (35.2%). Secular trends were observed in dietary patterns, with a decline in the traditional diet pattern and gradual increases in the modified and western patterns. The percent of energy from fat increased over time, and it was positively associated with abdominal obesity in boys. The western dietary pattern increased the risk of being overweight (P = 0.05) and having elevated serum triglycerides (P = 0.07) in boys.

CONCLUSIONS

Gradual changes over time in dietary patterns are occurring in Korean adolescents. The emerging western dietary pattern and high-fat intake could negatively affect the adolescent population studied here in later life; therefore, appropriate monitoring is suggested.

Dietary patterns associated with hypertension among Korean males

The objectives of this study were to identify the dietary patterns associated with hypertension among Korean males. Data from the 2001 Korean National Health and Nutrition Survey of 1,869 men aged 20-65 years were used for the analysis. As an initial analysis, a factor analysis was applied to identify major dietary patterns among the subjects. Then logistic regression analysis was conducted to identify the pattern related with hypertension. As a result of the initial analysis, three major dietary patterns were identified. Dietary pattern 1 (traditional) was heavily loaded with vegetables, fish and cereal. Dietary pattern 2 (Western) was loaded with fast foods, bread, meats and dairy products. Dietary pattern 3 (Drinker) was loaded with mostly pork, beer and soju (Korean liquor). From the second stage of the analysis, there was a tendency of positive association between traditional patterns and hypertension risks. However, the tendency did not meet statistical significance level (p<0.05). In summary, unlikely findings from European and American studies, vegetables rich traditional dietary patterns did not show any protective effect on hypertension in Korean males. The Korean dietary practice, which is consuming salted vegetables instead of fresh vegetables, might have played a role in these findings. However, the full explanation of the findings remained to be answered with further investigation since none of the dietary patterns identified showed any statistical significance.

Major patterns of dietary intake in adolescents and their stability over time

A diet-patterns approach has often been used to describe eating patterns in adults but has rarely been used in adolescents. We used principal components factor analysis to: 1) describe the dietary patterns of a cohort of ethnically diverse youth during early and middle adolescence; 2) examine if the patterns persisted 5 y later; and 3) study secular trends. Project EAT-I (Time 1) collected data on 4746 middle school (younger cohort) and high school (older cohort) students in 31 Minnesota schools in 1998-1999. Project EAT-II (Time 2) resurveyed 53% (n = 2516) of the original cohort in 2003-2004. Dietary intake was assessed at Time 1 and 2 using the Youth/Adolescent FFQ. We identified dietary patterns separately by cohort (older/younger) and gender (boys/girls). At Time 1, we identified 4 patterns in early and middle adolescents that were relatively consistent between boys and girls that we labeled vegetable, fruit, sweet/salty snack food, and starchy food. Longitudinal analyses indicated that patterns were relatively stable over 5 y, with the exception of a new fast food pattern. Examination of age-matched secular trends in middle adolescents (older cohort at Time 1, younger cohort at Time 2) showed similar patterns, with the exception of the fast food pattern that emerged at Time 2 among middle adolescent boys. We identified dietary patterns in this adolescent population that differed from those usually found in adults. Patterns were similar across gender and age cohorts and were relatively similar over time, with the exception a new fast food pattern.

Dietary patterns of adolescents and risk of obesity and hypertension

Increasingly, measures of dietary patterns have been used to capture the complex nature of dietary intake and investigate its association with health. Certain dietary patterns may be important in the prevention of chronic disease; however, there are few investigations in adolescents. The aim of this study was to describe the dietary patterns of adolescents and their associations with sociodemographic factors, nutrient intakes, and behavioral and health outcomes. Analysis was conducted using data collected in the 1995 Australian National Nutrition Survey of participants aged 12-18 y who completed a 108-item FFQ (n = 764). Dietary patterns were identified using factor analysis and associations with sociodemographic factors and behavioral and health outcomes investigated. Factor analysis revealed 3 dietary patterns labeled a fruit, salad, cereals, and fish pattern; a high fat and sugar pattern; and a vegetables pattern, which explained 11.9, 5.9, and 3.9% of the variation in food intakes, respectively. The high fat and sugar pattern was positively associated with being male (P < 0.001), the vegetables pattern was positively associated with rural region of residence (P = 0.004), and the fruit, salad, cereals, and fish pattern was inversely associated with age (P = 0.03). Dietary patterns were not associated with socioeconomic indicators. The fruit, salad, cereals, and fish pattern was inversely associated with diastolic blood pressure (P = 0.0025) after adjustment for age, sex, and physical activity in adolescents > or = 16 y. This study suggests that specific dietary patterns are already evident in adolescence and a dietary pattern rich in fruit, salad, cereals, and fish pattern may be associated with diastolic blood pressure in older adolescents.

Dietary patterns of urban adults in Benin: relationship with overall diet quality and socio-demographic characteristics

OBJECTIVES

To identify dietary patterns of urban Beninese adults and explore their links with overall diet quality and socio-demographics.

SUBJECTS AND METHODS

A sample of 200 men and women aged 25-60 years was randomly selected in 10 neighbourhoods. Food intake was assessed through three non-consecutive 24 h food recalls. Dietary patterns were examined using cluster analysis. Diet quality was assessed based on diversity, a micronutrient adequacy score (MAS) and a healthfulness score (HS). Socio-demographics were documented using a questionnaire.

RESULTS

Two distinct dietary patterns emerged: a 'traditional' type (66% of the subjects) and a 'transitional' type (34%). Subjects with a 'transitional diet' were predominantly from the upper socioeconomic status or born in the city. Compared with the traditional type, the 'transitional diet' had a significantly higher percentage of energy from fat (17.6 vs 15.5%), saturated fat (5.9 vs 5.2%) and sugar (6.3 vs 5.0%). It was also significantly higher in cholesterol and lower in fibre. The 'transitional diet' was more diversified, but it also showed a lower HS than the 'traditional diet'. Mean intake of fruit was low in both clusters (<16 g day(-1)). A higher intake of vegetables was associated with both a higher MAS (P<0.001) and a higher HS (P<0.001).

CONCLUSIONS

The dietary transition is evidenced in this study, although both dietary patterns were still low in fat and sugar. Programmes focusing on the prevention of diet-related chronic diseases in this population should encourage the maintenance of the healthful elements of the diets, while emphasizing consumption of fruits and vegetables.