Carbohydrate Intake Exhibited a Positive Association with the Risk of Metabolic Syndrome in Both Semi-Quantitative Food Frequency Questionnaires and 24-Hour Recall in Women

National Nutrition Surveys Applying Dietary Records or 24-h Dietary Recalls with Questionnaires: A Scoping Review

Development of an accurate and efficient dietary method is required for national nutrition surveys. Some countries conduct dietary surveys and combine 24-h dietary records or 24-h dietary recalls with dietary questionnaires. This scoping review aimed to summarize studies that used results from national surveys that combined detailed dietary surveys (dietary records or 24-h dietary recall) and dietary questionnaires and identify the purpose of combining the two methods. The PubMed database and manual searches were used for the literature review. We extracted 58 articles from 16 national nutrition surveys from 14 countries. Most studies used 24-h dietary recall for detailed dietary surveys and the food frequency questionnaire (FFQ) or food propensity questionnaire (FPQ) for questionnaire surveys. Among 37 studies from eight countries, the purpose of combining the two dietary survey methods was to estimate energy and nutrient intakes from detailed dietary surveys and habitual food intake from questionnaires. These findings are useful as a reference when introducing new dietary survey methods in future national nutrition surveys.

Inverse Association of the Adequacy and Balance Scores in the Modified Healthy Eating Index with Type 2 Diabetes in Women

Type 2 diabetes (T2DM) has markedly increased among Asians as their diets and lifestyles become more westernized. We, therefore, investigated the hypothesis that the Korean healthy eating index (KHEI) scores are associated with gender-specific T2DM risk in adults. The hypothesis was tested using the data from the Korea National Health and Nutrition Examination Survey-VI (2013–2017) with a complex sample survey design. Along with the KHEI scores, the modified KHEI (MKHEI) scores for the Korean- (KSD) and Western-style diets (WSD) were used as independent parameters, calculated using a validated semi-quantitative food-frequency questionnaire (SQFFQ). We estimated the association between the KHEI or MKHEI and the T2DM risk using logistic regression after adjusting for T2DM-related covariates. The adults with T2DM were more frequently older men who were less educated, married, on a lower income, and living in rural areas compared to those without T2DM. Not only the fasting serum glucose concentrations but also the waist circumferences and serum triglyceride concentrations were much higher in adults with T2DM than in those without T2DM in both genders. Serum HDL concentrations in the non-T2DM subjects exhibited a greater inverse relationship to serum glucose than in the T2DM group in both genders. Twenty-four-hour recall data revealed that women, but not men, had higher calcium, vitamin C, saturated and monounsaturated fatty acids, retinol, and vitamin B2 intakes than the T2DM group. Furthermore, overall, the KHEI score and the adequacy and balance scores among its components were significantly higher in the non-T2DM group than in the T2DM group, but only in women. The KHEI scores were inversely associated with T2DM only in women. The mixed grain intake score was higher in the non-T2DM than the T2DM group only in men. However, there were no differences between the groups in the MKHEI scores for KSD and WSD. In conclusion, high KHEI scores in the adequacy and balance components might prevent and/or delay T2DM risk, but only in women.

Habitual- and Meal-Specific Carbohydrate Quality Index and Their Relation to Metabolic Syndrome in a Sample of Iranian Adults

Aim

Most studies on diet quality have focused on the habitual and overall intake of foods without considering intakes at specific eating occasions. This study aimed to assess the association between habitual- and meal-specific carbohydrate quality index (CQI) and metabolic syndrome (MetS) in Iranian adults.

Methods

In this cross-sectional study, data from 850 participants were analyzed. Dietary information was obtained from a 3-day nonconsecutive 24 h recall. CQI was calculated from three criteria: dietary fiber, glycemic index, and solid carbohydrate/total carbohydrate ratio. The association between CQI and MetS was assessed by logistic regression.

Results

The prevalences of MetS in the lowest and highest tertile of CQI were 30.1 and 33.7, respectively (P = 0.6). In habitual diet and all the three meals, we failed to find any significant association between tertiles of CQI and MetS either before or after adjustment for covariates. However, in the habitual meals [odds ratio (OR): 0.69, 95% CI: 0.47–0.96] and lunch meals (OR: 0.66; 95% CI: 0.47–0.94), the highest CQI in comparison to the lowest one, significantly decreased the low high-density lipoprotein (HDL). In addition, the trend of low-HDL with CQI in habitual meal and lunch meal was statistically significant.

Conclusion

The results of this study showed that CQI was not associated with MetS and its components. Further investigations into the mechanisms underlying the role of carbohydrate quality in developing metabolic disorders are warranted.

Household-specific physical activity levels and energy intakes according to the presence of metabolic syndrome in Korean young adults: Korean National Health and nutrition examination survey 2016-2018

BACKGROUND

Participation in exercise, and dietary and nutritional intakes have an impact on the risk and prevalence of metabolic syndrome (MetS), but these effects may differ according to whether a person lives alone or in a multi-person household. We analyzed differences in physical activity (PA) levels and energy intake according to household-type and MetS presence among young adults, to investigate the relationships among these factors.

METHODS

Data of 3974 young adults (aged > 19 years and < 40 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016-2018). We analyzed PA levels (occupational and recreational PA, and transport) and energy intake (total, carbohydrate, protein, and fat).

RESULTS

Logistic regression data showed that low PA levels and higher energy intake were associated with MetS incidence and its components in young adults, after adjusting for body mass index, smoking, household-type, and sex. Overall, there was no significant difference in PA level between the MetS and non-MetS group. The total energy intake was higher in the MetS than in the non-MetS group (p <  0.05). These results were similar to those found in multi-person households. In single-person households, the MetS group had significantly lower PA levels (p <  0.01) and total energy intake (p <  0.05) than the non-MetS group.

CONCLUSIONS

We found significant association among low PA levels, high energy intake, and MetS components in young Korean adults, but with patterns differing according to household type. Energy intake was higher in young adults with than those without MetS, who lived in multi-person households, while young adults with MetS who lived alone had lower PA levels and lower energy intake than those without MetS. These findings highlight the need for different approaches of implementing PA and nutrition strategies according to the type of household in order to prevent MetS.

Vitamin C and Metabolic Syndrome: A Meta-Analysis of Observational Studies

Background: The association between vitamin C and metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. This meta-analysis was therefore employed to further investigate the above issue. Methods: The observational studies on the associations of dietary and circulating (serum and plasma) vitamin C levels with MetS were searched in the PubMed, Web of Science, and Embase database up to April 2021. The pooled relative risk (RR) of MetS for the highest vs. lowest dietary and circulating vitamin C levels and the standard mean difference (SMD) of dietary and circulating vitamin C levels for MetS vs. control subjects were calculated, respectively. Results: A total of 28 observational studies were identified in this meta-analysis. Specifically, 23 studies were related to the dietary vitamin C level. The overall multivariable-adjusted RR demonstrated that the dietary vitamin C level was inversely associated with MetS (RR = 0.93, 95% CI: 0.88-0.97; P = 0.003). Moreover, the overall combined SMD showed that the dietary vitamin C level in MetS was lower than that in control subjects (SMD = -0.04, 95% CI: -0.08 to -0.01; P = 0.024). With regard to the circulating vitamin C level, 11 studies were included. The overall multivariable-adjusted RR demonstrated that the circulating vitamin C level was inversely associated with MetS (RR = 0.60, 95% CI: 0.49-0.74; P < 0.001). In addition, the overall combined SMD showed that the circulating vitamin C level in MetS was lower than that in control subjects (SMD=-0.82, 95%CI: -1.24 to -0.40; P < 0.001). Conclusions: Current evidence suggests that both dietary and circulating vitamin C level is inversely associated with MetS. However, due to the limitation of the available evidence, more well-designed prospective studies are still needed.

Hyperglycemia and Hypo-HDL-cholesterolemia Are Primary Risk Factors for Age-related Cataract, and a Korean-style Balanced Diet has a Negative Association, based on the Korean Genome and Epidemiology Study

BACKGROUND

The prevalence of cataracts is steadily increasing among the middle-aged and elderly worldwide. We hypothesized that adults aged > 50 years with age-related cataracts (ARCs) have an association with metabolic syndrome (MS) and its components, and MS has interactions with different dietary patterns and lifestyles that affect ARC risk. We examined the hypothesis using the Korean Genome and Epidemiology Study (KoGES; a large-scale hospital-based cohort study), which collected data between 2004-2013.

METHODS

Participants ≥ 50 years old were classified as cases (1,972 ARC patients) and controls (38,290 healthy controls) based on a diagnosis of cataract by a physician. MS and its components were defined using WHO definitions for Asians. Dietary consumption was evaluated using a validated semi-quantitative food frequency questionnaire (SQFFQ), which contained 106 foods, and dietary patterns were analyzed by principal component analysis. After adjusting for potential covariates, logistic regression was used to investigate associations between MS and its components and between dietary patterns and a positive cataract history.

RESULTS

ARC had a positive association with MS after 1.32-fold adjusting for age, sex, residence area, body mass index, and energy intake. Plasma glucose and HbA1c concentrations exhibited an increased ARC risk in the participants with MS by 1.50- and 1.92-fold and without MS by 1.35 and 1.88-fold, respectively. Serum high-density lipoprotein (HDL) concentrations were negatively associated with ARC risk only in the MS patients, but not without MS. However, blood pressure, abdominal obesity, and serum triglyceride concentrations did not associate with ARC risk regardless of MS. High intake of a Korean-balanced diet (KBD) containing fermented food exhibited a negative association with ARC risk (OR = 0.81) only in the MS group. The fat and coffee intake had a negative association with ARC only in the non-MS group. Current- and former-smokers were positively associated with ARC risk.

CONCLUSION

Persons who have hyperglycemia and low-HDL-cholesterolemia had increased susceptibility of ARC prevalence. A KBD with a proper amount of fat (≥ 15%) is recommended, and smoking should be prohibited.

A Healthy Diet Rich in Calcium and Vitamin C Is Inversely Associated with Metabolic Syndrome Risk in Korean Adults from the KNHANES 2013-2017

The association between metabolic syndrome and eating patterns remains unclear. We hypothesized that Korean Healthy Eating Index (KHEI) scores were related to metabolic syndrome (MetS) risk in adults in a gender-dependent manner. We aimed to examine the hypothesis using the Korea National Health and Nutrition Examination Survey-VI (2013-2017) data with a complex sample survey design. Adjusted means and 95% confidence intervals of KHEI scores and nutrient intake estimated by the 24-h recall were calculated according to MetS status after adjusting for age, residence area, region, education, obesity, income, drinking status, smoking status, marriage, and exercise. Adjusted odds ratios for MetS were measured according to KHEI quartiles using logistic regression analysis while controlling for covariates. MetS incidence was significantly higher in females than in males. Those who were older, less educated, earning less income, more obese, living in rural areas, drinking severely, non-exercising, and married had higher MetS incidence than those with the opposite state. Total KHEI scores of all components KHEI scores were lower for those with MetS (MetS group) than those without MetS (Non-MetS group) in both genders. For KHEI components, having breakfast and milk and fat intake had lower scores for the MetS group than for the Non-MetS group in women, whereas fruits and milk and milk product intake had lower scores for the MetS group in men. Nutrient intake influenced the MetS risk in females more than in males. Fat, calcium, and vitamin C intakes from 24-h recall were lower in the MetS group than in the Non-MetS group in women. KHEI scores had an inverse association with MetS risk by 0.98-fold in both genders after adjusting for covariates. In conclusion, a healthy diet that includes adequate calcium and vitamin C is associated with a lower the risk of MetS in both men and women.

Contribution of minimally processed and ultra-processed foods to the cardiometabolic risk of Brazilian young adults: a cross-sectional study

Introduction

Introduction: the simultaneous increase in the prevalence of cardiometabolic diseases and in the consumption of ultraprocessed foods (UPF) suggests a possible relationship between UPF and cardiometabolic risk (CMR). Objective: to evaluate the association between food consumption, according to the degree of processing, and CMR in young adults. Methods: this is a comparative cross-sectional study in 120 Brazilian young adults aged 18-25 years, categorized by the presence of CMR. Food consumption was investigated using a semi-quantitative food frequency questionnaire, and classified according to the extent of food processing. Food groups and tertiles in grams of unprocessed, minimally processed (MPF), processed and ultra-processed foods (UPF) were compared using the Kruskal-Wallis test. The associations of food consumption, according to level of processing (MPF and UPF), with CMR components were evaluated using logistic regression models. Results: a high caloric contribution of UPF was observed in the diet of this study population. The total energy intake from lipids in all foods (p = 0.04) and in UPF (p = 0.03) was greater in the group with CMR. A greater consumption of UPF was a risk factor for abdominal obesity (OR = 1.09; 95 % CI = 1.00-1.18) while a greater consumption of MPF was protective for LDL-c alterations independently of sex, physical activity, and alcohol intake (OR = 0.70; 95 % CI = 0.50-0.98). Conclusions: UPF contributed to a greater caloric intake from fat in the CMR, and was a risk factor for abdominal obesity. MPF was an independent protective factor for LDL-c alterations.

Dietary pattern and risk of endometrioma in Korean women: a case-control study

Objective

The aim of this study was to investigate and compare the dietary patterns of Korean women diagnosed with endometrioma or other benign ovarian cysts.

Methods

A total of 66 patients, comprising 39 patients who were surgically diagnosed with ovarian endometrioma and 27 control patients with other benign ovarian cysts, were included in this case-control study. Trained interviewers identified and interviewed the case patients and controls on the day before the laparoscopic ovarian surgery, using a semiquantitative food frequency questionnaire developed by the Ministry of Health and Welfare of Korea. Statistical analysis was performed using the Wilcoxon sum-rank test for continuous variables and the χ² test or Fisher’s exact test for categorical variables.

Results

The calcium intake from daily food consumption was significantly lower in patients with endometrioma than in those with other benign ovarian cysts. The dietary intakes of vitamin D, iron, and zinc were also relatively lower in patients with endometrioma than in patients with other benign ovarian cysts, although they did not reach the statistical significance threshold.

Conclusion

The risk of endometrioma is significantly associated with a lower dietary intake of calcium. Future studies including a larger number of patients on a nationwide scale are urgently required for further clarification.

Development, validation and utilisation of dish-based dietary assessment tools: a scoping review

Objective:

To summarise the existing evidence of development, validation and current status of utilisation of dish-based dietary assessment tools.

Design:

Scoping review.

Setting:

Systematic search using PubMed and Web of Science.

Results:

We identified twelve tools from seventy-four eligible publications. They were developed for Koreans (n 4), Bangladeshis (n 2), Iranians (n 1), Indians/Malays/Chinese (n 1), Japanese (n 3) and Chinese Americans (n 1). Most tools (10/12) were composed of a dish-based FFQ. Although the development process of a dish list varied among the tools, six studies classified mixed dishes based on the similarity of their characteristics such as food ingredients and cooking methods. Tools were validated against self-reported dietary information (n 9) and concentration biomarkers (n 1). In the eight studies assessing the differences between the tool and a reference, the mean (or median) intake of energy significantly differed in five studies, and 26–83 % of nutrients significantly differed in eight studies. Correlation coefficients for energy ranged from 0·15 to 0·87 across the thirteen studies, and the median correlation coefficients for nutrients ranged from 0·12 to 0·77. Dish-based dietary assessment tools were used in fifty-nine studies mainly to assess diet–disease relationships in target populations.

Conclusions:

Dish-based dietary assessment tools have exclusively been developed and used for Asian-origin populations. Further validation studies, particularly biomarker-based studies, are needed to assess the applicability of tools.

Hubungan Magnesium Serum Dengan Kadar Glukosa Darah Pada Dewasa Overweight Dan Obesitas

Background:Fat deposits in obesity can trigger oxidative stress and systemic inflammation that cause insulin resistance, which increases the risk of diabetes mellitus. Magnesium is a cofactor of various enzymes in glucose metabolism that plays a role in the process of glucose uptake in the muscles and also acts as an anti-inflammatory. Good intake of nutrients can prevent the metabolic diseases.Objectives:to evaluate the correlation among serum magnesium,energy, macro nutrient and magnesium intake with fasting blood glucose levels in overweight and obese adults.Methods: A cross-sectional study was conducted on 93 overweight(BMI ≥ 25-29.9 kg/m2) and obese (BMI ≥30 kg/m2) adults in February to May 2019 in Serengan District, Surakarta City. The measurement of serum magnesium using kalorimetri and fasting blood glucose using hexokinase method. Energy, macro nutritionand magnesium intake was assessed using 2x24 hour food recall. The bivariate analysis was carried out using Pearson correlation with p value of <0.05 followed by multivariable multiple linear regression analysis with 95% CI.Results:There was no significant correlation of energy, macro nutrient and magnesium intake with blood glucose level. There was a significant negative correlation between serum magnesium and fasting blood glucose in overweight and obese adults (p=0.009; r=-0.286; CI95%=-71.321–(-10.480)).Conclusions: Serum magnesium are the factors most associated with blood glucose in overweight and obese adults. Blood glucose will increase along with decreasing level of serum magnesium.ABSTRAKLatar Belakang: Timbunan lemak pada obesitas menjadi pemicu terjadinya stress oksidatif dan inflamasi sitemik penyebab resistensi insulin sehingga risiko terjadinya diabetes mellitus akan meningkat. Magnesium merupakan kofaktor berbagai enzim dalam metabolisme glukosa yang berperan dalam proses ambilan glukosa di otot dan juga sebagai antiinflamasi. Asupan zat gizi yang baik dapat mencegah terjadinya penyakit metabolik.Tujuan: untuk mengevaluasi hubungan magnesium serum, asupan energi, zat gizi makro dan magnesium dengan glukosa darah puasa pada dewasa overweight dan obesitas.Metode: Penelitian crossectional terhadap 93 orang dewasa dengan status gizi lebih atau overweight (IMT ≥ 25-29,9 kg/m2) dan obesitas (IMT ≥30 kg/m2) pada bulan Februari hingga Mei 2019 di Kecamatan Serengan Kota Surakarta. Pemeriksaan magnesium serum dengan metode kalorimetri dan glukosa darah puasa dengan metode heksokinase. Penilaian asupan energi, zat gizi makro dan magnesium dengan food recall 2x24 jam. Analisis bivariat menggunakan korelasi Pearson dengan nilai p < 0,05 dilanjutkan analisis multivariabel regresi linier ganda dengan CI 95%.Hasil: Tidak ada korelasi signifikan asupan energi, zat gizi makro dan magnesium dengan glukosa darah. Adanya korelasi negatif yang signifikan antara kadar serum magnesium dengan glukosa darah puasa pada dewasa overweight dan obesitas (p=0,009; r=-0,286; CI95%=-71,321–(-10,480)).Kesimpulan: Kadar magnesium serum merupakan faktor yang paling berhubungan dengan glukosa darah pada orang dewasa overweight dan obesitas di Kecamatan Serengan Kota Surakarta. Glukosa darah akan meningkat seiring dengan penurunan kadar magnesium serum.

Carbohydrate intake and risk of metabolic syndrome: A dose-response meta-analysis of observational studies

BACKGROUND AND AIMS

Epidemiological association studies have reported inconsistent findings on the relationship between carbohydrate intake and risk of metabolic syndrome (MetS). Therefore, we aimed to conduct the first dose-response meta-analysis to investigate this effect.

METHODS AND RESULTS

A systematic search in PubMed and Web of Science databases from their inception to June 01, 2019, together with relevant literature scrutiny, was performed to identify related studies for inclusion into the meta-analysis. We calculated the odds ratios (ORs) with 95% confidence intervals (CIs) using a random effects model. Furthermore, subgroup, sensitivity, heterogeneity, and publication bias analyses were performed. This meta-analysis included 14 cross-sectional and four cohort studies, totaling 284,638 participants and 69,554 MetS cases. The highest versus the lowest carbohydrate intake values were associated with an increased risk of MetS (OR: 1.253, 95% CI: 1.147-1.368), with moderate heterogeneity (I² = 54.5%). Using dose-response analysis, we found a linear association between carbohydrate consumption and MetS risk with a corresponding OR of 1.026 (95% CI, 1.004-1.048) and with significant heterogeneity (I² = 82.0%) at 5% energy intake from carbohydrates. We have found similar results using subgroup analyses for major study characteristics and adjustment for confounders. Sensitivity analysis further enhanced the robustness of the results, and no publication bias was detected.

CONCLUSION

Carbohydrate intake is associated with an increased risk of developing MetS. Therefore, additional large prospective cohort studies are warranted to confirm our findings.

Association between Diabetes and the Use of Removable Dental Prostheses among the Korean Population

BACKGROUND

A balanced nutrient intake is important for patients with diabetes. Even if individuals have the same number of residual natural teeth, there are large differences in the masticatory performance between edentulous sites restored with a fixed dental prosthesis, including dental implants, and those restored with a removable dental prosthesis. This study assessed whether the prevalence and control of diabetes differed based on the use of removable dental prostheses through an analysis of nationally representative data.

METHODS

Overall, 8,155 individuals (3,525 men and 4,630 women) aged ≥ 50 years were included in this study and were classified into the following 3 groups: group 1, did not use any removable dental prostheses (NF); group 2, used removable partial dentures (RPD); and group 3, used removable complete dentures on at least 1 jaw (CD). The characterization of diabetic patients and glycemic control were analyzed and compared among groups. To determine the relationship between diabetes and the use of dental prostheses, multivariable logistic regression analysis was performed (P < 0.05).

RESULTS

The adjusted odds ratios and 95% confidence intervals for diabetes in men participants in groups NF, RPD, and CD were 1 (reference), 1.165 (0.878-1.544), and 1.491 (1.034-2.151), respectively, after adjusting for confounding factors. Diabetes and glycemic control were significantly associated with the use of removable dental prostheses among men.

CONCLUSION

The use of removable dental prostheses is a potential risk indicator for uncontrolled diabetes in Korean men adults, suggesting the need for a comprehensive approach to minimize the complications of diabetes mellitus.

The Effect of Coffee Consumption on the Prevalence of Diabetes Mellitus: The 2012-2016 Korea National Health and Nutrition Examination Survey

An inverse association between coffee consumption and the risk of diabetes mellitus (DM) has been observed. However, little is known about this association in Koreans, although they are now among the top global consumers of coffee. Therefore, the aim of this study was to evaluate the association between the prevalence of DM and the amount of coffee consumption using a unit of exact measurement, regardless of the type of coffee consumed. This study was based on data acquired from the Korea National Health and Nutrition Examination Survey 2012–2016. The participants who completed the survey were included in the statistical analysis (n = 14,578). Subjects were stratified by age (19–39 years old: young adult; 40–64 years old: middle-aged adult) and gender (men, women). The amount of coffee was measured using a teaspoon (tsp) unit corresponding to 5 mL of powdered coffee and was analyzed as a continuous variable. The mean powdered coffee intake per day was 1.97 tsp in women groups, 2.24 tsp in young adult men, and 2.72 tsp in middle-aged men. The frequency of coffee consumption showed an inverse relationship with the amount of coffee intake at a time. With each 1-tsp increment in daily coffee intake, the odds of DM were 0.89 (95% confidence interval (CI): 0.86–0.92, p < 0.001) and 0.93 (95% CI: 0.90–0.95, p = 0.003) in middle-aged women and men, respectively. Coffee consumption was inversely correlated with the prevalence of DM even with adjustment for covariates in middle-aged adults. We delineated that the prevalence for DM decreased as coffee intake increased in Korean middle-aged adults. Therefore, our data represented an inverse association between coffee consumption and the prevalence of DM, although Koreans have a unique coffee-drinking habit.