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Alkhatib B, Agraib LM, Al-Dalaeen A, Al-Shami I. Are There Any Correlations between Vitamin D, Calcium, and Magnesium Intake and Coronary and Obesity Indices? JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024; 43:12-19. [PMID: 37159492 DOI: 10.1080/27697061.2023.2203225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE The association between nutrient intake and obesity and coronary problems has received great attention. So, this study aimed to examine the association between vitamin D, calcium, and magnesium intake and obesity and coronary indices. METHODS A total of 491 male and female university employees (18-64 years) were randomly included in a cross-sectional study. Blood samples were drawn, and the lipid profile was analyzed. Different anthropometrics were measured. Obesity and coronary indices were calculated based on standard formulas. A 24-h recall was used to measure the average dietary intake of vitamin D, calcium, and magnesium. RESULTS For the total sample, vitamin D had a significantly weak correlation with the abdominal volume index (AVI) and weight-adjusted waist index (WWI). However, calcium intake had a significant moderate correlation with the AVI and a weak correlation with the conicity index (CI), body roundness index (BRI), body adiposity index (BAI), WWI, lipid accumulation product (LAP), and atherogenic index of plasma (AIP). In males, there was a significant weak correlation between calcium and magnesium intake and the CI, BAI, AVI, WWI, and BRI. Additionally, magnesium intake had a weak correlation with the LAP. In female participants, calcium and magnesium intake had a weak correlation with CI, BAI, AIP, and WWI. Additionally, calcium intake showed a moderate correlation with the AVI and BRI and a weak correlation with the LAP. CONCLUSION Magnesium intake had the greatest impact on coronary indices. Calcium intake had the greatest impact on obesity indices. Vitamin D intake had minimal effects on obesity and coronary indices.
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Affiliation(s)
- Buthaina Alkhatib
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Science, The Hashemite University, Zarqa, Jordan
| | - Lana M Agraib
- Department of Food Science and Nutrition, Faculty of Agriculture, Jerash University, Jerash, Jordan
| | - Anfal Al-Dalaeen
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Medical Sciences, Applied Science Private University, Amman, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Science, The Hashemite University, Zarqa, Jordan
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Park J, Lee DK, Sharma A, Lee HJ. An eight-week randomized intervention study on Korean adults to evaluate the effect of milk intake on obesity. J Dairy Sci 2023; 106:8262-8271. [PMID: 37678767 DOI: 10.3168/jds.2022-23212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/07/2023] [Indexed: 09/09/2023]
Abstract
The anti-obesity effect of milk intake has been suggested via a variety of designed studies, but findings of obesity interventions for Korean adults are scarcely reported. The study aimed to investigate the anti-obesity effect of cow milk in Korean adults with an 8-wk randomized intervention. A total of 121 adults overweight aged 19 to 60 yr old were randomly assigned to 1 of the 2 groups: milk or control. During the intervention, both groups were encouraged 500 kcal of restriction a day, and the milk group consumed 200 mL of milk twice a day; the same energy intake as the control group, including milk intake, was recommended for 8 wk. We detected no significant differences in body weight (BW) and body mass index (BMI) between the milk and control groups during the 8-wk intervention, although the changes in BW and BMI of those within the milk group were significant. High-density lipoprotein cholesterol levels and serum calcium levels increased significantly in the milk group compared with the control group. Calcium, phosphorus, vitamin A, and riboflavin intakes increased significantly, when compared with the control. In conclusion, 8-wk milk consumption had no effect on weight loss and BMI change but improved some blood biomarkers and nutrient intake in Korean adults who were overweight. To evaluate the effect of milk on obesity reduction, well-designed, long-term, and large-scale studies are needed.
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Affiliation(s)
- Junghyun Park
- Institute for Aging and Clinical Nutrition Research, Gachon University, Gyeonggi-do 13120, South Korea
| | - Do-Kyung Lee
- Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon 21999, South Korea
| | - Anshul Sharma
- College of Bionanotechnology, Department of Food and Nutrition, Gachon University, 13120, South Korea.
| | - Hae-Jeung Lee
- Institute for Aging and Clinical Nutrition Research, Gachon University, Gyeonggi-do 13120, South Korea; Department of Health Sciences and Technology, GAIHST, Gachon University, Incheon 21999, South Korea; College of Bionanotechnology, Department of Food and Nutrition, Gachon University, 13120, South Korea.
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Yang S, Bhargava N, O'Connor A, Gibney ER, Feeney EL. Dairy consumption in adults in China: a systematic review. BMC Nutr 2023; 9:116. [PMID: 37865793 PMCID: PMC10590529 DOI: 10.1186/s40795-023-00781-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/12/2023] [Indexed: 10/23/2023] Open
Abstract
BACKGROUND Research on dairy consumption in China is lacking, however, some evidence has demonstrated significant changes in recent years, with a reported increase in the overall consumption of dairy products. To fully understand these changes, a systematic review was conducted to examine reported dairy intakes and differences between dairy consumption in different population groups in China. METHODS Web of Science, Embase, and PubMed databases were searched for studies published from January 2000 to September 2022. The China National Knowledge Infrastructure (CNKI) was used to retrieve papers available in Chinese. Papers reporting dietary intakes of dairy consumption across age, sex, and geographical location sub-groups were considered for inclusion in this review. In addition, this review includes the consumption of different types of dairy foods and changes in dairy intake over time. RESULTS Forty-seven papers were included in the present study. Twelve papers examined dairy consumption across age groups, showing that middle-aged adults tend to consume less dairy than other age groups. Studies comparing across location-specific cohorts reported dairy intakes among urban populations were higher than rural, as well as being higher than the national average. Coastal, Northern and Eastern residents consumed more dairy products than those living in other regions of China, and people in larger cities had higher reported intakes than smaller cities. Milk was the primary dairy product reportedly consumed by Chinese population, followed by yogurt. Concerning sex, evidence showed that females generally reported a greater daily dairy intake than males. CONCLUSIONS This review shows that, in China, several different population groups displayed significant differences in the amount and type of dairy consumed. When considering the incorporation of dairy products into healthy eating guidelines or positioning specific dairy products on the market, it is important to consider the differences and variations in consumption patterns within population groups.
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Affiliation(s)
- Shuhua Yang
- Food for Health Ireland, University College Dublin, Dublin 4, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin 4, Republic of Ireland
- School of Agriculture and Food Science, University College Dublin, Dublin 4, Republic of Ireland
| | - Nupur Bhargava
- Food for Health Ireland, University College Dublin, Dublin 4, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin 4, Republic of Ireland
| | - Aileen O'Connor
- Food for Health Ireland, University College Dublin, Dublin 4, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin 4, Republic of Ireland
| | - Eileen R Gibney
- Food for Health Ireland, University College Dublin, Dublin 4, Republic of Ireland
- Institute of Food and Health, University College Dublin, Dublin 4, Republic of Ireland
- School of Agriculture and Food Science, University College Dublin, Dublin 4, Republic of Ireland
| | - Emma L Feeney
- Food for Health Ireland, University College Dublin, Dublin 4, Republic of Ireland.
- Institute of Food and Health, University College Dublin, Dublin 4, Republic of Ireland.
- School of Agriculture and Food Science, University College Dublin, Dublin 4, Republic of Ireland.
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Lee KW, Kang MS, Lee SJ, Kim HR, Jang KA, Shin D. Prospective Associations between Dietary Patterns and Abdominal Obesity in Middle-Aged and Older Korean Adults. Foods 2023; 12:foods12112148. [PMID: 37297392 DOI: 10.3390/foods12112148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023] Open
Abstract
This study aimed to identify major dietary patterns associated with abdominal obesity in middle-aged and older Korean adults. Data from the Korean Genome and Epidemiology Study were used. A total of 48,037 Korean adults aged ≥40 years without abdominal obesity at baseline were followed-up. Dietary assessment was conducted using a validated 106-item food-frequency questionnaire, and dietary patterns were identified using factor analysis. Abdominal obesity was defined as a waist circumference of ≥90 cm for men and ≥85 cm for women, according to the Korean Society for the Study of Obesity. Multivariable Cox proportional-hazards models were used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the future risk of abdominal obesity for each dietary pattern after adjusting for potential covariates. After an average follow-up of 4.89 years, we reported 5878 cases (1932 men and 3946 women) of abdominal obesity. Based on factor analysis, three major dietary patterns were identified in both men and women: the "healthy", "coffee and sweets", and "multi-grain" patterns. In the fully adjusted model, the "healthy" pattern was inversely associated with the incidence of abdominal obesity (HR for fourth vs. first quartile: 0.86; 95% CI: 0.75-0.98; p for trend = 0.0358 for men; HR for fourth vs. first quartile: 0.90; 95% CI: 0.83-0.99; p for trend = 0.0188 for women), whereas the "coffee and sweets" pattern was positively associated with it (HR for fourth vs. first quartile: 1.23; 95% CI: 1.08-1.40; p for trend = 0.0495 for men; HR for fourth vs. first quartile: 1.14; 95% CI: 1.04-1.25; p for trend = 0.0096 for women). In contrast, the "multi-grain" pattern in men and women showed no significant association with the incidence of abdominal obesity. Diets rich in colorful vegetables, seaweeds, mushrooms, tubers, fruits, soy products, and fish and low in coffee, sweets, and oils/fats might be favorable for reducing the future risk of abdominal obesity, particularly in middle-aged and older Korean adults.
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Affiliation(s)
- Kyung Won Lee
- Department of Home Economics Education, Korea National University of Education, Cheongju 28173, Republic of Korea
| | - Min-Sook Kang
- Department of Agro-Food Resources, National Institute of Agricultural Sciences, Rural Development Administration, Wanju 55365, Republic of Korea
| | - Seung Jae Lee
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Haeng-Ran Kim
- Department of Agro-Food Resources, National Institute of Agricultural Sciences, Rural Development Administration, Wanju 55365, Republic of Korea
| | - Kyeong-A Jang
- Department of Agro-Food Resources, National Institute of Agricultural Sciences, Rural Development Administration, Wanju 55365, Republic of Korea
| | - Dayeon Shin
- Department of Food and Nutrition, Inha University, Incheon 22212, Republic of Korea
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Fateh HL, Muhammad SS, Kamari N. Associations between adherence to MIND diet and general obesity and lipid profile: A cross-sectional study. Front Nutr 2023; 10:1078961. [PMID: 37113290 PMCID: PMC10126273 DOI: 10.3389/fnut.2023.1078961] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
Background The term "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has recently been coined to describe a new eating pattern. Recent research is looking at how this food pattern affects chronic illnesses. Thus, this study aimed to investigate the association between the use and adherence to the MIND diet with general obesity and blood lipid profile. Methods In this cross-sectional study, 1,328 Kurdish adults between the ages of 39 and 53 had their dietary intake evaluated using a valid and reliable 168-item Food Frequency Questionnaire (FFQ). Adherence to the MIND diet was examined based on the components advised in this eating pattern. Each subject's lipid profiles and anthropometric measurements were documented. Results The mean age and BMI in the study population were 46.16 ± 7.87 year and 27.19 ± 4.60 kg/m2, respectively. The chances of having increased serum triglycerides (TG) were 42% lower in those in the third tertile of the MIND diet score compared to those in the first tertile (ORs: 0.58; 95% CI 0.38-0.95; P = 0.001). In the crude model and after adjusting for confounders, lowering high-density lipoprotein cholesterol (HDL-C) (ORs: 0.72; 95% CI 0.55-1.15; P = 0.001). Conclusion We found that greater adherence to the MIND diet was associated with the decrease odds of general obesity and lipid profile. Further study is essential owing to the relevance of chronic diseases like MetS and obesity in health status.
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Affiliation(s)
- Hawal Lateef Fateh
- Nursing Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Sarmad S. Muhammad
- Medical Laboratory Technology Department, Kalar Technical College, Sulaimani Polytechnic University, Sulaymaniyah, Iraq
| | - Negin Kamari
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
- *Correspondence: Negin Kamari,
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Abstract
Although a decrease in carbohydrate intake and an increase in fat intake among Koreans have been reported, investigations of changes in protein intake have been limited. Thus, this study aimed to explore trends in the dietary intake of total, plant and animal proteins overall and by socio-demographic subgroups in Korea over the past two decades. A total of 78 716 Korean adults aged ≥ 19 years who participated in the seven survey cycles of the Korea National Health and Nutrition Examination Survey 1998-2018 were included. Dietary protein intake, overall and by source, was calculated using a single 24-h dietary recall data. Changes in dietary protein over 20 years were estimated using multiple linear regression analysis after adjusting for potential covariates. For total protein intake, a significant decrease was reported from 1998 to 2016-2018 (P for trendlinearity < 0·001), whereas an increasing trend was observed from 2007-2009 to 2016-2018 (P for trendlinearity < 0·001). In terms of protein intake by source, plant protein intake decreased while animal protein intake increased over the past two decades, indicating steeper trends during the recent decade (P for trendlinearity < 0·001). These trends were more pronounced among younger adults and those with higher household income and education levels. These findings suggest that continuous monitoring of dietary protein intake overall and by source (plant v. animal) across socio-demographic group is needed.
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Lee J, Hoang T, Lee S, Kim J. Association Between Dietary Patterns and Dyslipidemia in Korean Women. Front Nutr 2022; 8:756257. [PMID: 35096924 PMCID: PMC8797145 DOI: 10.3389/fnut.2021.756257] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 12/20/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The prevalence of dyslipidemia among Korean women differs significantly according to menopausal status. This study aimed to identify major dietary patterns among Korean women and examine their associations with the prevalence of dyslipidemia and its components. Methods: This study recruited 6,166 women from the Cancer Screenee Cohort 2007–2019 from the National Cancer Center of Korea. Dietary patterns were identified using factor analysis. Multivariable logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between dietary patterns and the prevalence of dyslipidemia and its components, including hypercholesterolemia, hypertriglyceridemia, hypo-high-density lipoprotein (HDL) cholesterol, and hyper-low-density lipoprotein (LDL) cholesterol. Stratification analyses were performed for the premenopausal and postmenopausal subgroups. Results: The factor analysis identified three main dietary patterns, including traditional, western, and prudent dietary patterns. Compared with those with the lowest pattern scores, those with the highest pattern scores of the traditional (OR = 1.32, 95% CI = 1.05–1.67) and western (OR = 1.40, 95% CI = 1.11–1.78) diets had a higher prevalence of hyper-LDL cholesterol. When accounting for menopausal status in the analysis, traditional (OR = 1.44, 95% CI = 1.10–1.89) and western (OR = 1.43, 95% CI = 1.09–1.88) diets were still associated with hyper-LDL cholesterol in postmenopausal women. Additionally, consumption of a traditional diet was associated with a decreased prevalence of hypertriglyceridemia (OR = 0.73, 95% CI = 0.54–0.99), and consumption of a western diet was associated with an increased prevalence of hypercholesterolemia (OR = 1.41, 95% CI = 1.11–1.79) but a reduced prevalence of hypo-HDL cholesterol (OR = 0.60, 95% CI = 0.36–0.99). However, the prudent dietary pattern was not significantly associated with dyslipidemia and its components in the group of all women or the subgroups according to menopausal status. Conclusion: There were significant associations between the traditional and western dietary patterns and hyper-LDL cholesterol in the entire group and postmenopausal subgroup of women. In the perspective of energy restriction, our findings recommend women not to eat either traditional or western diets excessively or too frequently. Menopause may induce the effect of both the traditional diet on triglyceride reduction and the western diet on increasing total cholesterol.
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Is High Milk Intake Good for Children's Health? A National Population-Based Observational Cohort Study. Nutrients 2021; 13:nu13103494. [PMID: 34684495 PMCID: PMC8541527 DOI: 10.3390/nu13103494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 11/24/2022] Open
Abstract
Milk is widely considered as a beneficial product for growing children. This study was designed to describe the milk consumption status of Korean children aged 30–36 months and to investigate its association with the risk of obesity and iron deficiency anemia (IDA). This nationwide administrative study used data from the Korean national health insurance system and child health screening examinations for children born in 2008 and 2009. In total, 425,583 children were included, and they were divided into three groups based on daily milk consumption: low milk group (do not drink or drink <200 mL milk per day, n = 139,659), reference group (drink 200–499 mL milk per day, n = 255,670), and high milk group (drink ≥500 mL milk per day, n = 30,254). After adjusting variable confounding factors, the consumption of a large amount of milk of ≥500 mL per day at the age of 30–36 months was associated with an increased risk of obesity at the age of 42–72 months and IDA after the age of 30 months. These results may provide partial evidence for dietary guidelines for milk consumption in children that are conducive to health.
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Lee JH, Lee HS, Ahn SB, Kwon YJ. Dairy protein intake is inversely related to development of non-alcoholic fatty liver disease. Clin Nutr 2021; 40:5252-5260. [PMID: 34534894 DOI: 10.1016/j.clnu.2021.08.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and is closely related to metabolic dysfunction, including insulin resistance, obesity, and metabolic syndrome. Dairy protein, rich in casein and whey protein, could help to reduce metabolic diseases. Therefore, we investigated the relationship between dairy protein intake and incident NAFLD. METHODS We analyzed data for 5171 adults aged 40-69 years from the Korean Genome and Epidemiology Study.(KoGES) Participants were separated as men, women aged ≥50 years, and women aged <50 years and then divided into tertiles based on dairy protein intake. NAFLD was defined as NAFLD liver fat score >-0.640. Scores were calculated as 1.18 × metabolic syndrome (Yes: 1, No: 0) + 0.45 × diabetes mellitus (Yes: 2, No: 0) + 0.15 × serum insulin +0.04 × AST - 0.94 × (AST/ALT) - 2.89. Cox proportional hazards spline curves were drawn to visualize dose-response relationships between dairy protein intake and incident NAFLD. Multiple Cox hazard regression analysis was conducted to examine associations between dairy protein intake and incident NAFLD. RESULTS The Cox proportional hazards spline curves revealed a negative linear relationship between dairy protein intake and incident NAFLD. The cumulative incidence of NAFLD significantly decreased with increasing tertiles of dairy protein intake in men and women aged ≥50 years. After adjusting for confounding factors, the hazard ratios and 95% confidence intervals for NAFLD in the middle and highest tertiles, compared to the lowest tertile, were 0.80 (0.67-0.96) and 0.71 (0.57-0.88) in men, 0.89 (0.72-1.09) and 0.72 (0.56-0.92) in women aged ≥50 years, and 1.01 (0.80-1.27) and 0.91 (0.67-1.24) in women aged <50 years, respectively. CONCLUSIONS We found that higher dairy protein intake was significantly and inversely associated with the risk of incident NAFLD in men and women aged ≥50 years. Consumption of milk and other dairy products could help prevent the development of NAFLD.
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Affiliation(s)
- Jun-Hyuk Lee
- Department of Family Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, 01830, Republic of Korea.
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Department of Research Affairs, Yonsei University College of Medicine, Seoul, 06273, Republic of Korea.
| | - Sang Bong Ahn
- Department of Internal Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, 01830, Republic of Korea.
| | - Yu-Jin Kwon
- Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, 16995, Republic of Korea.
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Lee KW, Shin D. Comparison of Dietary Behaviors and the Prevalence of Metabolic Syndrome in Single- and Multi-Person Households among Korean Adults. Healthcare (Basel) 2021; 9:1116. [PMID: 34574889 PMCID: PMC8468171 DOI: 10.3390/healthcare9091116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 01/24/2023] Open
Abstract
Changes in household dynamics in Korea, such as the transition from multi- to single-person households, have led to changes in individuals' dietary behavior patterns and health status. Thus, this study aimed to compare dietary behaviors and determine the prevalence of metabolic syndrome (MetS) as well as explore factors associated with MetS according to household type among Korean adults. Using data from the Korea National Health and Nutrition Examination Survey 2014-2018, we included 21,944 Korean adults with available health examination and dietary recall data. Based on self-reported information, individuals were divided into two household types: single- and multi-person households. We used multivariable logistic regression to estimate the adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for MetS and its components after adjusting for potential covariates. Among the study population, 9.19% and 90.81% lived in single-person and multi-person households, respectively. Individuals in single-person households had a higher energy intake overall and a greater percentage of energy from animal protein; total, saturated, and monounsaturated fats; and animal source foods and a lower percentage of energy from carbohydrates, plant protein, and plant source foods than those from multi-person households (all, p < 0.05). Individuals living in single-person rather than multi-person households were more likely to consume milk/dairy products, alcoholic and non-alcoholic beverages, oils/fats, and others but were less likely to consume vegetables/mushrooms, fruits, seaweeds, and fish/shellfish (all, p < 0.05). Living alone was associated with higher energy intake from main meals and foods prepared away from home but a lower dietary variety score and fewer total main meals consumed (all, p < 0.05). Skipping breakfast, frequent eating out, food insecurity, and MetS combination phenotypes significantly differed by household type. Individuals living alone had higher odds of MetS (AOR: 1.14, 95% CI: 1.02-1.29), abdominal obesity (AOR: 1.14, 95% CI: 1.01-1.28), elevated blood pressure (AOR: 1.28, 95% CI: 1.12-1.47), and elevated fasting blood glucose (AOR: 1.18, 95% CI: 1.05-1.33) than those living with others. Compared with those in multi-person households, individuals in single-person households tend to have health and dietary behaviors that increase vulnerability to MetS; therefore, establishing health care strategies and nutrition policies according to household type is necessary.
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Affiliation(s)
- Kyung Won Lee
- Department of Home Economics Education, Korea National University of Education, Cheongju 28173, Korea;
| | - Dayeon Shin
- Department of Food and Nutrition, Inha University, Incheon 22212, Korea
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Jin S, Je Y. Dairy Consumption and Risk of Metabolic Syndrome in Korean Adults and Elderly People. Metab Syndr Relat Disord 2020; 19:272-280. [PMID: 33373535 DOI: 10.1089/met.2020.0122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background: To investigate the association of dairy consumption with metabolic syndrome (MetS) in a representative sample of Korean adult and elderly population. Methods: We used data from the Korea National Health and Nutrition Examination Survey, 2013-2018. A total of 18,206 adults (19-64 years) and 5113 elderly people (≥65 years) were included in the analysis. Dairy product consumption was assessed with a 24-hr dietary recall, and the subjects were divided into three groups based on their total dairy consumption (0, <1, ≥1 serving/day). The primary outcome, MetS, was defined according to the National Cholesterol Education Program Adult Treatment Panel III and the Korean Society for the Study of Obesity. Results: After adjusting for covariates, high dairy consumption was associated with 12% lower odds of MetS in adults compared with no dairy consumption [odds ratio (OR) 0.88, 95% confidence interval (CI) 0.78-0.998, P for trend = 0.048]. A similar inverse association was found in adult men (OR 0.84, 95% CI 0.71-0.99), but no significant association was found in adult women (OR 0.93, 95% CI 0.78-1.11). For the elderly, high dairy consumption was associated with 20% lower odds of MetS (OR 0.80, 95% CI 0.65-0.98, P for trend = 0.020); a significant inverse association was shown in elderly women (OR 0.72, 95% CI 0.56-0.94) but not in elderly men (OR 0.93, 95% CI 0.68-1.28). Conclusion: Our findings suggest that one or more servings/day of dairy products were associated with lower prevalence of MetS in Korean adult men and elderly women.
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Affiliation(s)
- Shaoyue Jin
- Department of Food and Nutrition, Kyung Hee University, Seoul, South Korea
| | - Youjin Je
- Department of Food and Nutrition, Kyung Hee University, Seoul, South Korea
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Association between dairy product intake and body composition among South Asian adults from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Br J Nutr 2020; 126:1100-1109. [PMID: 33308330 DOI: 10.1017/s0007114520005061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
South Asians, who are at a disproportionately greater risk of atherosclerotic CVD (ASCVD), represent a rapidly growing population in the USA. The relationship between dairy products, a major component of South Asian diets, and body composition - an established risk factor for ASCVD, is unclear. The aim of the present study was to examine associations between dairy intake and multiple measures of body composition (BMI, waist and hip circumference, waist:hip ratio, abdominal lean mass, subcutaneous, visceral, and intermuscular fat areas) among South Asian adults in the USA. A baseline analysis was conducted using existing data from the Mediators of Atherosclerosis in South Asians Living in America cohort. In women, the highest (>1·9 servings/d) v. lowest (<1 serving/d) tertile of dairy intake was associated with 53 % lower odds of a waist circumference >80 cm (95 % CI 0·25, 0·89, Pfor trend<0·05). No associations were observed between dairy intake and measures of body composition. However, >3 servings of low-fat yogurt/week was associated with a 9·9 cm2 lower visceral fat area (95 % CI -19·07, -0·72, P<0·05) and 2·3 cm2 lower intermuscular fat area (95 % CI -3·76, -0·79, P<0·05) as compared with those with three servings/week. Milk and cheese were not associated with body composition measures. These analyses suggest that higher consumption of low-fat yogurt is associated with lower visceral and intermuscular fat in the whole sample, and women with higher dairy intake have lower waist circumference. Our study supports dietary incorporation of dairy products, and recognises the utility of multidimensional measures of central adiposity.
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Kouvari M, Panagiotakos DB, Chrysohoou C, Georgousopoulou EN, Yannakoulia M, Tousoulis D, Pitsavos C. Dairy products, surrogate markers, and cardiovascular disease; a sex-specific analysis from the ATTICA prospective study. Nutr Metab Cardiovasc Dis 2020; 30:2194-2206. [PMID: 32988722 DOI: 10.1016/j.numecd.2020.07.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/20/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND AIMS Dairy products are a very diverse food group with multiple effects on the cardiac health of men and women. The aim of this work was to evaluate the sex-specific association between dairy products (total and subtypes) and 10-year first fatal/nonfatal cardiovascular disease (CVD) incidence. METHODS AND RESULTS In 2001-2002, n = 1514 men and n = 1528 women (>18 years old) from greater Athens area, Greece, were enrolled. Dietary assessment was based on a validated semi-quantitative food frequency questionnaire. Dairy product consumption was examined in relation to 10-year CVD incidence. Follow-up (2011-2012) was achieved in n = 2020 participants (n = 317 CVD cases). Ranking from lowest (<1 serving/day) to highest (>2 servings/day) total dairy intake, CVD incidence in men was 17.8%, 15.0%, and 10.9% (p = 0.41), while in women it was 14%, 6.0%, and 5.7% (p = 0.02). Multiadjusted analysis revealed that total dairy intake protected against CVD only in women [Hazard Ratio (HR) = 0.48 and 95% Confidence Interval (95% CI) (0.23, 0.90)], irrespective of the fat content. Further analysis revealed that only fermented products (yogurt and cheese), protected against CVD. For per 200 g/day yogurt consumption, CVD risk was 20%-30% lower with this claim being more evident in women, while for per 30 g/day cheese intake, about 5% lower risk was observed particularly in men. As for butter, nonsignificant associations were highlighted. These associations were mainly retained in the case of hepatic steatosis, insulin resistance, and systemic inflammation. CONCLUSIONS This work provides incentives for researchers to elucidate the diversity of ingredients and mechanisms through which dairy products exert their effect on cardiac health separately for men and women.
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Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; Faculty of Health, University of Canberra, Canberra, Australia.
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Ekavi N Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece; School of Medicine, The University of Notre Dame, Sydney, Australia; Medical School, Australian National University, Canberra, Australia
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
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Fahed M, Abou Jaoudeh MG, Merhi S, Mosleh JMB, Ghadieh R, Al Hayek S, El Hayek Fares JE. Evaluation of risk factors for insulin resistance: a cross sectional study among employees at a private university in Lebanon. BMC Endocr Disord 2020; 20:85. [PMID: 32522257 PMCID: PMC7288486 DOI: 10.1186/s12902-020-00558-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 05/25/2020] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Worldwide, the prevalence of insulin resistance ranges from 15.5 to 46.5%, among adults. Lebanon reported one of the highest rates reaching 44.6%. The literature suggests an association between dairy product consumption and insulin resistance, however results are inconclusive. To our knowledge, no study examined this association in the Middle Eastern Region. The aim of the study was to investigate the prevalence of insulin resistance among a sample of Lebanese adults, to identify its risk factors depending on gender, and to evaluate the association between insulin resistance and dairy products consumption. METHODS A cross-sectional study was conducted among employees at Notre Dame University - Louaize. Four questionnaires were administered including a background and International Physical Activity Questionnaire short form questionnaires, food frequency questionnaire and a 24 h recall. Bioelectric Impedance Analysis (BIA) was used to measure percent body fat (PBF). Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) was used to quantify insulin resistance. A person with HOMA-IR ≥ 2.5 was considered as insulin resistant. Statistical analyses were performed using the Statistical Package for Social Sciences version 23 for Windows. P < 0.05 was considered statistically significant. RESULTS Out of 286 study participants, 38.0% were insulin resistant. Average dairy product intake in the total sample was 2.2 ± 1.0 servings per day. Among males, the odds of having insulin resistance were 3.9 times higher (95%CI 1.4-11.0; p = 0.009) for those having a risky waist circumference compared to those having a healthy waist circumference. Among females, being married (OR: 0.2, 95%CI 0.1-0.5; p = 0.002), PBF (OR: 1.2, 95%CI 1.0-1.3; p = 0.008) and hypertriglyceridemia (OR: 8.7, 95%CI: 2.1-35.9; p = 0.003) were associated with HOMA-IR, after controlling for confounders. Dairy intake was not associated with HOMA-IR neither among males (p = 0.777), nor among females (p = 0.968), after controlling for confounders. CONCLUSION Dairy consumption was not associated with increased insulin resistance. More research focusing on the relationship between dairy intake and insulin resistance is needed, especially in the Arab and Middle-Eastern region. Future studies should examine the effect of different types of dairy products and the effect of different nutrients in dairy products on insulin resistance.
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Affiliation(s)
- Myriam Fahed
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
| | - Maya G. Abou Jaoudeh
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
| | - Samar Merhi
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
| | - Jocelyne Matar Bou Mosleh
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
| | - Rachelle Ghadieh
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
- Department of Endocrinology, Diabetes, Metabolism and Eating Disorders, University Hospital of Saint-Etienne, Saint-Etienne Cedex, France
| | - Sibelle Al Hayek
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
- Department of Dietetics and Nutrition, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160 USA
| | - Jessy E. El Hayek Fares
- Department of Nursing and Health Sciences, Notre Dame University- Louaize (NDU), Zouk Mosbeh, Lebanon
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Lee HA, An H, Lee E. Dietary patterns related to cardiovascular disease based on reduced rank regression analysis of healthy middle-aged Koreans: data from the community-based Korean Genome and Epidemiology Study (KoGES) cohort. Am J Clin Nutr 2020; 111:1159-1169. [PMID: 32338724 DOI: 10.1093/ajcn/nqaa078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 03/27/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Dietary patterns (DPs) provide a comprehensive picture of the foods consumed by an individual. OBJECTIVES Using 12-y follow-up data from the Korean Genome Epidemiology Study (KoGES), we determined the associations of DPs with incident cardiovascular disease (CVD) using reduced rank regression (RRR). METHODS This study analyzed the data of 7354 CVD-free subjects aged 40-69 y drawn from the community-based KoGES cohort. Based on the daily intake of 26 food groups at baseline, we identified DPs based on retinol, vitamin B-2 (riboflavin), and vitamin B-3 (niacin) intakes using RRR. The effects of the DPs on incident CVD were assessed using HRs with 95% CIs. Furthermore, using a marginal structural model, the association between DPs and incident CVD was evaluated after adjusting for time-varying confounders. RESULTS The incidence of CVD during the follow-up period was 3.7 per 1000 person-years (n = 274). The identified DP accounted for 28.99% of the variation in the response variables (i.e., the intake amounts of all 3 nutrients) and was characterized by high intakes of eggs, fish, milk, and dairy products. The effect of DP quintile on incident CVD differed by sex (Pinteraction = 0.03); the highest DP quintile was associated with a protective effect against the development of CVD in women (HR: 0.44; 95% CI: 0.22, 0.89), but not in men (HR: 1.57; 95% CI: 0.82, 3.00), compared with the lowest quintile. Even after adjusting for time-dependent variables, the effect of DP on incident CVD was significant in women (HR: 0.43; 95% CI: 0.22, 0.84), but not in men (HR: 1.49; 95% CI: 0.71, 3.10). CONCLUSIONS In this study, we identified DPs related to CVD, and a DP characterized by high intakes of eggs, fish, milk, and dairy products protected against incident CVD in women.
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Affiliation(s)
- Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Hyoin An
- Department of Statistics, Ewha Womans University, Seoul, Korea
| | - EunJin Lee
- Department of Statistics, Ewha Womans University, Seoul, Korea
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Jiang S, Ma X, Li M, Yan S, Zhao H, Pan Y, Wang C, Yao Y, Jin L, Li B. Association between dietary mineral nutrient intake, body mass index, and waist circumference in U.S. adults using quantile regression analysis NHANES 2007-2014. PeerJ 2020; 8:e9127. [PMID: 32411541 PMCID: PMC7204818 DOI: 10.7717/peerj.9127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 04/14/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Mineral nutrients play an important role in maintaining material and energy metabolism. Reports on mineral nutrient intakes and body mass index (BMI) and waist circumference (WC) are rare in the United States. This study examined the relationship between BMI, WC and dietary mineral intakes. METHOD We used the data from National Health and Nutrition Examination Survey 2007-2014. Nutrient intakes were adjusted for energy according to the residual adjustment method. We used the quantile regression model to analyze the relationship between BMI, WC under different distributions and the average daily mineral intakes. RESULT A total of 19,952 people were included in the study, including 9,879 men and 10,073 women (≥20 years old). The median BMI was 27.935 kg/m2 and the median WC was 97.700 cm. The results of quantile regression showed that calcium, magnesium, potassium, copper, zinc and iron intakes were negatively correlated with BMI and WC, after adjusting for age and gender. Sodium and phosphorus intakes were positively correlated with BMI, sodium intakes were positively correlated with WC. This correlation was enhanced with increasing quantiles of risk levels. In high BMI or high WC populations, mineral intakes had a greater impact on BMI and WC. The quantile regression coefficients of selenium intakes were not statistically significant at each quantile. CONCLUSION Our results suggested that the mineral nutrient intakes were associated with BMI and WC in American adults. However, we also need to further study the longitudinal effects of mineral intakes and obesity.
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Affiliation(s)
- Shan Jiang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Xiaoyu Ma
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Meng Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Shoumeng Yan
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Hantong Zhao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Yingan Pan
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Changcong Wang
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Yan Yao
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Lina Jin
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
| | - Bo Li
- Department of Epidemiology and Biostatistics, Jilin University School of Public Health, Changchun, Jilin, People’s Republic of China
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Aminianfar A, Hassanzadeh Keshteli A, Esmaillzadeh A, Adibi P. Association between adherence to MIND diet and general and abdominal obesity: a cross-sectional study. Nutr J 2020; 19:15. [PMID: 32066452 PMCID: PMC7026971 DOI: 10.1186/s12937-020-00531-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/11/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Recently, a new eating pattern called as "Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND)" has been coined. Emerging studies are examining this dietary pattern with chronic conditions. We aimed to investigate the association between the MIND diet score and general and central obesity among adults. METHODS This cross-sectional study was conducted in a framework of the Study on the Epidemiology of Psychological Alimentary Health and Nutrition (SEPAHAN). Dietary information was collected using a validated self-administered 106-item Willett-format dish-based semi-quantitative food frequency questionnaire (DS-FFQ) in 6724 adults. Adherence to the MIND diet was examined based on components suggested in this eating pattern. Anthropometrics data were collected using a validated self-reported questionnaire. General obesity was defined as body mass index ≥30 kg/m2, and abdominal obesity as waist circumference > 102 cm for men and > 88 cm for women. RESULTS Mean age, BMI and WC in the study population was 36.8 ± 8.08 y, 24.9 ± 3.8 kg/m2 and 83.7 ± 16.02 cm, respectively. Overall, 9.5% of subjects were generally obese and 24.4 were abdominally obese. Examining the whole study population, we found no significant association between the MIND diet score and odds of general obesity, either before (ORs for comparing T3 vs. T1: 1.03; 95% CI: 0.83, 1.27; P-trend = 0.74) or after controlling for potential confounders (ORs for T3 vs. T1: 0.91; 95% CI: 0.67, 1.25; P-trend = 0.58). This was also the case for men and women when analyzed separately. We also failed to find any significant association between the MIND diet score and odds of abdominal obesity after controlling for potential confounders in the whole study population (ORs for T3 vs. T1: 1.00, 95% CI: 0.79, 1.27; P-trend = 0.87). However, women with the greatest adherence to the MIND diet were 19% less likely to be abdominally obese than those with the lowest adherence in crude model (OR = 0.81; 95% CIs: 0.67, 0.98; P-trend = 0.03). This association disappeared after controlling for potential confounders (OR = 0.87; 95% CIs: 0.66, 1.14; P-trend = 0.55). CONCLUSION No significant association was observed between adherence to the MIND diet and odds of general and central obesity.
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Affiliation(s)
- Azadeh Aminianfar
- Students' scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Ammar Hassanzadeh Keshteli
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular -Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Kim J, Hoang T, Bu SY, Kim JM, Choi JH, Park E, Lee SM, Park E, Min JY, Lee IS, Youn SY. Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis. J Lipid Atheroscler 2020; 9:205-229. [PMID: 32821732 PMCID: PMC7379076 DOI: 10.12997/jla.2020.9.1.205] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Previous studies have separately reported the contributions of dietary factors to the risk of cardiovascular disease (CVD) and its markers, including blood pressure (BP) and lipid profile. This study systematically reviewed the current evidence on this issue in the Korean population. METHODS Sixty-two studies from PubMed and Embase were included in this meta-analysis. We performed a random-effects model to analyze pooled odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (CIs) for the consumption of 14 food items, three macro- and eight micro-nutrients, two dietary patterns, and three dietary indices. RESULTS An analysis of pooled effect sizes from at least four individual study populations showed significant associations between coffee consumption and CVD (OR/HR, 0.71; 95% CI, 0.52-0.97) and elevated/high triglycerides (TG) (OR, 0.84; 95% CI, 0.78-0.90), sugar-sweetened beverage intake and elevated BP (OR/HR, 1.20; 95% CI, 1.09-1.33), and milk and dairy intake and elevated/high TG and low high-density lipoprotein cholesterol (HDL-C) (OR/HR, 0.82; 95% CI, 0.76-0.89 for both). Carbohydrate consumption and the low-carbohydrate-diet score were consistently related to an approximately 25% risk reduction for elevated TG and low HDL-C. A lower risk of elevated total cholesterol, but not low-density lipoprotein, was additionally observed for those with a higher low-carbohydrate-diet score. A healthy dietary pattern was only associated with a reduced risk of elevated TG in the Korea National Cancer Screenee Cohort (OR, 0.81; 95% CI, 0.67-0.98). CONCLUSION This study showed that milk and dairy and coffee had protective effects for CVD and its risk factors, such as BP and lipid profile, while sugar-sweetened beverages exerted harmful effects.
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Affiliation(s)
- Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Korea
| | - Jeong-Hwa Choi
- Department of Food and Nutrition, Keimyung University, Daegu, Korea
| | - Eunju Park
- Department of Food and Nutrition, Kyungnam University, Changwon, Korea
| | - Seung-Min Lee
- Department of Food and Nutrition, Yonsei University, Seoul, Korea
| | - Eunmi Park
- Department of Food and Nutrition, Hannam University, Daejeon, Korea
| | - Ji Yeon Min
- Dietetics and Nutrition Services Team, Asan Medical Center, Seoul, Korea
| | - In Seok Lee
- Nutrition Support Team, Kyung Hee University Medical Center, Seoul, Korea
| | - So Young Youn
- Clinical Nutrition Part, Samsung Medical Center, Seoul, Korea
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Zhang F, Ye J, Zhu X, Wang L, Gao P, Shu G, Jiang Q, Wang S. Anti-Obesity Effects of Dietary Calcium: The Evidence and Possible Mechanisms. Int J Mol Sci 2019; 20:E3072. [PMID: 31234600 PMCID: PMC6627166 DOI: 10.3390/ijms20123072] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 02/07/2023] Open
Abstract
Obesity is a serious health challenge worldwide and is associated with various comorbidities, including dyslipidemia, type 2 diabetes, and cardiovascular disease. Developing effective strategies to prevent obesity is therefore of paramount importance. One potential strategy to reduce obesity is to consume calcium, which has been implicated to be involved in reducing body weight/fat. In this review, we compile the evidence for the anti-obesity roles of calcium in cells, animals, and humans. In addition, we summarize the possible anti-obesity mechanisms of calcium, including regulation of (a) adipogenesis, (b) fat metabolism, (c) adipocyte (precursor) proliferation and apoptosis, (d) thermogenesis, (e) fat absorption and excretion, and (f) gut microbiota. Although the exact anti-obesity roles of calcium in different subjects and how calcium induces the proposed anti-obesity mechanisms need to be further investigated, the current evidence demonstrates the anti-obesity effects of calcium and suggests the potential application of dietary calcium for prevention of obesity.
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Affiliation(s)
- Fenglin Zhang
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Jingjing Ye
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Xiaotong Zhu
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Lina Wang
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Ping Gao
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Gang Shu
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Qingyan Jiang
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
| | - Songbo Wang
- Guangdong Provincial Key Laboratory of Animal Nutrition Control, College of Animal Science, South China Agricultural University, Guangzhou 510642, China.
- National Engineering Research Center for Breeding Swine Industry and ALLTECH-SCAU Animal Nutrition Control Research Alliance, South China Agricultural University, Guangzhou 510642, China.
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Lee KW, Lyu J, Park JK, Jo C, Kim SS. Dietary carbohydrate quality and quantity in relation to the incidence of type 2 diabetes: A prospective cohort study of middle-aged and older Korean adults. Nutrition 2019; 57:245-251. [DOI: 10.1016/j.nut.2018.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/26/2018] [Accepted: 04/22/2018] [Indexed: 12/14/2022]
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Li H, Li X, Yuan S, Jin Y, Lu J. Nut consumption and risk of metabolic syndrome and overweight/obesity: a meta-analysis of prospective cohort studies and randomized trials. Nutr Metab (Lond) 2018; 15:46. [PMID: 29977320 PMCID: PMC6013998 DOI: 10.1186/s12986-018-0282-y] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/13/2018] [Indexed: 11/10/2022] Open
Abstract
Background Nut consumption has been shown to reduce the risk of cardiovascular disease. However, its role in the prevention of metabolic disorders, such as metabolic syndrome (Mets) and overweight/obesity, remains controversial. We therefore conducted a meta-analysis to determine the association of nut consumption with Mets and overweight/obesity. Methods Eligible studies were identified by searching the PubMed and Embase databases and by reviewing the references of relevant literatures. We used random effect models to pool the studies-specific risk ratio (RR) and weighted mean difference (WMD). Results This meta-analysis included six prospective cohort studies with 420,890 subjects and 62 randomized feeding trials with 7184 participants. Among the cohort studies, the summary RR for every 1-serving/week increase in nut intake was 0.96 (95% confidence interval [CI]: 0.92 to 0.99; n = 3) for Mets, 0.97 (95% CI: 0.95 to 0.98; n = 2) for overweight/obesity, and 0.95 (95% CI: 0.89 to 1.02; n = 2) for obesity. Pooling of randomized trials indicated that nut consumption was related to a significant reduction in body weight (WMD: - 0.22 Kg, 95% CI: -0.40 to - 0.04), body mass index (WMD: - 0.16 Kg/m2, 95% CI: -0.31 to - 0.01), and waist circumference (WMD: - 0.51 cm, 95% CI: -0.95 to - 0.07). These findings remained stable in the sensitivity analysis, and no publication bias was detected. Conclusion Nut consumption may be beneficial in the prevention of Mets and overweight/obesity. Additional prospective studies are needed to enhance these findings and to explore the metabolic benefits for specific subclasses of nut.
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Affiliation(s)
- Hang Li
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071 China
| | - Xia Li
- Department of Geratology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071 China
| | - Sheng Yuan
- Department of Geratology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071 China
| | - Yalei Jin
- Department of Geratology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071 China
| | - Jinping Lu
- Department of Geratology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, 430071 China
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Lee KW, Shin D. A Healthy Beverage Consumption Pattern Is Inversely Associated with the Risk of Obesity and Metabolic Abnormalities in Korean Adults. J Med Food 2018; 21:935-945. [PMID: 29569988 DOI: 10.1089/jmf.2017.0119] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
As the use of beverages in diets is increasing, several studies have examined the effect of beverage consumption in human health. Thus, we aimed at identifying specific beverage patterns and determining their associations with obesity and metabolic syndrome (MetS) risk factors in Korean adults. Based on the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2012 data, 19,800 Korean adults (≥20 years) with a single 24-h dietary recall and health examination data were investigated. All beverage items consumed by participants were categorized into 15 beverage groups based on the KNHANES coding system. Three major beverage consumption patterns were identified according to factor analysis: (1) the "healthy beverage" (high intake of dairy products, 100% fruit/vegetable juices and low intake of alcoholic beverages); (2) the "sugar-sweetened beverage" (high intake of soda, sweetened coffee/tea, and fruit drink); and (3) the "unsweetened beverage" (high intake of unsweetened coffee) patterns. Multivariable logistic regression analyses were conducted to determine the odds of obesity (body mass index ≥25 kg/m2) and MetS (defined by National Cholesterol Education Program III [NCEP III]) for each beverage pattern after controlling for covariates. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations of the "healthy beverage" pattern with risks of obesity, abdominal obesity, and elevated triglycerides, fasting blood glucose (FBG), and blood pressure (BP) were 0.88 (0.79-0.98), 0.83 (0.74-0.92), 0.88 (0.78-0.99), 0.85 (0.79-0.98), and 0.81 (0.72-0.92), respectively. AORs (95% CIs) of associations of the "sugar-sweetened beverage" pattern with risks of abdominal obesity, elevated FBG and BP were 1.15 (1.03-1.30), 1.14 (1.01-1.29), and 1.18 (1.04-1.33), respectively. However, no associations were found between the "unsweetened beverage" pattern and any parameters examined. Intake of healthy beverages should be encouraged to reduce risks of obesity and metabolic abnormalities; however, individuals who consume sugar-sweetened beverages should be advised on the adverse effects of those beverages on the risk of obesity and MetS.
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Affiliation(s)
- Kyung Won Lee
- 1 Department of Food Science and Human Nutrition, Michigan State University , East Lansing, Michigan, USA .,2 Division of Epidemiology and Health Index, Center for Genome Science, Korea National Institute of Health , Korea Centers for Disease Control and Prevention, Chungcheongbuk-do, Korea
| | - Dayeon Shin
- 3 Department of Public Health, Food Studies and Nutrition, Syracuse University , Syracuse, New York, USA
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Lordan R, Tsoupras A, Mitra B, Zabetakis I. Dairy Fats and Cardiovascular Disease: Do We Really Need to be Concerned? Foods 2018; 7:E29. [PMID: 29494487 PMCID: PMC5867544 DOI: 10.3390/foods7030029] [Citation(s) in RCA: 150] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 02/23/2018] [Accepted: 02/24/2018] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVD) remain a major cause of death and morbidity globally and diet plays a crucial role in the disease prevention and pathology. The negative perception of dairy fats stems from the effort to reduce dietary saturated fatty acid (SFA) intake due to their association with increased cholesterol levels upon consumption and the increased risk of CVD development. Institutions that set dietary guidelines have approached dairy products with negative bias and used poor scientific data in the past. As a result, the consumption of dairy products was considered detrimental to our cardiovascular health. In western societies, dietary trends indicate that generally there is a reduction of full-fat dairy product consumption and increased low-fat dairy consumption. However, recent research and meta-analyses have demonstrated the benefits of full-fat dairy consumption, based on higher bioavailability of high-value nutrients and anti-inflammatory properties. In this review, the relationship between dairy consumption, cardiometabolic risk factors and the incidence of cardiovascular diseases are discussed. Functional dairy foods and the health implications of dairy alternatives are also considered. In general, evidence suggests that milk has a neutral effect on cardiovascular outcomes but fermented dairy products, such as yoghurt, kefir and cheese may have a positive or neutral effect. Particular focus is placed on the effects of the lipid content on cardiovascular health.
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Affiliation(s)
- Ronan Lordan
- Department of Biological Sciences, University of Limerick, Limerick V94 T9PX, Ireland.
| | - Alexandros Tsoupras
- Department of Biological Sciences, University of Limerick, Limerick V94 T9PX, Ireland.
| | | | - Ioannis Zabetakis
- Department of Biological Sciences, University of Limerick, Limerick V94 T9PX, Ireland.
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Bertram HC, Jakobsen LMA. Nutrimetabolomics: integrating metabolomics in nutrition to disentangle intake of animal-based foods. Metabolomics 2018; 14:34. [PMID: 30830329 DOI: 10.1007/s11306-018-1322-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/09/2018] [Indexed: 01/14/2023]
Abstract
Food intake and metabolization of foods is a complex and multi-facetted process that encompasses the introduction of new metabolite compounds in our body, initiation or alterations in endogenous metabolic processes and biochemical pathways, and likely also involving the activity of the gut microbial community that we host. The explorative nature of metabolomics makes it a superior tool for examining the whole response to food intake in a more thorough way and has led to the introduction of the term nutrimetabolomics. Protein derived from animal sources constitutes an important part of our diet, and there is therefore an interest in understanding how these animal-derived dietary sources influence us metabolically. This review aims to illuminate how the introduction of nutrimetabolomics has contributed to gain novel insight into metabolic and nutritional aspects related to intake of animal-based foods.
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Dairy-Related Dietary Patterns, Dietary Calcium, Body Weight and Composition: A Study of Obesity in Polish Mothers and Daughters, the MODAF Project. Nutrients 2018; 10:nu10010090. [PMID: 29337863 PMCID: PMC5793318 DOI: 10.3390/nu10010090] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/08/2018] [Accepted: 01/10/2018] [Indexed: 12/11/2022] Open
Abstract
The role of the family environment in regards to dairy products and dietary calcium in the context of obesity is not fully understood. The aim of the study was to investigate the association among dairy-related dietary patterns (DDPs), dietary calcium, body weight and composition in mothers and daughters. Data were collected through a cross-sectional survey within the MODAF Project. A total sample of 712 pairs of mothers (<60 years) and daughters (12-21 years) was studied. This study included 691 pairs. A semi-quantitative food frequency questionnaire (ADOS-Ca) was used to collect dietary data. Waist circumference (WC), body fat, waist-to-height ratio (WHtR) and body mass index (BMI) were determined. Previously derived DDPs were used-three in mothers and three in daughters. In mothers, two of the DDPs were characterized by higher consumption of various dairy products with suboptimal calcium content (means: 703 or 796 mg/day) which decreased the chance of: z-WC > 1 standard deviation (SD), WC > 80 cm, body fat > 32%, WHtR > 0.5, BMI = 25-29.9 kg/m² or BMI ≥ 30 kg/m² by 44-67% when compared to low-dairy low-calcium DDP (288 mg/day). In mothers per 100 mg/day of dietary calcium, the chance of z-WC > 1SD, WC > 80 cm, z-WHtR > 1SD, WHtR > 0.5 cm, BMI = 25 to 29.9 kg/m² or BMI ≥ 30 kg/m² decreased by 5-9%. In correspondence analysis, a clear association was found between mothers' and daughters' low-dairy low-calcium DDPs and upper categories of z-WC (>1 SDs). This study reinforces evidence of the similarity between mothers and daughters in dairy-related dietary patterns and provides a new insight on the adverse relation between low-dairy low-calcium dietary patterns and obesity. It was found that diets containing various dairy products with suboptimal dietary calcium content may be recommended in obesity prevention.
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Lordan R, Tsoupras A, Zabetakis I. Phospholipids of Animal and Marine Origin: Structure, Function, and Anti-Inflammatory Properties. Molecules 2017; 22:E1964. [PMID: 29135918 PMCID: PMC6150200 DOI: 10.3390/molecules22111964] [Citation(s) in RCA: 131] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/06/2017] [Accepted: 11/11/2017] [Indexed: 12/29/2022] Open
Abstract
In this review paper, the latest literature on the functional properties of phospholipids in relation to inflammation and inflammation-related disorders has been critically appraised and evaluated. The paper is divided into three sections: Section 1 presents an overview of the relationship between structures and biological activities (pro-inflammatory or anti-inflammatory) of several phospholipids with respect to inflammation. Section 2 and Section 3 are dedicated to the structures, functions, compositions and anti-inflammatory properties of dietary phospholipids from animal and marine sources. Most of the dietary phospholipids of animal origin come from meat, egg and dairy products. To date, there is very limited work published on meat phospholipids, undoubtedly due to the negative perception that meat consumption is an unhealthy option because of its putative associations with several chronic diseases. These assumptions are addressed with respect to the phospholipid composition of meat products. Recent research trends indicate that dairy phospholipids possess anti-inflammatory properties, which has led to an increased interest into their molecular structures and reputed health benefits. Finally, the structural composition of phospholipids of marine origin is discussed. Extensive research has been published in relation to ω-3 polyunsaturated fatty acids (PUFAs) and inflammation, however this research has recently come under scrutiny and has proved to be unreliable and controversial in terms of the therapeutic effects of ω-3 PUFA, which are generally in the form of triglycerides and esters. Therefore, this review focuses on recent publications concerning marine phospholipids and their structural composition and related health benefits. Finally, the strong nutritional value of dietary phospholipids are highlighted with respect to marine and animal origin and avenues for future research are discussed.
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Affiliation(s)
- Ronan Lordan
- Department of Biological Sciences, University of Limerick, V94 T9PX Limerick, Ireland.
| | - Alexandros Tsoupras
- Department of Biological Sciences, University of Limerick, V94 T9PX Limerick, Ireland.
| | - Ioannis Zabetakis
- Department of Biological Sciences, University of Limerick, V94 T9PX Limerick, Ireland.
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Shin S, Lee HW, Kim CE, Lim J, Lee JK, Kang D. Association between Milk Consumption and Metabolic Syndrome among Korean Adults: Results from the Health Examinees Study. Nutrients 2017; 9:nu9101102. [PMID: 28991181 PMCID: PMC5691718 DOI: 10.3390/nu9101102] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 09/26/2017] [Accepted: 10/03/2017] [Indexed: 12/11/2022] Open
Abstract
It has been suggested that a greater dairy consumption, particularly of milk, may have contributed in lowering the prevalence of metabolic syndrome (MetS). A cross-sectional analysis was conducted to examine the association between milk consumption and MetS, and its components among Korean adults aged 40–69. A total of 130,420 subjects (43,682 men and 86,738 women) from the Health Examinees Study were selected for the final analysis. Milk consumption was estimated using a validated 106-item food frequency questionnaire. MetS was defined using the National Cholesterol Education Program, Adult Treatment Panel III (NCEP III). Logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) between milk consumption and MetS after adjusting for potential confounders. In this study, the average milk consumption was 77.9 g/day, with the overall prevalence of MetS being 26.1% (29.1% in men and 24.6% in women). We found that the prevalence of the MetS was significantly lower in subjects with higher milk consumption (p < 0.0001). Adjusted OR for MetS was significantly lower in the highest milk consumption category (≥1 serving/day among men; ≥2 serving/day among women) than those in the lowest milk consumption category (OR: 0.92 95%CI: 0.86–0.99, p trend = 0.0160 in men; OR: 0.68, 95%CI: 0.60–0.76, p trend < 0.0001 in women). Overall, higher milk consumption was inversely associated with the MetS components: elevated waist circumference, elevated triglyceride, and reduced high-density lipoprotein cholesterol (HDL-C) (all p trend < 0.05). This study concludes that higher milk consumption is associated with the lower odds of MetS in Korean adults.
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Affiliation(s)
- Sangah Shin
- Department of Food and Nutrition, Chung-Ang University, Gyeonggi-do 17546, Korea.
| | - Hwi-Won Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea.
| | - Claire E Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea.
| | - Jiyeon Lim
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
| | - Jong-Koo Lee
- JW Lee Center for Global Medicine, Seoul National University College of Medicine, Seoul 03087, Korea.
- Department of Family Medicine, Seoul National University Hospital, Seoul 03080, Korea.
| | - Daehee Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul 03080, Korea.
- Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul 03080, Korea.
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